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  • Aki 1

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    May Zaiter
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    1. A 69-year-old male presented with fatigue, dizziness, fever, and ECG changes. His labs showed hypokalemia, hyponatremia, and acute kidney injury. 2. The goals of treatment are to correct electrolyte imbalances, reduce fever, minimize further kidney damage, and restore renal function. Any medications harming the kidneys should be stopped. 3. The patient was given IV fluids, potassium supplements, and paracetamol for fever. Medications like enalapril and hydrochlorothiazide were stopped due to their nephrotoxic effects, while other medications were continued or adjusted. Close monitoring of

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    AKI 1

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    1. A 69-year-old male presented with fatigue, dizziness, fever, and ECG changes. His labs showed hypokalemia, hyponatremia, and acute kidney injury. 2. The goals of treatment are to correct electrolyte imbalances, reduce fever, minimize further kidney damage, and restore renal function. Any medications harming the kidneys should be stopped. 3. The patient was given IV fluids, potassium supplements, and paracetamol for fever. Medications like enalapril and hydrochlorothiazide were stopped due to their nephrotoxic effects, while other medications were continued or adjusted. Close monitoring of

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    4 views2 pages

    Aki 1

    Uploaded by

    May Zaiter
    1. A 69-year-old male presented with fatigue, dizziness, fever, and ECG changes. His labs showed hypokalemia, hyponatremia, and acute kidney injury. 2. The goals of treatment are to correct electrolyte imbalances, reduce fever, minimize further kidney damage, and restore renal function. Any medications harming the kidneys should be stopped. 3. The patient was given IV fluids, potassium supplements, and paracetamol for fever. Medications like enalapril and hydrochlorothiazide were stopped due to their nephrotoxic effects, while other medications were continued or adjusted. Close monitoring of

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    of 2

    Internal medicine Case 1 (AKI)

    Mohammad Foqahaa 11840178

    1)Finding

    Name: ZY Age: 69years BP: 96/60 mm


    Gender: Male Blood group: A+ HR: 90 bpm
    Height: 175cm Weight: 90kg SpO2: 99%
    Adress: Tulkarm Tel:05999999 Tem:39
    Immunization: Full immunized Food/drug allergy: NKFDA BSA: 2.09 m2
     Family history: Free.

     Social history: He is unemployed and does not smoke or drink alcohol. He is married
    and has three daughters and two sons. He is committed to an eating plan that is low in
    sodium and rich in fiber. He likes to drink caffeine and tea.

     PMH: HTN, CHF & PBH. Previous CABG surgery before 3years.

     Current medications:
    Baby Aspirin PO once daily
    Hydrochlorothiazide 25mg PO once daily
    Bisoprolol 2.5mg PO once daily
    Enalapril 10mg POonce daily
    Doxasozine 4mg PO once daily
    Amlodipine 5mg PO once daily

     Chef compliance: Patient oriented, alert presented to ED with fatigue, Dizziness, fever.

     Sings & symptoms:


    -Fatigue, Dizziness, fever, ECG changes.
    -LABS: Sodium 120mEq/L
    Potassium 3mmol/L
    Creatinine 1.6mg/dl
    C-reactive protein 8 mg/dL
     Final diagnosis: Hypokalemia, Hyponatremia & AKI.

    2) Assessment

     Short term gals:


    -Correcting electrolyte levels.
    -Reduce body temperature.
    -Minimizing the degree of insult to the kidney.
    -Reducing extra renal complications.
    -Expediting recovery of renal function.
    -Maintenance of adequate cardiac output and blood pressure to optimize tissue
    perfusion while restoring renal function to pre-AKI baseline.

     Long term gals:


    -Restore kidney function to pre-AKI baseline.
    -Reduce mortality and morbidity.
    -maintained controlled blood pressure.

     DRP: Any medication that harms kidney function should be stopped.

    3)Resolution

     Non-pharmacological
    -Appropriate fluid replacement should be initiated:
    Give IVF NS 500ml q5hrs with KCL 10mcg with ECHE drip.
    -Avoidance of nephrotoxins.

     Pharmacological
    -Continue :
    Aspirin 81mg PO once daily
    Bisoprolol 2.5mg PO once daily
    Doxasozine 4mg PO once daily
    Amlodipine 5mg PO once daily
    -Stop:
    Enalapril 10mg POonce daily
    Hydrochlorothiazide 25mg PO once daily
    -Add:
    Paracetamol 1g PO SOS
    Furosemide 40mg PO once
    Slow-k tab 1*3

    4) Monitoring

    Aspirin: monitor sings of bleeding


    Doxasozine and Amlodipine: Blood pressure (risk of hypotention), dizziness, headache.
    Bisoprolol: heart rate and blood pressure.
    Furosemide: potassium, SCr& kidney functions. Contraindicated with anuria.

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