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

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 JH’s urine by dipstick. Blood is drawn for laboratory analysis, and the results are as follows:
 pH = 7.36 
PaCO2 = 33 mm Hg 
PaO2 = 100 mm Hg 
HCO3 – = 18 mEq/L 
Hct = 30% 
Na+ = 130 mEq/L 
K+ = 5.4 mEq/L 
BUN = 58 mg/dl 
creatinine = 3.9 mg/dl 
albumin = 2.0 g/dl

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