Med Surg Question

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Guys help me out:

The following laboratory results are received for a patient being managed with osmotic diuretics for increase intracranial pressures. Which of the following laboratory results should the nurse be concerned with? Select all that apply:

  1. Sodium level
  2. Creatinine clearance
  3. Serum osmolality
  4. Sedimentation rate

I think is A,B,C. Some students think is C b/c they believe serum osmolality alone is an indicator of creatinine clearance and Sodium level. What if the serum osmolality is 310(they recommend up to 320 to decrease ICP and avoid renal failure) but the patient has a very low creatinine clearance, would you still manage him/her with osmotic diuretics(mannitol in this case)?

Thank you for reading

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

First you must know what osmotic diuresis is.........Osmotic diuretics

https://www.inkling.com/read/pharm-phys-anesthetic-practice-stoelting-4th/chapter-25/osmotic-diuretics

What diuretics do and how they work.....https://www.google.com/search?q=osmotic+diuretics+for+increase+intracranial+pressures&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a

What does an elevated serum osmo mean and what side effects to the patient can it cause?

Which lab would be an indicator of extreme dehydration?

So if your patient is being treated with an osmotic diuretic......

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Than you for reading.

Sorry I did not explain myself very well. After knowing how mannitol works, and what those set of lab. values mean.....Is the serum osmolality value by itself enough supportive data to keep treating the patient with mannitol or would you also consider creatinine clearance and serum sodium? If the patient has an aceptable value of serum osmolality does that fact necessary mean the Na+ and creatinine clearance are within normal values? My main concern is with kidney failure.

Thank you again

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Is this the whole question?

The following laboratory results are received for a patient being managed with osmotic diuretics for increase intracranial pressures. Which of the following laboratory results should the nurse be concerned with? Select all that apply:

  1. Sodium level
  2. Creatinine clearance
  3. Serum osmolality
  4. Sedimentation rate

Then the links I posted answered your question. If this patient is getting this therapy which labs would the nurse look for?

You keep treating the patient do the desired effect....a normalized ICP (intercranial pressure), or abnormal lab values. Osmotic diuretics are also ordered in the presence of renal failure.....but the question is asking what labs will the nurse watch carefully while this patient is on the therapy.....what labs will be disturbed by diuresis?

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Thank you

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Your focus is not the renal failure, it's the increased intracranial pressure, because that's gonna have worse effects faster than anything the kidneys can do. Look up how serum osmolarity affects that. Figure out how renal dysfunction affects that.

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