Critically analyse the signs and symptoms of Acute Kidney Injury (AKI) secondary to post-infectious glomerulonephritis to inform comprehensive nursing care for Michael Thompson - 750 words Identify three patient education goals focused on AKI recovery and chronic kidney disease (CKD) prevention- 750 words Using the information from the case study, complete the attached comprehensive care plan template for handover to the Primary Healthcare Nurse - 500 words By completing this assessment task, you will: Demonstrate understanding of the pathophysiology, signs and symptoms of AKI secondary to glomerulonephritis, potential complications, and identify key nursing interventions required to ensure patient recovery Demonstrate the ability to tailor education and care planning to individual patient needs, preferences, and goals, with particular attention to preventing recurrent AKI episodes and progression to CKD. Develop an appropriate handover using the comprehensive care plan template to ensure continuity of care in the primary healthcare setting Case Scenario It is 1400 hours. You are the RN for Michael Thompson, a 28-year-old man who has been admitted to the medical ward with Acute Kidney Injury (AKI) secondary to post-infectious glomerulonephritis. Michael presented to the Emergency Department three days ago with severe fatigue, reduced urine output, facial and peripheral oedema, and dark-coloured urine. He reported having a throat infection approximately two weeks prior, which he did not seek treatment for at the time. On admission, Michael's investigations revealed: Serum creatinine: 380 µmol/L (baseline 85 µmol/L) eGFR: 18 mL/min/1.73m² (previously >90 mL/min/1.73m²) Urinalysis: Haematuria, proteinuria (3+), red cell casts Blood pressure: 165/98 mmHg Serum potassium: 5.8 mmol/L Fluid status: Positive fluid balance of +2.5L over 48 hours Michael has responded well to conservative management over the past three days, including fluid restriction, diuretic therapy, dietary modifications (low sodium, potassium restriction), and antihypertensive therapy. His renal function is showing early signs of improvement, with serum creatinine now at 280 µmol/L, eGFR now 30 mL/min/1.73m² and urine output increasing to 1200mL over the past 24 hours. Current Status Pain Management: Michael reports mild flank discomfort, controlled with paracetamol Medications: Antihypertensive therapy (ACE inhibitor commenced) Diuretic therapy (furosemide) ceased as Miachel’s fluid balance has stabilised Sodium bicarbonate for mild metabolic acidosis Calcium resonium ceased (potassium now 5.2 mmol/L) Fluid Management: Strict fluid restriction (1.5L/24 hours)- reviewed by nephrologist given improving urine output. Patient to maintain oral fluid intake of 2L/day post-discharge unless otherwise advised by GP/nephrologist. Vital Signs: BP 142/88 mmHg; HR 78 bpm; RR 16; SpO₂ 98% on room air; Temp 36.8°C Renal Function: Improving trend - creatinine decreasing, eGFR improving, urine output increasing Diet & Activity: Renal diet (low sodium, potassium restricted); mobilising with assistance; bowels regular Discharge Planning: Michael is medically stable for discharge and will be collected by his wife at 5:30pm. Follow-up appointment with GP in 5 days for renal function review (UEC, eGFR), blood pressure monitoring, and medication review. Nephrology outpatient appointment arranged for 4 weeks post-discharge. You are to prepare Michael for discharge. This entails ensuring he understands his follow-up care, the importance of ongoing monitoring, answering any questions he may have, and providing a written care plan to the Primary Healthcare Nurse in advance of Michael's follow-up appointment in five days' time. You are required to complete the attached care plan template and email it to the Primary Healthcare Clinic prior to your shift finishing at 9pm, so it is available in the Practice tomorrow morning. You tell Michael you will be preparing his care plan for the primary healthcare nurse that evening. He says, "That's good to know - I'm worried about my kidneys. Will they go back to normal? And what do I need to do to make sure this doesn't happen again?" Assessment Task Instructions Your assessment task has three (3) components. 1. Critical Analysis of AKI Secondary to Post-Infectious Glomerulonephritis (750 words) Critically analyse and prioritise the appropriate medical and nursing management strategies used in Michaels’ AKI secondary to post infectious glomerulonephritis. a. Analyse Michael's presenting symptoms of AKI and appraise the medical management strategies for each symptom. Evaluate the pharmacological and non-pharmacological management strategies for each symptom, with particular attention to: Explain Michael's presenting symptoms and why they are occurring Critically evaluate the timing, risks and benefits of pharmacological and non-pharmacological therapies initiated during AKI management and recovery Discuss the importance of early recognition and management of AKI complications (fluid overload, electrolyte imbalances, hypertension) 2. Post-AKI Patient Education (750 words) Demonstrate understanding of recovery from AKI and prevention of CKD by providing Michael with patient-centred education: b. Identify and explain three priority nursing education interventions that Michael requires following his AKI episode. For each intervention, describe the specific information he needs for both immediate recovery and long-term renal health management. c. Support your selected education interventions with evidence from current nursing practice guidelines and research related to post-AKI care and CKD prevention, explaining why each intervention is essential for Michael's recovery and long-term wellbeing. 3. Nursing Comprehensive Care Plan (500 words) Complete the Nursing Comprehensive Care Plan Template below (attached) for handover to Michael's Primary Healthcare Nurse, who works as a practice nurse at his GP clinic, upon discharge following AKI: Comprehensive Care Plan Registered Nurse Name: Date: Patient Name: Patient Medical Diagnosis: E3 - Risk assessment (risk screening – disease or injury, risk assessment – ID risk of harm and mitigation strategies) E4 - Interventions (Prioritised - List nursing or collaborative interventions with rationale for each goal and risk) E5 - Multidisciplinary team (roles and responsibilities) E6 - Evaluation and Replanning (Were the goals met? What is new with the patient’s case) Should be presented as Person-centred goals Clinical goals Organisational goals Mitigation strategies: Organisational: Should be presented as Person-centred goals Clinical goals Organisational goals Person centred care: Goals/ Interventions: Rationale: New assessment Clinical goals: Personal: New interventions: Organisational: Criteria For marking. 1. Critical analysis of AKI secondary to post-infectious glomerulonephritis and nursing management 2. Post AKI patient education 3. Comprehensive care plan