Steps of the Nursing process

As in all case studies, review the facts of the case and consider the various steps of the nursing process in order to address the critical thinking questions.

Case Study:

D.B., a 58-year-old Caucasian male client on the medical-surgical floor, has complaints of nausea, vomiting, and lethargy. The client’s history includes gentamicin IV use for pneumonia, and uncontrolled hypertension. The client’s clinical manifestations include decreased urine output, volume overload (heart failure), generalized edema, anemia, shortness of breath (dyspnea), fatigue, and pulmonary edema. The client’s basic metabolic panel reads as follows:

Potassium: 5.1

Sodium: 127

BUN: 78

Creatinine: 3.1

Bicarbonate: 11

Calcium: 7.1

Phosphate: 4

• Is D.B. most likely experiencing prerenal, intrarenal, or postrenal failure? Why? What risk factor(s) does he have?
• Using the nursing process, what is your plan of care for D.B., including appropriate medications, collaborative care, possible diagnostic studies, nursing