Question: R. K. G. Is A Thin 60-year-old Man Admitted To The Hospital For Cardiac Catheterization For Recurrent Angina. Past Medical History Includes Hypertension, Type 2 Diabetes Mellitus, And A Previous Myocardial Infarction 2 Years Ago. Current Medications Are Metformin (Glucophage), Glipizide (Glucotrol), Enteric-coated Aspirin (Ecotrin), And Lisinopril (Zestril)….

r. K. G. is a thin 60-year-old man admitted to the hospital forcardiac catheterization for recurrent angina. Past medical historyincludes hypertension, type 2 diabetes mellitus, and a previousmyocardial infarction 2 years ago. Current medications aremetformin (Glucophage), glipizide (Glucotrol), enteric-coatedaspirin (Ecotrin), and lisinopril (Zestril). Laboratory tests onadmission revealed the following: normal electrolyte levels; bloodurea nitrogen (BUN), 40 mg/dL; and serum creatinine, 2.0 mg/dL. Acomplete blood cell count and urinalysis were unremarkable. Mr. K.G. is receiving Normal Saline at an infusion rate of KVO (keep veinopen) rate (20 mL/hr) on the morning of the procedure. Hesuccessfully undergoes the catheterization and returns to thetelemetry unit. The day after the procedure, Mr. K. G.’s urineoutput decreases to less than 10 mL/hr. Mr. K. G. is given a 500 mlfluid bolus of ­normal saline without any increase in urine output.Furosemide 30 mg is administered IV push, with a slight increase inurine output to 15 mL/hr for several hours. Laboratory studiesreveal the following: potassium, 6.4 mEq/L; BUN, 70 mg/dL; serumcreatinine, 7.1 mg/dL, and carbon dioxide total content, 16 mEq/L.The next day Mr. K. G. has 2+ edema and basilar crackles, and hecomplains of feeling short of breath. A preliminary diagnosis ofacute renal failure is made. QUESTION 1 What laboratory diagnosticswould indicate acute kidney injury (acute renal failture)? Serumcreatinine 4.5 mg/dL Phosphorus level of 6.0 mg/dL Urine sodium ofgreater than 20 mEq/L Calcium level of 7.0 mg/dL FENa less than 1%BUN/creatinine ratio of 30:1 QUESTION 2 What physician ordersshould the nurse anticipate for K.G? Select all that apply.Administer another dose of furosemide 30 mg IV push. Electrolytesin the AM Prepare patient for insertion of a temporary percutaneouscatheter for hemodialysis. Administer sodium polystyrene sulfonate30 grams PO. QUESTION 3 What were some of the cause(s) of K.G’sacute renal failure? (Select all that apply.) Advanced ageBibasilar crackles 2+ pitting edema Shortness of breath Theinfusion of normal saline received on the morning of the cardiaccatheterization. Use of lisinopril QUESTION 4 Contrast inducednephropathy can be prevented with , , and QUESTION 5 When caringfor the client with acute kidney injury and a temporary subclavianhemodialysis catheter, what would be a priority to report to theprovider? Crackles bilaterally at the bases Temperature of 100.8 F1+ pitting ankle edema Anorexia and nausea

QUESTION 1

1. What laboratory diagnostics would indicate acute kidney injury(acute renal failture)?

QUESTION 2

1. What physician orders should the nurse anticipate for K.G?Select all that apply.

QUESTION 3

1. What were some of the cause(s) of K.G’s acute renal failure?(Select all that apply.)

QUESTION 5

1. When caring for the client with acute kidney injury and atemporary subclavian hemodialysis catheter, what would be apriority to report to the provider?