NRNP 6550: Advanced Care of Adults in Acute Settings II i- Human: Ken Fowler V5(Week 7) 2021/2022

1) How can I help you today? "I went to see my doctor this morning because I have been feeling bad for the past few days. I'm tired, with nausea & vomiting. Well, he examined me and ordered some labs, and then told me that "kidneys are failing," something about a big change in my creatinine and that I needed to come to the emergency department. He told me to bring the test results here with me. [Test results today: creatinine 3.2 mg/dL; 1 month ago Test results 1.1 mg/dL; urine protein = 400 mg microalbuminuria] Do you understand what all that means? I sure don't!" 2) Do you have any other symptoms or concerns we should discuss? I also feel exhausted, probably from all the vomiting and not eating. 3) When did your nausea start? It started three days ago, I woke up feeling nauseous and started throwing up everything I ate. 4) What are the events surrounding this start of your nausea and vomiting? Nothing really happened that I can think of. 5) Do you have difficulty breathing? Uh… no. 6) When do you fatigue start? Just the last few days. 7) Do you have a problem with fatigue/tiredness? Yup 8) Does your fatigue come and go? No. 9) Have you gained or lost weight or intentionally, despite normal appetite and exercise? Uh… no. 10) Have you gained weight? No. 11) Has there been a change in your urination frequency? Actually, I have been peening less recently. 12) What is the color of urine, has it changed recently? It's usually fine, but I have been peeing less recently 13) Does anything make your fatigue/tiredness better or worse? No. 14) Do you have pain anywhere? If so where? I hurt my back last week, but that's fine now. 15) Have you noticed swelling in any part of your body? No ..................................................................................................CONTINUE