Let’s return to Kyle Boulard, whom we met in the previous chapter. After two days in the hospital, Mr. After two days in the hospital, Kyle Boulard has recovered from his acute diabetic crisis and his type 1 diabetes is once again under control. The last update on his chart before he is discharged includes the following:
BP 150/95, HR 75, temperature
Urine: pH 6.9, negative for glucose and
Mr. Boulard is prescribed a thiazide diuretic and an angiotensin converting enzyme (ACE) inhibitor. He is counseled on the importance of keeping his diabetes under control, taking his medications regularly, and keeping his outpatient follow-up appointments.
Explain how the thiazide diuretic might have caused this problem.
When asked about his medications, Mr. Boulard admits that he did not fill his ACE inhibitor prescription because it was too expensive. He could only afford the thiazide medications along with his insulin.
Want to see the full answer?
Check out a sample textbook solutionChapter 24 Solutions
EBK ANATOMY & PHYSIOLOGY
- Lisa Smith (LS) is brought to the emergency department [ER] for management of accidental acute poisoning. She is nonresponsive and admitted to the critical care unit [CCU] to be closely monitored. LS has no urinary output, and her laboratory values are serum K+ = 6.7 mEq/L; serum Na+ = 177 mEq/L; arterial blood gases [ABGs]: pH = 7.13, PaCO2 = 35 mmHg, HCO3- = 16 mEq/L, PaO2 = 89 mmHg, and oxygen saturation = 94%. What electrolyte disturbances need to be monitored at this time? What clinical signs & symptoms should the nurse be assessing LP, at this time, for the electrolyte disturbances?arrow_forwardPlease help me with these questions, more than one answer may be correct for each:1) Which of the following statements are true about the renin-angiotensin-aldosterone axis? A) Angiotensin II stimulates production of aldosterone, which increases sodium reabsorption B) Renin converts angiotensinogen to angotensin I C) Angiotensin II stimulates production of vasopressin, which increases aquaporins in the collecting duct D) Vasopressin decreases thirst E) Renin lowers GFR 2) The purpose of excretion is to A) maintain internal pH B) remove harmful substances C) maintain plasma volume D) maintain osmotic balance E) maintain internal solute concentrationarrow_forwardAn 80-year-old woman was admitted with a diagnosis of hypertension, congestive heart failure, anemia, possible diabetes, and chronic renal failure. Her blood workup shows a BUN level of 58 mg/dL and a plasma creatinine of 6.2 mg/dL. What is the most probable cause of the patient’s elevated urea nitrogen?arrow_forward
- In reviewing the patient’s current information, a concern exists that acute kidney injury has developed. Select to highlight the laboratory information that would support this concern.UrinalysisCasts - +++Cola-color to urineProteinuriaBlood ValuesRBC - 3.9 cells/L (4.0-4.9 cells/L)Hgb 10 g/dL (12-16 g/dL)Hct-40% (37%-48%)WBC 11.0 cells/L (4.0-10.0 cells/L)Platelets - 140 cells/L (150-450 cells/L)Sodium - 140 mEq/L (135-145 mEq/L)Potassium - 4.5 mEq/L (3.5-5.2 mEq/L)BUN - 32 mg/dL (5-20 mg/dL)Creatinine 1.8 mg/dL (0.5-1.5 mg/dL)Blood Glucose - 180 mg/dL (nonfasting) (<200 mg/dL)AST-40 Units/mL (5-40 Units/mL)ALT - 30 Units/mL (5-35 Units/mL)Bilirubin (total)- 0.8 mg/dL (<1.0 mg/dL)Albumin - 4.0 (3.5-5.5 g/dL)PT-22 (11.5-14 seconds)arrow_forwardPlease provide detail understanding and hand written solutionarrow_forwardAnswer first question. What disorder is affecting this individual?arrow_forward
- What are the following for each patient? Edward urine composition: _______ blood compostion: _______ Ariana urine composition: ________ blood composition: _______arrow_forwardAdult male suffered myocardial infarction and is currently in cardiogenic shock. Blood pH = 7.25, [HCO3-] = 14 mmol/L, PaCO2 = 38 mmHg. What kind of acid-base imbalance is the patient suffering from? Briefly describe fully how this occurred.arrow_forwardJ.H. is a 12-year-old boy diagnosed several months ago with nephrotic syndrome following postinfectious glomerulonephritis secondary to an episode of pneumococcal pneumonia. He has been coming to the clinic to have his condition monitored and therapies adjusted as needed. At his latest clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized edema are noted. Trace amounts of protein are detected in J.H.’s urine by dipstick. Blood is drawn for laboratory analysis, and the results are as follows:pH = 7.36 PaCO2 = 33 mm Hg PaO2 = 100 mm Hg HCO3 – = 18 mEq/L Hct = 30% Na+ = 130 mEq/L K+ = 5.4 mEq/L BUN = 58 mg/dl creatinine = 3.9 mg/dl albumin = 2.0 g/dl How would a pneumococcal infection lead to glomerulonephritis? How can glomerulonephritis result in nephrotic syndrome? (Explain the pathophysiology of how pneumococcal infection leads to glomerulonephritis. Explain the pathophysiology of how glomerulonephritis results in nephrotic syndrome.)…arrow_forward
- J.H. is a 12-year-old boy diagnosed several months ago with nephrotic syndrome following postinfectious glomerulonephritis secondary to an episode of pneumococcal pneumonia. He has been coming to the clinic to have his condition monitored and therapies adjusted as needed. At his latest clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized edema are noted. Trace amounts of protein are detected in J.H.’s urine by dipstick. Blood is drawn for laboratory analysis, and the results are as follows:pH = 7.36 PaCO2 = 33 mm Hg PaO2 = 100 mm Hg HCO3 – = 18 mEq/L Hct = 30% Na+ = 130 mEq/L K+ = 5.4 mEq/L BUN = 58 mg/dl creatinine = 3.9 mg/dl albumin = 2.0 g/dl What additional physical or laboratory findings would be helpful in determining J.H.’s degree of renal impairment? ( List at least 4 additional physical findings/symptoms or laboratory tests that would be helpful in determining the degree of renal impairment.) 2. What would the treatment…arrow_forwardBased on the following information, what is the fraction of the drug that is excreted unchanged in the urine? CLR = 11.2 L/hr Dose = 1000 mg AUC, = 27.9 mg/L x hr %3Darrow_forwardDiscuss why fluid intake is important for a patient diagnosed with a urinary tract infection.arrow_forward