NRNP 6566 WK 10 Knowledge Check.

NRNP 6566 WK 10 Knowledge Check. A 57 year old female is admitted to the oncology unit for chemotherapy related to her to acute leukemia. Her initial dose of chemo was 2 days ago. While rounding today, the patients tells the NP that she feels so weak. The NP notes her heart rate is 44 today (down from 68 2 days ago). She has had less than 100 cc of urine out over the last 24 hours. Labs from this morning include: LAB DATA: -Sodium 131 -Potassium 7.8 -Chloride 105 -Bicarbonate 17 -BUN 67 -Creatinine 5.8 -Glucose 83 -Calcium 7.6 -Phosphorus 6.8 -Uric acid 16.3 What is your working diagnosis for this patient? How would you treat her? Correct Answer: Diagnosis is hyperkalmeia probably from tumor lysis syndrome. Chemotherapy has cause cells to die releasing potassium into the circulation. The elevated uric acid, phsophorus, low calcium, and acute renal failure all stem from tumor lysis. Treatment Check a 12 lead EKG Give calcium gluconate to stabilize cardiac function Begin insulin and dextrose to shift potassium into the intracellular space. Aggressively administer fluids to treat potential pre-renal azotemia Consider Kayexalate to remove potassium. Response Feedback: [None Given] Using the Cockcroft and Gault formula, calculate the estimated GFR for the following patient. 52 year old female weighting 177 pounds. Plasma creatinine is 3.3