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A client who underwent renal artery bypass surgery had a nursing diagnosis of risk for ineffective tissue perfusion related to inadequate anticoagulation. What nursing intervention would promote renal tissue perfusion and kidney function?

Explanation

• Acute kidney injury is abrupt loss of kidney function due to decreased renal blood flow from any cause or process. It is diagnosed by lab findings such as increased BUN and creatinine or anuria

 

• Monitoring serial creatinine levels promotes effective tissue perfusion and kidney function by following progression of the treatment

 

• Maintaining strict I&Os promotes the goal of effective tissue perfusion and kidney function by collecting data on the progression and treatment of the acute kidney injury

 

• Report red or brown urine. These manifestations are caused by a release of myoglobin secondary to muscle ischemia. This is reported to facilitate intervention to promote tissue perfusion

 

Incorrect options:

 

• Evaluating effectiveness of pain medication helps determine the adequacy of analgesia, not tissue perfusion or kidney function

 

• Encouraging independence improves both physical and psychological recovery, but not tissue perfusion or kidney function

 

• Blood and drainage may appear on dressings or beneath the site because of gravity. Monitoring for this is important, but does not directly promote renal tissue perfusion and kidney function

 

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