Case 1 (Chapter 31): Alterations in Renal and Urinary Tract FunctionSource: Copstead, L. & Banasik, J. (2006). Pathophysiology (3rd ed.). Mosby.P.W. was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of the left thigh. He was discovered approximately 2 hours after the incident and is now in the emergency department. P.W.’s vital signs and hematocrit suggest that he has had a major blood loss of about 2000 ml. A catheter is inserted to monitor urine output, and P.W. is fluid resuscitated while his wounds are cleaned and sutured. The urine output is quite low, with high urine osmolality and low urine sodium.Case QuestionsWhat type of renal failure is P.W. at risk for developing?What is the best therapy to preventing renal failure?In view of the low urine output, high osmolality, and low sodium, what stage is P.W. currently in?In addition to urine output, what laboratory data should be monitored to assess changes in P.W.’s renal function?
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