Question

Case Study, Chapter 25, Disorders of Renal Function

The client comes to the emergency department reporting severe flank pain radiating to the abdomen and scrotum. The client is diaphoretic and complaining of intense nausea. The initial diagnosis is kidney stones. (Learning Objectives: 10–13)

The client wants to know why the doctor thinks it is a kidney stone rather than a urinary tract infection (UTI). What manifestations are typically associated with a UTI?

What are the manifestations associated with a kidney stone?

What diagnostic testing would be helpful in confirming the diagnosis?

The nurse instructs the client to strain all of his urine. The client responds, “Why do I need to strain it? Don’t you think I will know when I pass it?” How should the nurse respond?

What is a possible complication associated with kidney stones?

What are the different types of stones and what are possible causes of each?

What are some treatment options at this point?

Case Study, Chapter 33, Diabetes Mellitus and the Metabolic Syndrome

Twelve-year-old S is brought to the emergency department by his parents after they found him unresponsive in his room. They are furious that he is “obviously intoxicated because of the way he smells.” (Learning Objectives: 3 and 10)

How will the nurse approach the parents?

What does the nurse suspect and why?

What are other manifestations associated with this diagnosis?

What diagnostic findings would support this diagnosis?

What is the pathophysiology associated with this diagnosis?

S’s parents report that he has never been diagnosed with diabetes, but they have noticed him acting a little different lately. What manifestations are typically associated with diabetes?

Differentiate between the different types of diabetes.

S is diagnosed with diabetes type 1 and is started on insulin. What are some possible complications associated with poorly controlled diabetes of any type?

Answer 1

Answer: The manifestations associated with a UTI are:

• Burning sensation while urination
• Blood in the urine
• Smell in the urine.
• Dark coloured urine.

The symptoms of Kidney stone are:

• Pain
• Nausea
• Vomiting
• Fever.

Diagnosis test for kidney stone:

• Ultrasound scan.
• CT scan
• Pain usually occurs when the stone moves to the ureter.

Nurse should teach the patient regarding the straining of urine as due to stone, some of the fluids gets accumulated in the kidney. Hence it is necessary to emptying the urinary bladder regularly.