CASE SCENARIO ACUTE GLOMERULONEPHRITIS: J.B., female 36 years old, single, a bus conductor was apparently well, until 4 days prior to admission, when she experienced dizziness and headache while at work. Once parked at the terminal, she asked to be checked in the clinic and BP was recorded at 180/100 mmHg, which was unusual since she usually had a BP of 90/60 mmHg. Clonidine 75 mcg was placed sublingual, which reduced her BP to 150/90 mmHg. She was then advised by the company nurse to go home. 2 days PTA, a co employee noticed that her eyes were puffy and even kidded if she broke off with her boyfriend. She just shrugged off the comment and did her usual chores. Few hours PTA, while preparing for work, she noticed blood in the toilet bowl after urinating, which prompted her to seek consult and eventually admission. Her history is essentially negative for past kidney or urinary problems. She admitted that her eyes seemed a little puffy, but she thought this was due to lack of sleep and fatigue. She has eaten little the past 2 days, but was not alarmed because she is on a diet. She related though having had a “pretty bad” sore throat a couple of weeks before admission. Since she was busy with work, she self medicated with a few antibiotics she had from a previous bout of Streptococcus throat infection, increased fluid intake and gargled with Bactidol. The sore throat resolved, and she felt well until the dizziness and headache episode. The nurse admitting J.B., upon further assessment, gathered that aside from blood, she likewise noticed brown and foamy urine a day prior. This prompted the attending physician to admit her in the wards and ordered a throat culture, ASO titer, CBC, BUN, serum creatinine, and urinalysis. (more details pls see attached pics thank you)QUESTIONS:1. What are the subjective and objective data from this case scenario?2. How did J.B.’s use of previously prescribed antibiotics to treat her sore throat affect her risk for developing poststreptococcal glomerulonephritis?3. What additional risk factors did J.B. have for developing glomerulonephritis? 4. Why was J.B. placed on a restricted fluid and restricted sodium and protein diet? Why was the antibiotic started after the throat culture? after 4 months. She verbalizes understanding of the relationship between the strep throat,her inappropriate use of antibiotics, and the glomerulonephritis. She says, "I may notalways remember to take every pill on time in the future, but I sure won't save them forthe next time again!" Family History:(+) Hypertension, father and motherCourse in the Ward:On the first hospital day, pertinent physical assessment findings include: T° = 98.8°F(37.1° C) PO, PR=102 bpm, RR=18 cpm, and BP=160/90 mmHg. Weight=160 pounds(75 kg), up from her normal of 155 (70.45 kg). Moderate periorbital edema and edemaof hands and fingers noted. The physician then placed J.B. on bed rest with bathroomprivileges. He ordered fluid restriction (1200 mL/day) and a restricted sodium andprotein diet. Antibiotic was started after the throat swab was done. Other medicationsprescribed were Furosemide 80 mg OD after breakfast and Losartan 50 mg tab OD.Vital signs and I and O were monitored q shift.On the second hospital day laboratory results were released as; Throat culture is notyet available until at least 48 hour but ASO titer was high. CBC essentially normal. BUN42 mg/dL, serum creatinine 2.1 mg/dL. Urinalysis revealed the presence of protein, redblood cells, and RBC casts. A subsequent 24-hour urine protein analysis showed 1025mg of protein (normal 30 to 150 mg/24 hours). Medications continued and nursing careprovided.On the third hospital day, Throat culture result was released which turned out negative.J.B. was released from the hospital after 4 days. She decided to return to her parents'home for the 6 to 12 weeks of convalescence prescribed by her doctor. J.B.'s renalfunction gradually returns to normal with no further azotemia and minimal proteinuria

Question

CASE SCENARIO ACUTE GLOMERULONEPHRITIS: J.B., female 36 years old, single, a bus conductor was apparently well, until 4 days prior to admission, when she experienced dizziness and headache while at work. Once parked at the terminal, she asked to be checked in the clinic and BP was recorded at 180/100 mmHg, which was unusual since she usually had a BP of 90/60 mmHg. Clonidine 75 mcg was placed sublingual, which reduced her BP to 150/90 mmHg. She was then advised by the company nurse to go home. 2 days PTA, a co employee noticed that her eyes were puffy and even kidded if she broke off with her boyfriend. She just shrugged off the comment and did her usual chores. Few hours PTA, while preparing for work, she noticed blood in the toilet bowl after urinating, which prompted her to seek consult and eventually admission. Her history is essentially negative for past kidney or urinary problems. She admitted that her eyes seemed a little puffy, but she thought this was due to lack of sleep and fatigue. She has eaten little the past 2 days, but was not alarmed because she is on a diet. She related though having had a “pretty bad” sore throat a couple of weeks before admission. Since she was busy with work, she self medicated with a few antibiotics she had from a previous bout of Streptococcus throat infection, increased fluid intake and gargled with Bactidol. The sore throat resolved, and she felt well until the dizziness and headache episode. The nurse admitting J.B., upon further assessment, gathered that aside from blood, she likewise noticed brown and foamy urine a day prior. This prompted the attending physician to admit her in the wards and ordered a throat culture, ASO titer, CBC, BUN, serum creatinine, and urinalysis. (more details pls see attached pics thank you)QUESTIONS:1. What are the subjective and objective data from this case scenario?2. How did J.B.’s use of previously prescribed antibiotics to treat her sore throat affect her risk for developing poststreptococcal glomerulonephritis?3. What additional risk factors did J.B. have for developing glomerulonephritis? 4. Why was J.B. placed on a restricted fluid and restricted sodium and protein diet? Why was the antibiotic started after the throat culture? after 4 months. She verbalizes understanding of the relationship between the strep throat,her inappropriate use of antibiotics, and the glomerulonephritis. She says, &#34;I may notalways remember to take every pill on time in the future, but I sure won't save them forthe next time again!&#34; Family History:(+) Hypertension, father and motherCourse in the Ward:On the first hospital day, pertinent physical assessment findings include: T° = 98.8°F(37.1° C) PO, PR=102 bpm, RR=18 cpm, and BP=160/90 mmHg. Weight=160 pounds(75 kg), up from her normal of 155 (70.45 kg). Moderate periorbital edema and edemaof hands and fingers noted. The physician then placed J.B. on bed rest with bathroomprivileges. He ordered fluid restriction (1200 mL/day) and a restricted sodium andprotein diet. Antibiotic was started after the throat swab was done. Other medicationsprescribed were Furosemide 80 mg OD after breakfast and Losartan 50 mg tab OD.Vital signs and I and O were monitored q shift.On the second hospital day laboratory results were released as; Throat culture is notyet available until at least 48 hour but ASO titer was high. CBC essentially normal. BUN42 mg/dL, serum creatinine 2.1 mg/dL. Urinalysis revealed the presence of protein, redblood cells, and RBC casts. A subsequent 24-hour urine protein analysis showed 1025mg of protein (normal 30 to 150 mg/24 hours). Medications continued and nursing careprovided.On the third hospital day, Throat culture result was released which turned out negative.J.B. was released from the hospital after 4 days. She decided to return to her parents'home for the 6 to 12 weeks of convalescence prescribed by her doctor. J.B.'s renalfunction gradually returns to normal with no further azotemia and minimal proteinuria

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