Address the concern of fluid retention

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Reference no: EM133229354

Lisa is a 70-year-old white woman who presented to the emergency department because of a 4-day history of increased shortness of breath and generalized weakness. Lisa stated that she has been able to do her daily chores at home independently, but for the last few days it was getting difficult for her to get around and that she needed to take frequent breaks because she was short of breath and had no energy.

Hx: heart failure, diabetes mellitus type 2, and hypertension.

Lisa is admitted with a tentative diagnosis of acute kidney injury (AKI).

Subjective Data:
- Has been having headaches on and off, with nausea and dizziness
-Reported that she hadn't been taking her medications regularly at home because of "forgetfulness"
- Has not been urinating a lot
- Feels "puffy" in her legs and hands

Objective Data
Physical Examination
-BP 178/96, pulse 110, tempt 98.9° F, RR 24
- A X O4
-Mild jugular venous distention
-Fine crackles in bilateral lower lobes
-Heart rate regular, no murmurs
-Bowel sounds normoactive and present in all four quadrants u 2+ edema bilateral lower extremities and ha

Objective Data
Diagnostic Studies
-Echocardiogram shows decreased left ventricular function
-Urinalysis: Urine dark yellow and cloudy, protein 28 mg/dL, negative for glucose and ketones, positive for casts, red blood cells and white blood cells
-24-hour urine output = 380 mL

Laboratory Tests:
-Hemoglobin 8 g/dL u Hematocrit 23.8%
-RBC 2.57 million/mm3
-WBC 4.7 mm3
-Sodium 132 mEq/L
-Potassium 5.2 mEq/L
-Calcium 9 mg/dL
-BUN 36 mg/dL
-Creatinine 4.9 mg/dL
-BNP 182 pg/m

Question 1: What additional tests, if needed, could be done to determine the cause of AKI?

Question 2: What are the priority nursing diagnoses to address the concern of fluid retention?

Question 3: What are the priority nursing interventions for these nursing diagnoses?

Question 4: What are the goals of conservative therapy for a patient with AKI?

Reference no: EM133229354

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