Description

DB #3 UTI & Renal Failure

Mrs. Yu: Adult Urinary Tract Infection, Renal Failure

Mrs. Yu is a 39 y/o Korean American female with past medical history of Diabetes Mellitus Type 1 (DMT1), Hypertension (HTN), Chronic Kidney Disease (CKD) & is legally blind.  She comes to the clinic today for a follow-up visit. You have not cared for her before, but your colleague who is her Health Care Provider is off, so you have been assigned to follow-up with her.

You review her chart before seeing her.  She was seen in the Health Clinic 12 days ago & treated for a Urinary Tract Infection (UTI).  She was put on levofloxacin (Levaquin) 750 mg PO for a 10 day course.  She was instructed to return after completing the antibiotic for a follow-up urinalysis & culture. She had no known drug allergies.  Her home medications include: Lisinopril 20 mg PO daily, HCTZ 25 mg PO daily, Lantus 60 units SQ BID, Humalog Insulin 10 units SQ with each meal, & Multivitamin daily.

Assessment today:

Vital Signs:  BP 164/96, HR 94, RR 20, POX 93% RA, Temp 97.8

Physical Assessment: Neuro A& O x3; Lungs clear; Heart Sounds regular, S1,S2, no murmurs appreciated; Abd soft, nontender, nondistended, bowel sounds +; Extremities PP+, scant pedal edema.

Labs & a urinalysis/culture are sent & you ask Mrs. Yu to wait for the results.

§  NA 149, K 6.1, BUN 68, Cr 4.8, Cr Clearance 36; glucose 156

§  WBC 6.2; Hgb 10.9; Hct 32.2; Plt 229

§  Urinalysis: no nitrates; no leukocyte esterase; specific gravity 1.430; bacteria none

§  Urine Culture: Pending

4-Review the pathophysiology of what you consider the priority diagnosis? Support your decision for your diagnosis. 

5.     -There are several abnormal lab findings.  Explain why they are abnormal.

6.     -Which abnormal lab is the most life threatening & why?

Discussion Board Requirements Students will discuss assigned topics integrating information from the reading assignments and class content to be posted. Additionally, students are expected to comment on materials/comments posted by fellow students. The postings need to be thoughtful; that is, they refer to the week's readings, in the clinical setting, or on information obtained from other sources, or ideas expressed in the postings of other class members. References should be included as needed to support your position. Your postings must demonstrate that you have reflected on the assigned readings, and synthesized the material with your previous knowledge and experience. In order to receive credit, all discussion board posts including responses to peers must be written or pasted into the text box rather than submitted as an attachment. This reduces the likelihood of viruses. The initial post is to be posted by 11:59 pm on Thursday of the assigned week with responses to two peers due by 11:59 pm on Sunday of that same week. All discussion posts should be a maximum of 500 words. Aim to present your ideas concisely yet thoroughly. Blackboard Discussion Forum Evaluation Criteria: Students are expected to make one initial posting based upon the assigned discussion question and two peer responses. Your peer responses should be substantive (that is, more than “I agree.”). It should add knowledge, respectfully challenge, etc. Please remember that all postings should use professional language and not contain slang or inappropriate language. See separate rubric for grading criteria.