Case-1: Patient History
J.H. is a 12-year-old boy diagnosed several months ago with nephrosis following postinfectious glomerulonephritis secondary to an episode of pneumococcal pneumonia. He has been coming to the clinic to have his condition monitored and therapies adjusted as needed. At his latest clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized edema are noted. Trace amounts of protein are detected in J.H.âs urine by dipstick. Blood is drawn for laboratory analysis, and the results are as follows:
pH = 7.36
PaCO2 = 33 mm Hg
PaO2 = 100 mm Hg
HCO3 â = 18 mEq/L
Hct = 30%
Na+ = 130 mEq/L
K+ = 5.4 mEq/L
BUN = 58 mg/dl
creatinine = 3.9 mg/dl
albumin = 2.0 g/dl
Analyze this case study and answer the next four questions that follow.
Case-1: Question-3
What additional physical or laboratory findings would be helpful in determining J.H.âs degree of renal impairment? (select all that apply)
A) Physical findings would include dehydration and hypotension.
B) Urinalysis is performed to determine the actual amount of protein loss, and RBC count with indices to assess for anemia.
C) Physical findings would include edema, pruritus, and hypertension.
D) Because he has renal disease, obtaining a creatinine clearance with a urine collection to most accurately determine glomerular filtration rate would be helpful.
Case-1: Patient History
J.H. is a 12-year-old boy diagnosed several months ago with nephrosis following postinfectious glomerulonephritis secondary to an episode of pneumococcal pneumonia. He has been coming to the clinic to have his condition monitored and therapies adjusted as needed. At his latest clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized edema are noted. Trace amounts of protein are detected in J.H.âs urine by dipstick. Blood is drawn for laboratory analysis, and the results are as follows:
pH = 7.36
PaCO2 = 33 mm Hg
PaO2 = 100 mm Hg
HCO3 â = 18 mEq/L
Hct = 30%
Na+ = 130 mEq/L
K+ = 5.4 mEq/L
BUN = 58 mg/dl
creatinine = 3.9 mg/dl
albumin = 2.0 g/dl
Analyze this case study and answer the next four questions that follow.
Case-1: Question-3
What additional physical or laboratory findings would be helpful in determining J.H.âs degree of renal impairment? (select all that apply)
| A) | Physical findings would include dehydration and hypotension. |
| B) | Urinalysis is performed to determine the actual amount of protein loss, and RBC count with indices to assess for anemia. |
| C) | Physical findings would include edema, pruritus, and hypertension. |
| D) | Because he has renal disease, obtaining a creatinine clearance with a urine collection to most accurately determine glomerular filtration rate would be helpful. |
