36. A 3-month-old boy is brought to the emergency department because of a 2-day history of lethargy. Physical examination shows no other abnormalities. The results oflaboratory studies are shown:SerumNa+165 mEq/L (N=139-146)CI-130 mEq/L (N=95-105)334 mOsmol/kg H₂O (N=282-295)OsmolalityUrine1.001Specific gravityOsmolality117 mOsmol/kg H₂O (N>200)He is admitted to the hospital. His urine output is increased. His serum ADH (vasopressin) concentration is 24 pg/mL (N=1-5); aldosterone and renin concentrationsare within the reference ranges. The urine osmolality remains unchanged after administration of 1-deamino-8-arginine vasopressin. An MRI of the brain and pituitarygland shows no abnormalities. Ultrasonography shows normal kidneys. The most likely underlying cause of the findings in this patient is a defect in which of thefollowing?A) Angiotensin-converting enzymeB) AquaporinC) 11a-HydroxylaseD) ReninE) Vasopressin receptors

A) Angiotensin-converting Enzyme - Defect in Angiotensin-converting Enzyme (ACE) prevent an enzyme…

Answered: 36. A 3-month-old boy is brought to the…

Curren'S Math For Meds: Dosages & Sol

11th Edition

ISBN:9781305143531

Author:CURREN

Publisher:CURREN

Chapter20: Iv Medication And Titration Calculations

Section: Chapter Questions

Problem 27SST

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A 68-year-old lady with bowel cancer who had been admitted to hospital following a fall had a persistent low plasma sodium including the following plasma results (refer- ence ranges are given in brackets): Sodium Potassium Urea Creatinine Glucose Osmolality 120 mmol/L 3.9 mmol/L 3.4 mmol/L 53 μmol/L 5.2 mmol/L 255 mOsm/kg (135-145) (3.5-5.0) (3.5-6.6) (70-150) (3.5-5.5) (285-305) In this patient, the urine volume was low and relatively concentrated, the urine osmo- lality was 374 mOsm/kg and its sodium concentration was 75 mmol/L. Comment on these results.
A 3-month-old boy is brought to the emergency department because of a 20day history of lethargy. Physical examination shows no other abnormalities. The results of laboratory studies are shown: serum: Na+ 165 mEa/L (N=139-146) Cl- 130 mEq/L (N=95-105) Osmolality 334 mOsmol/kg H2O (N=282-295) urine: specific gravity 1.001 osmolality 117 mOsmol/kg H2O (N>200) He is admitted to the hospital. His urine output is increased. His serum ADH (vasopressin) concentraion is 24 pg/mL (N=1-5); aldosterone and renin concentrations are within the reference ranges. The urine osmolality remains unchanges after administration of 1-deamino-B-arginine vasopressin. An MRI of the brain and pituitary gland shows no abnormalities. Ultrasonography shows normal kidneys. The most likely underlying cause of the findings in this patient is a defect in which of the following?a. angiotensin-converting enzyme b. aquaporin c. 11a-Hydroxylase d. renin e. vasopressin receptors
A 60-year-old woman with history of lung cancer is admitted for weakness and lethargy for 4 weeks. Her serum [Na*] is 120 mEq/L. She weighs 60 kg. Her serum osmolality is 250 mOsm/kg H2O with urine osmolality of 616 mOsm/kg H2O. The diagnosis of SIADH is made. What would be her serum [Na], if she receives 1 L of isotonic saline? A. 122 mEq/L B. 116 mEq/L C. 118 mEq/L D. 120 mEq/L E. 124 mEq/L
A 78-year-old lady receiving treatment for hypertension was investigated by her doctor by monitoring renal function tests (reference ranges are given in brackets): 142 mmol/L 2.2 mmol/L Sodium Potassium Urea Creatinine Comment on these results. 8.9 mmol/L 142 μmol/L (135-145) (3.5-5.0) (3.5-6.6) (70-150)
Table 3. Serum creatinine values at admission and after 12h Admission +12h SCR(mg/dL) 1.55 1.42 Using the “MDRD” (Modification of Diet in Renal Disease) equation for estimating glomerularfiltration, provided below, and the data available in the above table, calculate the patient's (a 34 year old white male) estimated glomerularfiltration rate (eGFR) at admission and 12h after admission.MDRD GFR Equation (mL/min/1.73 m2)= 175 × (Scr)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if African American)Based on your calculated values, state whether LF’s function is normal or abnormal?Previous research suggests that patients with asthma have an increased risk for chronic kidneydisease, but the mechanisms underlying this increased risk are poorly understood. Propose one potential mechanism by which asthma might impair kidney function, and discuss how this dysfunction may impair thebody’s ability to respond to respiratory alkalosis
