G.R. is a successful collage artist. He works with adhesives,paints, and solvents, which often must be heated to producetextured artworks. During the summer months he works out of doorsand in the colder weather works in his studio, which is equippedwith an exhaust fan. On very cold days he sometimes turns off thefan. He has been working very long hours to prepare for hisupcoming winter show. Several times in the past few days he hascommented to his partner that he feels weak, nauseated, and unableto work. He has noticed that he is not producing as much urine andthinks that this is due to decreased fluid intake during work. Hispartner contacts his doctor and takes him to the emergencydepartment as directed. When seen in the emergency clinic, hisblood pressure is 170/96, he has an abnormal pulse, and blood testsreveal elevated BUN, K+ and creatinine levels. Further tests leadto a diagnosis of acute renal failure due to tubular necrosis.

1. What are possible causes of acute renal failure in thiscase?

2. How have the kidneys been damaged; will they recover normalfunction?

3. What is the cause of nausea and fatigue?

4. Explain how hypertension has developed in G.R.

5. Explain the cause of oliguria.

G.R. is hospitalized and treated with steroid medication andemergency hemodialysis. Four days later he begins to void largevolumes of urine.

1. What is the significance of diuresis in this case?

2. What can G.R. expect in the future; what changes need to bemade in regard to his work to prevent recurrence of acute renalfailure or the development of chronic renal failure in thefuture?

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1As the patient is a artist he was been exposed to organic solvents for many years and some times he ... View the full answer