A 72 y/o 50kg female presents to the ER complaining of blurred vision, nausea an

Question

A 72 y/o 50kg female presents to the ER complaining of blurred vision, nausea and vomiting. A physical exam found right unilateral weakness and numbness. During the exam, she experienced a seizure and became comatose. Bloodwork found:

            Serum [Na+]                 140 mEq/L                  

            Serum [K+]                 4.2 mEq/L                   

            Serum [HCO3-]            27 mEq/L                    

            PCO2 41 mmHg                    

            Serum creatinine           1.0 mg/dl        

The physician immediately ordered an infusion of 5 g/kg mannitol. After equilibration, how would the body volumes change if one assumes that no excretion occurs and that the volume of the mannitol solution is 1000 ml. (3pts)

How would this benefit the patient acutely (1pt)?   Chronically (1pt)?

Explanation / Answer

1) The patient is suffering from acute renal failure and the signs and symptoms are nauaea ,vomiting, blirred vision, unilateral weakness and seizure and coma and decreased urine production is seen( oliguria), so when mannitol is administered, the mannitol acts as a diuretics and used in the prevention and treatment of oliguria of acute renal failure and also helps in reduction of introcular, intracranial and cerebral edema and also helps in elimating the toxic substances from the body, and intracellular dehydration is seen ,and extracellular volume expansion, hypernaterimia, hyperosmolar , and hypetkalemia etc. 2) the benefit of mannitol acuetly is increases urine output and helps to keep the kidney from shutting down, the benefit of mannitol chronically is it prevents the damage of kidney

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