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NRNP 6550 – Advanced Care of Adults in Acute Settings II: Human Case Studies (Ken Fowler V5, Updated 2026)

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This document provides an updated 2026 version of NRNP 6550 course material focused on the advanced care of adults in acute settings. It includes human case studies, clinical scenarios, and detailed analyses to support critical thinking, assessment skills, and evidence-based decision-making for adult patients in acute care environments.

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NRNP 6550 Advanced Care of Adults in Acute Settings II i-
Human Ken Fowler V5 updated 2026


Week #7: Week #7 - Conditions of the Renal and GenitourinarySystems
NRNP 6550: Advanced Care of Adults in
Acute Settings II i-Human: Ken Fowler V5



FILL OUT THIS TEMPLET AS YOU GO THROUGH THE I-HUMAN PATIENT
MODULE SO YOU KNOW WHAT YOU ARE DOING AS YOU GO.


YOU ARE ALL WELCOME!!!


Name: Ken Fowler
Age: 70 years
Sex: M
Ht: 5'10" (178.0 cm)
Wgt: 190 lb (86.0 kg) (BMI 27.3)


NOTES FROM i-HUMAN ASSESSMENT:
1) Observations: warm and sweaty

2) Chief complaint: Nausea and fatigue



QUESTIONS: (ask the patient up to 100 questions)
• How can I help you today? "I went to see my doctor this morning
because I have been feeling bad for the past few days. I'm tired,
with nausea & vomiting. Well, he examined me and ordered some
labs, and then told me that "kidneys are failing," something about a
big change in my creatinine and that I needed to come to the
pg. 1

, NRNP 6550 Advanced Care of Adults in Acute Settings II i-
Human Ken Fowler V5 updated 2026
emergency department. He told me to bring the test results here
with me. [Test results today: creatinine 3.2 mg/dL; 1 month ago
Test results 1.1 mg/dL; urine protein = 400 mg microalbuminuria]
Do you understand what all that means? I sure don't!"
• Do you have a problem with fatigue/tiredness? Yup
• Does your fatigue come and go? No.
• Have you gained or lost weight or intentionally, despite
normal appetite and exercise? Uh… no.
• Have you gained weight? No.




pg. 2

, NRNP 6550 Advanced Care of Adults in Acute Settings II i-
Human Ken Fowler V5 updated 2026
• Has there been a change in your urination frequency? Actually, I
have been peening less recently.
• What is the color of urine, has it changed recently? It's usually
fine, but I have been peeing less recently
• Does anything make your fatigue/tiredness better or worse? No.
• Do you have pain anywhere? If so where? I hurt my back last
week, but that's fine now.
• Have you noticed swelling in any part of your body? No
• Can you tell me about any current or past medical problems she
had? I have high blood pressure. I take medications for that. I was
told last month my blood pressure has caused some kidney
damage. Something about my protein in my urine. Oh, about a
week ago I pulled my back lifting a heavy carton when I was
cleaning out my garage. It was pretty painful so I took something
for the pain. My back is really pretty good right now, but then this
nausea vomiting began.
• Any previous medical, surgical, or dental procedures? Yes. I had
my tonsils out as a kid and then my appendix out about 35 years
ago now.
• What treatments have you had for the pain in your back? Just Naproxen.
• Are you taking any prescription medications? I take lisinopril,
metoprolol, and hydrochlorothiazide for BP. I have not taken
anything for the last 24 hours because I feel so sick, can’t keep the
pills down.
• Do you have any pain in your back? Not anymore
• When you urinate, have you noticed any pain, burning, blood,

pg. 3

, NRNP 6550 Advanced Care of Adults in Acute Settings II i-
Human Ken Fowler V5 updated 2025
difficulty starting or stopping, dribbling, incontinence, urgency
during day or night, or any changes in frequency? Uh, no. In fact, I
am barely peeing at all.
• When are the events surrounding the start of your difficulty urinating?
That’s not a
problem for me.
• When you pee, is a stream or flow of urine weak or do you dribble? No
• Do you have problems with nausea, vomiting, constipation,
diarrhea, coffee grounds in your vomit, dark tarry stool, bright
red blood in your bowel movements, early satiety or bloating? Yes,
I have already told you about my nausea and vomiting. But none of
the other stuff. My poop is normal
• How severe is your nausea and/or vomiting? I have not eaten
much of anything in the last three days, so I am not sure how to
answer that question. Vomiting is and miserable business so for
me it is bad.
• Do you have any other symptoms or concerns we should
discuss? I also feel exhausted, probably from all the
vomiting and not eating.
• When did your nausea start? It started three days ago, I woke
up feeling nauseous and started throwing up everything I ate.
• What are the events surrounding this start of your nausea and
vomiting? Nothing really happened that I can think of.
• Do you have difficulty breathing? Uh… no.
• When do you fatigue start? Just the last few days.


pg. 4

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