Kidney Clues
After several days of vomiting, urine output falls, mucous membranes are dry, and urine is concentrated without edema. This mechanism most likely explains the acute kidney change.
What is prerenal kidney hypoperfusion?
Before hemodialysis, no thrill or bruit is detected over the arteriovenous fistula. This is the nurse's immediate response.
What is stop use of the access and notify the dialysis team?
Pain begins near the umbilicus, then localizes to the right lower quadrant with anorexia and low-grade fever. This diagnosis is most likely.
What is acute appendicitis?
A new stoma is dusky, cool, and increasingly dark rather than moist pink-red. This complication must be reported immediately.
What is impaired stoma perfusion, or ischemia?
A client treated with nitrofurantoin for lower urinary symptoms now has fever and flank pain. This change in syndrome requires this medication decision.
What is reassess and clarify therapy for possible pyelonephritis?
Following prolonged hypotension, creatinine rises and the urine sediment contains muddy brown granular casts. This intrinsic kidney injury is most likely.
What is acute tubular necrosis?
During an initial hemodialysis treatment, a client develops headache, nausea, confusion, and a seizure as solutes shift rapidly. This complication is most likely.
What is dialysis disequilibrium syndrome?
A client develops a rigid boardlike abdomen, rebound tenderness, fever, tachycardia, and absent bowel sounds. This abdominal emergency best fits the findings.
What is peritonitis from a possible perforated viscus?
A client with a new ileostomy has watery output, muscle cramps, thirst, and declining urine output. This combined complication is most likely.
What is fluid and electrolyte depletion from high ileostomy output?
A client with inflammatory bowel disease develops marked distention, fever, and decreasing bowel sounds while receiving loperamide. This medication decision is safest.
What is stop the antidiarrheal and evaluate for toxic megacolon?
Cola-colored urine, RBC casts, hypertension, edema, and reduced GFR appear after a recent infection. This renal syndrome fits the pattern.
What is acute glomerulonephritis, or a nephritic syndrome?
A client receiving peritoneal dialysis reports diffuse abdominal pain; the effluent is cloudy and the temperature is elevated. This complication must be presumed.
What is peritoneal dialysis-associated peritonitis?
Cramping abdominal pain, vomiting, distention, high-pitched bowel sounds, and inability to pass flatus occur after prior abdominal surgery. This process is most likely.
What is a mechanical small-bowel obstruction from adhesions?
During an enteral feeding, a client begins coughing, oxygen saturation falls, and coarse breath sounds appear. This is the nurse's first action.
What is stop the feeding and assess for aspiration and tube position?
A client with CKD uses a magnesium-containing antacid and develops weakness, hypotension, depressed respirations, and diminished reflexes. This electrolyte disturbance is most likely.
What is hypermagnesemia?
Generalized edema, heavy proteinuria, hypoalbuminemia, and hyperlipidemia occur with relatively bland urine sediment. This syndrome is most likely.
What is nephrotic syndrome?
The hand below a new AV fistula is pale, cool, painful, and numb with a weakened distal pulse. This access complication best fits the cue cluster.
What is dialysis access steal syndrome?
A client with ulcerative colitis develops marked abdominal distention, fever, tachycardia, tenderness, and decreased bowel sounds. This complication is the priority concern.
What is toxic megacolon?
After partial gastrectomy, a client develops cramping, tachycardia, diaphoresis, and diarrhea shortly after meals. This syndrome explains the pattern.
What is dumping syndrome?
A client with peptic ulcer disease takes an NSAID and anticoagulant, then develops melena and orthostatic symptoms. This medication action is required.
What is hold and urgently reconcile the bleeding-risk medicines?
An older adult has abrupt anuria, a distended bladder, bilateral hydronephrosis, and a history of progressive urinary hesitancy. This category of AKI best explains the findings.
What is postrenal AKI from urinary obstruction?
Soon after a hemodialysis bloodline disconnects, the client develops abrupt dyspnea, chest pain, hypotension, and altered mentation. This rare complication is the priority hypothesis.
What is venous air embolism?
A client with cirrhosis and known esophageal varices has hematemesis, falling pressure, rising lactate, and a heart rate of 64/min while taking propranolol. This problem must be treated despite the pulse.
What is hemorrhagic shock from an acute variceal bleed?
A client with a new ileostomy produces 1.8 L of liquid output daily; weight falls, creatinine rises, and urine becomes scant. This relationship best explains the kidney trend.
What is prerenal AKI caused by high-output stoma losses?
A client with suspected mechanical bowel obstruction has vomiting, distention, and no flatus; an oral stimulant laxative is prescribed. This response is safest.
What is hold the laxative and clarify the prescription?