Which assessment finding for this patient is most important to ...

[nummyann]

Which assessment finding for this patient is most important to report to the health care provider?
 
  A.Heart rate 46 and prolonged QRS duration
  B.Crackles at lung bases and peripheral edema
  C.Confusion and 1+ deep tendon reflexes
  D.Nausea and abdominal distention

Question 2

The next week, the patient's urine output increases to 3500 mL over 24 hours. The BUN and creatinine remain elevated and the GFR is now 48 mL/min.
 
  Which collaborative and nursing actions will you plan to implement during the diuretic phase of acute kidney injury?
  What will be an ideal response?

[mammy1697]

Answer to Question 1

A

Answer to Question 2

Important Points:
During the diuretic phase of acute kidney injury, the kidneys are unable to concentrate urine and urine output increases to as much as 5 L/day.
The patient may develop dehydration and hypovolemia, with potential shock and recurrent kidney injury.
The kidney continues to be unable to perform other functions, such as remove metabolic wastes, control acid-base balance, and maintain normal electrolyte levels.
The patient may develop hyponatremia and hypokalemia during this phase.
Nursing and collaborative interventions include:
Careful assessment for manifestations of dehydration and hypovolemia: vital sign changes, such as hypotension and tachycardia, poor pulse quality, flat neck veins, dry oral mucosa, poor skin turgor, and changes in orientation and alertness.
Assessment for electrolyte disturbances, such as hyponatremia or hypokalemia caused by diuresis.
Infusion of fluids (based on the patient's I & O and fluid balance) and monitoring for signs of fluid excess, such as hypotension or hypertension, tachycardia, increased respiratory rate and dyspnea, crackles in the lungs, pericardial and pleural friction rubs, peripheral edema, and increases in daily weights.

[nummyann]

Thank you

[mammy1697]

No problemo