HCR 240 Case Study 30 - Acute Renal Failure
✓ Why do you expect that an ultrasound study of the patient’s urinary tract was not
conducted?
I expect that an ultrasound study of the patient’s urinary tract was not conducted because
the patient had no signs of blockage, kidney stones, or postrenal acute renal failure.
✓ Which therapeutic measures should be considered “first and foremost” and may be
very beneficial in reversing the signs of acute renal failure?
The therapeutic measure that should be considered “first and foremost” and may be very
beneficial in reversing the signs of acute renal failure is rapid I.V fluid therapy. This will help
resolve the dehydration the patient has been experiencing along with other problems. Treating
the patient's viral infection is another thing that should be looked at immediately.
✓ Would dialysis be appropriate treatment for this patient at this time?
No, dialysis would not be appropriate treatment for this patient at this time.
✓ Should sodium polystyrene sulfonate therapy be initiated in this patient?
No, sodium polystyrene sulfonate therapy should not be initiated since the patient is not
experiencing high levels of potassium in the blood.
✓ Based on the information provided above, which two types of acute renal failure are
most likely?
Based on the information provided above, the two types of acute renal failure that are
most likely include prerenal acute renal failure and intrarenal acute renal failure.
✓ List four major risk factors that are likely to be contributing to the patient’s kidney
failure.
, Four major risk factors that are likely to be contributing to the patient’s kidney failure
include history of heart failure, vomiting, diarrhea, and hypertension.
✓ What is the significance of (a) poor skin turgor and (b) an absence of itching?
The significance of poor skin turgor is that it’s consistent with dehydration and an
absence of itching indicates that toxins have not yet build up in the patient’s blood and that his
renal failure has not reached a server level.
✓ What is the importance of the absence of JVD and HJR?
The importance of the absence of JVD and HJR is that there is no indication that this
patient’s renal failure has progressed to a significant degree.
✓ What is the significance of the “faint S3” cardiac sound?
The significance of the “faint S3” cardiac sound is that it has some ventricular
dysfunction which may be a sign of heart failure that can lead to prerenal acute failure.
✓ What is the significance of the absence of pulmonary crackles?
The significance of the absence of pulmonary crackles is that there is no fluid in the lungs
(edema) so no indication of left heart failure.
✓ Why do you expect that an ultrasound study of the patient’s urinary tract was not
conducted?
I expect that an ultrasound study of the patient’s urinary tract was not conducted because
the patient had no signs of blockage, kidney stones, or postrenal acute renal failure.
✓ Which therapeutic measures should be considered “first and foremost” and may be
very beneficial in reversing the signs of acute renal failure?
The therapeutic measure that should be considered “first and foremost” and may be very
beneficial in reversing the signs of acute renal failure is rapid I.V fluid therapy. This will help
resolve the dehydration the patient has been experiencing along with other problems. Treating
the patient's viral infection is another thing that should be looked at immediately.
✓ Would dialysis be appropriate treatment for this patient at this time?
No, dialysis would not be appropriate treatment for this patient at this time.
✓ Should sodium polystyrene sulfonate therapy be initiated in this patient?
No, sodium polystyrene sulfonate therapy should not be initiated since the patient is not
experiencing high levels of potassium in the blood.
✓ Based on the information provided above, which two types of acute renal failure are
most likely?
Based on the information provided above, the two types of acute renal failure that are
most likely include prerenal acute renal failure and intrarenal acute renal failure.
✓ List four major risk factors that are likely to be contributing to the patient’s kidney
failure.
, Four major risk factors that are likely to be contributing to the patient’s kidney failure
include history of heart failure, vomiting, diarrhea, and hypertension.
✓ What is the significance of (a) poor skin turgor and (b) an absence of itching?
The significance of poor skin turgor is that it’s consistent with dehydration and an
absence of itching indicates that toxins have not yet build up in the patient’s blood and that his
renal failure has not reached a server level.
✓ What is the importance of the absence of JVD and HJR?
The importance of the absence of JVD and HJR is that there is no indication that this
patient’s renal failure has progressed to a significant degree.
✓ What is the significance of the “faint S3” cardiac sound?
The significance of the “faint S3” cardiac sound is that it has some ventricular
dysfunction which may be a sign of heart failure that can lead to prerenal acute failure.
✓ What is the significance of the absence of pulmonary crackles?
The significance of the absence of pulmonary crackles is that there is no fluid in the lungs
(edema) so no indication of left heart failure.
