How to correct lab values as nurse

Question

what is interventions that can correct lab with the patient with CKD, GI bleed

elevated BUN

low albumin

elevated ALT

elevated Cl

Low calcium

Answer 1

These are the following interventions that may aid in the normalization of patient status:

1. Fluid resuscitation. Kidney disease can lead to an imbalance of fluid, electrolyte, and acid-base balance. Careful management of fluid balance is an effective therapy, personalized for the patient, incorporated with frequent assessments of fluid and electrolytes. Disorders of sodium, chloride, potassium, calcium, and phosphorus are life-threatening conditions that are common in kidney disease. Fluid replacement is best accomplished by infusing small amounts of fluid repeatedly while closely monitoring CVP, urine output, and other endpoints. Colloid fluids are designed to stay in the intravascular space. During the anuric phase, once the intravascular space is filled adequately, fluid restrictions may be required to prevent fluid volume overload. Despite receiving two colloid fluid replacements, the patient’s kidney function still doesn’t show any improvement. It can be implied that more fluid may be required which can improve oxygenation, especially that the patient has signs of sepsis.
2. Adherence to the medication regimen. If the patient is hemodynamically unstable, IV dextrose 50%, insulin, and calcium replacement may be administered to shift potassium back into the cells. Since many medications are eliminated through the kidneys, dosages must be reduced when a patient has ARF. Examples of commonly used agents that require adjustment are antibiotic medications (especially aminoglycosides), digoxin, ACE inhibitors, and magnesium-containing agents. On the other hand, Diuretic agents are often used to control fluid volume, but they have not been shown to improve recovery from ARF.
3. Dialysis treatment. In patients with severe acidosis, the arterial blood gases and serum bicarbonate levels (CO2-combining power) must be monitored because the patient may require sodium bicarbonate therapy or dialysis. This may be necessary for in patients with advanced (stage 5) CKD.
4. Self-management. As a nurse, you should educate the patient about the disease process and how the treatment regimen is important to follow to prevent further complications (ex. heart disease, pulmonary edema, etc.) If the patient has hypertension, teach the patient that blood pressure control is necessary by taking the prescribed medications for it, and also ensuring they are aware that reducing raised blood pressure is a key factor in preventing progression of CKD. Encourage home blood pressure monitoring where appropriate.