Case-3: Patient History P.W. is 23 years old. He was the victim of a hit-and-run
ID: 91790 • Letter: C
Question
Case-3: Patient History
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. The urine output is averaging 15 ml/hr, with a high urine osmolality and low urine sodium.
Analyze this case study and answer the next four questions that follow.
Case-3: Question-3
In addition to urine output, what laboratory data should be monitored to assess changes in P.W.’s renal function? (select all that apply)
A) Creatinine clearance can be measured to more accurately assess glomerular filtration rate.Explanation / Answer
Option A, B and C are correct answer. Creatinin is a breakdown product of creatin phosphate in muscle which is excreted by the kidney in unchanged form. Abnormal clearance indicates that the rate of filtration of creatinine by glomerulas of kidney is not proper. An increase in serum BUN, creatinine and potassium level indicate decreased renal function. In severe blood loss, the composition of IV fluid given is a major factor because a hepertonic may cause pulmonary edema and hypotonioc solution may enhance the complication of hypovolamia.