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Kidney and Urinary Disorders

You are a clinical coordinator of a medical unit specializing in the care of patients with kidney and urinary tract disorders. You are charged with making assignments for this unit for the day shift. Your discussion post should be focused on the appropriate assignments of staff members to client groups. Your unit has 12 beds. Currently, your census is 11, with one empty bed. Please include your assignments for the shift with your rationale for making those assignments. Include your personal role as the coordinator during this shift. You may wish to review course materials from Nursing 108 on delegation and supervision. 

The staff for the next shift includes:

  • Raul; an experienced RN.
  • Tara; an RN orientee assigned with Raul for the shift. It is her third day on the unit.
  • Monique; a supplemental RN. The last assignment in this unit was three weeks ago.
  • Dorothy; an experienced LPN.
  • Timmy; an experienced nursing assistant.
  • Val; unit secretary, split between your unit and the one next door as your secretary called in sick.

Patients currently on unit:

#2201: PP, a 51-year-old female with T1DM (type one diabetes) who has ESKD (end-stage kidney disease). She was admitted for a revision of her A-V fistula. She has a temporary Hemodialysis catheter in place. She’s scheduled for hemodialysis this morning. 

#2202: RP, a 72-year-old male patient with a CBI (continuous bladder irrigation) who is post-op from a TURP yesterday. He has had many clots passed through the CBI and has needed the catheter manually irrigated three times during the past shift. 

#2203: empty bed.

#2204: MG, an 88-year-old female patient admitted two days ago with urosepsis. She’s currently getting IV antibiotics through a peripheral IV every eight hours. She has been incontinent of urine twice during the past shift. She is currently complaining about pain at the site of her IV. 

#2205: MW, a 44-year-old female patient who had a cystoscopy yesterday for a biopsy of her bladder. Cancer is suspected. She is currently waiting for the provider to write her discharge orders so she can go home today. 

#2206: JS, a 69-year-old male patient with uncontrolled hypertension and chronic kidney disease admitted last evening. He has a history of non-adherence to his medications at home and comes into the hospital every four to five months with chest pain, high BP readings, and weight gain. He’s been prescribed Lasix, Lisinopril, and metoprolol. His provider would like to send him home tomorrow. He has not been evaluated by the case-manager on your unit yet.

#2207: AM, a 21-year-old female patient with an acute kidney infection. She was admitted during the night. The patient currently has IV of NSS infusing at 100 ml/hr via peripheral IV and is complaining of 9 out of 10 back pain. Is febrile with a temp of 100.6 F 

#2208: MS, a 60-year-old male patient with a renal calculi diagnosed by CT scan. Being medicated with IV Fentanyl every three hours for 10 out of 10 pain reported by the patient. Receiving IV fluids and needs assistance to the bathroom. Urine must be strained each time the patient voids. 

#2209: SS a 72-year-old male admitted with hematuria. He is having diagnostic testing completed for renal carcinoma. The patient has a history of leukemia as a 40-year-old. This patient and his family are very upset by the diagnosis and the patient is intermittently tearful. 

#2210: CT, a 55-year-old female admitted with community-acquired pneumonia. She is currently on 4 L NC and has a 02 saturation of 92% at rest. She is short of breath and has been ringing for the nurse frequently as she is frightened of dying when she gets SOB. She is receiving Levaquin IV every 24 hours for her pneumonia. This patient also has an ileal conduit with a drainage bag attached. She had her bladder removed ten years ago due to cancer. 

#2211: RM, a 76-year-old male patient with cellulitis on his left shin. He’s on contact precautions for MRSA. He has been receiving continuous peritoneal dialysis at night, he’s assigned to your unit, as your staff has the training to use the PD equipment.

#2212: AF, a 40-year-old female patient with an intellectual disability from a group home setting. She was admitted with pyelonephritis during the night. She is scheduled for discharge today. She will need her IV discontinued and discharge instructions will need to be given to the patient and her caregiver. 

Please assign these patients to staff, being mindful of the scope of practice and ability levels of staff members. What nursing intervention is the top priority for each patient? Please indicate if the staff member is able to complete that priority independently, or if you (the charge nurse) need to assign it to another staff member. 

Include information about how you will assign yourself and your support staff during the shift. Keep in mind that an empty bed will mean somebody will get admission during the shift

Your initial post is due by Thursday at 11:59 PM EST. Your response to a peer is due by Sunday at 11:59 PM EST.

Discussion Guidelines

Posts need to be written in a professional manner. The content should have a clear beginning, middle, and end. Professionals communicate using correct grammar and spelling. It is acceptable to use a grammar or spelling editor prior to submitting your post. Any language that is disrespectful or discourteous is not acceptable. Your posts should be of sufficient length to answer the question, but information that is extraneous or irrelevant will not strengthen your post.

The purpose of the discussion is to explore topics and to share information. Your original thought about the question is important. It is acceptable to use personal experiences from a professional standpoint. Your information and opinions should have support from the textbooks, professional position statements, and journals. It is not acceptable to copy and paste information from outside sources without using direct quotes. It is preferable to paraphrase information. When you restate the information in your own words by paraphrasing, you demonstrate that you have read about the topic and that it has meaning to you. You are showing that you can apply the information.

Evaluation

Your work in the discussion will be assessed using the AD Discussion Rubric. All discussions combined are worth 25% of your grade; each individual discussion is worth 3.57%.

References

Outcomes
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