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April 25, 2023

Howard is a 44-year old male admitted to hospital with hypertension and kidney failure

Howard is a 44-year old male admitted to hospital with hypertension and kidney failure. He currently receives hemodialysis three times per week but has missed his last two sessions because he was unable to find transportation to his appointments. Howard’s blood pressure on arrival to the unit is 240/130, pitting edema of his lower extremities, and weight increase of 3kg over the past two days. Lab values are bUN 205, creatine 32.5, and potassium 6.8.

1. Based on Howard’s presenting symptoms and lab values, what is the patient care priority?

2. If hemodialysis is not immediately available, what other treatment options would be implemented?

3. What are the possible considerations and interventions to address regarding Howard’s adherence to his treatment plan?

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