Posted: April 9th, 2022

Renal Case Study Discussion 5

Renal Case Study Discussion 5

Carmelita Gomez, age 8, is brought to the Children’s Clinic by her mother because she is nauseated and has vomited three times in the past 24 hours. Her urine has turned “tea colored”. Carmelita is lethargic and she is complaining of diffuse abdominal pain. Ten days ago she had a sore throat and fever and stayed home from school for two days. She was not seen by a health care provider at that time. Upon questioning, Carmelita cannot remember needing to urinate in the past 12 hours. On exam, Carmelita is irritable and listless. She has slight periorbital edema. Carmelita has active bowel sounds with no palpable abdominal masses, but she is tender in all four quadrants. Carmelita is given a presumptive diagnosis of poststreptococcal glomerulonephritis (PSGN), pending laboratory tests.

Her laboratory values are:

Serum creatinine: 2.3 mg/dL

BUN 26.1 mg/dL

Serum sodium: 142 mEq/L

Potassium 4.2mEq

Specific gravity 1.025

Phosphorous: 6.3 mEq/dL

Calcium: 7 mEq/dL

UA: hematuria 4+, red cell casts

Antistreptococcal antibody titre: 800U

POINTS TO PONDER:

Which lab values are abnormal?
What clinical manifestations correspond to the abnormal values?
Describe the changes (pathophysiology) in the body causing each abnormal value and link the value to a clinical manifestation present in the patient?
Which values are within normal limits?
What nursing care needs to be implemented?
Provide one nursing diagnosis appropriate to this patient.
Reading

Urinalysis p.1146 (Leeuwen, pg. 546-552)
Culture p.230
Kidney stone analysis p.696 (Leeuwen, pg. 61,265,426,444)

Case Study Rubric

Criteria

Abnormal Values

What do the labs indicate specific to this patient

values and signs and symptoms

The relationship between the abnormal Signs & Symptoms and lab values is clearly demonstrated. **Must be specific**

Pathophysiology used to demonstrate connections between lab results, manifestations and disease process.

Expected care to be given for exhibited s/s and lab values. Expected correction of lab values based on care given. Patient education to prevent recurrence of abnormal lab values.

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Discussion of Renal Case Study 5
Discussion of Renal Case Study 5

Carmelita Gomez, 8, is taken to the Children’s Clinic by her mother because she is sick and has vomited three times in the last 24 hours. Her urine has become “tea colored.” Carmelita is sluggish and complaining of diffuse abdominal ache. She had a sore throat and fever ten days ago and missed two days of school. At the time, she was not seen by a health care provider. Carmelita cannot recall needing to urinate in the previous 12 hours when questioned. On exam, Carmelita is irritable and listless. She has slight periorbital edema. Carmelita has active bowel sounds with no palpable abdominal masses, but she is tender in all

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