Rhabdomyolysis with Crush Injury

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Lesson 9

Ved Niki Wiggam

WRT Measurement Plan

Ved Phiona Lloyd-Henry - Central Board Office (0001)

Types of Cellular Injury

Ved Chan Samuel

Patient Rx map Ali Forghany

Ved Ali Forghany

Renal ischemia

Free radical formation

Non-pharmacologic interventions

Pharmacologic interventions

Hyperphosphatemia

Hypocalcemia

Aggressively correct hypovolemia

metabolic acidosis

Mannitol

Myalgia and weakness

Buildup of lactic acid

Muscle Ischemia

Treat hypokalemia

Acute tubular necrosis

Strict I&Os

Monitor Labs

Fluid management

RAAS activation, SNS activation, ADH release

Renal constriction

Allopurinol

Hypovolemia

Half-isotonic saline with sodium bicarbonate

Low pH of urine

Decrease in GFR

Distal tubular obstruction

Filtered through kidneys

Causes myoglobinuria

Buildup causes cast formation

Release of intracellular contents into the bloodstream

Nucleotides

liver

increase of uric acid in kidneys

Cardiac Arrhythmias

Myoglobin

Hyperkalemia

Compression of muscle due to inelastic fascia

Crush injury

Muscle swelling due to trauma

Lysis of skeletal muscle cells

Compartment Syndrome

Nursing interventions

Increased uric acid concentration?

Rhabdomyolysis