Question

J.R. is a 73-yr old man, who was admitted to the hospital with clinical manifestations of probable renal failure. He has had hypertension for 14 years, and an acute myocardial infarction 10 yrs prior. He has a history of atherosclerosis. 1. What questions do you need to ask J.R. to assess for renal failure? 2. What are the risk factors for renal failure? What does J.R. have that is contributing to this condition? 3. What is the difference between chronic and acute renal failure? What might you suspect J.R. has? Why?

Answer 1

1. Questions to be asked to assess renal failure

1) Do you have diarrhea or vomitting?

2) How many liters of water do you drink daily?

3) What is the colour of urine?

4) Ask the patient about the flow of urine- is it is reducing or stoping while urinating?

5) Ask for any pain while urinating? obesity

*

2. The risk factors for renal disease

* High blood pressure

* chain smoking

* heart disease

* diabetes

* age facors

* Continous urinary infections

* exposure to certain medications

* urinary stones

* abnormal kidney structure

JR has high blood pressure and acute MI contributing to this condition.

Difference between acute and chronic renal failure

     Acute renal failure                                               Chronic renal failure

     * it can be reversible                                               * it is irreversible

     * it occurs over days to weeks                                 * it occurs over weeks to months

     * oliguria and anuria                                                * polyuria and nocturia

     * high gravity                                                          * low gravity

     * normal haemoglobin concentration                         * low haemoglobin concentration

     * size of kidney will be normal                                  * size of kidney is reduced

     * dialysis required for short period                             * dialysis required repeatedly

     * renal transplantation not required                            * renal transplantation required

I think JR has acute renal failure because there is no where mentioned about any history of kidney disease, urinary infection and problems regarding urination- its frequency, colour,pain etc. I guess he has acute renal failure due to the history of severe blood pressure and heart disease