Renal failure case study

 CASE STUDY 2

This is a 1-day-old girl born at 26 weeks’ gestation via a spon-

taneous vaginal delivery 2 days following premature rupture

of membranes. Her birth weight was 750 g and her Apgar

scores were 5 and 6 at 1 and 5 minutes of life. She was intu-

bated and given surfactant. After a blood specimen was

drawn for culture, she was started on ampicillin and gentami-

cin and given maintenance intravenous (IV) fluid. She fails to

pass urine in the first 24 hours after birth, and her blood pres-

sures are persistently low at 30/20 mm Hg.

Questions

1. When should newborns pass the first urine after birth?

2. What should you do first to evaluate and treat this infant?

3. Is she at risk for gentamicin toxicity?

Comments

Post a Comment

Popular posts from this blog

The answer of case 2 renal failure

 1. Studies have shown that almost 100% of newborns have  the first void within 24 hours after birth and nearly half of  them void 8 hours after birth (Clark, 1977). Although very  few infants of less than 32 weeks’ gestation were documented in these studies and the time of the first void varies considerably, failing to pass urine beyond 24 hours  should prompt the physician to evaluate and intervene for  newborns of any gestational age. 2. She required resuscitation at birth and has a persistently  low blood pressure that may be limiting perfusion of vital  organs, including the heart and kidneys. Prolonged hypotension could serve as a prerenal etiology for acute ischemic and hypoxic injury to the kidney and should be  corrected immediately. A normal saline infusion at 10 mL/kg (over 30 minutes) can be given at this time, and a re- peated dose with the same volume could be considered if  there is no significant improvement in the blood pressure.  A renal ultrasound is also recommended
Read more

neonatal pharmacokinetics

 One of the most important things in neonates is their pharmacokinetics as it differs a lot from adult one must know to be able to use the medications effectively  Use this link to know everything you need about neonatal pharmacokinetics   https://youtu.be/5IkWtCFyIoo
Read more