CASE SCENARIO ACUTE GLOMERULONEPHRITIS: J.B., female 36 years old, single, a bus conductor was apparently well, until 4 days prior to admission, when she experienced dizziness and headache while at work. Once parked at the terminal, she asked to be checked in the clinic and BP was recorded at 180/100 mmHg, which was unusual since she usually had a BP of 90/60 mmHg. Clonidine 75 mcg was placed sublingual, which reduced her BP to 150/90 mmHg. She was then advised by the company nurse to go home. 2 days PTA, a co employee noticed that her eyes were puffy and even kidded if she broke off with her boyfriend. She just shrugged off the comment and did her usual chores. Few hours PTA, while preparing for work, she noticed blood in the toilet bowl after urinating, which prompted her to seek consult and eventually admission. Her history is essentially negative for past kidney or urinary problems. She admitted that her eyes seemed a little puffy, but she thought this was due to lack of sleep and fatigue. She has eaten little the past 2 days, but was not alarmed because she is on a diet. She related though having had a “pretty bad” sore throat a couple of weeks before admission. Since she was busy with work, she self medicated with a few antibiotics she had from a previous bout of Streptococcus throat infection, increased fluid intake and gargled with Bactidol. The sore throat resolved, and she felt well until the dizziness and headache episode. The nurse admitting J.B., upon further assessment, gathered that aside from blood, she likewise noticed brown and foamy urine a day prior. This prompted the attending physician to admit her in the wards and ordered a throat culture, ASO titer, CBC, BUN, serum creatinine, and urinalysis. (more details pls see attached pics thank you) QUESTIONS: 1. Create CHART for patient J.B.  C-HIEF COMPLAINT, H-ISTORY, A-SSESSMENT, R-X/TREATMENT, T-RANSPORT)

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
icon
Related questions
Question
100%

CASE SCENARIO ACUTE GLOMERULONEPHRITIS: J.B., female 36 years old, single, a bus conductor was apparently well, until 4 days prior to admission, when she experienced dizziness and headache while at work. Once parked at the terminal, she asked to be checked in the clinic and BP was recorded at 180/100 mmHg, which was unusual since she usually had a BP of 90/60 mmHg. Clonidine 75 mcg was placed sublingual, which reduced her BP to 150/90 mmHg. She was then advised by the company nurse to go home. 2 days PTA, a co employee noticed that her eyes were puffy and even kidded if she broke off with her boyfriend. She just shrugged off the comment and did her usual chores. Few hours PTA, while preparing for work, she noticed blood in the toilet bowl after urinating, which prompted her to seek consult and eventually admission. Her history is essentially negative for past kidney or urinary problems. She admitted that her eyes seemed a little puffy, but she thought this was due to lack of sleep and fatigue. She has eaten little the past 2 days, but was not alarmed because she is on a diet. She related though having had a “pretty bad” sore throat a couple of weeks before admission. Since she was busy with work, she self medicated with a few antibiotics she had from a previous bout of Streptococcus throat infection, increased fluid intake and gargled with Bactidol. The sore throat resolved, and she felt well until the dizziness and headache episode. The nurse admitting J.B., upon further assessment, gathered that aside from blood, she likewise noticed brown and foamy urine a day prior. This prompted the attending physician to admit her in the wards and ordered a throat culture, ASO titer, CBC, BUN, serum creatinine, and urinalysis. (more details pls see attached pics thank you)

QUESTIONS:

