J.B, female 36 years old, single, a bus conductor was appare
J.B, female 36 years old, single, a bus conductor was apparently… 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 notice 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.Personal HistoryNon-smoke and non-alcoholic drinkerFamily 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 edema of hands and fingers noted. The physician then placed J.B. on bed rest with bathroom privileges. He ordered fluid restriction (1200 mL/day) and a restricted sodium and protein diet. Antibiotic was started after the throat swab was done. Other medications prescribed 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 not yet available until at least 48 hour but ASO titer was high. CBC essentially normal. BUN 42 mg/dL, serum creatinine 2.1 mg/dL. Urinalysis revealed the presence of protein, red blood cells, and RBC casts, A subsequent 24-hour urine protein analysis showed 1025 mg of protein (normal 30 to 150 mg/24 hours). Medications continued and nursing care provided. On the third hospital day, Throat culture result was released which turned out negative. J.B. was release 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 renal function gradually returns to normal with no further azotemia and minimal proteinuria 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 not always remember to take every pill on time in the future, but I sure won’t save them for the next time again!” TASKS:1. Name the nursing diagnoses for J.B. and expected outcomes. (10 points)2. Formulate a NCP for J.B. based on your diagnoses. (10 points)3. Give rationale for each nursing intervention you intend to do. (10 points)4. Formulate a plan of action. (10 points)5. Name of complications of AGN? (10 points)Health Science Science Nursing NCMA 219
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