Question

Case-1: Patient History J.H. is a 12-year-old boy diagnosed several months ago with nephrosis 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 Analyze this case study and answer the next four questions that follow. Case-1: Question-2 Use J.H.’s laboratory values to determine if he is still experiencing nephrosis or his condition is progressing to renal failure. (select all that apply) A) J.H is no longer experiencing nephrosis. B) J.H. looks to be developing uremia. The BUN and creatinine are significantly elevated, he has a compensated metabolic acidosis, his K+ is elevated, and his hematocrit is low. These signs are all associated with renal failure. C) J.H is only experiencing nephrosis, there is no evidence of renal failure. D) The low albumin and hyponatremia are indicative of the continuing protein loss of nephrosis.

          Case-1: Patient History
J.H. is a 12-year-old boy diagnosed several months ago with
nephrosis 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
Analyze this case study and answer the next four questions that
follow.
Case-1: Question-2
Use J.H.’s laboratory values to determine if he is still
experiencing nephrosis or his condition is progressing to renal
failure. (select all that apply)
A) J.H is no longer experiencing nephrosis.
B) 
J.H. looks to be developing uremia. The BUN and creatinine are
significantly elevated, he has a compensated metabolic acidosis,
his K+ is elevated, and his hematocrit is low. These signs are all
associated with renal failure.
C) 
J.H is only experiencing nephrosis, there is no evidence of
renal failure.
D)
The low albumin and hyponatremia are indicative of the
continuing protein loss of nephrosis.

Added by Jared J.

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