After assessing K.Z., the physician admits him with a diagnosis of CAD and HF for coronary artery bypass graft (CABG) surgery
Significant laboratory results drawn at this time are Hct 25.3%, Hgb 8.8 g/dL, BUN
33 mg/dL, and creatinine 3.1 mg/dL. K.Z. is given furosemide (Lasix) and 2 units of packed red blood cells
(PRBCs).
Review K.Z.'s health history. Can you identify a probable explanation for his chronic renal
insufficiency and anemia?
Why is he receiving 2 units of PRBCs? What is the purpose of the furosemide?
If the perfusion to the kidneys is poor over a prolonged period, renal insufficiency develops.
One major cause of chronic, poor perfusion to his kidneys may be renal artery vascular disease
promoted by his long-term smoking habit. In addition, poorly perfused kidneys are not able to
produce adequate amounts of erythropoietin, an important factor stimulating RBC production. This
contributes to a chronic anemic condition.
K.Z. was anemic, and RBCs are necessary to carry oxygen and remove carbon dioxide. The
furosemide is a diuretic and is given to help K.Z. eliminate excess fluid and decrease the risk of
exacerbating the HF with the PRBC transfusions.
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