Question

Case Study 10 Name Class/Group Date Group Members INSTRUCTIONS: All questions apply to this case study. Your responses should be brief and to the point. Adequate space has been provided for answers. When asked to provide several answers, they should be listed in order of priority or significance. Do not asume information that is not provided. Please print or write clearly. If your response is not legible, it will be marked as ? and you will need to rewrite it. Scenario F.F, a 58-year-old man with type 2 DM (non-insulin-dependent diabetes mellitus), presents at the ED with severe R flank and abdominal pain, and N/V. The abdomen is soft and without tenderness. The right flank is extremely tender to touch and palpation. VS are 142/80, 88, 20, 99.0" F; urinalysis shows hematuria; an IV of 9 NS is started and is to infuse at 125 mLh. An IVP (intravenous pyelogram) confirms the diagnosis of a staghom-type stone in the R renal pelvis. The R kidney looks enlarged. F.F. states that he did not sleep well last night and has not eaten much today. He is obviously very fatigued. His laboratory results are as follows: Na 144 mmol/L. K 4.0 mmol/L, CI 101 mmolL, CO, 26 mmo/L, BUN 30 mg/dl, creatinino 3.6 mg/dL, glucose 260 mg/dL, uric acid 5.0 mg/dL, Ca 9.0 mg/dL, phos 2.6 mg/dL, total protein 7.8 g/dL, albumin 4.0 g/dL, total bilirubin 0.3 mg/dl, direct bilirubin 0.1 mg/dL, chol 200 mg/dL, alk phos 61 U/L, LDH total 100 U/L, AST (SGOT) 13 U/L, ALT (SGPT) 13 U/L, GGTP 40 U/L, amylase 98 U/L. 1. F.F's pain is treated with IV morphine. It is late afternoon before he is admitted to your unit, and he is scheduled for lithotripsy in the morning. What specific priorities do you identity for F.F? 2. The physician has prescribed gentamicin 80 mg IVPB q8h. You question the physician about giving this largo of a dose of gentamicin to F.F. You are met with angry and belittling statements. Articulate why you should question this specific order for F.F.

Answer 1

1. Specifi friorities . Avadance of carbonated beverages before procede Not fer and f ECG Candiae clearance 1 Stop taking medicines like asperin, or NSAID. 2 As gertanyain is rephrotopic so in patient with kidney stone there is more risk of causing disease 3. You should ask the physicion of gentanglie is safe to use in the patient 4. There will be signe front drop in Glomeruler filterton - Scanned with CamScanncate'