NUR 502 STU WK 4 Manifestations of Gastroenteritis & Renal Injury Case Study

I don’t know how to handle this Health & Medical question and need guidance.

Urinary Function:

Mr. J.R. is a 73-year-old man, who was admitted to the hospital with clinical manifestations of gastroenteritis and possible renal injury. The patient’s chief complaints are fever, nausea with vomiting and diarrhea for 48 hours, weakness, dizziness, and a bothersome metallic taste in the mouth. The patient is pale and sweaty. He had been well until two days ago, when he began to experience severe nausea several hours after eating two burritos for supper. The burritos had been ordered from a local fast-food restaurant. The nausea persisted and he vomited twice with some relief. As the evening progressed, he continued to feel “very bad” and took some Pepto-Bismol to help settle his stomach. Soon thereafter, he began to feel achy and warm. His temperature at the time was 100. 5°F. He has continued to experience nausea, vomiting, and a fever. He has not been able to tolerate any solid foods or liquids. Since yesterday, he has had 5–6 watery bowel movements. He has not noticed any blood in the stools. His wife brought him to the ER because he was becoming weak and dizzy when he tried to stand up. His wife denies any recent travel, use of antibiotics, laxatives, or excessive caffeine, or that her husband has an eating disorder.

Case Study Questions

  1. The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented name the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.
  2. Create a list of risk factors the patient might have and explain why.
  3. Unfortunately, the damage on J.R. kidney became irreversible and he is now diagnosed with Chronic kidney disease. Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.

Expert Solution Preview

Introduction:
The case of Mr. J.R. is a complex one with multiple clinical manifestations and possibilities of Acute Kidney Injury. As a medical professor, it is important to analyze the case and answer the questions effectively.

1. The attending physician suspected Acute Kidney Injury (AKI) in Mr. J.R.’s case. There are three types of AKI: Prerenal, Intrarenal, and Postrenal. The clinical manifestations mentioned in the case study, such as fever, nausea, vomiting, and diarrhea, suggest that the patient might have developed Intrarenal AKI or Interstitial Nephritis. It is also possible that Postrenal AKI has developed due to the obstruction in the urinary tract, causing urine retention.

2. Mr. J.R. might have multiple risk factors that led to his condition. Some of the possible risk factors are advanced age, dehydration, medication toxicity (due to Pepto-Bismol), and bacterial infection (presumed gastroenteritis). The consumption of fast food may also contribute to his present condition.

3. Unfortunately, the damage to Mr. J.R’s kidneys has become irreversible, and he has been diagnosed with Chronic Kidney Disease (CKD). As a consequence, he may experience complications related to the Hematologic system. One such complication is Coagulopathy (a bleeding disorder), which occurs due to platelet dysfunction or thrombocytopenia. Another complication is Anemia, which arises when the kidneys are unable to secrete adequate amounts of erythropoietin. The pathophysiologic mechanisms involved in both these complications are directly related to the reduced renal function due to CKD, resulting in abnormal blood clotting and reduced red blood cell production.

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