A 50-year-old male patient is brought into
A 50-year-old male patient is brought into an outpatient dialysis center by his daughter. He is complaining of shortness of breath and can only speak in short sentences. He has a history significant for Type 2 diabetes and is followed for his chronic renal failure. However, he does not always follow the guidelines set by his nephrologist. He states that he exceeded his restricted fluid intake at a family event over the weekend. Heart Rate (HR): 110 bpm and regular Radial Pulses: bounding but regular Respiratory Rate (RR): 25 breaths/minute with accessory muscle use and pursed lip breathing Oxygen Saturation (SpO2): 80% On auscultation: Coarse crackles heard throughout Cough produces pink tinged frothy sputum Temperature (Tâ—¦): 37.6â—¦C tympanic Lips and nail beds are cyanotic The dialysis staff quickly transfer him to the Emergency Department and you are assigned as his primary nurse. On further discussion with his daughter you learn that the patient produces only scant concentrated urine and has been on hemodialysis for a few years. For a patient on hemodialysis they require an external machine to perform the blood filtration that would normally be managed by their kidneys. What types of blood components can this patient no longer maintain in homeostasis due to his condition? Is hemodialysis the last option to manage his condition or is there another option for him? If so, what risks are present with this other option? The patient is also short of breath with pink frothy sputum. This is caused by a build up of fluid in his circulation as he has exceeded his fluid restriction and his kidneys can’t remove the excess fluid. Why does is the excess fluid causing him to be short of breath? What supportive measures can be undertaken to treat this condition and what will correct it?
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