Question

In: Anatomy and Physiology

J. S. is 23 years old. He was brought to the emergency department after an auto...

J. S. is 23 years old. He was brought to the emergency department after an auto accident. He suffered a concussion and a deep laceration of his right thigh. He lost about 4 units of blood prior to effective control of bleeding and closure of the wound. Fluid resuscitation is initiated, and a urinary catheter is inserted post operation to monitor his urine output. However, he continues to have significant oozing from his sutured wound. His 24-hour urine volume is 350 ml with a high urine osmolality and low urine sodium. A coagulation screen results indicate the following: platelet count 250,000, bleeding time and a PTT time are both extended.

What type of renal failure is J. S. developing? Why is this type of renal failure developing?

If J. S. does not receive adequate treatment, what further condition may he develop?

Why? What is the best treatment option to prevent this from occurring?

What other laboratory data beside urine output should be collected to evaluate J. S.'s renal function?

If J. S.’s renal function continues to be diminished without any improvement, what could be the subsequent stages of his renal disorder?

Cite specific areas from your readings and research to support your ideas.

Solutions

Expert Solution

J. S. is 23 years old. He had a deep laceration of his right thigh, due to that he lost 4 units of blood.

Now he continues to have significant oozing from his wound.

His 24-hour urine volume is 350 ml with a high urine osmolality and low urine sodium.

1. In this case, J.S is developing acute prerenal kidney failure.

2. J.S is in the hypovolemic state due to severe blood loss which resulted in decreased perfusion to kidneys.

Lack of blood flow to the kidney is the main reason for acute prerenal kidney failure.

3. If J.S does not receive adequate treatment then it can develop to chronic prerenal kidney failure, its because of shrinkage of kidneys due to lack of blood flow for a long period of time.

The best treatment option to prevent the occurrence of chronic prerenal kidney failure is adequate fluid resuscitation and blood transfusion because of this renal failure is a lack of blood flow to the kidney.

During fluid resuscitation period the patient may need hemodialysis for a short period of time.

4. Besides urine output serum sodium, serum potassium, serum urea, and creatinine, uric acid, blood urea nitrogen (BUN) and arterial blood gas monitoring to check the acid-base imbalance should be obtained.

Sydney Mullin answered 1 year ago
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