“Delivering Bad News”
You are working as an AGACNP in the inpatient setting. You have been following an 80-year-old female for the past four days who was originally admitted with acute cystitis and possible pyelonephritis. She was found to have weakness, dehydration, and suspected prerenal acute kidney injury in combination with the infection, which prompted hospital admission. She has been alert and oriented on all examinations.
During hospital admission, she underwent a renal ultrasound to evaluate kidney function further as her acute kidney injury was not improving by hospital day #3. The ultrasound revealed renal masses which were suspicious for potential renal cell carcinoma with a suggestion for a chest/abdomen/pelvis CT for further evaluation.
Answer the questions below, while considering your role as the advanced practice provider who has seen the patient while hospitalized.
How would you approach communicating this diagnostic finding with the patient?
Would you order the chest/abdomen/pelvis CT for this patient?
Would you include any other persons in this difficult conversation or in this patient’s overall care?
“Delivering Bad News” You are working as an AGACNP in the inpatient setting. You
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