Final answer:
The patient with SOB, DOE, and edema who has 3+ protein on urinalysis likely has significant proteinuria indicating a possible kidney disorder. A 24-hour urine collection and blood tests should be ordered next to evaluate kidney function and guide further management.
Step-by-step explanation:
The patient presents with shortness of breath (SOB), difficulty on exertion (DOE), and edema in both lower extremities. The urinalysis showing 3+ protein suggests significant proteinuria, which raises the suspicion of a renal syndrome, possibly glomerular in nature, leading to an abnormal amount of protein leaking into the urine. Given the clinical presentation and the findings, the next step for further evaluation would be to order more specific tests. These might include a 24-hour urine collection for total protein and creatinine clearance to assess the kidney's filtering capacity more accurately. Additionally, blood tests such as serum creatinine, electrolytes, blood urea nitrogen (BUN), and a complete blood count (CBC) would help assess renal function and the possibility of nephrotic syndrome or other kidney diseases. If these tests support the initial suspicion, a renal ultrasound or a referral to a nephrologist might be appropriate.