Appendix D

HCA/240 Version 4

Associate Level Material

Appendix D
Read each scenario and write a 25- to 50-word answer for each question following the scenarios.
Use at least one reference per scenario and format your sources consistent with APA guidelines.

Scenario A
Acute renal failure: Ms. Jones, a 68-year-old female, underwent open-heart surgery to replace
several blocked vessels in her heart. On her first day postoperatively, it was noted that she had
very little urine output.
1. What is happening to Ms. Joness kidneys, and why is it causing the observed symptom?
Ms. Jones is suffering from surgical shock, which has caused the blood volume decrease as
its traveling towards the kidneys (Zelman et al., 2010). Her oliguria levels are the result of her
kidneys working overtime to filter the blood due to the restricted blood flow (Acute Kidney
Failure, 2012).
2. What other symptoms and signs might occur?
Oliguria is the first sign, therefore her medical team should watch for other signs associated
with acute renal failure. Symptoms such as headache, confusion, fatigue, gastrointestinal
distress, fluid retentions, shortness of breath, odor of ammonia on the breath, and chest pain
show progression of this disease (Acute kidney failure, 2012).
3. What is causing Ms. Joness kidney disease?
Ms. Jones condition happened as a result of her open heart surgery. When the surgeon was
operating on the blocked blood vessels in her heart, the blood transfusion used was rejected
by her body, causing the kidneys to work harder in attempt to filter waster production (Zelman
et al., 2010).
4. What are possible treatment options, and what is the prognosis?
Acute renal failure needs a urinalysis test perform to check for abnormalities; a blood sample
to check levels of urea and creatininie; and to start her on diuretics to help the oliguria and to
see if her body will expel the extra fluids and toxins (Acute kidney failure, 2012).

Reference:

Acute kidney failure. (2012). Retrieved from http://www.mayoclinic.org/diseasesconditions/kidney-failure/basics/definition/con-20024029

Zelman, M., Tompany, E., Raymond, J., Holdaway, P., & Mulvihill, M. (2010). Human
diseases: A systematic approach (7th ed). Upper Saddle River, NJ: Pearson.

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HCA/240 Version 4

Scenario B
Chronic renal failure: Mr. Hodges, a 73-year-old man, has had congestive heart failure for the
past 5 years. His doctor has told him that his heart is not functioning well, needing more and more
medicine to maintain circulatory function. He has noticed that he is not urinating more than once a
day.
5. Why is the condition of Mr. Hodgess kidneys affecting the rest of his body?
Mr. Hodges kidneys tissues have been destroy or damage due to the hypertension he has
from congestive heart failure from the past five years (What is High Blood Pressure, 2015).
The glomerulus is unable to filter and eliminate the waste within the blood and urinary output
to decrease.
6. As his chronic renal failure worsens, what other symptoms and signs might occur in his
respiratory, digestive, nervous, and urinary systems?
Symptoms like vision loss, cognitive functions decreasing, convulsions or comma in addition
to shortness of breath in the nervous and respiratory system. The toxic levels which have
built up can convert into ammonia casing loss of appetite, nausea, vomiting, and diarrhea
affecting his digestive and urinary system (Zelman et al., 2010).
7. What is causing Mr. Hodgess kidney disease?
Mr. Hodges kidneys were unable to filter his congestive heart failure medicines causing him
to develop hypertension, which is symptomatic with chronic renal failure (Zelman et al.,
2010). The combination of heart disease and high blood pressures are risk factors of chronic
kidney disease (What is High Blood Pressure?, 2015).
8. What are possible treatment options, and what is the prognosis?
Mr. Hodge has developed chronic renal failure and he his treatment will be kidney dialysis.
This is a technique that removes toxic substance from the blood, and the blood is returned to
the body (Zelman et al., 2010). The kidney dialysis will act as a temporary kidney for his body .

Reference
Chronic kidney disease. (2015). Retrieved from http://www.mayoclinic.org/diseasesconditions/kidney-disease/basics/definition/con-20026778

What is High Blood Pressure?. (2015). Retrieved from

https://www.kidney.org/atoz/content/what-is-high-blood-pressure
Zelman, M., Tompany, E., Raymond, J., Holdaway, P., & Mulvihill, M. (2010). Human
diseases: A systematic approach (7th ed). Upper Saddle River, NJ: Pearson.

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