Urinary and Fluid/Electrolytes/Acid/Base Balance Case Studies | Answered 100% Latest updated 2026/2027. American Sentinel University at Post

Urinary and Fluid/Electrolytes/Acid/Base Balance Case Studies | Answered 100% Latest updated 2026/2027. Part 1 Case 1: A 54-year-old female complains of a “burning” when urinating x 2 days. She shared, “I feel like I have to pee every 60 minutes or so.” She denies suprapubic/back pain and fever. Past medical history: high cholesterol, high blood pressure. Medications: atorvastatin for cholesterol. Allergies: Penicillin (skin rash). Physical examination: temperature 98.8°F; pulse 80 bpm; respirations 14 per minute; blood pressure 114/68 mmHg. Examination unremarkable; no suprapubic or costovertebral angle tenderness. Urine dipstick reveals moderate leukocytes and positive nitrites, with all other values within normal limits. Part 2 – Please complete all of Part 2. A 46-year-old female is asymptomatic and has a routine urinalysis as part of her annual physical. The urinalysis with microscopy report is as follows: Part 3– Please complete only one case from Part 3. Only one case is required. Hematuria (blood in the urine) is common and can be due to benign conditions (e.g., strenuous exercise) or serious disorders (e.g., renal cell carcinoma). Review these cases and determine the most likely cause of hematuria. Discuss data that supports your decision as well as diagnostic and treatment strategies. Case 1: A 50-year-old White male is complaining of right-sided flank pain that started about 3 hours ago. He describes the pain as sharp and intermittent. He notes that his urine is a bit darker, but he denies seeing blood. The pain started after he finished mowing a client’s lawn (he is a landscaper). He denies dysuria, urgency, or fever. Past medical history: gout. Medications: allopurinol 100 mg orally every day. Allergies: no known drug allergies (NKDA). Social history: denies smoking, alcohol use, or drug misuse. Physical examination: temperature 98.7°F; pulse 94 bpm; respirations 18 per minute; blood pressure 140/88 mmHg. General: anxious, holding right side, and moving around; otherwise, examination is unremarkable. Part 4 – Complete all of Part 4. A 15-year-old male complains of a sore throat persisting x 3 days. After 1 day, he developed fatigue, fever, and nausea. Throat culture: presence of group A beta-hemolytic streptococci. The child was then started on antibiotic therapy. Symptoms gradually improved, but 10 days later, he returned with fever, nausea, and malaise. He became SOB and tachypneic. The caregiver noted that his eyes were swollen, his ankles were puffy, and his urine was cloudy and dark. Physical exam: BP was 144/98 mmHg; pulse 118 bpm; and respirations 30 per minute. Orbital/ankle edema were +. Crackles were auscultated bilaterally. Negative for heart murmurs. Slight tenderness to percussion over the flank areas was noted. A chest X-ray indicated congestion bilaterally. Hematocrit 37%,; WBC count 11,200/mm3. Blood urea nitrogen (BUN) 46 mg/dL (normal is 20 mg/dL). Urinalysis results showed that the client’s protein was 2+ (24-hour excretion was 0.8 g), specific gravity was 1.012, and there were moderate amounts of RBCs and WBCs in the urine. Serum albumin was 4.1 g/dL (normal is 3.5–4.5). Fluid/Electrolytes and Acid/Base Balance Part 1– Please complete two cases (of your choosing) from Part 1. Only two cases are required. The following activity includes several case presentations of edema. Make a diagnosis for each case, remembering the following questions: ● What medications are the client taking? ● Is the edema acute/sudden or chronic (e.g., duration, progression)? Is it unilateral or bilateral? ● Is the edema generalized or localized? Is it pitting or nonpitting? Is it dependent? ● In addition to edema, what other characteristics are associated with the edema (e.g., redness, pain)? What is the pertinent past or coexisting medical history? Activity: Identify the probable diagnosis and what data support your decision. ● Describe the pathogenesis for the diagnosis. ● What data is inconsistent with your diagnosis? ● What diagnostic tests would you order, if any, and how would you treat this client? Note: Assume “within normal limits” history/examination if not listed. Case 1: A 47-year-old female complains of intermittent, mild bilateral feet/ankle swelling x 45 days, worse on the L leg, especially after prolonged standing. She denies pain, but states her legs feel “heavy” at times and reports standing for long periods worsens the swelling. For the past 10 months, she has been experiencing intermittent numbness in both feet. She also reports her R knee has been “achy”. She is a server at a restaurant and often works 8-10-hour days. She denies any warmth, trauma, fever, or erythema. Past medical history: obesity (BMI 30); diabetes mellitus type 2. Medications: metformin (diabetes). Case 2: A 67-year-old male complains of R leg swelling x 2 weeks. The swelling began while he was traveling. The swelling is intermittent and below the knee all the way to his foot. He describes a cramp-like pain in his R calf. Recently, both legs have been cramping upon ambulation, and resolves upon rest. He denies trauma, warmth, fever, or erythema. Past medical history: dyslipidemia; iliofemoral deep vein thrombosis (DVT) of his R leg after he had R hip replacement for osteoarthritis 8 months ago; treated with rivaroxaban x 6 months; stable angina; obesity (BMI 31.1). Social history: ceased smoking 6 years ago, resumed 1/4 pack per day x 6 months ago. Medications: metoprolol; simvastatin; aspirin. Physical examination: vital signs within normal limits; L leg is within normal limits except hairless, shiny skin; R leg 1+ pitting edema in the pretibial area/foot; mild pain with R calf compression, one small tortuous vein on the medial aspect of calf; R leg is hairless and shiny. A venous duplex Doppler ultrasound of his left leg was done and is negative. Part 2 – Complete all of Part 2. A 71-year-old female was treated for pneumonia with antibiotics. After 1 week on antibiotics, she started developing severe diarrhea of approximately 6 loose stools/day x 3 days. She has decreased appetite, feels nauseous, and has not been drinking a lot of fluids. She feels very weak and dizzy. She lives alone. She is diagnosed with diarrhea, presumptive Clostridium difficile. Client medical history: Clostridium difficile 1 year prior. Physical examination: temperature 99.0°F; pulse 100 bpm; respirations 24 bpm; and blood pressure 90/50 mmHg (decreased to 72/42 mmHg while sitting). Examination: dry mucous membranes and generalized mild abdominal tenderness upon palpation. Laboratory findings reveal: Chemistry panel: sodium 135 mEq/L; potassium 3.4 mEq/L; chloride 100 mmol/L; HCO3- 12 mEq/L; blood urea nitrogen 40 mg/dL. Creatinine: 1.2 mg/dL. ABG: pH 7.22, PaO2 85 mmHg, PaCO2 20 mmHg, HCO3- 12 mEq/L