Appendix D Hca/240

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Heidi L. Rands
Pamela S. Williams RN, MSN
October 13, 2011

Axia College Material
Appendix D

Read each scenario and write a 25- to 50-word answer for each question following the scenarios. Use at least one reference per scenario and format your sources consistent with APA guidelines.

Scenario A

Acute renal failure: Ms. Jones, a 68-year-old female, underwent open-heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output.

1. What is happening to Ms. Jones’s kidneys, and why is it causing the observed symptom? *
* Ms. Jones’ kidneys are impaired. The kidneys regulate their own blood flow as well as GFR. The reason it is causing the observed systems is because the kidneys became hypoperfused which narrows the renal arteries, and vessels in the kidneys dilate with the help of prostaglandins to facilitate the flow. *

2. What other symptoms and signs might occur?
* Some of the other symptoms and signs that may occur would be that she may experience * hypertension, skin irritation, muscular cramps, and swelling around the eyes, hands and feet. 3. What is causing Ms. Jones’s kidney disease?

* Ms. Jones is having a decrease of blood flow from the kidney to the heart and brain leading to acute renal failure. She is suffering from preferential renal vasoconstriction. This was caused from the progression of the heart operation. *

4. What are possible treatment options, and what is the prognosis? *
* Some of the possible treatments that Ms. Jones may undergo include, fluid resuscitation, medication and in some extreme cases, dialysis or hemofiltration may be required. Acute renal failure can usually be reversed, but can also cause permanent loss of kidney function leading to chronic kidney disease. Scenario B

Chronic renal failure: Mr. Hodges, a 73-year-old man, has had congestive heart...
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