Manny Castillo and his partner, Andy White, have just moved to Kinzig from the bustling city of Chicago. They were hoping to move out of the busy city to reduce Manny’s stress level because it has taken a toll on his health. Due to uncontrolled hypertension, Manny has been diagnosed with renal insufficiency. Manny is being followed by Dr. Martin, a nephrologist in Kinzig who was recommended by his nephrologist in Chicago. His records were sent to Dr. Martin’s office and Manny has set up his first appointment with Dr. Martin.
Manny went to Dr. Martin’s office and had blood work drawn. Dr. Martin conducted a comprehensive exam and reviewed his health history, medications, and developed a plan of care for Manny. Manny left the office with a new medication regime to treat his renal insufficiency. The medications he will take are 20mg furosemide once a day, 10mg enalapril once a day, and 1 Nephplex vitamin capsule once a day.
· What are the indications for the furosemide, enalapril, & Nephplex vitamin?
· What non-pharmacological treatments could help Manny?
A few days later Manny received the test results and was educated that he needed to be sure to follow his medication regime and watch his diet. A couple of weeks after the visit with Dr. Martin, Manny and Andy received a phone call from the adoption agency notifying them of a possible little girl who they could adopt. This was great news for Manny and Andy because they have been waiting for this phone call for years! They want nothing more than to be parents and now it could be possible. Even though this was going to add stress to Manny’s life, they decide to go through with the paperwork as this was their ultimate dream.
· What could the added stress due to Manny’s health?
· How can Manny decrease his stress level during this intense time?
A few months later Manny started feeling bad and went back to the nephrologist. Dr. Martin ordered more lab tests and a urinalysis. Two days later Manny received a phone call from Dr. Martin’s office regarding his blood work and lab tests and was asked to immediately come to see Dr. Martin. In fear of bad news, Manny called Andy and he met Manny at the Dr.’s office to provide support. Once they arrived at the office, Dr. Martin reviewed the blood work with Manny and Andy.
Manny’s BUN is 50mg/dL, creatinine is 5.6mg/dL, GFR is 14mL/min, K is 6.2 mEq/L, Phosphorus is 5.4mEq/L, Hemoglobin is 8.2mg/dL, Hematocrit is 27.3. His UA revealed protein and glucose in his urine.
· What do you think is happening here?
· What are normal BUN & Creatinine, GFR, K, Mg, Phosphorus, Hemoglobin, and Hematocrit levels?
· Why did he have protein and glucose in his urine?
Dr. Martin instructs Andy to immediately take Manny to the hospital because he will need to be admitted for emergency dialysis. This news worried Manny and Andy’s ability to adapt their little girl. They worried they would not be approved due to Manny’s declining health. An interesting point about the little girl they could possibly adopt is that she too has renal issues and requires special medical care.
Manny was admitted to the hospital and a hemodialysis catheter was placed and dialysis was done. His lab values trended back to normal and he was able to go home but on a dialysis schedule of Monday, Wednesday & Friday. During his hospital stay, he had an AV fistula created in his left lower arm by a very skilled vascular surgeon, Dr. Evans. Manny understands that he still needs to continue having his dialysis using his hemodialysis catheter until his AV fistula matures.
He was also sent home with a different medication regime. His new regime is:
10mg enalapril PO BID
800mg Renvela PO TID with meals
50units/kg Epogen IV 3 times a week (during dialysis)
100mg Iron sucrose IV 3 times a week (during dialysis)
1 Nephplex vitamin PO BID
· What are the therapeutic indications of each of these drugs?
· What are the adverse reactions/side effects of each of these drugs that you would need to teach Manny?
· What dietary restrictions are you going to educate Manny about?
· What will you educate Manny about regarding his new AV fistula?
Manny goes home and reports Monday to an outpatient dialysis clinic for his dialysis session. After 30 minutes on the dialysis machine, Manny complains of severe cramping and pain.
· What can the nurse do for him to alleviate the cramping and pain?
Good news, the adoption was approved and Manny and Andy have their little girl!
As the best, my homework help website in the world, Writersabc.com strives to deliver only high-quality finished papers to all customers. We value impeccable quality and guarantee that we will deliver on that promise more than anything else. We will deliver!
With us you are guaranteed of quality work done by our qualified experts.Your information and everything that you do with us is kept completely confidential.
Have you received your finished paper but are not satisfied with what our writer submitted? You can initiate our money-back guarantee to get your money back with no strings attached.Read more
Writersabc.com is the best my homework help website in the world. At WritersABC, we have a team of certified, tried, and tested writers who work around the clock to ensure that you receive only high-quality, 100% original finished papers.Read more
At WritersABC, we guarantee all our customers of the best essay writing service in the writing industry. And that’s precisely what we strive to deliver. As such, we encourage all our customers to utilize our unlimited free-revision policy if you aren’t satisfied with your paper. Don’t accept any paper until you are 100% satisfied with it.Read more
We value the trust that our clients accord us and respect every customers’ rights to personal data protection. We will never share, sell, or rent any information that we collect from you with any third parties. Both your personal and financial information is safe with us.Read more
We have only gotten this far with the help of our loyal customers and a team of dedicated experts. As the best, my homework help website, WritersABC implores customers to help make our writers’ work easier. Visit our fair-cooperation guarantee for more information on the same.Read more