JH is a 12-year-old boy diagnosed several months ago with nephrosis following postinfectious glomerulonephritis secondary to an episode of pneumococcal pneumonia. He has been coming to the clinic to have his condition monitored and therapies adjusted as needed.
At his latest clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized edema are noted. Trace amounts of protein are detected in JHâs urine by dipstick. Blood is drawn for laboratory analysis, and the results are as follows:⨠pH = 7.36 â¨PaCO2 = 33 mm Hg â¨PaO2 = 100 mm Hg â¨HCO3 â = 18 mEq/L â¨Hct = 30% â¨Na+ = 130 mEq/L â¨K+ = 5.4 mEq/L â¨BUN = 58 mg/dl â¨creatinine = 3.9 mg/dl â¨albumin = 2.0 g/dl
How would a pneumococcal infection lead to glomerulonephritis? How can glomerulonephritis result in nephrosis?
Use JHâs laboratory values to determine if he is still experiencing nephrosis or if his condition is progressing to renal failure.
What additional physical or laboratory findings would be helpful in determining JHâs degree of renal impairment?
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