Arf Case Study Essay

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Pages: 11

ARF Case Study

Acute Renal Failure Case Study

Directions: Please carefully read the following case study and answer the following questions in typed format. The resources that you will need to complete this case study include your textbook and drug book. Please include in text citations. This independent assignment is worth 25 points.
Ann Hayes, age 68, initially was admitted to the hospital for elective surgical repair of an abdominal aortic aneurysm. Her surgery was documented as uneventful. However, complications developed during her 5th postoperative day as a result of a small bowel perforation.

Postoperative Day 5 Vital Signs | B/P | 170/94 mmHg | HR | 110 bpm | Respirations | 30 breaths/min |
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A pattern of several hours of anuria with flank pain followed by polyuria is a hallmark finding. This type of renal failure can occur after diagnostic catheterization of the uterus, a procedure that may cause edema of the tubular lumen (Perrin, 2009).

2. Describe the four phases in the clinical course of ARF.

1. Onset phase- is the phase which immediately follows the period of renal injury; it lasts about two to four days. Throughout this phase, the patient’s urinary output typically declines to 20% of normal and the BUN and creatinine may begin to slightly increase (Perrin, 2009). 2. Oliguric phase- during this phase, the pt excretes less than 400 mL of urine/day. This phase typically lasts 10 to 14 days, and the pt retains fluid, is unable to maintain electrolyte and/or acid-base balance, and cannot excrete sufficient amounts of nitrogenous wastes (Perrin, 2009). 3. Diuretic phase- during this phase, a pts urinary output generally increases, often producing up to five liters of urine each day. However, it is not uncommon that these pts still may not be able to completely excrete wastes and regulate electrolyte or acid-base balance. The BUN and creatinine usually decline slowly toward normal over a 10 day period (Perrin, 2009). 4. Recovery phase- this phase generally lasts anywhere from 6 months to a year. Renal