Mr. RX is a 40 year-old male who has a longstanding history of hypertension and diabetes and presents with a complaint of pruritis, lethargy, lower extremity edema, nausea and emesis. Mr. RX denies any other medical illnesses.

Question Mr. RX is a 40 year-old male who has a longstanding history of hypertension and diabetes and presents with a complaint of pruritis, lethargy, lower extremity edema, nausea and emesis. Mr. RX denies any other medical illnesses.On physical exam the patient is a well-developed, well-nourished male in moderate distress. Blood pressure 180/110, pulse 80, respirations 24 and he was afebrile. Body weight 76.5 kg. Cardiac exam had an S1, S2 and S4. The remainder of the exam was remarkable for 2+ lower extremity edema and superficial excoriations of his skin from scratching.Laboratory DataChemistry   UrinalysisSodium 133mmol/L pH 6.0Specific gravity 1.010Protein 1+Glucose negativeAcetone negativeOccult blood negativeBile negativeWaxy casts         Potassium 6.2 mmol/L Chloride 100 mmol/L Total CO2  15 mmol/L BUN 170 mg/dl Creatinine 16.0 mg/dl   Glucose 108 mg/dl Calcium 7.2 mg/dl Phosphorus 10.5 mg/dl Alkaline Phosphatase 306 IU/LParathyroid Hormone 895 pg/mlHemoglobin 8.6 gm/dlHematocrit 27.4%Mean cell volume 88FL24-hour urine protein and creatinine – volume 850 ml, protein 600 mg/dl and creatinine 180 mg/dlRenal ultrasound- Right kidney 9 x 6.0 cm, Left kidney 9.2 x 5.8 cmBoth kidneys illustrate hyperechogenicity and no hydronephrosis. POINTS TO PONDER:Which lab values are abnormal?What clinical manifestations correspond to the abnormal values?Describe the changes (pathophysiology) in the body causing each abnormal value and link the value to a clinical manifestation present in the patient?Which values are within normal limits?Give 3 nursing diagnosis Health Science Science Nursing Share QuestionEmailCopy link Comments (0)