Concept Of Elimination: Acute Kidney Injury

Based on the symptoms presented by the patient, including thirst, dry skin, and decreased urine output, the most likely diagnosis would be Fluid Volume Deficit. Thirst is a common symptom of dehydration, which is associated with a decrease in fluid volume. Dry skin can also be a sign of dehydration, as the body lacks sufficient fluid to keep the skin moisturized. Decreased urine output is another indication of fluid volume deficit, as the body conserves water by producing less urine. Therefore, based on these symptoms, Fluid Volume Deficit is the most appropriate diagnosis.

Based on the symptoms of thirst, dry skin, and decreased urine output, the most likely diagnosis would be fluid volume deficit. These symptoms are indicative of dehydration, which occurs when there is an insufficient amount of fluid in the body. This can be caused by factors such as inadequate fluid intake, excessive fluid loss (through sweating, vomiting, or diarrhea), or certain medical conditions. Treatment for fluid volume deficit typically involves rehydration through oral or intravenous fluids.

Potassium is the major intracellular ion because it is predominantly found inside cells, while sodium is mainly found outside cells. Potassium plays a crucial role in maintaining cell membrane potential, regulating cell volume, and controlling muscle and nerve cell function. It is important for various physiological processes, including heart rhythm, nerve impulses, and muscle contractions. Calcium and magnesium are also important electrolytes, but they are primarily found outside cells and have different roles in the body.

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Sodium is the major extracellular ion because it is the most abundant positively charged ion found outside of cells. It plays a crucial role in maintaining fluid balance, nerve function, and muscle contraction. Sodium is actively pumped out of cells and is predominantly found in the extracellular fluid, making it the major extracellular ion. Potassium, magnesium, and phosphate are also important ions in the body, but they are primarily found inside cells rather than in the extracellular fluid.

Metabolic Acidosis occurs in AKI because the kidneys cannot synthesize Ammonia or excrete acid products of metabolism, resulting in an increased acid load.

The given causes such as vomiting, diarrhea, prolonged NG suction, diuretics, kidney disease, renal, liver, and heart failure, and SIADH are all associated with fluid loss or excessive water intake, leading to a dilution of sodium in the body. This condition is known as hyponatremia, which is characterized by low levels of sodium in the blood.

Common indicators for renal replacement therapy include high potassium levels, metabolic acidosis, change mental status, volume overload resulting in compromised cardiac status, BUN greater than 120 mg/dL, and pericarditis, pericardial effusion or cardiac tamponade. Although the other treatments may be used this will not be as effective for this older patient. Loop Diuretics may help but will not be sufficient. Insulin and sodium bicarbonate can be used temporarily to drive potassium back into the cells. Kayexlate is used to acutally decrease overall potassium in body.

Because the patient has been completely immobile for the past 2 days, the home health nurse would be concerned with her fluid status, as she is is probably dehydrated and hypovolemic. Decreased cardiac output is most likely because she is older and takes heart medicine. Both hypovolemia and decreased cardiac ouput contribute to low perfusion to the kidneys putting her at risk for prerenal AKI.

Intrarenal causes of AKI include those conditions and factors that cause direct damage to the kidney tissue. Rember the fire is in the house. This conditions include nephrotoxic drugs, acute glomerulonephritis, tubular obstruction by myoglobin, and prolonged ischemia.

Hyperkalemia is a potentially life-threatening complication of AKI in the oliguric phase. Muscle weakness and abdominal cramping are signs of neuromuscular impairment that occurs with hyperkalemia. Additionally, hyperkalemia can lead to arrhythmias of peaked T waves, prolonged PR interval, prolonged QRS interval, and depressed ST segment. Urine output of 400ml or less is expected during the oliguric phase of AKI as well as the development of peripheral edema.

Hyperkalemia can lead to fatal dysrhythmias. The nurse understands the priority action is to monitor the cardiac rhythm while contacting the physician or calling RRT if the protocol is met.