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Which of the following medications are used to treat hyperphosphotemia of ESRD? Select ALL that apply.

D.B is a 67-year-old male with ESRD on dialysis who has been on Epogen 3000 units SC three times a week for anemia of chronic renal failure. His recent labs are as follows:

Hgb …………………. 12.6 g/dL (13.5 – 16.5 g/dL for males)

Hct …………………… 38.6 % (40% – 52%)

MCV …………………. 86 fL

WBC ………………… 4.0 thous/microL

Platelets …………….. 185 thous/microL

With regards to his Epogen dosing, what would be the most appropriate course of action?

R.N. a 56-year-old male, presents to ER with progressively worsening shortness of breath at rest, fatigue, and bilateral pitting edema of his legs for the last few months. He has a history of diabetes and long standing hypertension. 

Current Medications:

Metformin 1000 mg bid

Pioglitazone 30 mg/day

Hydrochlorothiazide 25 mg/day

Lisinopril 40 mg/day

Amlodipine 10 mg/day

VS:   BP: 110/63 mmHg    P: 110,    Resp Rate: 26    Temp: 97.8

Labs:

BUN  ................................   19 mg/dL

Serum Creatinine .........    1.1 mg/dL

Potassium .....................     3.1 mEq/L

BNP ...............................     960 (10 - 300)

Troponins .....................     Negative

Chest x-ray ..................      Enlarged cardiac silhouette, mild pulmonary edema

Echo: EF  ......................      32%

Which of his medications may be worsening his symptoms? Select ALL that apply.

If your patient is on Normal Saline IV maintenance rate of 100 cc per hour, how many miliEquivalents of NaCl will he be receiving in a day?  MW of NaCl = 58.5

Round DOWN to the nearest WHOLE number. 

R.P. a 78-year-old male patient with history of HTN, stage 4 CKD, and type 2 DM, complains of severe chronic pain.

Social history: Smoker

Vitals: BP: 129/88 mm Hg,   Pulse: 74   Resp Rate: 14   Temp: 98.6

Serum Creatinine ……………  3.9 mg/dL

Which of the following pain medications is/are not renally cleared and thus a good choice for R.P? Select ALL that apply.

J.S is a 46 year-old-male with DKA has been admitted to ICU. His Basic Metabolic Panel is as follows:

Na⁺  ……………..  135 mEq/L

Cl^- …………….…  100 mEq/L

HCO3^- ………….    5 mEq/L

Ca⁺⁺  …………...    8.5 mg/dL

Calculate his Anion Gap. Enter answer as a WHOLE number.

Which of the following is NOT a suspending agent?