Discussion 3

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.

Reproductive Function:
Ms. P.C. is a 19-year-old white female who reports a 2-day history of lower abdominal pain, nausea, emesis and a heavy, malodorous vaginal discharge. She states that she is single, heterosexual, and that she has been sexually active with only one partner for the past eight months. She has no previous history of genitourinary infections or sexually transmitted diseases. She denies IV drug use. Her LMP ended three days ago. Her last intercourse (vaginal) was eight days ago and she states that they did not use a condom. She admits to unprotected sex “every once in a while.” She noted an abnormal vaginal discharge yesterday and she describes it as “thick, greenish-yellow in color, and very smelly.” She denies both oral and rectal intercourse. She does not know if her partner has had a recent genitourinary tract infection, “because he has been away on business for five days.
Microscopic Examination of Vaginal Discharge
(-) yeast or hyphae
(-) flagellated microbes
(+) white blood cells
(+) gram-negative intracellular diplococci

Case Study Questions

1.     According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probably diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.

2.     Based on the vaginal discharged described and the microscopic examination of the sample could you suggest which would be the microorganism involved?

3.     Name the criteria you would use to recommend hospitalization for this patient

 

 Submission Instructions:

·        Include both case studies in your post.

·        Your initial post should be 500 words per each case study, formatted and cited in current APA 7^th style with support from at least 3 academic sources. 

• Turnitin similarity should be less than 14%
• Each student must adhere to the formatting rules which include but is not limited to in-text citations and references outlined in the 7th Edition of the APA handbook.   For example, this tool does not italicize journals or book names. 
• Quotes “…” cannot be used at a higher learning level for your assignments, so sentences need to be paraphrased and referenced.
• Acceptable references include scholarly journal articles or primary legal sources (statutes, court opinions), journal articles, and books published in the last five years. No websites to be referenced without prior approval.

 

Textbook(s)

Delugash, L., Story, L. (2020). Applied Pathophysiology for the Advanced Practice  Nurse. Burlington, MA: Jones and Bartlett Learning. ISBN: 978-1284150452

Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s).

Read

·        Delugash, L., Story, L. (2020).

·        Chapter 7: Urinary Function (35:46)
STU. (2021). Chapter 7: Urinary function [Video]. Studio.
 

·        Chapter 8: Reproductive Function (51:07)
STU. (2021). Chapter 8: Reproductive function [Video]. Studio.
 

Online Materials & Resources:

1.     Complete the online tutorial covering renal pathologic conditions and diseases (Links to an external site.)
Klatt, E. C. (n.d.). Renal pathology for medical education – WebPath. EHSL – Spencer S. Eccles Health Sciences Library. https://library.med.utah.edu/WebPath/RENAHTML/RENALIDX.html

2.     View and Prepare a profile of a child with Wilms tumor (Links to an external site.)
Kidney (Renal cell) cancer—Patient version. (n.d.). National Cancer Institute. https://www.cancer.gov/cancertopics/types/wilms/

3.     Aging changes in the male reproductive system (Links to an external site.)
Aging changes in the male reproductive system: MedlinePlus medical encyclopedia. (2020, October 8). National Library of Medicine – National Institutes of Health. https://www.nlm.nih.gov/medlineplus/ency/article/004017.htm

4.     Aging changes in the female reproductive system (Links to an external site.)
Aging changes in the female reproductive system: MedlinePlus medical encyclopedia. (2020, October 8). National Library of Medicine – National Institutes of Health. https://www.nlm.nih.gov/medlineplus/ency/article/004016.htm

5.     Anatomy of the urinary system (Links to an external site.)
Anatomy of the urinary system. (n.d.). Johns Hopkins Medicine, based in Baltimore, Maryland. https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-urinary-system

6.     Bladder infection in adults (Links to an external site.)
Bladder infection (Urinary tract infection—UTI) in adults. (2017, March 22). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-infection-uti-in-adults

7.     Urinary tract and how it works (Links to an external site.)
The urinary tract & how it works. (2020, June 8). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-how-it-works

8.     Chronic kidney disease (CKD) (Links to an external site.)
Chronic kidney disease (CKD). (2016, October 25). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd

9.     Sexually transmitted diseases (Links to an external site.)
Sexually transmitted diseases – Information from CDC. (2020, August 21). Centers for Disease Control and Prevention. https://www.cdc.gov/std/default.htm

10.  Prostatitis: Inflammation of the prostate (Links to an external site.)
Prostatitis: Inflammation of the prostate. (2014, July 9). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostatitis-inflammation-prostate

11.  Pelvic organ prolapse (Links to an external site.)
Pelvic organ prolapse. (2019, May 14). Office on Women’s Health. https://www.womenshealth.gov/a-z-topics/pelvic-organ-prolapse

12.  Endometriosis (Links to an external site.)
Endometriosis. (2019, April 1). Office on Women’s Health. https://www.womenshealth.gov/a-z-topics/endometriosis

13.  Testicular torsion (Links to an external site.)
Testicular torsion: Symptoms, diagnosis & treatment. (n.d.). Urology Care Foundation. https://www.urologyhealth.org/urologic-conditions/testicular-torsion

14.  Sexually transmitted infections (STIs) (Links to an external site.)
Sexually transmitted infections (STIs). (2019, June 14). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)

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