Arf Case Study
ARF Case Study
Acute Renal Failure Case Study
Directions: Please carefully read the following case study and answer the following questions in typed format. The resources that you will need to complete this case study include your textbook and drug book. Please include in text citations. This independent assignment is worth 25 points.
Ann Hayes, age 68, initially was admitted to the hospital for elective surgical repair of an abdominal aortic aneurysm. Her surgery was documented as uneventful. However, complications developed during her 5th postoperative day as a result of a small bowel perforation.
Postoperative Day 5 Vital Signs | B/P | 170/94 mmHg | HR | 110 bpm | Respirations | 30 breaths/min | Temperature | 38.6 degrees | Hgb | 10.1 g/dL | Hct | 30% | RBC’s | 3.5 x 106 | WBC’s | 20,000/mm3 | Urine Tests | Creatinine | 0.6 g/24hr | Osmolarity | 460 mOsm/kg | Specific Gravity | 1.01 | pH | 9.0 | Na+ | 45mmol/L | K+ | 15 mmol/L | Cl- | 48 mmol/L | Electrolyte Panel | Na+ | 135 mmol/L | K+ | 4.8 mmol/L | Cl- | 88 mmol/L | Ca++ | 6 mg/dL | Creatinine | 1.4 mg/dL | Uric acid | 9 mg/dL | Phosphorous | 5.2 mg/dL | Alkaline Phosphatase | 14.8 | Laboratory results and vital signs were telephoned to her physician. Her physician order’s included the following:
Hydralazine (Apresoline) at 10 mg QID
Gentamicin Sulfate (Garamycin) IV at 5mg/kg TID in divided doses
Piperacillin sodium (Pipracil) 3 grams every 12 hours
Gastrointestinal Fistula Repair
As a result of an abnormal abdominal X-ray film, Mrs. Hayes was returned to surgery for a repair of a small bowel perforation. Four days after Mrs. Hayes’s bowel surgery, she developed a gastrointestinal fistula. She was again taken to surgery for repair of the fistula. Post-operatively her blood pressure decreased to 80/52 mm Hg and her urine output was 20 mL/hr, requiring significant invasive monitoring. Mrs.
Acute Renal Failure Case Study
Directions: Please carefully read the following case study and answer the following questions in typed format. The resources that you will need to complete this case study include your textbook and drug book. Please include in text citations. This independent assignment is worth 25 points.
Ann Hayes, age 68, initially was admitted to the hospital for elective surgical repair of an abdominal aortic aneurysm. Her surgery was documented as uneventful. However, complications developed during her 5th postoperative day as a result of a small bowel perforation.
Postoperative Day 5 Vital Signs | B/P | 170/94 mmHg | HR | 110 bpm | Respirations | 30 breaths/min | Temperature | 38.6 degrees | Hgb | 10.1 g/dL | Hct | 30% | RBC’s | 3.5 x 106 | WBC’s | 20,000/mm3 | Urine Tests | Creatinine | 0.6 g/24hr | Osmolarity | 460 mOsm/kg | Specific Gravity | 1.01 | pH | 9.0 | Na+ | 45mmol/L | K+ | 15 mmol/L | Cl- | 48 mmol/L | Electrolyte Panel | Na+ | 135 mmol/L | K+ | 4.8 mmol/L | Cl- | 88 mmol/L | Ca++ | 6 mg/dL | Creatinine | 1.4 mg/dL | Uric acid | 9 mg/dL | Phosphorous | 5.2 mg/dL | Alkaline Phosphatase | 14.8 | Laboratory results and vital signs were telephoned to her physician. Her physician order’s included the following:
Hydralazine (Apresoline) at 10 mg QID
Gentamicin Sulfate (Garamycin) IV at 5mg/kg TID in divided doses
Piperacillin sodium (Pipracil) 3 grams every 12 hours
Gastrointestinal Fistula Repair
As a result of an abnormal abdominal X-ray film, Mrs. Hayes was returned to surgery for a repair of a small bowel perforation. Four days after Mrs. Hayes’s bowel surgery, she developed a gastrointestinal fistula. She was again taken to surgery for repair of the fistula. Post-operatively her blood pressure decreased to 80/52 mm Hg and her urine output was 20 mL/hr, requiring significant invasive monitoring. Mrs.