Author Question: A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow ... (Read 45 times)

jjjetplane · **on:** Jun 28, 2018

A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?

a. Propranolol (Inderal)
b. Calcium gluconate
c. Mannitol (Osmitrol) or furosemide (Lasix) (or both)
d. Sodium, chloride, and potassium

Question 2

What major complication is associated with a child with chronic renal failure?

a. Hypokalemia
b. Metabolic alkalosis
c. Water and sodium retention
d. Excessive excretion of blood urea nitrogen

diana chang · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: C
In ARF, if hydration is adequate, mannitol or furosemide (or both) is administered to provoke a flow of urine. If glomerular function is intact, an osmotic diuresis will occur. Propranolol is a beta-blocker; it will not produce a rapid flow of urine in ARF. Calcium gluconate is administered for its protective cardiac effect when hyperkalemia exists. It does not affect diuresis. Electrolyte measurements must be done before administration of sodium, chloride, or potassium. These substances are not given unless there are other large, ongoing losses. In the absence of urine production, potassium levels may be elevated, and additional potassium can cause cardiac dysrhythmias.

Answer to Question 2

ANS: C
Chronic renal failure leads to water and sodium retention, which contributes to edema and vascular congestion. Hyperkalemia, metabolic acidosis, and retention of blood urea nitrogen are complications of chronic renal failure.