Question

John, age 19 years, has been diagnosed with chronic renal failure and scheduled for routine hemodialysis. His mucous membranes are dry and cracked. His skin is warm and dry with tenting and blood pressure is elevated. The nurse receives the following results, which are significant from her lab work: Urinalysis = + Protein; + RBCs; +WBCs, nitrates BUN = 35 Creatinine = 3.5 GFR = 65 Na+ = 150 WBC = 12,000

What problems would you expect John to have reported to his physician before this diagnosis? (See Chronic Renal Failure.)

What symptoms and signs has John been experiencing?

How would you explain patient’s lab findings?

How will renal dialysis affect John’s studies at university?

What accommodations should he request?

Answer 1

The Kidney plays a significant role in excretion of waste products from our body such as creatinine, urea, uric acid, maintaining electrolyte concentration etc.

1. Symptoms might been reported by John are nausea and vomiting, itching, inflammation in feet and ankles, breathing issues and not getting adequate sleep, appetite loss, muscle cramps, urine passage trouble and renal infections etc. Showing indications of renal issues at such a early stage indicates suspicion of polycystic kidney disease, glomerulonephritis and other nephrotic syndrome related differential diagnosis.

2. John symptoms were dry skin with cracks, appetite loss, muscle cramps, swelling in feet and ankles etc.

3. Based on the parameters of glomerular filteration rate (GFR) qualifies stage 2 of chronic kidney disease, BUN: creatinine ratio is 10:1 that indicates the symptoms of renal issues, Na+ concentration is high.

4. John should appoint personal nurse care who can help him and guide him how to balance studies along with his medical condition. Another option is that he can take home tutions classes and complete his course of dialysis.