Question

Christina is an 8-year-old girl who had been taking ampicillin for an ear infection. Seven days ago, she had an anaphylactic reaction to the ampicillin, was brought to the Emergency Department by her parents, and admitted to the Pediatric Intensive Care Unit where she was stabilized. Five days after admission, Christina developed oliguria and her serum BUN and creatinine levels are as follows: BUN: 42 - Creatinine: 2.1 *Discuss the pathophysiology of why Christina's renal system is reacting this way. *Explain the type of acute kidney injury (AKI) Christina has developed. *What other physical assessment findings and lab test results would you expect? Explain the pathophysiology. *Christina's parents are concerned she will require dialysis and a kidney transplant. How will you respond? Explain your rationales.

1. Explain the type of acute kidney injury (AKI) Christina has developed.

2. What other physical assessment findings and lab test results would you expect? Explain the pathophysiology.

3. Christina's parents are concerned she will require dialysis and a kidney transplant. How will you respond? Explain your rationales.

Answer 1

Kidneys are bean shaped organs that involves in filtering blood and excreting waste products. Any acute injury to the kidneys results in the impairment of renal function and thereby increases the accumulation of waste products like urea,creatinine and blood urea nitrogen.

The type of acute kidney injury (AKI) Christina has developed is Drug induced nephrotoxicity. The antibiotics are the common cause of acute kidney injury.

Christina developed oliguria and her serum BUN and creatinine levels are as follows: BUN: 42 - Creatinine: 2.1.

Pathophysiology :

Ampicillin or other antibiotics causes inflammatory reactions in the glomerulus, renal tubules and the interstitium that results in the formation of fibrosis. As a result of fibrosis scarring forms in the renal tissues.

This anaphylactic reactions commonly occurs towards a drug.

The unfavorable reaction towards the drug causes acute interstitial nephritis and the medications bind to the kidneys sensing the normal immune system to initiate hypersentivity reaction.

Nurse must console the parents stating that drug induced renal impairment are reversible. The renal function will revert once the drug causing hypersensitivity reaction is stopped.

Supportive treatments like mainataining blood pressure, hydration, hemodynamic stability will prevent patient from entering into dialysis and renal transplantment.