NURS 4700 NURSING CONCEPTS AND INTERVENTIONS FOR THE CARE OF OLDER ADULTS II (Module 3) CASE STUDIES MARQUETTE UNIVERSITY
Critical Thinking Questions
1. What are the most common causes of acute kidney injury in older
adults?
a) Acute tubular necrosis
b) Comorbidities that accumulate with age e.g., Hypertension,
renovascular disease, and congestive heart failure.
c) Comorbidities may necessitate procedures, drugs, or surgery that
function as kidney stressors and nephrotoxins. In this case study, our
patient had CABG (open heart surgery) 12 years ago.
d) The kidney undergoes age-dependent structural and functional
alterations over time. The result of the latter is reduced GFR at
baseline and diminished kidney reserve in the setting of
pathophysiological challenges lending elderly patients very vulnerable
to acute stress and more likely to develop clinically relevant acute
kidney injury
e) Mechanical obstructions (kidney stones)
2. What is the most likely cause of the patient’s acute kidney injury
(AKI)? Why?
This patient has heart failure exacerbation. When the heart is no longer
pumping efficiently it becomes congested with blood, causing pressure to
build up in the main vein connected to the kidneys and leading to
congestion of blood in the kidneys, too.
And they have HF because of long standing hypertension
3. Is the cause of acute kidney injury (AKI) prerenal, intrarenal, or
postrenal, and why?
I believe the patient’s AKI is Caused by Prerenal injury. Our patient has
heart failure exacerbation which means the heart is no longer pumping
efficiently. Prerenal acute kidney injury (AKI) occurs when a sudden
reduction in blood flow to the kidney (renal hypoperfusion) causes a loss of
kidney function. In prerenal acute kidney injury, there is nothing wrong with
the kidney itself.
4. What phase of acute kidney injury do you suspect the patient in?
Explain your rationale.