Fluids and Electrolytes (Acute Renal Failure)

Case Study
Missy is a healthy 4-year-old who seems to be in perpetual motion. She came home from preschool today and told her mother she was tired and wanted to take a nap. Her mother immediately sensed there was something wrong, because Missy never volunteers to take a nap. Missy’s appetite was diminished at dinner, and although she appeared pale, she went to bed that night without complaint.
The following morning, Missy looks very ill, refuses to get out of bed, and hasn’t urinated since 8 p.m. the evening before. Missy’s mother brings her to the pediatrician’s office, where Missy is diagnosed with acute tubular necrosis (ATN). Her pediatrician admits Missy to the local acute care facility. You are the nurse admitting Missy to the pediatric unit.
Question 1
What questions would you ask Missy’s mother to determine contributory factors of the development of acute tubular necrosis?
Question 2
What orders would you anticipate from the healthcare provider to prevent the development of ARF?
Question 3
What independent nursing orders would you develop to provide holistic, family-centered care for Missy?
Question 4
What nursing diagnosis would be appropriate for Missy’s plan of care?