NR 507 Week 5 Discussions Alterations in Renal Function

Discussion Part Two

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1) NR 507 Week 5 Discussions Alterations in Renal Function

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1) NR 507 Week 5 Discussions Alterations in Renal Function

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

A 56-year-old female comes into the clinic complaining of intermittent severe pain that radiates from the flank to the groin and sometimes to the inner thigh. Upon further questioning she tell you that she has an urge to always go to the restroom and that she sometime sweats and feels nauseous. A urinalysis provides traces of blood, a few white blood cells and no bacteria. NR 507 Week 5 Discussions Alterations in Renal Function

• What is your differential diagnosis? Discuss in detail the pathophysiology of each item in your differential and how it might fit in describing this case.

• The x-ray comes back and there is nothing abnormal except a slightly dilated ureter. Does this change your differential or narrow it?

• How would you treat the pain in this case?

Discussion Part Two

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1) NR 507 Week 5 Discussions Alterations in Renal Function

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough.

She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. NR 507 Week 5 Discussions Alterations in Renal Function

Write a differential of at least five (5) possible diagnosis’s and explain how each may be a possible answer to the clinical presentation above.

Remember, to list the differential in the order of most likely to less likely.

Based upon what you have at the top of the differential how would you treat this patient?

Suppose now, the patient has a fever of 100.4 and complains of foul smelling mucous and breath. Indeed, she complains of producing cups of mucous some days. She has some trouble breathing on moderate exertion but this is only a minor complaint to her. How does this change your differential and why? NR 507 Week 5 Discussions Alterations in Renal Function