Creatinine doubles, but the lab does not flag it. Would you catch the change? Nora connects three original adult cases with AKI recognition, baseline comparisons, urine-output math, supply–filter–drain causes, fluid assessment, medicine safety, urgent complications and recovery. Slow, friendly teaching, simple analogies, repeated cues and eight pause-and-answer checks make the kidney story easier to follow. Recaps Episode 16 and previews a planned gastrointestinal bleeding review.

• Compare the change: a creatinine inside the lab interval can still represent an acute doubling from baseline.
• Check the flow: interpret urine output with weight, time and measurement accuracy; do not wait for a diagnostic interval to assess deterioration.
• Watch the whole person: assess supply, filter and drain; fluid tolerance, medicines, complications and recovery determine the response.

Chapters

00:00 The result is normal. The change is not.

00:45 Your slow, simple kidney map

02:38 Chapter one: the filter, the supply, and the drain

04:23 Chapter two: compare with the person's baseline

07:32 Chapter three: urine needs a weight and a clock

10:02 Chapter four: before, inside, or after the kidney

12:43 Chapter five: low urine does not automatically mean more fluid

14:57 Chapter six: the medicine list is part of the assessment

17:23 Chapter seven: breathing, potassium, acid and symptoms

20:23 Chapter eight: a fuller urine bag is not the finish line

22:40 Eight decisions: pause, choose, keep the cue

25:29 Compare the change. Check the flow. Watch the person.

Primary sources checked 15 October 2026; current orders, emergency protocols, device instructions and scope apply.

• KDIGO 2012 Clinical Practice Guideline for Acute Kidney Injury
• NICE NG148: Acute kidney injury, recommendations (updated 2024)
• National Kidney Foundation: Acute Kidney Injury
• NIDDK: Keeping Kidneys Safe, Smart Choices about Medicines
• UK Kidney Association: Management of Hyperkalaemia in Adults (2023)
• KDIGO AKI/AKD guideline update status

Independent educational content; not affiliated with or endorsed by NCSBN. NCLEX-RN is a registered trademark of NCSBN. Fictional teaching cases and host persona; licensed stock synthetic narration. Use alongside nursing education and current official exam resources. No individual medical advice or exam-result guarantee.

Previous: Episode 16, anaphylaxis. Next planned: gastrointestinal bleeding; not yet released.

All platforms: https://linktr.ee/BlueCueNCLEXRN. Corrections: ted.lownie@dal.ca

No hives, but a changing voice and falling pressure. Would you wait? Nora walks through three fictional adult cases with slow, friendly teaching, simple analogies, chapter previews and repeated take-home cues. Learn recognition, epinephrine first, dose-and-route safety, positioning, reassessment, adjunct limits, observation and device teach-back. Eight pause-and-answer checks help the lesson stick. Recaps Episode 15 and previews a planned acute kidney injury review.

• No rash does not rule out anaphylaxis; assess the exposure and airway, breathing and circulation urgently.
• IM epinephrine is first-line in the usual initial pathway; verify dose, concentration, route and timing, and do not substitute antihistamines.
• Bring help to the patient, reassess after treatment and follow the observation and device-training plan.

Chapters

00:00 No rash. Still an emergency.

00:57 Our plan: notice, act, reassess

02:45 Chapter one: the skin is only one clue

05:27 Chapter two: why epinephrine gets the first move

08:00 Chapter three: dose, concentration, route, time

11:00 Chapter four: do not walk the patient to help

13:37 Chapter five: first dose does not mean finished care

16:16 Chapter six: the itch can wait its turn

18:16 Chapter seven: better is a reassessment point

20:24 Chapter eight: a plan the patient can actually use

22:53 Eight decisions: pause, choose, hear the cue

25:25 Three cues, and what comes next

Primary sources checked 11 October 2026; current orders, emergency protocols, device instructions and scope apply.

• Resuscitation Council UK: Emergency treatment of anaphylaxis (2021)
• ASCIA: Acute management of anaphylaxis (October 2026)
• AAAAI/ACAAI: Anaphylaxis practice parameter update (2023)
• PHAC: Anaphylaxis and other acute reactions following vaccination
• DailyMed: EpiPen instructions and prescribing information
• DailyMed: Adrenalin prescribing information

Independent educational content; not affiliated with or endorsed by NCSBN. NCLEX-RN is a registered trademark of NCSBN. Fictional teaching cases and host persona; licensed stock synthetic narration. Use alongside nursing education and current official exam resources. No individual medical advice or exam-result guarantee.

Previous: Episode 15, HHS. Next planned: acute kidney injury; not yet released.

All platforms: https://linktr.ee/BlueCueNCLEXRN. Corrections: ted.lownie@dal.ca

Glucose falls from 900 to 230—but the patient is still confused. Has the crisis really ended? Nora follows three original adult cases through HHS, DKA overlap, hyperosmolality, fluid correction, potassium safeguards, insulin and dextrose, recovery criteria, transition overlap and SGLT2-related ketoacidosis. Eight rapid decisions connect the laboratory pattern to the safest nursing response.

• Assess the whole hyperosmolar emergency: severe hyperglycemia, dehydration, osmolality, cognition and the precipitating illness.
• Correct the crisis carefully: individualize fluids, track osmotic trends, review potassium before insulin and distinguish uncomplicated HHS from DKA overlap.
• Glucose improvement alone does not establish recovery; check the full resolution cluster, safe insulin transition and an achievable sick-day plan.

Chapters

00:00 The glucose looks better

00:39 Episode fifteen: the hyperosmolar emergency

01:59 Rosa: water lost before the emergency is named

03:52 HHS and DKA: similar danger, different dominant mechanism

05:43 Four HHS criteria, three DKA components

08:11 The calculation that protects the brain

10:08 Perfusion first, controlled correction throughout

12:58 The overlap case changes the branch

15:18 Dextrose can help insulin finish its job

17:34 The screen is better, the emergency is unfinished

19:46 Jan: ketoacidosis without spectacular glucose

21:59 Eight rapid decisions

24:14 Follow the patient, not the victory number

Primary sources checked 11 October 2026. Adult scope; current orders, local emergency protocols and the individual diabetes plan control.

• Umpierrez et al. 2024 international adult hyperglycemic-crisis consensus
• ADA 2026 Standards of Care: Diabetes Care in the Hospital
• ADA 2026 abridged hospital standards
• JBDS adult HHS care pathway
• DailyMed: JARDIANCE prescribing information, revised January 2026
• ADA: Managing ketones with diabetes

Adapted from Umpierrez et al. (2024), Diabetologia, doi:10.1007/s00125-024-06183-8, CC BY 4.0: https://creativecommons.org/licenses/by/4.0/. Original scenarios and teaching structure added; no figures reproduced.

Independent educational content; not affiliated with or endorsed by NCSBN. NCLEX-RN is a registered trademark of NCSBN. Fictional teaching cases and host persona; licensed stock synthetic narration. Use alongside nursing education and current official exam resources. No individual medical advice or exam-result guarantee.

Corrections: ted.lownie@dal.ca