1. Create CHART for patient J.B. 

  • C-HIEF COMPLAINT, H-ISTORY, A-SSESSMENT, R-X/TREATMENT, T-RANSPORT)
Family History:
(+) Hypertension, father and mother
Course in the Ward:
On the first hospital day, pertinent physical assessment findings include: T° = 98.8°F
(37.1° C) PO, PR=102 bpm, RR=18 cpm, and BP=160/90 mmHg. Weight=160 pounds
(75 kg), up from her normal of 155 (70.45 kg). Moderate periorbital edema and edema
of hands and fingers noted. The physician then placed J.B. on bed rest with bathroom
privileges. He ordered fluid restriction (1200 mL/day) and a restricted sodium and
protein diet. Antibiotic was started after the throat swab was done. Other medications
prescribed were Furosemide 80 mg OD after breakfast and Losartan 50 mg tab OD.
Vital signs and I and O were monitored q shift.
On the second hospital day laboratory results were released as; Throat culture is not
yet available until at least 48 hour but ASO titer was high. CBC essentially normal. BUN
42 mg/dL, serum creatinine 2.1 mg/dL. Urinalysis revealed the presence of protein, red
blood cells, and RBC casts. A subsequent 24-hour urine protein analysis showed 1025
mg of protein (normal 30 to 150 mg/24 hours). Medications continued and nursing care
provided.
On the third hospital day, Throat culture result was released which turned out negative.
J.B. was released from the hospital after 4 days. She decided to return to her parents'
home for the 6 to 12 weeks of convalescence prescribed by her doctor. J.B.'s renal
function gradually returns to normal with no further azotemia and minimal proteinuria
Transcribed Image Text:Family History: (+) Hypertension, father and mother Course in the Ward: On the first hospital day, pertinent physical assessment findings include: T° = 98.8°F (37.1° C) PO, PR=102 bpm, RR=18 cpm, and BP=160/90 mmHg. Weight=160 pounds (75 kg), up from her normal of 155 (70.45 kg). Moderate periorbital edema and edema of hands and fingers noted. The physician then placed J.B. on bed rest with bathroom privileges. He ordered fluid restriction (1200 mL/day) and a restricted sodium and protein diet. Antibiotic was started after the throat swab was done. Other medications prescribed were Furosemide 80 mg OD after breakfast and Losartan 50 mg tab OD. Vital signs and I and O were monitored q shift. On the second hospital day laboratory results were released as; Throat culture is not yet available until at least 48 hour but ASO titer was high. CBC essentially normal. BUN 42 mg/dL, serum creatinine 2.1 mg/dL. Urinalysis revealed the presence of protein, red blood cells, and RBC casts. A subsequent 24-hour urine protein analysis showed 1025 mg of protein (normal 30 to 150 mg/24 hours). Medications continued and nursing care provided. On the third hospital day, Throat culture result was released which turned out negative. J.B. was released from the hospital after 4 days. She decided to return to her parents' home for the 6 to 12 weeks of convalescence prescribed by her doctor. J.B.'s renal function gradually returns to normal with no further azotemia and minimal proteinuria
after 4 months. She verbalizes understanding of the relationship between the strep throat,
her inappropriate use of antibiotics, and the glomerulonephritis. She says, "I may not
always remember to take every pill on time in the future, but I sure won't save them for
the next time again!"
Transcribed Image Text:after 4 months. She verbalizes understanding of the relationship between the strep throat, her inappropriate use of antibiotics, and the glomerulonephritis. She says, "I may not always remember to take every pill on time in the future, but I sure won't save them for the next time again!"
Expert Solution
steps

Step by step

Solved in 3 steps

Blurred answer
Similar questions
  • SEE MORE QUESTIONS
Recommended textbooks for you
Phlebotomy Essentials
Phlebotomy Essentials
Nursing
ISBN:
9781451194524
Author:
Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:
JONES+BARTLETT PUBLISHERS, INC.
Gould's Pathophysiology for the Health Profession…
Gould's Pathophysiology for the Health Profession…
Nursing
ISBN:
9780323414425
Author:
Robert J Hubert BS
Publisher:
Saunders
Fundamentals Of Nursing
Fundamentals Of Nursing
Nursing
ISBN:
9781496362179
Author:
Taylor, Carol (carol R.), LYNN, Pamela (pamela Barbara), Bartlett, Jennifer L.
Publisher:
Wolters Kluwer,
Fundamentals of Nursing, 9e
Fundamentals of Nursing, 9e
Nursing
ISBN:
9780323327404
Author:
Patricia A. Potter RN MSN PhD FAAN, Anne Griffin Perry RN EdD FAAN, Patricia Stockert RN BSN MS PhD, Amy Hall RN BSN MS PhD CNE
Publisher:
Elsevier Science
Study Guide for Gould's Pathophysiology for the H…
Study Guide for Gould's Pathophysiology for the H…
Nursing
ISBN:
9780323414142
Author:
Hubert BS, Robert J; VanMeter PhD, Karin C.
Publisher:
Saunders
Issues and Ethics in the Helping Professions (Min…
Issues and Ethics in the Helping Professions (Min…
Nursing
ISBN:
9781337406291
Author:
Gerald Corey, Marianne Schneider Corey, Cindy Corey
Publisher:
Cengage Learning