1. James Bean, a patient 67 years of age, is 3 days postoperativeafter a coronary artery bypass graf

1. James Bean, a patient 67 years of age, is 3 days postoperativeafter a coronary artery bypass graft operation. The patient has a history of hypertension; type 1 diabetes; coronary artery disease; and end-stage kidney disease, which is treated with hemodialysis three times per week. The patient has a left atriovenous (AV) shunt. The patient is taking the following medications:Sevelamer: two capsules with each mealVitamin D, B12, and iron supplements with mealsCalcium carbonate: three tablets with each mealProcrit: 100 U/kg/dose subcutaneously every Monday, Wednesday, and Friday (dialysis days)70/30 NPH and regular insulin 30 U twice daily (fingerstick blood sugars taken before meals and at bedtime, and regular insulin given per sliding scale)Coreg: 12.5 mg twice dailyLanoxin: 0.125 mg (every other day, on even days)Acetaminophen with codeine No. 3: one to two tablets every 6 hoursDiphenhydramine hydrochloride: 25 mg every 8 hours PRN for itchingDocusate sodium: 100 mg b.i.d.(Learning Outcome 5) The patient is prescribed to have daily dialysis. What is the rationale for this order? The patient is going to hemodialysis at 9 am on an odd day. Which medication or medications should the nurse hold before sending the patient? What nursing management considerations should be made for this patient? 2. Dudley Wayne is a 62-year-old factory worker. Mr. Wayne makes an appointment with his primary provider because he has lost 15 pounds in the last 2 months, and has recently noticed blood in his urine. He denies pain on urination. During the admission assessment, Mr. Wayne states that he is a two-pack-per-day smoker and just thought he was losing weight because of increased work stress. He also states that he worked 30 years in a building that was recently closed due to asbestosis contamination. Upon physical examination, Mr. Wayne complains of pain when the provider percusses and palpates his flank area. A CT scan is prescribed along with an ultrasonogram; both reveal a mass in the renal pelvis. (Learning Outcomes 1 and 2)  What risk factors for renal cancer does Mr. Wayne demonstrate? The diagnosis of renal cancer is made. What are the classic symptoms of this disease process? Upon further evaluation, metastatic renal carcinoma is diagnosed, and Mr. Wayne is scheduled for renal artery embolization. What is the rationale for this procedure? Mr. Wayne develops postinfarction syndrome. What clinical manifestations does the nurse correlate to this syndrome? How are these symptoms managed?   Health Science Science Nursing NURSING MISC Share QuestionEmailCopy link Comments (0)

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