diagnosis—-Acute kidney injury and hyperkalemia. Case Summary Elderly lady wit
diagnosis----Acute kidney injury and hyperkalemia. Case Summary Elderly lady with chronic kidney disease, acute kidney injury and hyperkalemia, secondary to dehydration and nephrotoxic medication. Clinical Findings Moderate dehydration. Tachycardic and borderline hypotensive Raised creatinine, potassium approximately 6.0 on arrival Characteristic EKG changes OMS simulation. What are the main concepts relevant to the patient scenario? Please provide rationales and supporting evidence including course textbook and scholarly references. What are the normal and abnormal signs and symptoms you recognized in the patient scenario? What are the steps you took in your assessment of the patient? What are your findings? Based on your findings, how did you prioritize the care of the patient? Please provide rationales and supporting evidence including course textbook and scholarly references Based on your assessment findings, what are your independent nursing interventions? (Nursing interventions do not require a provider’s order). Please provide rationales with supporting evidence including course textbook and scholarly references. What specific steps did you take to improve the patient’s outcome in the scenario? What did you learn from this scenario? At least two scholarly references are required for this assignment. In addition to your textbook, please include at least one scholarly reference such as an article from a peer-reviewed journal. APA formatting is required; please use 7th edition APA Manual. See the grading rubric for expectations in the completion of this assignment. Answer the following in your OMS Application Journal Assignment: Related Concepts – In this section please identify and document the main concept of the scenario and then identify and discuss how four other concepts connect to and are impacted by the main concept and how they relate to your patient. (Total of five concepts should be discussed.) Think about and explain how alterations in the main concept would affect other concepts. Think about and explain how alterations in other concepts would affect the main concept. Example-main concept of tissue integrity; if tissue integrity is altered/impaired what would be the impact on other concepts such as nutrition, mobility, elimination, perfusion, thermoregulation OR if there is an alteration in nutrition, mobility, elimination, perfusion, or thermoregulation how would that impact tissue integrity? Related Assessments – In this section, explain five assessments needed to find and/or rule out alterations with the main concept and provide rationale. Relate these assessments to your patient. Provide assessment data from the patient in the OMS scenario. Example – main concept of tissue integrity; wound assessment to include location, color, size, shape, odor, and drainage. Report your assessment findings-the patient has a 2cm oval wound on the L heel. The wound is red in color, has no odor, and is producing a scant amount of serous drainage. The wound edges are defined, and the surrounding tissue is pink and warm with no edema. Related Nursing Interventions – In this section, document Five independent nursing interventions needed to care for your patient related to alterations of the main concept and provide rationale. Independent nursing interventions are those that do not require a provider order. An intervention is defined as “any treatment, based upon clinical judgment and knowledge, that a nurse performs to enhance patient/client outcomes” (Butcher, Bulechek, Docterman, & Wagner, 2018, p.xii). Example-main concept of skin integrity: reposition the patient at least every two hours or more frequently if needed. Place a rolled sheet or blanket underneath the ankles to reduce the pressure of the heels against the bed, use pillow or cushions to pad other bony prominences to prevent future pressure ulcers from occurring. References Butcher, H. K., Bulechek, G. M., Dochterman, J. M., & Wagner, C. M. (Eds.). (2018). Nursing interventions classification (NIC) (7th ed.). St. Louis, MO: Elsevier.

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