February 2, 2012
* Scenario A: Acute renal failure. Ms. Jones, a 68-year-old female, underwent open-heart surgery to replace several blocked vessels in her heart. On her first day postoperatively, it was noted that she had very little urine output.
* What is happening to Ms. Jones’s kidneys, and why is it causing the observed symptom?
* Oliguria – is a sudden drop in urine volume, or complete cessation of urine production.
* What other symptoms and signs might occur?
* Other symptoms that may occur is headache, gastrointestinal distress, and the odor of ammonia on the breath.
* What is causing Ms. Jones’s kidney disease?
* Her disease can be caused from the blood flow to the kidneys resulting from the surgical shock from her open heart surgery.
* What are possible treatment options and prognosis?
* Since Mrs. Jones has had open heart surgery it is very important to make sure that they monitor her hyperkalemia to make sure the levels of potassium stay where they need to so it does not cause the heart to weaken. Treatment should include restoration of the blood volume to normal, restricted fluid intake, and dialysis.
* Scenario B: Chronic renal failure. Mr. Hodges, a 73-year-old man, has had congestive heart failure for the past 5 years. His doctor has told him that his heart is not functioning well, needing more and more medicine to maintain circulatory function. He has noticed that he is not urinating more than once a day
* Why is the condition of Mr. Hodges’s kidneys affecting the rest of his body?
* It affects the rest of the body because the metabolic waste accumulates in the blood which has an... [continues]
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