DB #3 UTI & Renal Failure
Mrs. Yu: Adult Urinary Tract Infection, Renal Failure
Mrs. Yu is a 39 y/o Korean American female with past medical history of Diabetes Mellitus Type 1 (DMT1), Hypertension (HTN), Chronic Kidney Disease (CKD) & is legally blind. She comes to the clinic today for a follow-up visit. You have not cared for her before, but your colleague who is her Health Care Provider is off, so you have been assigned to follow-up with her.
She was put on levofloxacin (Levaquin) 750 mg PO for a 10 day course. She was instructed to return after completing the antibiotic for a follow-up urinalysis & culture. She had no known drug allergies. Her home medications include: Lisinopril 20 mg PO daily, HCTZ 25 mg PO daily, Lantus 60 units SQ BID, Humalog Insulin 10 units SQ with each meal, & Multivitamin daily.
Vital Signs: BP 164/96, HR 94, RR 20, POX 93% RA, Temp 97.8
Physical Assessment: Neuro A& O x3; Lungs clear; Heart Sounds regular, S1,S2, no murmurs appreciated; Abd soft, nontender, nondistended, bowel sounds +; Extremities PP+, scant pedal edema.
Labs & a urinalysis/culture are sent & you ask Mrs. Yu to wait for the results.
§ NA 149, K 6.1, BUN 68, Cr 4.8, Cr Clearance 36; glucose 156
§ WBC 6.2; Hgb 10.9; Hct 32.2; Plt 229
§ Urinalysis: no nitrates; no leukocyte esterase; specific gravity 1.430; bacteria none
§ Urine Culture: Pending
4-Review the pathophysiology of what you consider the priority diagnosis? Support your decision for your diagnosis.
5. -There are several abnormal lab findings. Explain why they are abnormal.
6. -Which abnormal lab is the most life threatening & why?
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