-Any type of -Poor kidney -The goal is to treat the main -Nutritionally, it acidosis not function disrupts cause of acidosis. It is is important to caused by the important to avoid encourage excessive acid correcting pH too quickly, as patients to adhere amounts of buffer system that can cause further to any fluid Metabolic CO2.1 within the body. complications.1 restrictions. With Acidosis* -In this case The kidneys fail to CKD, the ICD-10-CM study, metabolic respond to high combination of E87.2 acidosis likely levels of hydrogen volume overload occurred due to ions in the blood and pulmonary high levels of as well as to retain edema can create bicarbonate HCO3-.1 both respiratory excretion from and metabolic the kidneys.1 acidosis.1 -The most -Volume overload -Medical treatment will -Encourage common culprit increases blood focus on the root cause.1 patients to adhere to volume pressure and -In this case, the Veteran to fluid and overload is a overworks the received diuretics. sodium Volume (Fluid) reduction in urine heart.1 restrictions.1 Overload* output.1 ICD-10-CM -When excess E87.7 fluid is present, fluid will shift into interstitial spaces causing edema.1 -Unspecified -A lack of -Treatment centers around -Educating anemia is erythropoietin recombinant human patients on heme Anemia, generally contributes to an erythropoietin (rHuEPO) as and nonheme Unspecified considered more overall decrease in well as iron supplementation iron food ICD-10-CM of a symptom due the production of either orally or sources. D53.9 to an underlying red cells and a intravenously.1 -Educating disease.1 subsequent drop in patients on tips to
Metabolic Acidosis* ICD-10-CM E87.2 -Any type of acidosis not caused by excessive amounts of CO2.1 -In this case study, metabolic acidosis likely occurred due to high levels of bicarbonate excretion from the kidneys.1 -Poor kidney function disrupts the acid buffer system within the body. The kidneys fail to respond to high levels of hydrogen ions in the blood as well as to retain HCO3-.1 -The goal is to treat the main cause of acidosis. It is important to avoid correcting pH too quickly, as that can cause further complications.1 -Nutritionally, it is important to encourage patients to adhere to any fluid restrictions. With CKD, the combination of volume overload and pulmonary edema can create both respiratory and metabolic acidosis.1 Volume (Fluid) Overload* ICD-10-CM E87.7 -The most common culprit to volume overload is a reduction in urine output.1 -When excess fluid is present, fluid will shift into interstitial spaces causing edema.1 -Volume overload increases blood pressure and overworks the heart.1 -Medical treatment will focus on the root cause.1 -In this case, the Veteran received diuretics. -Encourage patients to adhere to fluid and sodium restrictions.1 Anemia, Unspecified ICD-10-CM D53.9 -Unspecified anemia is generally considered more of a symptom due to an underlying disease.1 -A lack of erythropoietin contributes to an overall decrease in the production of red cells and a subsequent drop in -Treatment centers around recombinant human erythropoietin (rHuEPO) as well as iron supplementation either orally or intravenously.1 -Educating patients on heme and nonheme iron food sources. -Educating patients on tips to
allison_k_fassler_clinical_case_study.docx