Case Scenario: A 23-year-old patient was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately two hours after the incident and is now in the ER. His vital signs and hematocrit suggest that he has had a blood loss of about 2500 ml. A urinary catheter is inserted to monitor urine output, and fluid resuscitation is initiated while his wounds are cleaned and sutured. The urine output is averaging 15 ml/hr, with a high urine osmolality and low urine sodium.
Case Scenario: A 34-year-old man has taken his youngest daughter to soccer practice. He begins to experience low abdominal and back pain and is nauseated. He finds himself squatting down in an attempt to alleviate the pain. Unable to alleviate the discomfort, he takes his daughter home. On arrival, he literally falls out of the minivan and onto the driveway. His wife asks a neighbor to watch the children, and she drives him to a nearby ER. As they pull into the parking lot, the pain immediately subsides. They enter the ER and approach the triage desk. Describing his symptoms, the staff suggests it could have been a kidney stone.
CASE 1
In this case, 23 Year old patient was presented in the ER with complaints of multiple abrasions, concussion and deep laceration in the left thigh and he had a blood loss of 2500ml and the urine output is average 15ml/hr.
Low urine output also occurs when there is a decreased blood supply to the kidney, such as occurs with excessive blood loss. Blood loss may also lead to a loss of urine output by causing the body to go into shock. This state of shock reduces blood flow to organs such as the kidneys. The kidneys cannot make urine without this blood flow.
In this case the patient’s GFR ( Glomerular Filtration Rate) is normal . An estimate of the normal value for GFR can be obtained by using the equation: GFR = 140 – [your age].
GFR= 140-( age of the patient)
=I40-23 yrs=117 mL/min.
The obtained value is normal of the patient which indicates the patient is having the normal kidney function. Low urine output is due the loss of severe blood loss only.
Clinical problems associated with low urine output
CASE 2
In this case, the patient presented with complaints of low abdominal and back pain and is nauseated and after sometime the pain got subsided.
Kidney stones, or renal calculi, are solid masses made of crystals. Kidney stones usually originate in the kidneys. However, it can develop anywhere along the urinary tract including kidneys and ureters.
Signs and symptoms of kidney stones include:
Usually the pain starts when a stone moves into the narrow ureter. This causes a blockage, which makes pressure build up in the kidney. Pain often comes and goes in waves, which is made worse by the ureters contracting as they try to push the stone out.
Here the patient came with few symtoms of kidney stones such as severe low abdominal and back pain and the pain is intermittent which is mentioned above. Hence from these signs and symptoms the staff suggested that the patient may have kidney stones.
Case Scenario: A 23-year-old patient was the victim of a hit-and-run auto-pedestrian accident and suffered multiple...
Case Scenario: A 23-year-old patient was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately two hours after the incident and is now in the ER. His vital signs and hematocrit suggest that he has had a blood loss of about 2500 ml. A urinary catheter is inserted to monitor urine output, and fluid resuscitation is initiated while his wounds are cleaned and sutured....
P.W. is 23-years-old. He was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately 2 hours after the incident and is now in the emergency department. P.W's vital signs and hematocrit suggest that he has had a blood loss of about 2500 ml. A urinary catheter is inserted to monitor urine output and fluid resuscitation is initiated while his wounds are cleaned and sutured....
Hi, please help with answers to questions below in 100-250 words well-developed paragraphs. Your patient has a diagnosis of proteinuria. The patient is 12 years old and appears in good health. Symptoms have been present for approximately one week. The mother states she noticed her son’s legs are swollen, and he has had a sore throat for at least three weeks. Question: After the blood work is completed, the doctor wants to admit the patient for a complete urinary tract...
Case Scenario: A 35-year-old woman presents with an enlargement of her neck. She has been experiencing intermittent fevers and no other symptoms of infection, drenching night sweats, itchy skin, and fatigue. She has no prior health problems. She also reports to have lost 20 pounds in the last month, that was not an intentional loss. The doctor fears Hodgkin lymphoma. There is no family history. Question: Explain tests the doctor will likely run for a definitive diagnosis. You will need...
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...
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...
Case Scenario: A 40-year-old woman has been admitted with possible embolism. Her symptoms are chest pain, right leg temperature warmer than left, delivery of a baby by C-section three weeks ago, and fatigue and shortness of breath. Question: Why is this treated as an emergency? Support your answer using specific facts, data, examples, and other information drawn from the textbook and at least one other supplemental source.
Case Scenario: Your patient has cardiovascular disease (CVD) and has been admitted with these vitals: BP 190/90, HR 100, RR 35. When asked about symptoms, the patient states, “I have a very bad headache and feel light headed.” History reveals he has had one heart attack three years ago. He is a pack a day smoker and often drinks more than one drink per day. Question: Explain how vasoconstrictor hormones affect blood pressure. State the hormone and the direct cause...
Hi, please help with answers to questions below in 100-250 words well-developed paragraphs. Case Scenario: A mother drops off her 15-year-old son at soccer practice. He plays for a traveling team, and she is headed to the grocery store to do some shopping while he is occupied. While at the store, she receives a telephone call from the coach, telling her that her son was kicked just below the knee, causing him to fall to the ground. He was wearing...
Hi, please help with answers to questions below in 100-250 words well-developed paragraphs. Case Scenario: A 75-year-old gentleman was referred to an orthopedic physician because of shoulder pain. Upon examination, the physician finds that the man has had shoulder pain for more than five weeks. However, he doesn’t feel the pain when moving his shoulder. Instead, he feels pain after eating. His abdomen is distended, making him uncomfortable, but he states that he has no pain in this area. He...