a 60 yrs old male patient. brought to the hospital with complaints of SOB since 2 days bp.180/100mmhg bl.urea63mg/DL.sr.creatinine.10.1mg/DL...RBs 180 mg/DL....wbc...17,000...ESR...100..hb%-6.5gms



1)limb leads are not available 2)available ecg----sinus tachycardia tall" T"WAVE 3)DIGNOSIS---CRF 4)CAUSE---HT &DM NEPHROPATHY 5)treatment---urgent Hemodialysis when on HE pl.DO following a)ABG STUDY b)ST. ELECTROLYTE STUDY FOR PITASSIUM LEVEL c)Correction of HT. DM d)correction of anaemia F/U--HD 3TIMES IN A WK. F/U RFT HB. ELECTROLYTES ADV.---REST.FLUID INTAKE ---------AVOID---FRUITS PUNGENT ITEM AVOID COCONUT WATER FLUID INTAKE ---less than 1.5 lt./day

based on the reports its End Stage Renal Disease (CKD) and sob is becoz pat is in LVF....ECG S/o Sinus tachycardia and HYPERKALEMIA...Do Abg for met acidosis and take the pat immediately for HaemoDialysis urgently....its an medical emergency!!! post HD repeat all lab reports


It's nephropathy. Ecg reveals tall tented T waves suggestive of hyperkalemia.there is a discrepancy in RFT report. Creatinine is 10.1mg and bl urea is only 63mg.pl get his Creatinine clearance test.pl push in lasix 40mg iv.pl go for USG Abdomen pelvis. He may need dialysis after consulting Nephrologist

Limb leads are missing, 1° av block, peaked tented t wave,and also st seg dep and upslope t wave in leadv3to v5, hyper kalaemic, with LVH,pt is in CRF.

hyperkalemia T/t- calcium gluconate albuterol lasix k bind dialysis

case HTN with CKD.

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Give IV calcium gluconate 10ml 10% over 3 min with cardiac monitor repeat the dose of no change in the cardiac monitor ensure that patient is not taking dioxin if taking give it in 100 ml of 5% dextrose over 30 min after that give 10 units of regular insulin with 50 ml of 50% dextrose monitor blood glucose after 15 min as glucose in this patient is 180 administer both dextrose and insulin if glucose is more than 200 then we will administer only insulin After that give Nebulization with salbutomol Give IV sodium bicarbonate 150 meq in 1 lit 0.9%Nacl slowly over 2-3hrs Monitor K arrange for dialysis immediately Arrange resins for removal of potassium Advice adequate diet

Hyperkalemia with RVH.

Lateral wall infarction with hyperkalemia.

CKD Rx Go for HD Correction of HTN DM Electrolytes level DIURETIC must

What's the S.K peaked tall pointed T wave

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