Jeana Sanders | 28 years old
Chief Complaint: Jeana Sanders presents to the emergency department with complaints of cola-colored urine, swelling in her face and ankles, and a headache. She reports feeling generally unwell for the past week.
Medical History:
Jeana has a recent history of a sore throat two weeks ago, which she attributed to a cold. She has no significant past medical history, and she is not on any medications. Jeana denies any allergies or chronic conditions.
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Nurse's Note:
Patient presents with noticeable facial and ankle edema, and she reports dark-colored urine over the past few days. She also complains of a persistent headache and general malaise. Jeana’s blood pressure is elevated, and she appears anxious about her symptoms. She denies any recent infections or illnesses, other than a sore throat two weeks ago. Urinalysis has been ordered.
Vital Signs:
Blood pressure: 156/92 mmHg
Heart rate: 88 bpm
Respiratory rate: 18 breaths/min
Temperature: 98.6°F (37°C)
SpO2: 99% on room air
Provider's Orders:
Admit to the medical unit for further evaluation and management.
Obtain a complete blood count (CBC), basic metabolic panel (BMP), and serum creatinine.
Complete urinalysis and 24-hour urine collection.
Administer Labetalol 100 mg PO for hypertension.
Start IV fluids: Normal Saline at 50 mL/hr.
Monitor intake and output (I&O) closely.
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Follow Up Questions:
Question 1: What is the significance of the cola-colored urine in Jeana's case?
Question 2: Why was a kidney biopsy ordered for Jeana?
Question 3: What is the purpose of administering Prednisone in Jeana's treatment?
Question 4: Why is sodium restriction important in the management of acute nephritic syndrome?
Answers to Questions Below
Answers
Question 1: What is the significance of the cola-colored urine in Jeana's case?
The cola-colored urine indicates the presence of hematuria, which is a common symptom of acute nephritic syndrome due to glomerular inflammation and injury. Hematuria occurs when red blood cells leak into the urine through the damaged glomeruli, and it is often one of the first signs of glomerulonephritis.
Question 2: Why was a kidney biopsy ordered for Jeana?
A kidney biopsy was ordered to confirm the diagnosis of acute nephritic syndrome and to determine the specific type of glomerulonephritis. A biopsy provides a definitive diagnosis by allowing direct examination of kidney tissue, helping to guide appropriate treatment.
Question 3: What is the purpose of administering IV fluids to Joseph?
Prednisone is administered to reduce inflammation in the glomeruli and to help control the immune response that is causing the kidney damage. Also potentially slowing disease progression.
Question 4: Why is sodium restriction important in the management of acute nephritic syndrome?
Sodium restriction is important to help control hypertension and reduce edema, which are common complications of acute nephritic syndrome. Excess sodium can exacerbate fluid retention and hypertension, worsening the symptoms and complications associated with kidney inflammation
Med Surg Case Study #40: Jeana Sanders
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