Acute Kidney Injury in Older Adults: Case Presentation and Clinical Management
Über den Vortrag
Der Vortrag „Acute Kidney Injury in Older Adults: Case Presentation and Clinical Management“ von Kimberly Posey, AGPCNP-BC, DNP, PhD, GS-C ist Bestandteil des Kurses „Management of Genitourinary and Nephrological System Disorders in the Older Adult“.
Quiz zum Vortrag
Which finding from Fran's lab results specifically supports the diagnosis of stage three acute kidney injury in this older adult patient?
- A serum creatinine of 3.4 mg/dL representing approximately a fourfold increase from baseline of 0.8 mg/dL.
- A blood urea nitrogen of 75 mg/dL representing severe azotemia with significant uremic symptom risk.
- An estimated glomerular filtration rate of 15 mL/min indicating advanced stage chronic kidney disease.
- A fractional excretion of sodium of 2.1% indicating intrinsic renal disease and tubular dysfunction.
- A urine sodium concentration of 45 mEq/L indicating impaired sodium reabsorption and renal injury.
Which combination of urinalysis and related findings is most characteristic of intrinsic renal acute kidney injury due to acute tubular necrosis in Fran's case?
- Muddy brown casts, 3+ proteinuria, fractional sodium excretion of 2.1%, and urine sodium of 45 mEq/L.
- Muddy brown casts, 1+ proteinuria, fractional sodium excretion less than 1%, and urine sodium of 15 mEq/L.
- Red blood cell casts, 2+ proteinuria, fractional sodium excretion less than 1%, and urine sodium of 10 mEq/L.
- Granular casts only, 1+ proteinuria, fractional sodium excretion of 0.5%, and urine sodium of 20 mEq/L.
- Hyaline casts only, trace proteinuria, fractional sodium excretion of 0.5%, and urine sodium of 12 mEq/L.
Which medication change in Fran's initial treatment plan best reflects guideline-based management of nephrotoxic risk in her acute kidney injury?
- Stopping ibuprofen and temporarily holding lisinopril, furosemide, and metformin while monitoring renal function closely.
- Continuing ibuprofen for analgesia while holding only furosemide and lisinopril until volume status improves significantly.
- Holding ibuprofen and furosemide temporarily while continuing lisinopril and metformin at reduced dosages for safety.
- Discontinuing furosemide and metformin permanently while continuing ibuprofen and lisinopril at current dose levels.
- Stopping metformin and lisinopril temporarily while continuing ibuprofen and furosemide to maintain volume control.
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Dozent des Vortrages Acute Kidney Injury in Older Adults: Case Presentation and Clinical Management
Kimberly Posey, AGPCNP-BC, DNP, PhD, GS-C
Dr. Kim Posey is the Director of Graduate Nursing and an Associate Professor of Professional Practice at Texas Christian University.
She has achieved dual doctoral status, holding both a Ph.D. and a DNP in nursing. She is dual certified as an Advanced Adult Nurse Practitioner and Gerontological Nurse Practitioner and holds a certification in nursing education. As a Gerontological Specialist certified by the Gerontology Nursing Certification Commission she is recognized as an APRN who possesses expert knowledge, experience, and skill in managing the complex health needs of older adults. In addition to this impressive educational background, she maintains active clinical practice with adult and geriatrics patients in the primary care area.
At Lecturio, Dr. Posey teaches Gerontology for the advanced practice nurse.
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