Case Study An 80-year old woman was admitted with a diagnosis of hypertension, congestive heart failure, anemia, possible diabetes, and chronic renal failure. She was treated with diuretics, and IV fluids and released 4 days later. Her laboratory results are below: Five months later, she was readmitted for treatment of repeated bouts of dyspnea. She was placed on a special diet and medication to control her hypertension and was discharged. Medical staff believed that she had not been taking her medication as prescribed, and she was counseled regarding the importance of regular doses. First Admission Second Admission 2/11 2/15 7/26 7/26 Urea N(mg/dL) 58 * * 61 Creatinine(mg/dL) 6.2 6.2 6.4 6.0 Uric acid (mg/dL) 10.0 * * 9.2 Urea N/creatinine 9.4 * * 10.1 Glucose (mg/dL) 86 80 113 a * test not performed 1. What was the most probable cause of the patient's elevated urea nitrogen? Which data supports your conclusion? 2. Know that this patient's admitting diagnosis is "possible diabetes." If the patient had truly been diabetic with an elevated blood glucose and a positive acetone, what effect would this have had on the measured values of creatinine? Explain.
Case Study
An 80-year old woman was admitted with a diagnosis of hypertension, congestive heart failure, anemia, possible diabetes, and chronic renal failure. She was treated with diuretics, and IV fluids and released 4 days later. Her laboratory results are below:
Five months later, she was readmitted for treatment of repeated bouts of dyspnea. She was placed on a special diet and medication to control her hypertension and was discharged. Medical staff believed that she had not been taking her medication as prescribed, and she was counseled regarding the importance of regular doses.
First Admission Second Admission
2/11 2/15 7/26 7/26
Urea N(mg/dL) 58 * * 61
Creatinine(mg/dL) 6.2 6.2 6.4 6.0
Uric acid (mg/dL) 10.0 * * 9.2
Urea N/creatinine 9.4 * * 10.1
Glucose (mg/dL) 86 80 113 a
* test not performed
1. What was the most probable cause of the patient's elevated urea nitrogen? Which data supports your conclusion?
2. Know that this patient's admitting diagnosis is "possible diabetes." If the patient had truly been diabetic with an elevated blood glucose and a positive acetone, what effect would this have had on the measured values of creatinine? Explain.
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