Alistair Adams 213091062
Diagnostics
BEMC 2 Case Study:
Acid/Base disturbance
Mr B de Waal
Abstract The following case shows a good example of an acid-base disorder and also an acute renal failure due to a UTI. This case shows how these two disorders co-exist and compound each other’s affect as they are connected in terms of function. This is not the first report of this kind in literature. The patient is a 67 year old female with Known poorly managed type 2 diabetes. She also has chronic hypertension and is on chronic medication. The patient also has recurrent urinary tract infections. This case should provide a better understanding of how these conditions coexist and what their effects are as well as how management of these conditions should be approached which will help advance our knowledge in the pre-hospital setting. It may provide important information on how these conditions overlap and interlink with each other. It may also provide important information on the endocrine system which will help in that specific field of medicine.
Introduction A change in homeostatic conditions will result in a long term and short term compensatory response to try and return conditions
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Fluid replacement should also be commenced if the patient is dehydrated. Insulin should be given which will help regulate blood glucose levels. Fluid therapy in this patient is important and should be carefully monitored. Dextrose should also be administered because the insulin correction will result in tissues using more glucose which will drop the glucose levels in the blood stream again. Treatment of the acute renal failure may be corrected by correcting the UTI in the patient which may resolve the acute renal failure. Antibiotic therapy is used to do this which may resolve the possible pyelonephritis in the patient as well which will help with the renal
For PYC-652 Advanced Health Assessment, my clinical site will be the Richard A. Roudebush Veterans Affairs Medical Center. This site is located in Indianapolis, Indiana. I will be working with a nurse practitioner who works in one of the primary care clinics located at the hospital. According to my preceptor, the four most common diagnoses she encounters is type II diabetes mellitus, hypertension, hyperlipidemia, and chronic kidney disease.
I.V. fluids such as normal saline are utilized to increase volume and aid in the prevention of acute kidney injury. These I.V. fluids are initiated as soon as possible and are continued until the creatinine kinase level drops below 1,000 U/L. Diuretics such as Lasix are sometimes administered to promote the excretion of fluid. Bed rest is typically ordered for patients with rhabdomyolysis. In some cases, if compartment pressure exceeds 25 mm Hg, a fasciotomy and debridement may be
It was noted that the claimant presented to the ER with complaints of a headache and fever. Urinalysis showed urine pH of 8.0 with squamous epithelial cells of 31-50/LPF. She had elevated glucose at 126 with low levels of BUN at 6, potassium at 3.3, sodium at 135, and chloride at 95. She was diagnosed with a viral syndrome. Zofran and a follow-up visit were recommended.
The patient is a 42-year-old female who comes to the emergency room with a diagnosis of recurrent seizures. The patient is noted to have a long-standing history of pseudo seizures. She is followed by a psychiatrist and neurologist as outpatient. She presented the day of presentation having had 2 seizures at home and seizure in the emergency room. During the seizures she did not lose any consciousness or had no incontinence.
Patient/Family Medication Teaching Plan Today a 19-year-old patient named Matt presented to the ER with lethargy, excessive thirst, recent unexpected weight loss, fever, and complaints of frequent urination. Upon arrival the patient’s vitals were taken and documented as temperature 101.6, heart rate 99, respiratory 22, blood pressure 119/76 and blood oxygen levels were at 99%. Matt is a healthy young male who is an active athlete on his schools cross-country team. Being a college student he eats the typical college diet of premade food and claims he has a handful of beers each week. After assessing and observing the patient it is documented that the patient is diagnosed with type 1 diabetes and urinary tract infection.