65. In acute hypersensitivity reactions, 0.5 mL of a 1:1000 (w/v) solution of epi- nephrine may be administered subcuta- neously or intramuscularly. Calculate the milligrams of epinephrine given. 65. 0.5 mg epinephrine
80. An investigator is studying the effects of a hormone in two groups of experimental animals. During a 2-hour period, Group X receives an infusion of 0.9% saline and Group Y receives an infusion of the hormone. The following findings are recorded: Group X Group Y Pulse 380/min 550/min Mean arterial blood pressure Serum 120 mm Hg 150 mm Hg Glucose 80 mg/dL 130 mg/dL Free fatty acids 3.5 JEq/L 7.5 JEq/L Plasma renin 2.5 ng/ml/h 18 ng/mL/h Group Y most likely received which of the following hormones? A) ADH (vasopressin) B ) Aldosterone C ) Cortisol D) Epinephrine E) Glucagon F) Growth hormone G) Thyroxine (T 4)
An 85 year old women with a history of diabetes mellitus and a broken hip has been confined to bed for 3 months. She has been complaining of aching muscles and her recent blood glucose result is 250mg/dL (Normal Range 70 - 100mg/dL) Urinalysis is with the following results: Color: Reddish brown Appearance: Clear Sp Gr: 1.020, pн 5.0 Protein: 2+ Glucose: 100 mg/dL (3+) Ketones: Negative Blood: Moderate Bilirubin: Negative Urobilinogen: Normal Nitrite: Negative Leukocyte esterase: Negative Microscopic exam: 0 – 2 WBC/hpf; few squamous epithelial cells/hpf Questions (3): A. What is the significance of the negative Ketones result? a. Increased fat metabolism b. Fat is not being metabolized for energy c. Starvation d. Patient has just consumed a high fat meal B. Glucose will appear in the urine when the: a. Blood level of glucose is greater than 180 mg/dL b. Tm (Transport maximum) for glucose in tubular cells is exceeded c. Renal threshold for glucose is exceeded d. All of the above C. The…
A 26 year old female with hypokalaemia is prescribed an intravenous infusion of 0.15% potassium chloride (KCl) to correct this imbalance. She is to receive 50 mL 0.15% KCl over 6 hours. (0.15% KCl contains 20 mmol KCl per litre) How much potassium (in mmol/hour) is the patient receiving? units -mmol/hr
A nurse practitioner orders an isotonic sodium lactate solution with a 50. mL solution per kg body mass to be administered intravenously for a 225-lb patient with severe acidosis. The rate of flow is 151 gtts/min, and the IV administration set delivers 19 gtts/mL, where the unit gtts stands for drops of liquid. What is the running time in minutes?
Ibuprofen for infusion comes in vials containing 400 mg of ibuprofen in 4 mL. Scotty requires 410 mg of ibuprofen to be infused every 6 hours. The solution for infusion has a concentration of 2.5 mg per mL. Calculate the volume of 5% glucose solution required to dilute the concentrated solution. Answer: 0.44 mL X *********
A 72-year-old adult patient who weighs 78 kg is prescribed by the doctor “Potassium Chloride 40meq in 1L to run for 8 hours” via the peripheral line for a potassium level of 3.3 mEq/L that was drawn this morning. Note: 10 mEq of potassium chloride increases serum potassium levels by approximately 0.1 mEq/.L The concentration of potassium for intravenous administration via a peripheral line should not exceed 40mmol / 500 mL 10 mEq/hr maximum infusion rate; not to exceed 200 mEq dose/24hr Administration rates above 20mmol/hour require cardiac monitoring. How much will the order medication “Potassium Chloride 40meq in 1L to run for 8 hours” raise the patient's potassium level in a day? Is it still within the normal potassium serum levels, which is 3.5–5.0 mEq/L? Does the order comply with the maximum concentration of potassium to be administered peripherally? Does the order’s infusion rate do not exceed the standard maximum infusion rate? Does the order require cardiac monitoring?

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