What Factors Predisposed Mr. W. To Acute Kidney Injury Case Study

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1. What factors predisposed Mr. W. to acute kidney injury?

Some of the factors that caused Mr. W’s acute kidney injury are fever of 38.5° C, severe abdominal pain & nausea due to pancreatic inflammation with intra-abdominal ascites. One of the symptoms of ascites is infection which can cause kidney failure if not treated (ACG, 2013). Two different CT scan with contrast media performed can result to contrast-induced nephropathy due to preexisting decline in renal function. CIN can be defined as sudden, rapid deterioration of kidney function due to parenteral contrast administration. Contrast-induced kidney injury is diagnosed by an increase in serum creatinine of 25% or more within 48 to 72 hours following administration of contrast. Mr. W’s creatinine level increased from 0.8 to
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Nurses will administer medication after dialysis to prevent dialysis from clearing the medication before it becomes effective (Moore, 2016).
5. Which renal replacement therapy would be most suitable for this patient? Provide rationale for your selection.

After spending two days in the critical care unit, Mr. W’s urine output decreased to less than 0.5 mL/kg/hr. His serum potassium level was 6.3 mEq/L, and his creatinine level had risen to 3.8 mg/dL (hospital admission creatinine level was 0.8 mg/dL). I would expect continuous renal replacement therapy (CRRT) due to his hemodynamic instability. CTTR is gentler and also removes wastes and excess fluid in a slower fashion so that the hemodynamically unstable patient will be able to tolerate the therapy (Moore, 2016).

American college of gastroenterology. (2013). Ascites: A common problem in people with cirrhosis. Retrieved from http://patients.gi.org/topics/ascites/
NIH. (1999). Abdominal compartment syndrome; Critical care retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC137242/
Sole, M. L., Klein, D. G., & Moseley, M. J. (2013). Introduction to critical care nursing (6th ed.). St. Louis, MO:

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