A 45-year-old woman is complaining of urgency and dysuria for the past 2 days. Yesterday, she started getting chills, feels she is getting a fever, and her back hurts.
Week 7 Case study: APA FORMAT, CITATION AND REFERENCE!!!
Part one:
A 45-year-old woman is complaining of urgency and dysuria for the past 2 days. Yesterday, she started getting chills, feels she is getting a fever, and her back hurts.
- Past medical history: UTI 1 year ago.
- Medications: none.
- Allergies: no known drug allergy (NKDA).
- Physical examination: temperature 100°F, pulse 86 beats per minute; respirations 18 per minute; blood pressure 110/70 mmHg; positive costovertebral angle and suprapubic tenderness, otherwise unremarkable; urine dipstick reveals positive leukocytes but negative for nitrites and blood.
- What is the most likely diagnosis and pathogen causing this disorder and mode of transmission?
- Discuss data that support your decision.
- What diagnostic test, if any, should be done? What diagnostic test findings would support your diagnosis?
- Develop a treatment plan for this patient.
Part 2: Complete all
Review the following case and urinalysis report.
A 46-year-old woman is asymptomatic and has a routine urinalysis as part of her annual physical. The urinalysis with microscopy report is as follows: PLEASE SEE THE ATTACHMENT DIAGRAM
- Describe the urinalysis findings and determine possible reasons for the findings and follow-up, if necessary
Part 3:
Case 2
An 8-year-old Black girl is complaining of burning when urinating for the past day. She reports wetting herself at school because she was unable to hold it until she was able to get to the bathroom. When she toileted, she voided only small amounts. She denies fever, back, or suprapubic pain. The child is accompanied by her mother.
- No past medical history or medications.
- Allergies: penicillin (hives).
- Vaccines: up to date.
- Physical examination: vital signs and examination are within normal limits.
- Urine dipstick: positive for leukocytes, nitrites, and blood.
- Discuss most likely cause of the hematuria. Discuss data that supports your decision as well as diagnostic and treatment strategies.
Part 4:
A 13-year-old boy presented to the clinic complaining of a sore throat that persisted for 2 days. After those 2 days, he developed fever, nausea, and malaise. A throat culture revealed the presence of group A beta-hemolytic streptococci, and the child was started on antibiotic therapy. The child’s symptoms gradually improved, but approximately 2 weeks later, he returned to the clinic because the fever, nausea, and malaise returned. He became tachypneic and short of breath. The mother noted that his eyes were puffy, his ankles were swollen, and his urine was dark and cloudy.
On examination, the child’s blood pressure was 148/100 mmHg; his pulse 122 beats per minute; and his respirations were 35 per minute. Orbital and ankle edema were present. Crackles were auscultated bilaterally. No heart murmurs were found. Slight tenderness to percussion over the flank areas was noted.
A chest X-ray showed evidence of congestion and edema in the lungs. The patient’s hematocrit was 37%, and his WBC count was 11,200/mm3. Blood urea nitrogen was 48 mg/dL (normal is less than 20 mg/dL). Urinalysis results showed that the patient’s protein was 2+ (24-hour excretion was 0.8 g), specific gravity was 1.012, and there were moderate amounts of RBCs and WBCs in the urine. Serum albumin was 4.1 g/dL (normal is 3.5–4.5).
- Which evidence supports the conclusion that this patient has a kidney disease?
- Which clinical pattern of kidney disease does this patient have? Explain the symptoms.
- Which morphologic changes would you expect in the kidney?
- What is the prognosis?
- What are the possible short- and long-term complications of this disease?
- Is it necessary to hospitalize the patient?
TEXTBOOK & READING:
From your textbook. Applied Pathophysiology for the Advanced Practice Nurse, read the following chapter:
- Urinary Functions
APA FORMAT, CITATION AND REFERENCE!!!
