J.H. is a 12-year-old boy diagnosed several months ago with nephrotic syndrome 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.’s 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 – = 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 What additional physical or laboratory findings would be helpful in determining J.H.’s degree of renal impairment? ( List at least 4 additional physical findings/symptoms or laboratory tests that would be helpful in determining the degree of renal impairment.) 2. What would the treatment regimen include if J.H. has progressed to renal failure? (List 5 interventions for managing renal failure.)

J.H. is a 12-year-old boy diagnosed several months ago with nephrotic syndrome 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.’s 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 – = 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 What additional physical or laboratory findings would be helpful in determining J.H.’s degree of renal impairment? ( List at least 4 additional physical findings/symptoms or laboratory tests that would be helpful in determining the degree of renal impairment.) 2. What would the treatment regimen include if J.H. has progressed to renal failure? (List 5 interventions for managing renal failure.)