AKI. A 67-year-old woman presented to the ER with c/o oliguria, nausea/vomiting, & generalized edema.

AKI. A 67-year-old woman presented to the ER with c/o oliguria, nausea/vomiting, & generalized edema. BUN = 27, creatinine = 3.0, UA shows casts & protein. History: She has been on Amphotericin B for meningitis, DMII, HTN.

QUESTION: What nursing diagnosis are appropriate for the patient? Include AEB and R/T."

For a 67-year-old woman presenting with symptoms and laboratory findings suggestive of acute kidney injury (AKI), the following nursing diagnoses are appropriate:The following are nursing diagnoses that can be made for a 67-year-old woman who has features of acute kidney injury (AKI):

 1. Impaired Renal Function

 AEB: Enlargement of the kidneys, BUN 27 mg/dL, Creatinine 3 mg/dL. These include anuria, serum creatinine of less than 0 mg/dL, oliguria and urinary albumin and casts.

 R/T: Nephrotoxicity from Amphotericin B, DMII and HTN.

 2. Fluid Volume Excess

 AEB: In this case there will be generalised oedema of the body and decreased production of urine.

 R/T: Decreased kidney function in regard to the capability to excrete fluids because of the AKI.

 3. Risk for Electrolyte Imbalance

 AEB: A past history of AKI which can also cause the alteration of electrolytes.

 R/T: Reduced kidney function which lead to electrolyte imbalance and side effect of Amphotericin B and a history of DMII.

 4. Nausea and Vomiting

 AEB: Symptoms: Nausea and vomiting by the patient.

 R/T: High BUN and creaine which leads to uremic symptoms and side effects of the drugs used.

 5. Risk for Infection

 AEB: On amphotericin B treatment which increases their susceptibility to being infected.

 R/T: Potential drug side effects including the kidney dysfunction which is a risk factor of getting an infection.

 6. Altered Nutrition: Under the category of Body Needs, the following can be found:

 AEB: Nausea and vomiting, and the patient may not be able to take in food or only a small amount of it.

 R/T: Some of the gastrointestinal symptoms that can affect the patient’s oral intake as well as the possible effects of AKI on the nutritional status of the patient.

 Nursing Interventions:

 Monitor Renal Function: The patient’s BUN, creatinine and electrolytes should be checked at least once a day.

 Assess Fluid Status: Assess the patient’s dietary and fluid intake and output as well as the patient’s weight and presence of oedema.

 Manage Nausea and Vomiting: The patient should only be given antiemetic drugs if required and the patient’s response should be closely monitored.

 Educate on Medication: Provide details on the potential renal toxicity of Amphotericin B and emphasize on the importance of renal function assessment.

 Promote Optimal Nutrition: A dietitian should be consulted to suggest modification in the present diet plan with respect to the present symptoms and nutritional needs.