case study 2403

Case Study: Alterations of the Renal and Urologic Function

Mr. J.R. is a 73-year-old man, who was admitted to the hospital with clinical manifestations of gastroenteritis and possible renal failure. 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. Based on the information provided above, which two types of acute renal failure are most likely.
  2. List four major risk factors that are likely to be contributing to the patient’s kidney failure.
  3. If acute renal failure progresses to chronic renal failure, hemoglobin and hematocrit may decrease significantly and a peripheral blood smear may indicate a normocytic, normochromic anemia. Suggest two pathophysiologic mechanisms that explain the abnormal hemoglobin level, hematocrit, and peripheral blood smear.
  4. Which laboratory data suggest that the infection is probably viral and not bacterial?
  5. Why is it appropriate that a serum creatinine phosphokinase assay was not ordered?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
  • All replies must be constructive and use literature where possible.
  • Grading Rubric

    Your assignment will be graded according to the grading rubric.

    Discussion Rubric
    Criteria Ratings Points
    Identification of Main Issues, Problems, and Concepts 5 points
    DistinguishedIdentify and demonstrate a sophisticated understanding of the issues, problems, and concepts.
    4 points
    ExcellentIdentifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.
    2 points
    FairIdentifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.
    1 points
    PoorIdentifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.
    5 points
    Use of Citations, Writing Mechanics and APA Formatting Guidelines 3 points
    DistinguishedEffectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
    2 points
    ExcellentEffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
    1 point
    FairIneffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
    0 point
    PoorIneffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.
    3 points
    Response to Posts of Peers 2 points
    DistinguishedStudent constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.
    1 points
    FairStudent constructively responded to one other post and either extended, expanded or provided a rebuttal.
    0 point
    PoorStudent provided no response to a peer’s post.
    2 points

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