Renal Labs
Can be affected by dehydration and shock
What is BUN?
chvostek, trousseau, twitching around mouth
chronic renal fail, hypoparathyroidism, vit D def
Cal gluc, CaCl, vit D
What is hypocalcemia
perfusion to kidneys reduced but no destruction of tubular membrane
prerenal failure
less than 275
more than 295
what is hypoosmolar and hyperosmolar?
Treatment: carbs, dextrose IVP, IV infusion for repeat offenders, glucagon
what is hypoglycemia
This is considered the best indicator for GFR
What is the creatinine clearance?
muscle cramps/pain, ECG changes-widening QRS, Brady, PEA
CaCl, insulin, glucose, albuterol, dialysis
what is hyperkalemia
diabetes heart failure, hypertension, contrast, NSAIDS, ACE inhibitors, diuretics, antibiotics
Risks of renal failure
labs pertaining to DKA
what is ph <7.3, bloods sugar 300-600, hyperosmolar, bicarb<15, elevated WBC and HCT
cardinal sign:low Na, low UOP, low osmolar
What is SIADH?
(140-age)x(IBW)x(if its female 0.85)/72x serum creatinine
What is the formula for creatinine clearance?
fatigue/lethargy/confusion, seizures, brain herniation
excessive water ingestion, SIADH
What is hyponatremia
Name the criteria for a patient to qualify for dialysis
What is Acidemia
Electrolyte disorders
Intoxication
Overload
Uremia
state what is needed in osmolar formula
Na, BUN, Glucose
name the difference between DKA and HHS
Acidosis and presence of ketones
males 0.8-1.4 females 0.6-1.1
what are the normal creatinine for males and females?
decreased DTRs, reps distress/arrest, flushing, stridor
laxative abuse, renal failure
give furosemide, dialysis
what is hypermagnesemia
Most dangerous development for a patient with renal failure
What is sepsis?
what disease causes urine specificity is 1.001-1.005
What is DI?
polyuria 6-24 L/day, dehydration, polydipsia, ortho hypotension, dry mucous membranes, confusion, restlessness, lethargy, seizures, coma
Na >155, serum osm> 295, urine osm inappropriately low with high serum osm, decreased urine specific gravity, high BUN, Cr
what is DI
A nephrologist is consulted for a pt with AKI, and a number of lab tests are ordered. Which lab result would suggest that this pt has damage to his renal tubular basement membrane?
what is a low urine specific gravity, 10-15:1 BUN to Creat, high urine sodium, diluted urine concentration, low osmolality, abnormal casts in urine, no response to furosemide
pt has history of ETOH and has been getting TPN. Pt lethargic, decreased DTR, PaCO2 55. correct the underlying cause
Pt suffering from hypophosphatemia, what is give phosphorus
state what renal failure each category is acute pyelnophritis
BPH
Contrast dyes
diuretics
hemorrhage
intraabdominal tumor
renal calculi
septic shock
intrarenal
postrenal
intrarenal
prerenal/intrarenal
prerenal/intra if persistence
postrenal
postrenal
prerenal/intrarenal
pt admitted with weakness, lethargy, N/V, 98/56, 108,22,>380 glucose, ph 7.2, PaCO2 22, HCO 14, increased anion gap, serum K4, treat this
fluids, KCL, insulin
pt admitted to SICU after craniotomy, UOP greater than 600x3 hours, sp gravity 1.004, NA 158, K 3.8,glucose 110, BUN 32, Cr 1, Hct 45, urine osmo 195 you need these numbers to calculate what and what is this condition
calculate serum osmolality need Na, BUN, and glucose and this is DI