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-4
How will J.H.âs therapy change if his condition has progressed from nephrosis to uremia? (select all that apply)
A) Restrictions on salt and potassium intake may be instituted.
B) Diuretics will be used as long as the kidney responds to them in order to reduce fluid volume excess.
C) In nephrosis, the patient is encouraged to consume a high-protein diet. In uremia a low-protein diet is recommended and precautions to avoid fluid volume overload are needed as urine output falls.
D) In uremia, the patient is encouraged to consume a high-protein diet. In nephrosis a low-protein diet is recommended and precautions to avoid fluid volume overload are needed as urine output falls.
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-4
How will J.H.âs therapy change if his condition has progressed from nephrosis to uremia? (select all that apply)
| A) | Restrictions on salt and potassium intake may be instituted. |
| B) | Diuretics will be used as long as the kidney responds to them in order to reduce fluid volume excess. |
| C) | In nephrosis, the patient is encouraged to consume a high-protein diet. In uremia a low-protein diet is recommended and precautions to avoid fluid volume overload are needed as urine output falls. |
| D) | In uremia, the patient is encouraged to consume a high-protein diet. In nephrosis a low-protein diet is recommended and precautions to avoid fluid volume overload are needed as urine output falls. |
