HPI: John Jenkins is a 45 yr old male who presents to the cl

HPI: John Jenkins is a 45 yr old male who presents to the clinic… HPI:John Jenkins is a 45 yr old male who presents to the clinic with his grandmother Jana Jenkins. She is an 89 yr old female who is concerned about her kidneys.  She states she was recently hospitalized due to acute kidney injury (AKI) that was felt to be related to use of trimethoprim/sulfamethoxazole for a urinary tract infection. The medication was stopped, she was given IV fluids, and she recollects that her kidney function improved but she is not sure how much. She states that she is worried about her kidneys now because she has never had problems with them before and she REALLY does NOT want to have to do dialysis.  She states that she is hoping you can help her keep her kidneys healthy.Past Medical HistoryHTNGERDDMIIAKIPast Surgical HistoryHysterectomy at age 35 Current MedicationsLisinopril 20 mg dailyFamotidine 20 mg dailyMetformin 500 mg BIDAllergiesNKDAROSConstitutional: – fevers, chillsHEENT: No changes in vision, no ear drainage, no sore throat.Cardiovascular: No chest pain, palpitations. No edema.Respiratory: No shortness of breath or cough.GI: No n/v/abd pain.GU: No dysuria, difficulty voiding. No hematuria.Integumentary: No rashes, wounds.Neuro: – HA, dizziness.  MS: No red or swollen joints.Endocrine: No polyuria, polydipsia, polyphagia.O:Physical ExamVS: T 97.9 P 68 R 16 BP 130/70 O2 sat 98% RAGeneral: Healthy appearing 89 yo woman, appears younger than her stated age. Reliable historian.HEENT: Nose without drainage. Mouth with moist mucous membranes. Normal dentition. Posterior oropharynx pink and moist.Cardiovascular: S1S2 normal.  No murmurs, rubs, or gallops.Respiratory: Lungs clear to auscultation. Respirations even and unlabored.Skin: No rashes on exposed skin.Neuro: No focal deficits.MS: No red or swollen joints. Enlarged DIP and PIP joints bilaterally.Extremities: No edema, DP 2+ bilaterally.Labs/Diagnostics 01/2022Creatinine 1.2Baseline 0.9 – 1.0eGFR 48K+ 4.2At this time, Jana does not meet criteria for CKD as her decreased GFR has not been present for over 3 months consistently.  Would you stop her lisinopril and metformin at this time? Why or Why not?Health Science Science Nursing NSG 2871

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