Marquette University NURS 6202/ NURS6202: CKD NGN Case Study 2.0 (Answered 1005 latest 2025/26).

Case Study – CKD
Case Study Question 1 of 6

Admission Note
35-year-old female was diagnosed with chronic glomerulonephritis five years ago. Chronic kidney
disease progressed to end stage renal disease (ESRD) over last year. Client was started on automated
peritoneal dialysis six months ago. She developed fever, vomiting, and abdominal pain 1 day ago.
Current assessment: T 39.1 °C, (102.40 F), HR 104, RR 16, B/P 146/88 mmHg. Weight: 66.8 Kg/147 lbs.
NKDA. Periumbilical tenderness, defense and rebound. Erythema and creamy, yellow exudate around
peritoneal dialysis catheter exit site. Dialysate effluent is cloudy yellow. Peritoneal effluent culture
was obtained. Labs sent.


Laboratory Report
Lab Results Reference range
BUN 76 mg/dL 10-20 mg/dL
Creatinine (Serum) 6.7 mg/dL 0.6 to 1.3 mg/dL
C-reactive protein 61.5 mg/L. < 1.0 mg/dL
Albumin 3.7 g/L 3.4 to 5.4 g/dL
Potassium (serum) 5.86 mEq/L 3.5 to 5 mEq/L
Sodium (serum) 144 mEq/L 136 to 145 mEq/L
Calcium 7.9 mg/dL 9.0 to 10.5 mg/dL
Phosphorous 5.4 mg/dL 3.0 to 4.5 mg/dL
Hemoglobin 10.6 g/dL Females:12-16 g/dL
Hematocrit 31% Females: 37-47%
Serum WBC 14.22 × 103 / μL 4.5 – 10.5 × 103 / μL
Serum Neutrophils 89.8% 55-70%
Dialysate WBC 483 cells/μL Few
Dialysate polymorphonuclear cells 63% Few


➢ Which 5 findings are the most concerning?
 Temperature
 Heart rate
 Respiratory rate
 Blood pressure
 Periumbilical tenderness
 Peritoneal dialysis catheter exit site
 BUN
 Creatinine
 Serum WBC
 Dialysate WBC




Case Study Question 2 of 6

Admission Note
35-year-old female was diagnosed with chronic glomerulonephritis five years ago. Chronic kidney
disease progressed to end stage renal disease (ESRD) over last year. Client was started on automated
peritoneal dialysis six months ago. She developed fever, vomiting, and abdominal pain 1 day ago.
Current assessment: T 39.1 °C, (102.40 F), HR 104, RR 16, B/P 146/88 mmHg. Weight: 66.8 Kg/147 lbs.

, NKDA. Periumbilical tenderness, defense and rebound. Erythema and creamy, yellow exudate around
peritoneal dialysis catheter exit site. Dialysate effluent is cloudy yellow. Peritoneal effluent culture
was obtained. Labs sent.
Laboratory Report
Lab Results Reference range
BUN 76 mg/dL 10-20 mg/dL
Creatinine (Serum) 6.7 mg/dL 0.6 to 1.3 mg/dL
C-reactive protein 61.5 mg/L. < 1.0 mg/dL
Albumin 3.7 g/L 3.4 to 5.4 g/dL
Potassium (serum) 5.86 mEq/L 3.5 to 5 mEq/L
Sodium (serum) 144 mEq/L 136 to 145 mEq/L
Calcium 7.9 mg/dL 9.0 to 10.5 mg/dL
Phosphorous 5.4 mg/dL 3.0 to 4.5 mg/dL
Hemoglobin 10.6 g/dL Females:12-16 g/dL
Hematocrit 31% Females: 37-47%
Serum WBC 14.22 × 103 / μL 4.5 – 10.5 x × 103 / μL
Serum Neutrophils 89.8% 55-70%
Dialysate WBC 483 cells/μL Few
Dialysate polymorphonuclear cells 63% Few


➢ For each client finding, click to specify if the finding supports the diagnosis of peritonitis or end stage renal
disease (ESRD). Each finding may support more than one condition. Each column must have at least 1 option
selected.


Findings Peritonitis End Stage Renal Disease (ESRD)
BUN 76 mg/dL  
Creatinine 6.7 mg/dL  
C-reactive protein 61.5 mg/L.  
Potassium (serum) 5.86 mEq/L  
Phosphorous 5.4 mg/dL  
Hemoglobin 10.6 g/dL  
WBC 14.22 × 103 / μL  
Neutrophils 89%  


Case Study Question 3 of 6

The client is diagnosed with peritonitis.

➢ Drag (select) the most appropriate word(s) from the choices to fill in the blank of the following sentence.


The client is at highest risk for developing



Word Choices:

Abdominal abscess
Cellulitis
Pyelonephritis
Sepsis