Please respond to discussion below using APA Current 7th edition and 2-3 referen

Please respond to discussion below using APA Current 7th edition and 2-3 references within the past 4 years or less. Must be At least 150 words and respond to BOTH case studies. Case Study 1 Urinary function:
Case Study of Mr. J.R.
The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented names of the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.
Mr. J.R.’s physician thinks that he has developed an acute kidney injury (AKI). The types of AKI vary from
prerenal, intrinsic, and postrenal. Decrease blood flow to the kidney results in prerenal, and when there is damage
to the kidney themselves this is called intrinsic. Postrenal is caused by obstruction of the urinary tract (Kashani et
al., 2019). In this case, the patient’s symptoms of nausea, vomiting, diarrhea, and fever suggest Mr. J.R. may have
developed the intrinsic type. The above symptoms can occur when there is, suggestion or inflammation going on
with the kidneys. It was indicated that the patient has a history of eating burritos from fast food restaurants and
the timing of his symptoms following this meal indicate a possible food-borne illness as the cause of his intrinsic
AKI.
Create a list of risk factors the patient might have and explain why.
Many factors could have contributed to MR. J.R.’s development of AKI, and may include advanced age, which can
lead to a decline in kidney function, a history of kidney disease, diabetes, hypertension, which can both lead to
damage of the blood vessels in the kidneys. Certain medications such as non-steroidal, anti-inflammatory drugs
(NSAIDs) and antibiotics can be toxic to the kidneys. Additionally, the patient’s history of nausea, vomiting, and
diarrhea suggest that he might have a gastrointestinal infection, which can cause dehydration and electrolyte
imbalances, both of which can lead to AKI. Besides this patient food poisoning may have been a contributing factor
to his AKI.
Unfortunately, the damage to J.R.’s kidney became irreversible and he is now diagnosed with Chronic kidney disease. Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.
At this point, the worst thing that can happen to Mr. J.R. is his kidney condition turns into a chronic kidney disease
(CKD), and starts affecting his hematologic system, where coagulopathy occurs. This is a disorder of the blood
clotting system that can occur as a result of CKD (Kashani et al., 2019). This may result in a decrease in the
production of clotting factors by the liver, as well as an increase in the level of clotting inhibitors, both of which can
lead to an increased risk of bleeding. Another thing that can proceed is anemia, a condition characterizes by a
decrease in the number of red blood cells or the amount of hemoglobin in the blood. In the effect of CKD, the
kidneys play a crucial role in the production of erythropoietin, a hormone that stimulates the production of red
blood cells (Kashani et al., 2019). Damage kidneys produce less erythropoietin leading to anemia. Additionally, CKD
can cause inflammation, and lead to the destruction of red blood cells. Both coagulopathy and anemia are caused
by the pathophysiologic mechanism involved in CKD such as inflammation, damage to the blood vessels, and
decreased production of clotting factors and erythropoietin. It is imperative that constant watching and managing
of this complication accessorize in order to prevent further destruction of the patient’s condition. Case study # 2 Reproductive Function:
Case study Ms. P.C.
According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probable diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.
When there is an overgrowth of certain types of bacteria in the vagina, this is termed bacteria vaginosis (BV),
which is caused by an imbalance in the normal vaginal flora, leading to an overgrowth of certain types of bacteria
such as Gardnerella vaginalis, Mycoplasma hominis, and Mobiluncus species (Marnach et al., 2022). BV is often seen
in women that are sexually active and are using no methods of contraception such as condoms. This is because BV
is associated with sexual activity and hormonal changes associated with the menstrual cycle and pregnancy can also
increase the risk of BV. BV is considered a sexually transmitted disease and can occur in women who have never
had any prior sexual encounter, and hormonal changes associated with the menstrual cycle and pregnancy can also
increase the risk of BV. The symptoms of BV include heavy, malodorous vaginal discharge, lower abdominal pain,
nausea, and emesis. The discharge may be thick, greenish-yellow in color, and have a strong, unpleasant odor
(Brown & Drexler, 2020). Other recognized symptoms of BV include discomfort during intercourse, itching, and
burning. Complications can arise if BV is left untreated for example pelvic inflammatory disease, preterm birth, and
an increased risk of acquiring sexually transmitted infections. PID is an infection of the female reproductive organs
that can cause severe pain, fever, and abnormal vaginal discharge. Preterm birth can occur before 37 weeks of
pregnancy and can cause serious health problems for the newborn child. On the positive side, BV can be treated
with antibiotics such as metronidazole and clindamycin. These antibiotics are usually administered orally or as a
vaginal cream. When on these medications patients are advised to abstain from any sexual activity and avoid
scented products such as soaps and douches. Based on the vaginal discharge described and the microscopic examination of the sample could you suggest which would be the microorganism involved?
Gardnerella vaginalis gram-negative anaerobic rod-shaped bacterium commonly associated with vaginosis.
Gardnerella is an inhabitant of the vagina and is often found in low concentrations in the healthy vagina. This
overgrowth of G. vaginalis is caused by a disruption in the normal vaginal flora and a change in the vaginal ph. The
normal vaginal pH is acidic, between 3.8 and 4.5, which keeps the vaginal environment hostile to harmful bacteria
and promotes the growth of beneficial bacteria such as lactobacilli (Brown & Drexler, 2020). When G vaginalis is
present, it produces enzymes that degrade glycogen and convert it into lactic acid and causing the pH to rise. This
change in pH allows other bacteria such as Atopobium vaginae, Mycoplasma hominis, and Mobiluncus species to
thrive and this leads to BV. This bacterial overgrowth causes an imbalance in the normal vaginal flora and leads to a
change in the vaginal discharge. The discharge may be thick, greenish-yellow in color, and have a strong, unpleasant
odor. G. vaginalis is one of the most common causes of BV, but it is not the only one (Marnach et al., 2022). There
are other types of bacteria that have been linked to BV and they are Atopobium vaginae, Mycoplasma hominis, and
Mobiluncus species. It is important to know that BV can cause a combination of factors such as hormonal changes,
sexual activity, and other lifestyle factors such as smoking and the use of certain products such as douches and
scented soaps.
Name the criteria you would use to recommend hospitalization for this patient?
Individuals with severe abdominal pain, nausea, vomiting, fever, and dehydration as a response to oral
medications are subject to hospitalization. When the patient is pregnant and there is a concern for pelvic
inflammatory disease (PID) or other underlying medical conditions that might put her at risk for complications,
hospitalization would be recommended as well (Marnach et al., 2022). In these cases, patients are given antibiotics
and fluids to help clear the infection and prevent complications. Consequently, a patient PID will be counseled and
educated on how to prevent future infection or reinfection and maintain good hygiene.