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The main function of the kidneys is to filter blood by removing waste and water out the body, regulate blood pressure, maintain homeostasis and to produce erythropoietin. Several disorders may affect the kidney and when that happens it is difficult for the organ to function accordingly. One type of malfunction is acute kidney injury (AKI) and it is divided into three categories: 1) Prerenal- disruption of blood flow to the kidneys, 2) Intrarenal- structure damage of the kidneys, and 3) Postrenal- urine excretion interference (Dlugasch & Story, 2020).
Mr. J.R. has presented with manifestations that demonstrate he has prerenal acute kidney injury. This type of AKI disrupts the blood flow to the kidneys. Examples include hypotension, shock, heart failure, and dehydration. Mr. J.R. complained of nausea, vomiting and diarrhea for 48 hours and according to Dlugasch & Story (2020) that time frame is the onset of AKI. The vomiting and diarrhea places him at risk for dehydration, which decreases the blood flow due to hypovolemia from the gastroenteritis. The kidneys are unable to receive blood and that causes a loss of function. Mr. J.R. also complained of metallic taste in his mouth that can be described with chronic kidney disease due to the toxin buildup (Dlugasch & Story, 2020). Dehydration, age and dementia, which indicate fragility, are risk factors for contracting AKI (Wu et al., 2020). Based on Mr. J.R. being 73 years of age it places him at a greater risk because the kidneys start to loose normal function over time.
If AKI is left untreated then chronic kidney disease (CKD) may develop. The physician of this case study has declared Mr. J.R. now has chronic kidney disease and it could be due to his age and the kidneys becoming less effective. Complications of CKD affect multiple systems of the body. Affects on the hematologic system include coagulopathy and anemia. There will be platelet aggregation, risk for thrombosis and increased bleeding time due to the disruption of the kidney’s homeostasis function. Anemia also occurs because the kidneys can no longer produce erythropoietin (Dlugasch & Story, 2020).
The reproductive system is a system that involves reproducing offspring and secreting hormones. There are many organs involved between both men and women that function similarly however they are anatomically different. Sexually transmitted infections are a vast group of infections that is spread to the reproductive system via intercourse. The case study presented explains Ms. P.C.’s symptoms after having sexual intercourse with her partner over a week ago. The most probable diagnosis is that she contracted is Gonorrhea. This is due to the manifestations of the thick foul vaginal discharge. When placed under a microscope it revealed positive for gram-negative intracellular diplococci. According to Yeshanew & Geremew (2018), N. gonorrhoeae is the causative agent of gonorrhea and displays as a gram-negative coffee-bean shaped intracellular diploccocus bacterium diagnostically. This infection starts to expose within 2-10 days and Ms. P.C. stated she had vaginal intercourse eight days ago (Dlugasch & Story, 2020). If treatment is not effective and complications arise such as pelvic inflammatory disease or endocarditis due to the spread of the organism, then hospitalization is recommended for this patient.
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