DB #3 UTI & Renal Failure
Mrs. Yu: Adult Urinary Tract
Infection, Renal Failure
Mrs. Yu is a 39 y/o Korean
American female with past medical history of Diabetes Mellitus Type 1 (DMT1),
Hypertension (HTN), Chronic Kidney Disease (CKD) & is legally blind.
She comes to the clinic today for a follow-up visit. You have not cared for her
before, but your colleague who is her Health Care Provider is off, so you have
been assigned to follow-up with her.
You review her chart before
seeing her. She was seen in the Health Clinic 12 days ago & treated
for a Urinary Tract Infection (UTI). She was put on levofloxacin
(Levaquin) 750 mg PO for a 10 day course. She was instructed to return after
completing the antibiotic for a follow-up urinalysis & culture. She had no
known drug allergies. Her home medications include: Lisinopril 20 mg PO
daily, HCTZ 25 mg PO daily, Lantus 60 units SQ BID, Humalog Insulin 10 units SQ
with each meal, & Multivitamin daily.
Vital Signs: BP 164/96,
HR 94, RR 20, POX 93% RA, Temp 97.8
Physical Assessment: Neuro
A& O x3; Lungs clear; Heart Sounds regular, S1,S2, no murmurs appreciated;
Abd soft, nontender, nondistended, bowel sounds +; Extremities PP+, scant pedal
Labs & a urinalysis/culture
are sent & you ask Mrs. Yu to wait for the results.
149, K 6.1, BUN 68, Cr 4.8, Cr Clearance 36; glucose 156
6.2; Hgb 10.9; Hct 32.2; Plt 229
no nitrates; no leukocyte esterase; specific gravity 1.430; bacteria none
the pathophysiology of what you consider the priority diagnosis? Support your
decision for your diagnosis.
are several abnormal lab findings. Explain why they are abnormal.
abnormal lab is the most life threatening & why?
Discussion Board Requirements Students
will discuss assigned topics integrating information from the reading
assignments and class content to be posted. Additionally, students are expected
to comment on materials/comments posted by fellow students. The postings need
to be thoughtful; that is, they refer to the week's readings, in the clinical
setting, or on information obtained from other sources, or ideas expressed in
the postings of other class members. References should be included as needed to
support your position. Your postings must demonstrate that you have reflected
on the assigned readings, and synthesized the material with your previous
knowledge and experience. In order to receive credit, all discussion board
posts including responses to peers must be written or pasted into the text box
rather than submitted as an attachment. This reduces the likelihood of viruses.
The initial post is to be posted by 11:59 pm on Thursday of the assigned week
with responses to two peers due by 11:59 pm on Sunday of that same week. All
discussion posts should be a maximum of 500 words. Aim to present your ideas
concisely yet thoroughly. Blackboard Discussion Forum Evaluation Criteria:
Students are expected to make one initial posting based upon the assigned
discussion question and two peer responses. Your peer responses should be
substantive (that is, more than “I agree.”). It should add knowledge,
respectfully challenge, etc. Please remember that all postings should use
professional language and not contain slang or inappropriate language. See
separate rubric for grading criteria.