Need help in developing a timeplan!!

[Brainy]

Ok so tomorrow I have an 84 y.o patient diagnosed with AKI and right nephrectomy. I had a difficult time figuring out some appropriate assessments and making a timeplan. All help is appreciated

[203bravo, MSN, APRN]

I had a difficult time figuring out some appropriate assessments

This is a little confusing --- you develop you're nursing plan after doing an assessment... Why are you attempting to figure out specific assessments prior to meeting a patient?

[Brainy]

Our instructor sends us our patient assignment before coming into clinical so that we can prepare and create a timeplan ahead of time. I'm supposed to come up with some major assessments based on the patient's diagnosis.

[ArrowRN, BSN, RN]

You need to use the nursing process and your nursing diagnosis book. I don't know the the AKI acronym is, but think firstly about how would you feel after having a kidney yanked out of your body?

What does the kidney do?

what is the most dangerous post surgical complication?

I'm thinking infection risk especially considering age and also with 1 kidney who is to say the other one will compensate? I'd figure out what the kidney does and look for related fluid electrolyte imbalances and monitoring of fluid intake and output. Pain will also be in your planned assessment and assessing incision site for infection. Things you should know for your instructor..what are the signs of infection, how to assess pain, if you passing meds you need to look up what they do and the potential side effects. Look up the patient electrolyte labs(sodium, potassium, etc.) and know the normal values. Find out what labs are used to monitor the kidneys and know how will the body compensate for having 1 kidney? After you make a diagnosis and assessment what will be possible interventions you as a student can do? how do you evaluate those interventions?

[SopranoKris, MSN, RN, NP]

I typically write out a general plan of what I think I'll need to do and work in any tests, PT/OT, etc., the patient is scheduled to have, then put in med time(s), Accucheck (if necessary), charting, etc. Do you have to allot time to do end-of-shift/SBAR?

Once you have a general idea of what you need to accomplish, then it's easier to flesh out details.

[Esme12, ASN, BSN, RN]

What is AKI? What is a Nephrectomy? What would you look for in this patient? what is important? How do you care for a post op patient? How do you tailor it for this patient? man-nurse2b gave you good ideas

[iluvgusgus]

I/O, Cr/Bun , the nephrectomy site and status of the dsg, pain, lung sounds, quality of breathing ( it may hurt to take deep breaths) cxr results if there are any. Foley? appearance of urine. What fluids are ordered? After report I usually look at orders first, then the MAR ,lab results/labs needed, imaging/test results/ needed. What is the cause of the AKI? Is it resolved?

[Esme12, ASN, BSN, RN]

Other members have generously given you a good start....however it is vitally important for you to look up these things yourself. We ask all students to show what they have found out in their research so that you can learn to critically think yourself and be the best nurse you can be.