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NUR 502 Week 4 Discussion: Urinary and Reproduction Function

Sample Answer for NUR 502 Week 4 Discussion: Urinary and Reproduction Function
Week 4 Discussion: Urinary and Reproduction Function 
Urinary Function 
The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented name the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.  
Mr. J.R.’s symptoms seem to have developed acute kidney injury (AKI) based on his clinical presentation. One of the possible types often linked to gastrointestinal symptoms of vomiting and diarrhea is pre-renal AKI. According to Pickkers et al. (2021), this condition is characterized by reduced blood flow to the kidneys, affecting their optimum function. Due to the toxin or infection of the renal parenchyma, the fever, nausea, and diarrhea exhibited by the patient indicate the intrinsic type of AKI. His weakness and dizziness while standing may be accurate manifestations of post-renal AKI stemming from factors like obstructive urinary tract problems. 
Create a list of risk factors the patient might have and explain why.  
Mr. J.R. faces multiple health risks. Advanced age is a major risk factor, as older adults frequently experience a decline in immune system efficiency and may have reduced psychological reserves. Other notable risk factors include gastroenteritis after eating fast-food burritos, which suggests a foodborne infection, and the ingestion of Pepto-Bismol, which possibly would affect kidney function (Kellum et al., 2021). Having five to six watery bowel movements is another risk factor that suggests dehydration, exacerbating his weakness and dizziness. Fever, nausea, vomiting, or a metallic taste could be a sign of a systemic infection or toxin exposure, adding to the list of risk factors. 
Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.  
In agreement with and augmented by Mr. J.R.’s symptoms and risk factors, the most appropriate diagnosis is chronic kidney disease. This puts him at risk of coagulopathy and anemia, which are known hematologic complications. According to Gaut and Liapis (2020), CKD causes an imbalance of the components that ensure proper blood clotting and prevent it, causing an increased risk for bleeding and thrombosis. Notably, renal dysfunction is a leading cause of platelet disorders leading to hemostasis. On the other hand, anemia stems from CKD-induced erythropoietin deficiency due to reduced red blood cell production. While CKD uremic toxins can affect the production of red blood cells and the functioning of platelets, Mr. J.R.’s severe complications impact his hematologic system, necessitating careful management and monitoring 
Reproductive Function 
According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probably diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.  
Reflecting on the information provided regarding Ms. PC’s symptoms, sexual history, and microscopic examination results, the most probable diagnosis is Neisseria gonorrhoeae. According to Lovett et al. (2022), the clinical manifestations of this condition include a pus-like discharge (yellow, white, beige, or greenish), greater frequency or urgency of urination, a burning sensation during urination, itching, and soreness in your anus. and the presence of gram-negative intracellular diplococci, are similar clinical presentations with the patient. Also, the lower abdominal pain supports this diagnosis. The patient should be attended to with immediate effect, including antibiotic treatment and education on practicing protected sex, among other aspects of the treatment plan. 
Based on the vaginal discharged described and the microscopic examination of the sample could you suggest which would be the microorganism involved?  
Ms. P.C.’s thick, greenish-yellow vaginal discharge and gram-negative intracellular diplococci under a microscope strongly suggest Neisseria gonorrhoeae. The Neisseria gonorrhoeae bacterium frequently causes gonococcal infections, which are consistent with the discharge’s color and consistency. The presence of gram-negative intracellular diplococci, which resemble gonorrhoeae microorganisms, suggests their role in Ms. P.C.’s genitourinary symptoms. 
Name the criteria you would use to recommend hospitalization for this patient  
Ms. P.C. may need hospitalization for several reasons. The indication of a serious infection confirmed by her lower abdominal pain and malodorous vaginal discharge necessitates close monitoring. I also recommend hospitalization for this patient because the presence of gram-negative intracellular diplococci could cause systematic complications if untreated (Barbee & St. Cyr, 2022). Given the uncertainty about her partner’s recent genitourinary status and the possibility of unprotected sexual activity, hospitalizing Ms. PC would minimize the chances of compromise and enhance patient safety and comprehensive management. 
References 
Barbee, L. A., & St. Cyr, S. B. (2022). Management of neisseria gonorrhoeae in the United States: Summary of evidence from the development of the 2020 gonorrhea treatment recommendations and the 2021 centers for disease control and prevention sexually transmitted infection treatment guidelines. Clinical Infectious Diseases, 74(2), S95–S111. https://doi.org/10.1093/cid/ciac043  
Gaut, J. P., & Liapis, H. (2020). Acute kidney injury pathology and pathophysiology: A retrospective review. Clinical Kidney Journal, 14(2), 526–536. https://doi.org/10.1093/ckj/sfaa142 
Kellum, J. A., Romagnani, P., Ashuntantang, G., Ronco, C., Zarbock, A., & Anders, H.-J. (2021). Acute kidney injury. Nature Reviews Disease Primers, 7(1). https://doi.org/10.1038/s41572-021-00284-z 
Lovett, A., Seña, A. C., Macintyre, A. N., Sempowski, G. D., Duncan, J. A., & Waltmann, A. (2022). Cervicovaginal microbiota predicts Neisseria gonorrhoeae clinical presentation. Frontiers in Microbiology, 12. https://doi.org/10.3389/fmicb.2021.790531 
Pickkers, P., Darmon, M., Hoste, E., Joannidis, M., Legrand, M., Ostermann, M., Prowle, J. R., Schneider, A., & Schetz, M. (2021). Acute kidney injury in the critically ill: An updated review on pathophysiology and management. Intensive Care Medicine, 47(8), 835–850.

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