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ACUTE RENAL FAILURE AND CHRONIC RENAL FAILURE
I. ROC
Part I
Name: Julie Marrow
Age: 24
Gender: Female
History:
-2 days post partum
-underwent Cesarean section
-had Lupus Erythematosus for 3 years
Complaints:
- 34 weeks pregnant
- Pregnancy induced Hypertension (HTN)
Upon admission:
-diagnosed with HELLP syndrome
H -- hemolysis (the breakdown of red blood cells)
EL -- elevated liver enzymes
LP -- low platelet count
Upon delivery:
-hypovolymic
-suffered hypovolymic shock
- massive bleeding
several hrs after delivery :
-remained hemodynamically unstable inspite of blood, blood products and fluid replacement
-dopamine @ 3-10 mcg/kg/min
-levophed @ 4 mcg/min
For the past 2 days:
- BP ranges from 60/48 to 98/58
For the last 12 hours:
- urine output in minimal (0-30 cc/hour *
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SaO2 (Oxygen saturation) 90% [normal 90-95 %]
BUN 145 [normal 7-20 mg/dl]
Creatinine- 9.4 [normal 0.5-1.4]
K-6.4 U/L
Ca-8.0 U/L
Alk P- 154 U/L
SGOT (serum glutamic-oxaloacetic transaminase; or AST aspartate transaminase) 34 mcg/L [normal