1. Which lab values are abnormal? What clinical manifestations      correspond to the abnormal values? Describe the changes      (pathophysiology) in the body causing each abnormal value and link the      value to a clinical manifestation present in the patient? Which values are within normal      limits? What nursing care needs to be      implemented? Provide one nursing      diagnosis appropriate to this patient.

In this case scenario, Carmelita Gomez, an 8-year-old female, presents to the Children’s Clinic with symptoms of nausea, vomiting, tea-colored urine, diffuse abdominal pain, and slight periorbital edema. Upon examination, she was found to have active bowel sounds, tenderness in all four quadrants, and red cell casts with hematuria in her urine analysis. Her laboratory values show an elevated serum creatinine level of 2.3 mg/dL, BUN of 26.1 mg/dL, antistreptococcal antibody titre of 800U, and low calcium level of 7 mEq/dL. These findings are indicative of poststreptococcal glomerulonephritis (PSGN), a kidney disease that occurs after a streptococcal infection.

The abnormal lab values in this case are serum creatinine, BUN, antistreptococcal antibody titre, and calcium level. The elevated serum creatinine and BUN levels are indicative of impaired kidney function. The antistreptococcal antibody titre indicates a recent streptococcal infection, and the low calcium level may be due to impaired kidney function or hypoparathyroidism.

The clinical manifestations corresponding to the abnormal lab values include nausea, vomiting, tea-colored urine, diffuse abdominal pain, periorbital edema, hematuria, and red cell casts. These symptoms are all indicative of impaired kidney function and inflammation of the glomeruli.

The pathophysiology of PSGN involves an immune response to a streptococcal infection that results in inflammation and damage to the glomeruli in the kidneys. This inflammation leads to impaired kidney function, as evidenced by elevated serum creatinine and BUN levels, hematuria, and red cell casts. The low calcium level may be due to hypoparathyroidism resulting from impaired kidney function.

Nursing care for Carmelita should focus on monitoring and managing her symptoms, as well as promoting kidney function and preventing complications. This includes monitoring vital signs, urine output, and fluid and electrolyte balance. Medications such as diuretics and antihypertensives may be prescribed to manage symptoms and promote kidney function. The patient should also be educated on the importance of maintaining good hygiene and avoiding close contact with individuals who have streptococcal infections to prevent recurrence of PSGN.

One nursing diagnosis appropriate for this patient is “Risk for impaired renal function related to inflammation and damage to the glomeruli as evidenced by elevated serum creatinine and BUN levels, hematuria, and red cell casts.”