: Renal Case Study The patient is 41 year-old male who has a loting his home and diabetes and presents with complaint of promines, larg,
: Renal Case Study The patient is 41 year-old male who has a loting his home and diabetes and presents with complaint of promines, larg, lower extremity edema, standemek, le denies any cher medicale Os physical exam tbe patient is a well-developed well.sourished male in moderate distress, Blood pressure 180/1 io. pulse 80. respirations 24 and he was afebrile Body weight 765 Cardinamas si, 2 st The remainder of the exam was remarkable for lower eremity demand superficiale.corations of his skin from scratching Laboratory Data Urinalysis pH 60 Specific gravity 1.010 Protein- Glucose negative Acetosegative Occult blood negative Bile negative Wany cats Chemistry Sedium Post Chloride Total CO BUN Creatinine Glucose Calcium Phosphorus Alkaline Phosphatas Parathyroid Hormos Hemoglobin Hematocrit 133 62 100 15 170 160 108 72 10.3 306 895 35 Normal Values 136-146 mol 3.5-5.3 mot 98-108 mmoll 23-27 7-22 mg 0.7.15 mg 70-110 mg di 89.10.3 mg 26-6.4 mg 10-110 101 10-65 l 14-17 um 1 10-54 274 ** 83-95 TL Mean cell volume Renal round Right cx6.0 cm. Lakidney 92 x 55 cm both kidneys illustrate hyperechogenicity and to hydrocephrosis Begin by highlighting all the data that are abnormal in this case study Case Questions 1. Presents with a complaint of pruritus, lethargy, lower extremity edema, sea and emess what does the symptoms suggest to you? 2. What does S4 signit? What cardiac findings will you expect to find in a hypertene? What are the possibilities for his 2 lower extremity edema? 3. What is the significance of the finding “superficial excoriations of his skin from scratching 4. Why was a real sound ordered? What information can you gather from renal ultrcand studies
3. How does the results of the renal ultrasound influence your thinking on the diagnosis? What is the normal size of the kidney? Is his kidney size normal? What does small or large kidney signity 6. What is the cause of this patient’s renal filure is the real failure out of chronic? How did you arrive at that conclusion? 7. How is a 24 hour urine to be collected? &. What is glomerular filtration rate? 9. Why is the parathyroid hormone elevated? 10. What is the most likely cause of this patient’s anemia? 11. Should this patient be started on dialysis? What are the indications for dialysis? 12. What is hemodialysis? What is peritoneal dialysis? 13. What assessments should be performed on a pacient before sending them to hemodialysis dialysis? 14. Which medications should patients not take on the day of dialysis? What is the rationale for this? Is What are the types of access devices used for dialysis? How should a nurse care for these acces devices?
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