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📂 Case Study: Mr. Lyles Patient: Mr. James Lyles, 62-year-old male Chief Complaint: Fatigue, decreased urine output, and lower back pain Medical History: Type 2 diabetes for 15 years Hypertension History of recurrent UTIs Current Symptoms: Reports nausea, metallic taste in mouth, and persistent fatigue Urine is dark, with frothy appearance Swelling in lower extremities and face, particularly in the morning BP: 158/92 mmHg, HR: 88, Temp: 98.9°F Weight gain of 3 lbs in the last 4 days Laboratory Findings: BUN: 42 mg/dL Creatinine: 2.6 mg/dL GFR: 42 mL/min Proteinuria: 3.7 g/day Sodium: 130 mmol/L, Potassium: 5.6 mmol/L Urinalysis: hematuria, proteinuria, + WBCs Imaging: Renal ultrasound shows bilaterally enlarged kidneys with increased echogenicity. Education and Prevention Strategies What client education would you provide to help Mr. Lyles manage chronic kidney disease and prevent progression to ESKD? How can the nurse support self-monitoring, medication adherence, and lifestyle changes?

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