kindey dMs. Jones, a 68-year-old female, underwent open heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output. Answer questions 1-8 below. In each scenario, the patient is experiencing renal failure. 1. What is happening to Ms. Jones’s kidneys, and why is it causing the observed symptom? when a person produces less than 500 milliliters of urine in 24 hours, this defines decreased urine output (Northwestern Memorial Hospital, 2007). Ischemia, hemorrhage, poisons, and severe kidney disease may cause renal failure. 2. What other symptoms and signs might occur? Lethargy, weakness, shortness of breath, and generalized swelling may occur. Acute Renal failure: sudden drop in urine production, headache, gastrointestinal distress, and odor of ammonia on breath. Chronic renal failure: longstanding kidney disease such as chronic glomerulonephritis, hypertension, or diabetic nephropathy. 3. What is causing Ms. Jones’s kidney disease? The causes can be “from dehydration due to vomiting, diarrhea, or fever, with a lack of adequate fluid intake, severe infection leading to shock, drugs like anticholinergics, methotrexate, and diuretics” (Northwestern Memorial Hospital, 2007). Chronic renal failure: poorly controlled diabetes, poorly controlled high blood pressure, and chronic glomerulonephritis. Damages directly to the kidney itself include sepsis, medications toxic to the kidney like nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen), antibiotics (gentamicin, tobramycin), and lithium, Rhabdomyolysis, Multiple Myeloma, and acute glomerulonephritis (Medscape, 2008). 4. What are possible treatment options and prognosis? Restoration of the blood volume to normal, restricted fluid intake, and dialysis. Once it is present, prevention of added deterioration of