Beginning and Ending Supportive Therapy

Question: Discuss about the Beginning and Ending Supportive Therapy. Answer: Introduction: Acute kidney injury is an illness that is depicted by sudden loss of the ability of the kidney to filter out waste from the body. This condition is characterized by compiled end products that consist of urea and creatinine. The patient had been diagnosed to have a low urine output, increased metabolic acids in the body and having high levels of phosphorus and potassium in the system (Bagshaw, 2009). The physical assessment included evaluation of fluid status that depicted the final information from the albumin and saline reaction that gave the comparison in saline that was isotonic- reaction of four percent albumin in the patient and 0.9% of normal saline, signs of acute and chronic heart failure, infections present and drug history of the drugs recently used. Recent blood transfusion, if the patient had undergone any surgical procedure, the patient had lost weight and he was dehydrated. The blood pressure of the patient had also decreased significantly over two weeks period. The patient also depicted blueish finger tips, and had swellings in the lower back (Uchino, 2007). Acute kidney failure is commonly caused by a variety of causes. It can occur if the patient has a condition that reduces the pace of blood flow in the body, if the kidneys are damaged and if the ureters are clogged and thus hampering the release of waste from the body. Blood flow in the body can be hampered by reduced blood in the body, failure of the liver, if one is severely dehydrated, if one has used medications such as naproxen, heart attack and infections of the heart. The kidneys can be damaged if there are clots of blood in the body, kidney blockage due to high levels of cholesterol in the body, swelling of the kidneys, utilization of chemotherapy drugs, indulgence in alcohol consumption and inflammation of the blood vessels (Waikar, 2009). Clinical priorities that are important to patients suffering from acute kidney injury include rehydration this implies that the patients blood pressure is less than a hundred mmHg and they should be administered with a bolus of 250ml of crystalloid. They can also be checked to see if their ureters are blocked. The patients should also cease utilization of nephrotoxic medications. Urinalysis should also be performed on the patient and intensify as per the medication policies (Tumlin, 2008). The goals of the patient were: he wanted to heal quickly so that he could fend for his family, the patient desired that he could regain his lost weight and he desired to have his normal finger tips without the bluish appearance. Interventions performed on the patient were: controlling his blood sugar, he was rehydrated too so that the fluid levels in the body could increase. Nursing care that the patient received included administering of excessive fluids, reduction of the risk of unconventional nutritional guide, reduction of the chances of being infected, impacting of the patient with the relevant knowledge about the disease and reduction of the risk of having a cardiac arrest. Medical intervention provided included the rectification of the high acid with administration of a bicarbonate and rectification of defects of hematologic properties anemia. References Bagshaw SM, Uchino S, Bellomo R, et al. Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators.. J Crit Care2009 Uchino S, Bellomo R, Kellum JA, and the Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney). Int J Artif Organs Tumlin J, Wali R, Williams W, et al. Effi cacy and safety of renal tubule cell therapy for acute renal failure. J Am Soc Nephrol 2008 Golestaneh L, Melamed DL, Hostetter TH. Uremic memory: the role of acute kidney injury in long-term outcomes. Kidney Int 2009