N presents with include urinary frequency from a source of infection and a decrease in fluid intake is what’s causing Ms. N to feel confused. Urinary infection is another atypical presentation in elderly patient’s that may lead to urinary incontinence, acute confusion, causing Ms. N to experience increased risk for falling. Classic signs and symptoms in elderly patients that will cause them to have cognitive changes and include a loss of appetite. Moreover, Ms. N had normal lab values for SMA-24 and CBC, which suggested no infection and the fact that she was afebrile. Additional atypical symptoms that Ms. N has in this case study is sepsis without the abnormal leukocytosis, fever and a change in functional status (Flaherty & Zwicker,
I found the Q-tip test to be very cost efficient and quick to diagnose the patient. I agree with the plan. Based on the symptoms and the Q-tip test, stress incontinence is the most likely diagnosis. I personally would have had the patient leave a urine sample for UA and C&S to rule out the differential diagnosis of
Mrs. McGoldrick is an 81-year-old patient with chronic diseases - like diabetes and repeated heart attacks - and was admitted to the hospital for a urinary tract infection. She was also cited to have indications of
Module 9 Case Study Acute Renal Injury and Chronic Kidney Disease Will is a 68-year-old male with a history of hypertension. Eight months ago, he started regular dialysis therapy for ESRD. Before that, his physician was closely monitoring his condition because he had polyuria and nocturia. Soon it became difficult to manage his hypertension. He also lost his appetite, became weak, easily fatigued, and had edema around his ankles.
Frequent Urination is a result of excess sugar in the blood for it’s the body’s second attempt to getting rid of it. As more frequent urination occurs, dehydration, weight loss, increased hunger, and tiredness coincide for the body is getting rid of an excess amount of nutrients and calories that the body needs (1). 2. Type 1 diabetes is an incurable disease, however medications are prescribed to alleviate symptoms and give the body the assistance it needs to help break down glucose. After being diagnosed with Type 1 diabetes my endocrinologist decided it was best to use a pump and recommended Minimed Paradigm 722 which allows you to adjust your insulin intake throughout the day.
She is on Lantus insulin 45 units every evening and Novolog sliding scale insulin with meals. She presents to the clinic today for a well woman exam with complaints of vaginal itching and burning. Subjective Data History of Present Illness Vaginal itching and burning has been on and off x1 month with accompanying dysuria. She used a “generic Monistat” two weeks ago but did not have any relief, so went back and bought the name brand Monistat 1 this past Sunday.
The base of this test is that, insulin decreases the blood sugar levels in the body and this acts as a stimulant for the gland to release GH. Samples are collected every 2 hours to see if the GH is increased. In the GH deficiency the GH levels do not rise. What are some of the treatments used for conditions caused by GH excess or GH
As a result, most clinical trials of oral treatment utilize the tromethamine salt.[45,46] Despite the fact that reviews using fosfomycin calcium for treatment of systemic diseases were embraced in the 1970s,.[47] from that point forward the i.v. definition (fosfomycin disodium) has been utilized solely to treat contaminations other than UTIs.[48] Next to no clinical information is at present accessible to bolster the utilization of fosfomycin for nonUTI diseases. For fosfomycin disodium, average every day measurements in patients with typical renal capacity go from 12 to 16 g directed 6-, 8-or 12-hourly i.v. as a bolus or 30 – hour long infusion.[49] Nonetheless, day by day dosages as low as 1 g and as high as 24 g have been reported,[50] As have longer mixture times (of 4 h89). Fluctuation in the measurements controlled is in all probability because of the absence of data with respect to proper PK/PD focuses for maximal bacterial impact.
The body functions on the control of endocrine system. The hormones seriated is travelled to all parts of the body. It maintains the tissues and organs. The endocrine system is governed by the areas as follows:- 1. Reproduction 2.
The endocrine system is such an important system to the body because it functions the bodies use of hormones. The body uses many different hormones and the endocrine system regulates these. When the glands of the endocrine system secrete the hormones, the hormones are put into the bloodstream to be sent to the different parts of the body. The glands that comprise the endocrine system are the hypothalamus, the pituitary gland, and the pineal gland which are all located in the brain, the thyroid, parathyroid, and thymus which are located in the throat, the adrenals and pancreas which are located in the body’s midsection, and the ovaries (female) and testes (male) which are located in the pelvic region. The system is so important because it regulates the body’s metabolism, growth and sexual development, digestion, heart rate, and many of the other body functions regulated by hormones.