NRNP 6566 WK 10 Knowledge
Check.
• Question 1
Needs Grading
A 57 year old female is admitted to the oncology unit for chemotherapy related to
her to acute leukemia. Her initial dose of chemo was 2 days ago. While
rounding today, the patients tells the NP that she feels so weak. The NP notes her
heart rate is 44 today (down from 68 2 days ago). She has had less than 100 cc
of urine out over the last 24 hours.
Labs from this morning include:
LAB DATA:
-Sodium 131
-Potassium 7.8
-Chloride 105
-Bicarbonate 17
-BUN 67
-Creatinine 5.8
-Glucose 83
-Calcium 7.6
-Phosphorus 6.8
-Uric acid 16.3
What is your working diagnosis for this patient? How would you treat her?
Correct
Answer: Diagnosis is hyperkalmeia probably from tumor lysis syndrome.
Chemotherapy has cause cells to die releasing potassium into the
circulation. The elevated uric acid, phsophorus, low calcium, and
acute renal failure all stem from tumor lysis.
Treatment
Check a 12 lead EKG
Give calcium gluconate to stabilize cardiac function
Begin insulin and dextrose to shift potassium into the intracellular
space.
Aggressively administer fluids to treat potential pre-renal azotemia
Consider Kayexalate to remove potassium.
Response [None Given]
Feedback:
• Question 2
Needs Grading
Using the Cockcroft and Gault formula, calculate the estimated GFR for the
following patient. 52 year old female weighting 177 pounds. Plasma creatinine is
3.3
Correct
Answer: The formula is:
,
Check.
• Question 1
Needs Grading
A 57 year old female is admitted to the oncology unit for chemotherapy related to
her to acute leukemia. Her initial dose of chemo was 2 days ago. While
rounding today, the patients tells the NP that she feels so weak. The NP notes her
heart rate is 44 today (down from 68 2 days ago). She has had less than 100 cc
of urine out over the last 24 hours.
Labs from this morning include:
LAB DATA:
-Sodium 131
-Potassium 7.8
-Chloride 105
-Bicarbonate 17
-BUN 67
-Creatinine 5.8
-Glucose 83
-Calcium 7.6
-Phosphorus 6.8
-Uric acid 16.3
What is your working diagnosis for this patient? How would you treat her?
Correct
Answer: Diagnosis is hyperkalmeia probably from tumor lysis syndrome.
Chemotherapy has cause cells to die releasing potassium into the
circulation. The elevated uric acid, phsophorus, low calcium, and
acute renal failure all stem from tumor lysis.
Treatment
Check a 12 lead EKG
Give calcium gluconate to stabilize cardiac function
Begin insulin and dextrose to shift potassium into the intracellular
space.
Aggressively administer fluids to treat potential pre-renal azotemia
Consider Kayexalate to remove potassium.
Response [None Given]
Feedback:
• Question 2
Needs Grading
Using the Cockcroft and Gault formula, calculate the estimated GFR for the
following patient. 52 year old female weighting 177 pounds. Plasma creatinine is
3.3
Correct
Answer: The formula is:
,
