Appendix D

HCA/240 Version 4
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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 our sources consistent with A!A guidelines.
Scenario A
Acute renal failure" #s. $ones% a &'-ear-old female% underwent open-heart surger to replace
se(eral )loc*ed (essels in her heart. +n her first da postoperati(el% it was noted that she had
(er little urine output.
1. ,hat is happening to #s. $ones-s *idnes% and wh is it causing the o)ser(ed smptom.

A. ,hat is happening to #s. $ones-s *idnes is the are in shoc* from the surger. ,hich
are. !roducing (er little urine this is )ecause the *idnes are una)le to clean the
creatinine and urea from the )lood /#ul(ihill% 200&0. 1hese are the waste products of the
)od. 1he *idnes also )alance water% salt and minerals in the )od so when there is little
urine output it indicates that these waste products are )uilding up in the )od.
2. ,hat other smptoms and signs might occur.
A. Acute renal failure does not produce a classic set of smptoms. 1he most common
smptom decrease in urine output% which occurs in 203 of patients. +ther signs or
smptoms that might occur are headaches% )reath that smells li*e ammonia% swelling%
4astrointestinal distress /450% And stomach upset. 5n most serious cases the smptoms
can )e muscle wea*ness and possi)le cardiac arrest due to a high amount of potassium
in the )lood% also *nown as 6per*alemia according to /#ul(ihill% 200&0.
7. ,hat is causing #s. $ones-s *idne disease.
A. #s. $ones who is a &' ear old female is experiencing acute tu)ular necrosis /A180.
*idne disease is the result of the )loc*ed (essels in her heart for which she had surger.
/#ul(ihill% 200&0. 5f there is not enough )lood flow in the )od then the *idnes can )e
damaged.
9. ,hat are possi)le treatment options% and what is the prognosis.
cute renal failure is easier to treat than chronic renal failure /#ul(ihill% 200&0. 5t is possi)le that the
pro)lems that are causing the *idne failure can )e cured within a few das and her *idnes can
wor* well enough so that her life can )e normal with no long lasting effects. 6er doctor ma
recommend treatments li*e dialsis which mimics our *idnes so that our *idnes can get a
)rea*. 1he prognosis for #s. $ones is good% she will most li*el to reco(er.
Scenario B
:hronic renal failure" #r. 6odges% a 27-ear-old man% has had congesti(e heart failure for the
past 5 ears. 6is doctor has told him that his heart is not functioning well% needing more and more
medicine to maintain circulator function. 6e has noticed that he is not urinating more than once a
da.
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Appendix D
HCA/240 Version 4
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5. ,h is the condition of #r. 6odges-s *idnes affecting the rest of his )od.
A. 1he *idnes shift out waste products and extra water which )ecomes urine. 5f our *idnes can not
do this than the toxins )uild up and will cause ou to )ecome ill. 1his will cause to much potassium
in our )lood which will e(entuall lead to heart pro)lems.
&. As his chronic renal failure worsens% what other smptoms and signs might occur in his
respirator% digesti(e% ner(ous% and urinar sstems.
A. 6is hands and feet ma swell% he ma feel tired and wea*% suffer from nausea% (omiting% pro)lems
with (ision% cause confusion% fluid in the lungs% sei<ures or e(en a coma.
2. ,hat is causing #r. 6odges-s *idne disease.
=ince he has congesti(e heart failure his heart is una)le to suppl enough )lood flow to meet his )od-s
needs
'. ,hat are possi)le treatment options% and what is the prognosis.
1he first step is to treat the underling cause of the *idne damage. >ifestle change is (er important%
for instance our diet. 5f it gets to *idne failure there will )e a choice of dialsis or a *idne transplant.
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