The most common cause of renal failure in the US is diabetic nephropathy due to diabetes mellitus. Diabetic nephropathy can include multiple complications including arteriosclerosis, glomerulosclerosis, pyelonephritis and renal failure.

During the oliguric phase of acute kidney failure (AKF), the kidney is unable to excrete potassium properly, leading to high serum levels that could lead to dangerous ECG changes including peaked T waves and wide QRS complexes. The kidneys are also responsible for activating vitamin D allowing for proper calcium absorption from the GI which becomes decreased during AKF. Bicarbonate is also handled by the kidney and cannot be regenerated properly by the kidney during AKF. 

The risk for cervical spine injury is high due to electrical workers being subjected to having to work on utility poles that upon electrocution may lead to falls from tall heights. This possibility puts the person at risk for spinal and long bone fractures. Electrical burns often lead to damage below the surface of the skin and may not be fully appreciated on visual inspection. Chemical burns can lead to continual damage over 3 days, myoglobin in the blood stream from muscle damage puts the kidneys at risk for damage and the patient is usually at risk for metabolic acidosis not alkalosis. 

Insect vector-borne illnesses are given to humans through insects like ticks, mosquitoes, and chiggers. Rocky mountain spotted fever is caused by Rickettsia rickettsii. Ticks are the most common vector for rocky mountain spotted fever. Prevention of tick bites is a crucial teaching point in preventing the spread of the disease. Although misleading, the infection can be obtained throughout the United States of America. Roundworm is caused by a fungus. Rabies is a viral disease that is typically transmitted between mammals through bites. Cat scratch fever is a bacterial infection that can cause severe neurological, musculoskeletal, circulatory, and other system damage in immunocompromised individuals; in healthy people, no treatment is necessary and the infection is fought. Scabies causes extreme itchy red bumps commonly in between the fingers, on the wrist, and around the abdomen. The organism that causes this disease is actually in the arachnid family and is not an insect. 

Changes in baseline cognition and functioning of older adults may be due to infection. Urinary tract infections frequently cause confusion. Evaluate for an underlying condition before testing for rare diseases or dementia.

Rheumatic fever presents with a red rash over the trunk and extremities, fever, and a sore throat. It is caused by an untreated Streptococcus infection in the previous 2-6 weeks, such as strep throat, and can be confirmed with a positive antistreptolysin O titer.

Nystatin is an anti fungal medication, not effective in treating viral infections such HSV. Antiviral medications such as acyclovir, famciclovir, and valacyclovir would be prescribed to control symptoms and shorten episodes. These drugs are not curative. 

A sickle cell crisis will require interventions to control the client's pain due to widespread tissue ischemia. Oxygen is needed to treat hypoxia and control the amount of red bood cell sickling. Blood transfusions are usually not first line treatment in a crisis. 

The SIRS criteria includes 4 factors. 1.) temperature greater than  or less than  2.) A respiratory rate > 20, or  < , 3.) Heart rate greater than , and 4.) , , or immature neutrophils greater than 10% bands. To meet the SIRS definition must have 2 or more of these findings. 

The terms outbreak and epidemic are very similar, except an outbreak is confined to a smaller place. Both indicate an increase in incidence of disease. An endemic disease is always present in the community in a low level. An example is the common cold. A pandemic is an epidemic that occurs across multiple continents. A sporadic disease disease occurs randomly or in scattered incidence.