Adult UTI and chronic renal failure

Adult UTI and chronic renal failure : Discussion Board #3 Mrs. Yu: Adult Urinary Tract Infection, Acute on Chronic Renal Failure

Mrs. Yu is a 39 y/o Korean American female with past medical history of Diabetes Mellitus Type 1 (DMT1), Hypertension (HTN), Chronic Kidney Disease (CKD) & is legally blind.  She comes to the clinic today for a follow-up visit. You have not cared for her before, but as your colleague who is her Health Care Provider is on maternity leave & are assigned to care her.: Nursing Homework Help

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You review her chart before seeing her.  She was seen in the Health Clinic 12 days ago & treated for a Urinary Tract Infection (UTI).  She was put on levofloxacin (Levaquin) 750 mg PO twice a day for a 10 day course.  She was instructed to return after completing the antibiotic for a follow-up urinalysis & culture. She had no known drug allergies.  Her home medications include: Lisinopril 20 mg PO daily, HCTZ 50 mg PO daily, Lantus 60 units SQ BID, Humalog Insulin 10 units SQ with each meal, & Multivitamin daily.

Assessment today:
Vital Signs:  BP 164/96, HR 94, RR 20, POX 93% RA, Temp 97.8

Physical Assessment: Neuro A& O x3; Lungs clear; Heart Sounds regular, S1,S2, no murmurs appreciated; Abd soft, nontender, nondistended, bowel sounds +; Extremities PP+, + pedal edema.

Labs &  Urinalysis/Culture are sent & you ask Mrs. Yu to wait for the results.
Na 149, K 6.1, BUN 68, Cr 4.8, Cr Clearance 36, Glucose 156
WBC 6.2, Hgb 10.9, Hct 32.2, Plt 229
Urinalysis: No nitrates, no leukocyte esterase; specific gravity 1.430, bacteria none
Urine Culture: Pending
Labs & a urinalysis/culture are sent & you ask Mrs. Yu to wait for the results.

        Respond to the Questions:
One of her priority diagnoses is Acute on Chronic Renal Failure, specifically Acute Tubular Necrosis. Review the pathophysiology of it.
Support your reasons why this occurred. A clue is to be sure to review her medications.
What are other priority diagnoses?
There are several abnormal lab findings.  Explain why they are abnormal.
Which abnormal lab is the most life threatening & why?

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