Additional Information for the chronic renal failure case study:

[ad_1]

Do not leave any section blank on your care plan. Just place an if you do not have the information.

 

Additional Information for the chronic renal failure case study:

Patient’s other diagnoses-DM Type II, HTN, gout, recurring pyelonephritis (kidney infection) current infection resolved, anemia, left big toe amputation 1 year ago, and seasonal allergies.

Medications include: erythropoietin 40,000 unit injection subcutaneous weekly, lisinopril 50 mg daily PO, glimepiride 25mg daily PO, allopurinol 150mg twice daily PO, ferrous sulphate 325mg daily PO, sodium bicarbonate 650mg twice daily PO, Claritin D 10 mg daily PO, vitamin B-12, and multivitamin daily

Allergies: morphine, hydrocodone, and iodine

Patient’s eyes appear puffy.

Additional labs: Phosphorus- 4.7 (normal 2.5-4.5), pH 7.24 (normal 7.35-7.45)

Patient social history– He is unmarried and is an active member of the Islamic religion. He has two sisters that had been diagnosed with renal failure and 1 of them died. Patient’s parents are still living. Mother has a history of HTN and anemia. Father died at the age of 59 with kidney failure secondary to chronic HTN and DM Type II. Diabetes and hypertension is prevalent in the family’s history among the grandparents for patient’s mother and father.

**Patient had decrease urination and last void was small, amber color, and cloudy. The patient was placed on oxygen at 2 liters/minute continuously. The patient had a 20 French Foley catheter placed, to allow close monitor of patient’s output. Patient started on 0.9 NaCl 150 mL/hr 24 hours/daily with via 22 gauge peripheral IV catheter inserted on date of admission. Patient’s code status is full code. Patient has obtained a skin tear during transfer on the left upper extremity forearm 2cm x 2cm x 0.5cm; hydrocolloid dressing being applied and changed every 3-5 days. Glasgow coma score equals 13. ROM slightly limited. Patient utilizes a cane and left boot for ambulation assistance. Transfers with 1 person assist and cane. Patient sleeps an average of 5-6 hours at night. Patient responds appropriate to questions and mood tends to be adequate for the situation.

**Please see normal lab values below, to help with values given on the previously sent case study. This will help you recognize which labs are abnormal. Remember you only have to document on the care plan the abnormal values only. **

 

Below is a list of normal lab ranges to utilize for the case study:

 

HEMATOLOGY – Red Blood Cells.

It is the measurement of the normal range of red blood cell count of a person.

• RBC (Male) 4.2 – 5.6 10^6 / µL [Scientific Notation: 10^6 = 1,000,000]
• RBC (Female) 3.8 – 5.1 10^6 / µL
• RBC (Child) 3.5 – 5.0 10^6 / µL

HEMATOLOGY – White Blood Cells.

It is the measurement of the white blood cell count in the body.

• WBC (Male) 3.8 – 11.0 10^3 / mm3 [Scientific Notation: 10^3 = 1,000]
• WBC (Female) 3.8 – 11.0 10^3 / mm3
• WBC (Child) 5.0 – 10.0 10^3 / mm3

HEMOGLOBIN

Diseases that affect red blood cells or the amount of hemoglobin in the blood may be

• Hgb (Male) 14 – 18 g/dL
• Hgb (Female) 11 – 16 g/dL
• Hgb (Child) 10 – 14 g/dL
• Hgb (Newborn) 15 – 25 g/dL

HEMATOCRIT

Determines the proportion of blood that is made up of red blood cells and may be used to determine the severity of anemia.

• Hct (Male) 39 – 54%
• Hct (Female) 34 – 47%
• Hct (Child) 30 – 42%
• MCV 78 – 98 fL
• MCH 27 – 35 pg
• MCHC 31 – 37%
• neutrophils 50 – 81%
• bands 1 – 5%
• lymphocytes 14 – 44%
• monocytes 2 – 6%
• eosinophils 1 – 5%
• basophils 0 – 1%

CARDIAC MARKERS

Used to diagnose patients with chest discomfort suspected with acute coronary syndrome (ACS).

