A client with significant burns on his lower body has developed sepsis on the 3rd day following his accident. Which of the following manifestations would the nurse anticipate for an ischemic acute tubular necrosis rather than prerenal failure?
The client:
A) Exhibits pulmonary and peripheral edema
B) GFR does not increase after restoration of renal blood flow
C) Undergoes emergent hemodialysis that does not result in decreased BUN and creatinine
D) Exhibits oliguria and frank hematuria
Ans: B
Feedback:
In contrast to prerenal failure, the glomerular filtration rate (GFR) does not improve with the restoration of renal blood flow in acute renal failure caused by ischemic acute tubular necrosis. Edema, oliguria, and hematuria are not diagnostic of acute tubular necrosis (ATN), and hemodialysis does not normally fail to achieve a reduction in blood urea nitrogen (BUN) and creatinine.
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