case study discussion initial post should consist of three (3) paragraphs using at least two (2) sources.must cover the following information: 1)What type of kidney injury do you believe Ms. S is most likely to have? 2) Briefly explain the pathophysiology of this type of kidney injury and relate it to Ms. S’s symptoms. 3) What actions are top priorities for Ms. S? 4) What additional assessments do you anticipate for Ms. S?
Ms. S, a 78-year-old African American female, is brought to the emergency room by her son. He reports that she has been vomiting violently for the past 24 hours. Her mucous membranes are dry and cracked. Her skin is warm and dry with tenting. Her temperature is 38.2C and her heart rate is 115. Her blood pressure is 92/60. Upon further questioning Ms. S reports that she became ill after eating a spinach salad and delayed going to the ED until her son insisted that she go.
Ms. S is unable to void, so the nurse inserts a catheter with a return of less than 50 mL of amber, malodorous urine. The nurse receives the following results, which are significant from her lab work:
Urinalysis = + Protein; + RBCs; +WBCs, nitrates
BUN = 35
Creatinine = 3.5
GFR = 65
Na+ = 150
WBC = 12,000
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Introduction:
In this case study, we will discuss the possible kidney injury that Ms. S, a 78-year-old African American female, is most likely to have, along with the pathophysiology of the injury and its relation to her symptoms. We will also analyze the top priorities for Ms. S in terms of actions needed and additional assessments that might be required.
1) What type of kidney injury do you believe Ms. S is most likely to have?
Based on the symptoms presented in the case study, Ms. S is most likely suffering from acute kidney injury (AKI), also known as acute renal failure. AKI is a sudden loss of kidney function that can occur within hours or days, resulting in a high level of waste products and toxins in the blood.
2) Briefly explain the pathophysiology of this type of kidney injury and relate it to Ms. S’s symptoms.
The pathophysiology of AKI involves damage to the kidneys and their structures, which impairs their ability to filter waste products and toxins from the blood. This can be due to a variety of causes, including decreased blood flow to the kidneys, direct damage to the kidney tissues, or obstruction of the urinary tract.
In Ms. S’s case, her symptoms indicate a possible decrease in blood flow to the kidneys, which could be caused by dehydration, as evidenced by her dry and cracked mucous membranes, warm and dry skin with tenting, and her low blood pressure. Additionally, her inability to void and the results of her urinalysis suggest that there is an obstruction in her urinary tract. These factors contribute to a decreased glomerular filtration rate (GFR) and an increase in blood urea nitrogen (BUN) and creatinine levels.
3) What actions are top priorities for Ms. S?
The top priorities for Ms. S are to address the underlying causes of her AKI, prevent further kidney damage, and manage her symptoms. To achieve this, she needs immediate fluid resuscitation to restore her blood volume and blood pressure, as well as to increase renal perfusion. Her son’s report of her recent spinach salad intake may suggest that the cause of her AKI may be food poisoning, so investigations into foodborne illnesses may also be necessary.
4) What additional assessments do you anticipate for Ms. S?
Additional assessments for Ms. S would include a detailed physical examination to assess the degree of dehydration and any possible underlying health conditions, such as hypertension or diabetes, and to check for signs of edema or heart failure. Monitoring of her electrolyte levels, such as sodium and potassium, and her fluid balance would also be necessary. Renal ultrasound or CT imaging may be used to check for any anatomical abnormalities in her urinary tract. Additionally, her mental state may need to be evaluated due to her age and what appears to be an altered level of consciousness.