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Rzqust [24]
2 years ago
8

78-year old woman with a history of hypertension, aortic thoracic graft, and esophageal reflux disease complained of fever (100

o ) and weakness. She had been treated 3 weeks before at the hospital for a urinary tract infection. She was admitted to the hospital for a diagnostic workup and transfusion. Her laboratory results are listed below:
Na+ 129 mmol/L Hct 25.6%
K+ 3.7 mmol/L Hgb 8.5 g/dL
Cl- 97 mmol/L WBC 9,700
CO2 19 mmol/L
BUN 52 mg/dL
Creatinine 3.2 mg/dL
Urine culture was positive for Citrobacter.
Urinalysis results are listed:
Color Hazy/yellow
Specific gravity 1.015
pH 5
Blood Large
Protein 2
Glucose Negative
Ketones Negative
Nitrates Negative
RBC >25
WBC 1–4
Casts Granular, 1–4
The patient’s renal function continued to decline, and she was put on hemodialysis. A renal biopsy was performed that showed end-stage crescentic glomerulonephritis. Two days later, the patient sustained a perforated duodenal ulcer, which required surgery and blood transfusion. Subsequently, she developed coagulopathy and liver failure. Her condition continued to deteriorate in the next few days, and she died following removal of life support.
1. Looking at the urinalysis, what is the significance of the results of 2+ protein and >25 RBCs?
2. What is the most likely cause of glomerulonephritis?
3. Why was the patient put on hemodialysis?
Medicine
1 answer:
MrRa [10]2 years ago
6 0
1. The significance of 2+ proteins and high RBC indicates severe decrease in renal function. These two things should not be present in urine in a healthy individual

2. Maybe the UTI could be the cause of the glomerulonephritis. Patient has a history of GERD and so treatment with Proton Pump Inhibitors can sometimes lead to interstitial nephritis which may have been the case here.

3. Patient was put on dialysis due to decreased renal function
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Explanation:

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A client arrived in the emergency department with a sharp object penetrating the diaphragm. when planning nursing care, which nu
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Answer:

A client arrived in the emergency department with a sharp object penetrating the diaphragm. This can be a serious injury, however, the cardinal signs and symptoms of an impaired gas exchange should identify as a priority.

The nurse would first assess the airway by observing for any respiratory distress or inappropriate cough. Other potential indicators are tingling/tingling sensation on the tongue and lips, inability to swallow, hoarseness, or voice changes.

Explanation:

The nurse could identify the priority nursing diagnosis as an abnormal breathing pattern. The nurse may need to alert the physician that this type of injury will cause impaired gas exchange, which can affect vital organs in the body.

The priority of nursing care is to stop the bleeding and assess for any underlying injuries. A nursing diagnosis of pain and anxiety might be appropriate if the client was found to be in severe pain, but not stress related. Since we know that diaphragm injuries can cause impeded gas exchange, it would make sense if this client exhibited signs of impaired gas exchange and had shortness of breath after the brief attempt at identifying their wound.

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The nurse checks a client's blood pressure using an automatic, noninvasive machine. The nurse notes that the machine inflates fo
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Send the machine for maintenance and repeating the measurement manually is the appropriate action taken by the nurse.

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Eleanor takes several high-cost prescription drugs. She would like to enroll in a standalone Part D prescription drug plan that
andriy [413]

Answer:

A Medicare Prescription Drug Plan.  

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