Gerneralized edema with 3-4+ pitting edema of ext.
chronic cough
blurred vision
severe leg/back pain relieved with rest
depression
clear urine @x's
tea colored urine @x's
urinary frequency @x's
hives
insomnia
leg cramps
nausea
flank pain @x's
generalized weakness
just a few symptoms, any one know where to send this person first?
I know where not to send him. . .the local pub. It appears he/she has spent some of the best times he/she'll never remember there. Sad, messy case and you don't go quick.
[ QUOTE ] Old_School said:
I know where not to send him. . .the local pub. It appears he/she has spent some of the best times he/she'll never remember there. Sad, messy case and you don't go quick.
O_S
[/ QUOTE ]
Person doesn't drink, Usually first thing some one would say.
Sounds like he needs to go to an ER and get seen. Depending on what's going on, they'll probalby want to admit him for a few days and find out what's going on.
CKD.. And he/she probably didn't get it from a pub..
Edema- excess fluid from failing kidneys
Chronic cough- again fluid build up maybe PE.
Blurred vision - probably from underlying cause DM Type II
Severe leg pain- r/t to edema
Depression - r/t to chronic illness Many diabetics are.
Clear urine- headed toward ERSD kidneys overcompensating
Tea colored urine- blood in urine from kidney deterioration
Frequency- again overcompensation for failing kidneys
Hives- elevated phosphorus low calcium They are inversely
proportional
Leg cramps- Low CA+ elevated K+ r/t kidney failure
Nausea- r/t uremia
Flank pain.. And just where are the kidneys?
Generalized weakness. Kidney's secrete hormone that stimulates bone marrow to produce red blood cells. The kidneys are failing here if not already failed.
Renal profile, I bet ya my last $ the Bun and Creat are off the wall .. Phos is HIGH,( causing itching and the hives are probably from scratching) K+ is High H/H low. Ca low.
Have a surgeon handy to insert IJ for immediate acute hemodialysis.
I don't see many reasons for liver involvement. DM is by far the largest contributor to ESRD. A renal panel will shed the most light on this subject quickly. I'd like to see some vital signs and a blood sugar but I'll go with all the subjective s/s on this one and bet the farm even. Where is the OP and does he have an answer?
WR,,, three commas for Becca
I will temper one response of mine about the severe leg/back pain relieved with rest to diabetic neuropathy again a precussor to ESRD.
Did you want me to guess on the patient's ethnic background, sex, and age also because I could pull up the stats on that too although I probably wouldn't need to.
I would love to know what you come up with as far as ethnic, sex and age.
I was looking for some causes, I never thought about lead posioning, unlikely but could be another type of posioning. If it is a toxic chemical than the tx would be to remove the toxin. Chromium is a possibility and could be a multitude of others. Also this person was exposed to an illegal pesticide years ago. Need more research to see what the damage is from that. So before we whip this person into dialysis I want to explore all avenues. Thank you for your input. Please feel free to let me know if you think of anything else that could be contributing.
Renal profile will determine dialysis. The sum total of the symptoms point to CKD if not ESRD. And I've seen lead poisoning years ago in NC.. Didn't present like that at all..
It's renal failure. Pure and simple.
WR,,, three commas for Becca
Do you know the answer or is this all speculation?
Of course the kidney failure could be caused by some type of poisoning.. Unlikey but not out of the question. Usually, poisoning of any degree would be instanteous and much more critical. 3-4+ edema takes some time. Chronic cough could be from ACE inhibitors if this patient is being followed for DM.. ACE inhibitors have been shown to preserve kidney function. Not reverse it or deter it totally.
The blurred vision still leads me to DM Type II.
And the PE I spoke of is not Pulmonary Embolism but Pleural Effusion.. Sorry if that was unclear.
WR,,, three commas for Becca
The cause here is not the overriding issue; getting diagnosised properly and treated appropriately is.
Actually, now that I think of it this was the first scenario of Pathophysiology 101 and I "guessed" correctly that time too. Although this and that were far from guesses.
This discussion reminds me of the endless speculation of a patient's diagnosis on the basis of a Lead II Ekg Rythmn Strip. I came to realize then that diagnosing a patient using a rhythmn strip is about as useful as determining a woman's breast size by looking at a picture of her nose. I am also wondering if Iam has the answer and is just playing us.
This isn't coming from patho 101. The problem is that the symptoms come and go.Years ago this person inhaled a large amt. of an illegal pesticide, some time after that developed a stiff neck that continued down the shoulder developing into severe muscle spasms. This all lasted about 3 weeks was diagnosed as tendenitis. the above symptoms begin slowly and keep getting worse then everything reverses itself and the cycle starts all over. as the edema increases so does the blurred vision and all the other symptoms.
What type of medical care has this person recieved. Have they been worked-up in any way.. Now I know it's a guy...loll For sure.. Men are notorious for not going to the doctor.
WR,,, three commas for Becca.
Certainly could be acute kidney failure and it does keep resolving itself. I wouldn't bet the farm that it will continue to resolve itself forever.
not a man. by the time the patient gets to the doctor the symptoms are in the resolving phase. no care being given at all. was treated for depression and a severe case of hives, now the hives are tx with Benadryl. I forgot to mention that this person has a lot of joint pain, hips and knees.
Sure have, dependent edema with rest it goes away, takes a few days. and I know the differences. Do you mean fake a faint? ER's only take care of emergencies. So the work up never progresses. This person falls through every crack there is. Probably end up on the street to die eventually.
So does any one have any advise as she can't be seen by a doctor. Her profession will not let her work and she has no income, just a burden on society. They want to start shooting stray cats maybe it's time to start shooting ill people so we don't have to be burdened by them or we can lock them up. Except for the people with money of course.
With all due respect Iam, as nurses we played along and answered to the best of our abilty your origional post. You need to go to www.social-worker-forum.com and ask them.
