Renal TRauma
To use critical thinking and data collection to recognize and report complications that may impact the morbidity and mortality of clients who have sustained a traumatic insult to the urinary tract while functioning within the LPN scope of practice
Competency
Select appropriate nursing interventions for clients with disorders of the urinary system.
Instructions
Read the scenario below and answer the questions. When you see a that means a clue.
The Story
It is Friday the 13th and a full moon. You are an LPN that normally works on a medical-surgical unit, but your unit is overstaffed, and the emergency department is short-staffed. The nursing supervisor asks for a volunteer to go down to be an extra pair of hands. You volunteer as a tribute. When you get to the ER, you are asked to do vitals on a client in the trauma room. The client is a 24-year-old male who was stabbed multiple times in the abdomen. Today is Friday the 13th, and the moon is full. You are a licensed practical nurse (LPN) who usually works on a medical-surgical unit. However, your unit has more people than it needs, while the emergency department has too few people. The nurse’s supervisor asks for a volunteer to go down and help out. As a tribute, you offer to help. When you get to the ER, you’re told to check a patient’s vital signs in the trauma room. The client is a man who is 24 years old and was stabbed several times in the stomach.
The wounds appear superficial, and the client has been stable thus far. He will be going to a CAT scan as soon as they can fit him in. You approach the client, who appears slightly pale with cool, and clammy but is alert and talkative. The vital signs are:
97.3 (PO) P= 115 BP= 95/54 Resp rate= 24 Pain= 6/10. You notice the client voided 100 mL of tea-colored urine in his urinal.
One hour later, the client becomes unconscious. His pulse is now 144, and his blood pressure is 70/50. The client is taken to the OR and has a nephrectomy for a very damaged and bleeding right kidney.
Answer the following questions:
What were the clues in the data collection that should have alerted you and the staff that there might be a problem? (5-10 sentences)
Why is the urine “tea-colored?” (one sentence)
What are some other interventions that could have been done? (2-5 sentences)
Was the LPN in this scenario working within the scope of practice for an LPN? Why or why not? (5-10 sentences)
How did the environment of care (busy ER) contribute to the client’s deterioration? (5-10 sentences)
Format
Standard American English (correct grammar, punctuation, etc.)
Logical, original, and insightful
Professional organization, style, and mechanics in APA format
Incite citation
– essay writers
