A 75-year-old male with a history of hypertension, diabetes, and CKD stage 3b presented to your ED with a K of 5.8 and a creatinine of 4.2. Choose one of the following issues to address in your response. Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.
What are possible differentials/contributors to elevated potassium levels? What cardiac findings would you expect to see? What treatments are available for hyperkalemia?
Does this patient have a current indication for dialysis? What additional information would help you make this determination? What types of dialysis exist? Compare benefits, burdens, complications, long-term outcomes, and cost of each.
What are nutritional considerations related to chronic kidney disease that are relevant to this patient? What are complications related to both advanced renal disease and long-term dialysis, including anemia and bone metabolism disorders? How can one manage and prevent symptoms related to advanced renal disease and long-term dialysis?
How would you approach goals of care and advanced care planning with this patient? What do you know about advanced renal disease and quality of life considerations? What can you tell him about medical management versus dialysis in advanced renal disease in a person his age?
