Pginternalassessment/chandanavishwanatham
1.. Anatomical diagnosis - pedal edema causes 1) increased hydrostatic pressure 2) decreased oncotic pressure 3) lymphatic obstruction ?kidney ?cardiac ?liver. Etiological diagnosis - ?long standing CKD ( 6months history of pedal edema) sr creatine and blood urea levels are high ?diabetic nephropathy ? nephrotic pattern hypoalbuminemia ? abdomen distension ? right heart failure 2..reason of Azotemia:decreased excretion of nitrogenous waste by kidney causing increased BUN Anemia:iron deficiency, erythropoietin deficiency Hypoalbuminemia:albumin in urine is ++++, as there is proteinuria,there is hypoalbuminemia, nutritional cause may also contribute Acidosis:decreased resorption of bicarbonate, increased H+ ion secretion 3.. syp potclor was given to correct hypokalemia IV bicarbonate was given to correct metabolic acidosis and prevent adverse effects of acidemia(esp cardiovascular) IV bicarbonate should not be used in patients with high and low anion gap because it worsens la