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- Table 3. Serum creatinine values at admission and after 12h Admission +12h SCR(mg/dL) 1.55 1.42 Using the “MDRD” (Modification of Diet in Renal Disease) equation for estimating glomerularfiltration, provided below, and the data available in the above table, calculate the patient's (a 34 year old white male) estimated glomerularfiltration rate (eGFR) at admission and 12h after admission.MDRD GFR Equation (mL/min/1.73 m2)= 175 × (Scr)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if African American)Based on your calculated values, state whether LF’s function is normal or abnormal?Previous research suggests that patients with asthma have an increased risk for chronic kidneydisease, but the mechanisms underlying this increased risk are poorly understood. Propose one potential mechanism by which asthma might impair kidney function, and discuss how this dysfunction may impair thebody’s ability to respond to respiratory alkalosisA creatinine clearance is done on a patient with the following results: serum creatinine, 0.6 mg/dL; urine creatinine, 102 mg/dL; urine volume, 1650 mL/24 hours; body surface area, 1.93 m2. Based on the information from calculations above, which of the following is the best interpretation of this patient's creatinine clearance results? 1) Within the normal range 2) Above normal, probably because the 24-hr urine collection was not completed correctly 3) Above normal 4) Below normal no references, just homeworkUrine and blood samples were taken from four different patients and analyzed with the following results. Control Edward Taylor Ariana Perry Presence of Sodium in Urine Blue Blue Orange Blue Blue Presence of Ketone in Urine Pale Pink Pink Pale Pink Pale Pink Pale Pink Urine Glucose Levels (mmol/L) 0.0 1.0 0.0 0.0 1.0 Blood Glucose Levels (mmol/L) 5.6 8.4 5.2 6.1 9.6 Additional Note None Sweet smelling urine None Large urine output Sweet smelling urine Based on the results obtained from the tests above, determine the condition for each patient. PATIENT NAME CONDITION EDWARD TAYLOR ARIANA PERRY
- The order is for 1000ml of 5% D/W, 1000ml of Ringers Lactate, 500ml of NS to run over a 36 hour period. The drop factor is 15gtt/ml. How many gtt/min will you administer?An 85 year old women with a history of diabetes mellitus and a broken hip has been confined to bed for 3 months. She has been complaining of aching muscles and her recent blood glucose result is 250mg/dL (Normal Range 70 - 100mg/dL) Urinalysis is with the following results: Color: Reddish brown Appearance: Clear Sp Gr: 1.020, pн 5.0 Protein: 2+ Glucose: 100 mg/dL (3+) Ketones: Negative Blood: Moderate Bilirubin: Negative Urobilinogen: Normal Nitrite: Negative Leukocyte esterase: Negative Microscopic exam: 0 – 2 WBC/hpf; few squamous epithelial cells/hpf Questions (3): A. What is the significance of the negative Ketones result? a. Increased fat metabolism b. Fat is not being metabolized for energy c. Starvation d. Patient has just consumed a high fat meal B. Glucose will appear in the urine when the: a. Blood level of glucose is greater than 180 mg/dL b. Tm (Transport maximum) for glucose in tubular cells is exceeded c. Renal threshold for glucose is exceeded d. All of the above C. The…A 72-year-old adult patient who weighs 78 kg is prescribed by the doctor “Potassium Chloride 40meq in 1L to run for 8 hours” via the peripheral line for a potassium level of 3.3 mEq/L that was drawn this morning. Note: 10 mEq of potassium chloride increases serum potassium levels by approximately 0.1 mEq/.L The concentration of potassium for intravenous administration via a peripheral line should not exceed 40mmol / 500 mL 10 mEq/hr maximum infusion rate; not to exceed 200 mEq dose/24hr Administration rates above 20mmol/hour require cardiac monitoring. How much will the order medication “Potassium Chloride 40meq in 1L to run for 8 hours” raise the patient's potassium level in a day? Is it still within the normal potassium serum levels, which is 3.5–5.0 mEq/L? Does the order comply with the maximum concentration of potassium to be administered peripherally? Does the order’s infusion rate do not exceed the standard maximum infusion rate? Does the order require cardiac monitoring?
- Calculate the amount to dispense for each of the following orders. When more than one dosage strength is available, choose the most appropriate. Ordered: Baclofen 5 mg po daily for 60 days On hand: Baclofen 10 mg scored tabletIn reviewing the patient’s current information, a concern exists that acute kidney injury has developed. Select to highlight the laboratory information that would support this concern.UrinalysisCasts - +++Cola-color to urineProteinuriaBlood ValuesRBC - 3.9 cells/L (4.0-4.9 cells/L)Hgb 10 g/dL (12-16 g/dL)Hct-40% (37%-48%)WBC 11.0 cells/L (4.0-10.0 cells/L)Platelets - 140 cells/L (150-450 cells/L)Sodium - 140 mEq/L (135-145 mEq/L)Potassium - 4.5 mEq/L (3.5-5.2 mEq/L)BUN - 32 mg/dL (5-20 mg/dL)Creatinine 1.8 mg/dL (0.5-1.5 mg/dL)Blood Glucose - 180 mg/dL (nonfasting) (<200 mg/dL)AST-40 Units/mL (5-40 Units/mL)ALT - 30 Units/mL (5-35 Units/mL)Bilirubin (total)- 0.8 mg/dL (<1.0 mg/dL)Albumin - 4.0 (3.5-5.5 g/dL)PT-22 (11.5-14 seconds)The oral pediatric maintenance solution PEDIALYTE liquid has the following electrolyte content per liter: sodium, 45 mEq; potassium, 20 mEq; chloride, 35 mEq; and citrate, 30 mEq. Calculate the equivalent quantities of each in terms of milligrams.
- 1,000 mL of 0.9% NaCl is started at 1800 to infuse at 75 mL/hr. At 2000, the IV hourly rate is increased to 125 mL/hr per physican order. Parenteral intake is closed at 2200. Calculate the IV intake for this shift. Enter the numeral only (not the unit of measurement) in your answer.Figure 6 shows measurements of body weight and urinary electrolyte excretion rates in a female before and after taking aldosterone supplements for 3 days. Electrolytes intake rates remained constant throughout. Based on the observed changes in electrolyte excretion and the roles of aldosterone, what could be the reason of the increased body weight during aldosterone treatment? Body weight (kg) Urinary excretion (mmal 24 h-¹) 66.5 66.0 65.5 65.0 64.5 130 110- 90 70 50 0 B 4 8 2 3 Na+ +Aldosterone >> 6 Days Figure 6 (Source: McGeown, 2007)A 30-year-old female patient with uncontrolled hypertension is suspected by an investi- gating endocrinologist of having Conn's syndrome. Results of routine biochemistry were (reference ranges are given in brackets): Sodium Potassium Urea Creatinine Alkaline phosphatase Alanine aminotransferase Albumin Bilirubin Calcium 146 mmol/L 2.1 mmol/L 7.2 mmol/L 146 μmol/L 290 IU/L 20 IU/L 49 g/L 8 μmol/L 2.19 mmol/L (135-145) (3.5-5.0) (3.5-6.6) (70-150) (95-320) (5-42) (35-50) (<17) (2.12-2.62) (a) Are any of the electrolyte concentrations abnormal, and if so what condition is suggested? (b) What further biochemistry investigations would you undertake? Explain your reasoning.