PYELONEPHRITIS

A. PYELONEPHRITIS A patient consulted in the emergency department with complaints of high fever, chills, dysuria,…

A. PYELONEPHRITIS A patient consulted in the emergency department with complaints of high fever, chills, dysuria, and back pain. Laboratory results are as follows: WBC – 13,000 cells/mcL Neutrophils – 10,000 per mm3 Lymphocytes – 3,500 per mm3 Serum Sodium – 136 mEq/L Serum Potassium – 3.7 mEq/L Urinalysis: Color: Hazy yellow Bacteria: Too many to count Pus cells: >100 cells/hpf RBC: >100 cells/hpf Specific gravity: 1.280 The doctor ordered co-trimoxazole (Bactrim) 800/160mg tablet TID for 14 days and phenazopyridine (Pyridium) 200 mg tablet TID for 3 days. Given the above case, answer the following questions: 1. What laboratory values point towards the diagnosis of Pyelonephritis? 2. What is the most common causative agent of urinary tract infections? 3. Give at least two (2) health teaching points that will help the prevention of recurrence of UTI? 4. Create a drug study for the medication: CO-TRIMOXAZOLE specifying the following: a. Drug classification b. Mechanism of action c. Indication (*for the case of the patient mentioned above) d. Contraindication e. Side effects f. Nursing Considerations 5. Create a drug study for the medication: PHENAZOPYRIDINE specifying the following: a. Drug classification b. Mechanism of action c. Indication (*for the case of the patient mentioned above) d. Contraindication e. Side effects f. Nursing Considerations A. GLOMERULONEPHRITIS A patient with cleft lip and bronchial asthma was brought to the emergency department with chief complaint of low-grade fever, puffiness of the face and eyes in the morning, +2 edema on both feet, and tea-colored urine. Urinalysis revealed numerous RBC and certain degree of proteinuria and Antistreptolysin-O titer reaches more than 300 todd units. The doctor came up with the diagnosis of Acute Glomerulonephritis (AGN). Answer the following questions: 1. What history-taking question should be asked by the nurse to strengthen the diagnosis of AGN? 2. Explain the pathophysiological tracing on the development of AGN. 3. The doctor ordered hydrocortisone TIV, create a drug study specifying the following: a. Drug classification b. Mechanism of action c. Indication (*for the case of the patient mentioned above) d. Contraindication e. Side effects f. Nursing Considerations B. RENAL CALCULI An elderly patient with osteoporosis consulted in an Out-patient Department with complaints of severe lower back pain. She is taking 1000 mg of calcium carbonate once a day and reports of poor hydration due to her mobility problems. Ultrasound of the Kidneys, ureters, and bladder reveal several calculi in both kidneys and is counselled to be a candidate for nephrolithotomy. Answer the following questions: 1. What pertinent data in the patient’s history may have contributed with the development of renal calculi, defend your answer? 2. Identify three (3) priority nursing diagnoses in relation to the patient’s condition and create a hypothetical Nursing Care Plans for each nursing diagnosis. 3. Identify at least two (2) health teaching points on the prevention of recurrence of renal calculi for the patient. C. RENAL FAILURE A patient with uncontrolled Type 2 Diabetes consulted in the emergency department due to shortness of breath, bipedal edema, palpitation, and decreased urinary output during the past 2 days. The following laboratory test values are presented: Serum Creatinine – 2.5 mg/dL BUN level – 30 mg/dL Serum potassium – 5.9 mEq/L HBA1C – 8% A diagnosis of Acute Renal Failure secondary to DM Nephropathy was made by the doctor. Sodium polyesterene sulfonate (Kayexalate) was ordered to normalize potassium level. Oral hypoglycemic agents were revised, and insulin therapy was started to manage the blood sugar level. Urine output is closely monitored for possible hemodialysis. Answer the following questions: 1. Explain the relationship of diabetes mellitus on the development of acute renal failure using a flow chart. 2. Identify three (3) nursing diagnoses pertinent to the patient’s condition and create hypothetical Nursing Care Plans (NCPs) for each nursing diagnosis. 3. Create a drug study for the medication: SODIUM POLYESTERENE SULFONATE specifying the following: g. Drug classification g. Mechanism of action h. Indication (*for the case of the patient mentioned above) i. Contraindication j. Side effects k. Nursing Considerations

 

In: Nursing

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