• troponin I 0 – 0.1 ng/ml (onset: 4-6 hrs, peak: 12-24 hrs, return to normal: 4-7 days)
• troponin T 0 – 0.2 ng/ml (onset: 3-4 hrs, peak: 10-24 hrs, return to normal: 10-14 days)
• myoglobin (Male) 10 – 95 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12-24 hrs)
• myoglobin (Female) 10 – 65 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12-24 hrs)

GENERAL CHEMISTRY

The general chemistry panel evaluates a number of the body’s components.

• acetone 0.3 – 2.0 mg%
• albumin 3.5 – 5.0 gm/dL
• alkaline phosphatase 32 – 110 U/L
• anion gap 5 – 16 mEq/L
• ammonia 11 – 35 µmol/L
• amylase 50 – 150 U/dL
• AST,SGOT (Male) 7 – 21 U/L
• AST,SGOT (Female) 6 – 18 U/L
• bilirubin, direct 0.0 – 0.4 mg/dL
• bilirubin, indirect total minus direct
• bilirubin, total 0.2 – 1.4 mg/dL
• BUN 6 – 23 mg/dL
• calcium (total) 8 – 11 mg/dL
• carbon dioxide 21 – 34 mEq/L
• carbon monoxide symptoms at greater than or equal to 10% saturation
• chloride 96 – 112 mEq/L
• creatine (Male) 0.2 – 0.6 mg/dL
• creatine (Female) 0.6 – 1.0 mg/dL
• creatinine 0.6 – 1.5 mg/dL
• ethanol 0 mg%; Coma:
• greater than or equal to 400 – 500 mg%
• folic acid 2.0 – 21 ng/mL
• glucose 65 – 99 mg/dL
• (diuresis greater than or equal to 180 mg/dL)
• HDL (Male) 25 – 65 mg/dL
• HDL (Female) 38 – 94 mg/dL
• iron 52 – 169 µg/dL
• iron binding capacity 246 – 455 µg/dL
• lactic acid 0.4 – 2.3 mEq/L
• lactate 0.3 – 2.3 mEq/L
• lipase 10 – 140 U/L
• magnesium 1.5 – 2.5 mg/dL
• osmolarity 276 – 295 mOsm/kg
• parathyroid hormone 12 – 68 pg/mL
• phosphorus 2.2 – 4.8 mg/dL
• potassium 3.5 – 5.5 mEq/L
• SGPT 8 – 32 U/L
• sodium 135 – 148 mEq/L
• T3 0.8 – 1.1 µg/dL
• thyroglobulin less than 55 ng/mL
• thyroxine (T4) (total) 5 – 13 µg/dL
• total protein 5 – 9 gm/dL
• TSH Less than 9 µU/mL
• urea nitrogen 8 – 25 mg/dL
• uric acid (Male) 3.5 – 7.7 mg/dL
• uric acid (Female) 2.5 – 6.6 mg/dL
• LIPID PANEL (Adult)
• cholesterol (total) Less than 200 mg/dL desirable
• cholesterol (HDL) 30 – 75 mg/dL
• cholesterol (LDL) Less than 130 mg/dL desirable
• triglycerides (Male) Greater than 40 – 170 mg/dL
• triglycerides (Female) Greater than 35 – 135 mg/dL

URINE

Urine tests are used to diagnose different metabolic and kidney disorders.

• color Straw
• specific gravity 1.003 – 1.040
• pH 4.6 – 8.0
• Na 10 – 40 mEq/L
• K Less than 8 mEq/L
• C1 Less than 8 mEq/L
• protein 1 – 15 mg/dL
• osmolality 80 – 1300 mOsm/L
• 24 HOUR URINE
• amylase 250 – 1100 IU / 24 hr
• calcium 100 – 250 mg / 24 hr
• chloride 110 – 250 mEq / 24 hr
• creatinine 1 – 2 g / 24 hr
• creatine clearance (Male) 100 – 140 mL / min
• creatine clearance (Male) 16 – 26 mg / kg / 24 hr
• creatine clearance (Female) 80 – 130 mL / min
• creatine clearance (Female) 10 – 20 mg / kg / 24 hr
• magnesium 6 – 9 mEq / 24 hr
• osmolality 450 – 900 mOsm / kg
• phosphorus 0.9 – 1.3 g / 24 hr
• potassium 35 – 85 mEq / 24 hr
• protein 0 – 150 mg / 24 hr
• sodium 30 – 280 mEq / 24 hr
• urea nitrogen 10 – 22 gm / 24 hr
• uric acid 240 – 755 mg / 24 hr

