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Case Study #22: Polycystic Kidney Disease



Kevin Smith | 35 years old


Chief Complaint: Kevin presents with abdominal fullness and flank pain.


Medical History:

  • Hypertension

  • Family history of polycystic kidney disease (PKD)


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0800

Nurse's Note: Kevin complains of abdominal fullness and intermittent flank pain. He reports a family history of PKD. Abdominal examination reveals bilateral palpable masses consistent with enlarged kidneys.


Vital Signs:

  • Blood pressure: 150/95 mmHg

  • Heart rate: 80 bpm

  • Respiratory rate: 18 breaths/min

  • Temperature: 98.4°F (36.9°C)


Provider Orders:

  • Perform renal ultrasound.

  • Administer analgesics as needed for pain relief.

  • Order complete blood count (CBC) and renal function tests.

1030

1345


Question 1: What are the common clinical manifestations of polycystic kidney disease (PKD)?


Question 2: Why is antihypertensive therapy initiated in patients with PKD?


Question 3: What is the rationale behind ordering urine analysis and culture in this case?

Answers to Questions Below




Answers

Question 1: What are the common clinical manifestations of polycystic kidney disease (PKD)?

Common manifestations include abdominal fullness, flank pain, hematuria, polyuria, hypertension, renal calculi formation, and urinary tract infections (UTIs) due to cyst compression and obstruction of the urinary tract.


Question 2: Why is antihypertensive therapy initiated in patients with PKD?

Antihypertensive therapy is initiated to control blood pressure and reduce the risk of further kidney damage. Hypertension is a common complication of PKD and contributes to progression of renal dysfunction.


Question 3: What is the rationale behind ordering urine analysis and culture in this case?

Urine analysis and culture are ordered to assess for urinary tract infections (UTIs), which are common complications of PKD due to urinary stasis caused by cyst compression. Prompt detection and treatment of UTIs are essential to prevent worsening of symptoms and potential kidney damage.



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