COAGULATION

Coagulation factor tests calculate the role of proteins necessary for blood clot formation.

• ACT 90 – 130 seconds
• APTT 21 – 35 seconds
• platelets 140,000 – 450,000 /ml
• plasminogen 62 – 130%
• PT 10 – 14 seconds
• PTT 32 – 45 seconds
• FSP Less than 10 µg/dL
• fibrinogen 160 – 450 mg/dL
• bleeding time 3 – 7 minutes
• thrombin time 11 – 15 seconds

CEREBRAL SPINAL FLUID

It is a series of tests that assess substances present in the cerebral spinal fluid in order to be able to diagnose circumstances affecting the central nervous system.

• appearance clear
• glucose 40 – 85 mg/dL
• osmolality 290 – 298 mOsm/L
• pressure 70 – 180 mm/H2O
• protein 15 – 45 mg/dL
• total cell count 0 – 5 cells
• WBCs 0 – 6 / µL

HEMODYNAMIC PARAMETERS

The examination of hemodynamic parameters over time, such as blood pressure and heart rate in order to gauge blood flow and circulation.

• cardiac index 2.5 – 4.2 L / min / m2
• cardiac output 4 – 8 LPM
• left ventricular stroke work index 40 – 70 g / m2 / beat
• right ventricular stroke work index 7 – 12 g / m2 / beat
• mean arterial pressure 70 – 105 mm Hg
• pulmonary vascular resistance 155 – 255 dynes / sec / cm to the negative 5
• pulmonary vascular resistance index 255 – 285 dynes / sec / cm to the negative 5
• stroke volume 60 – 100 mL / beat
• stroke volume index 40 – 85 mL / m2 / beat
• systemic vascular resistance 900 – 1600 dynes / sec / cm to the negative 5
• systemic vascular resistance index 1970 – 2390 dynes / sec / cm to the negative 5
• systolic arterial pressure 90 – 140 mm Hg
• diastolic arterial pressure 60 – 90 mm Hg
• central venous pressure 2 – 6 mm Hg; 2.5 – 12 cm H2O
• ejection fraction 60 – 75%
• left arterial pressure 4 – 12 mm Hg
• right atrial pressure 4 – 6 mm Hg
• pulmonary artery systolic 15 – 30 mm Hg
• pulmonary artery diastolic 5 – 15 mm Hg
• pulmonary artery pressure 10 – 20 mm Hg
• pulmonary artery wedge pressure 4 – 12 mm Hg
• pulmonary artery end diastolic pressure 8 – 10 mm Hg
• right ventricular end diastolic pressure 0 – 8 mm Hg

NEUROLOGICAL VALUES

Confirms or excludes the occurrence of a neurological disorder

• cerebral perfusion pressure 70 – 90 mm Hg
• intracranial pressure 5 – 15 mm Hg or 5 – 10 cm H2O

Tests performed in order to measure the pH and the amount of oxygen (O2) and carbon dioxide (CO2) present in a sample of blood. The results of the tests are used to evaluate lung function and aid to identify an acid-base imbalance. The sample may be taken from arterial or venous blood.

ARTERIAL VALUES

• pH 7.35 – 7.45
• PaCO2 35 – 45 mm Hg
• HCO3 22 – 26 mEq/L
• O2 saturation 96 – 100%
• PaO2 85 – 100 mm Hg
• BE -2 to +2 mmol/L

The post Additional Information for the chronic renal failure case study: appeared first on Infinite Essays.

[ad_2]

Source link