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Rhabdomyolysis case study
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Understanding the Syndrome, Complications, and Nursing Considerations
Introduction
Mild muscle pain can be a common side effect of physical means, such as intense workouts, over usage of muscle, and/or blocked blood vessels, or by chemical means, such as toxins, heat or drugs. Oftentimes, people who experience muscle aches can easily pinpoint the cause due to their knowledge of the stress, tension, or physical activity they have endured. Rhabdomyolysis, or dissolution of skeletal muscle, is a syndrome caused by injury to skeletal muscle and involves the leakage of large quantities of potentially toxic intracellular contents into plasma (Muscal, 2013). In contrast to mild muscle pain, Rhabdomyolysis, commonly known as ‘Rhabdo’, may result in life-threatening renal failure and disseminated intravascular coagulation (DIC) while also being multifactorial in adult patients (Muscal, 2013). Approximately 28-37% of all Rhabdomyolysis cases in the United States require short term hemodyalysis (Melli G, 2013). The purpose of this paper is to explore the causes, signs and symptoms, nursing considerations and workout trends that are being blamed for inducing ‘Rhabdo’ in athletes.
Rhabdomyolysis
According to the National Discharge Survey, there are approximately 26,000 cases of Rhabdomyolysis that are reported throughout the United States annually (Melli G, 2013). Sixty percent of these cases in adults include multiple factors such as trauma and compression leading to direct muscle injury, occlusion of vessels from thromboemboli or surgical clamping, prolonged immobilization, burns and fractures. However, Rhabdomyolysis in pediatric patients is often caused from infections, trauma, metabolic conditions and muscle diseases. (Mannix R,...
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...ry and rhabdomyolysis. Crit Care Clin. Jan 2004;20(1):171-92.
Mannix R, Tan ML, Wright R, Baskin M. Acute pediatric rhabdomyolysis: causes and rates of renal failure. Pediatrics. Nov 2006;118(5):2119-25
Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis: an evaluation of 475 hospitalized patients. Medicine (Baltimore). Nov 2005;84(6):377-85.
Muscal, E. (2013, September 16). Rhabdomyolysis . Retrieved from Medscape: http://emedicine.medscape.com/article/1007814-overview.
Ray, M. (2010, January ). The Truth About Rhabdomyolysis . Retrieved from The CrossFit Journal : http://journal.crossfit.com/2010/01/rhabdo-pdf.tpl#featureArticleTitle
Sauret, J. M. (2002, March 1). Rhabdomyolysis . Retrieved from American Family Physician : http://www.aafp.org/afp/2002/0301/p907.html
Vanholder R, Sever MS, Erek E, Lameire N. Rhabdomyolysis. J Am Soc Nephrol. Aug 2000;11(8):1553-61.
Rhabdomyolysis is a disease that involves a rupture of skeletal muscle, causing myoglobin, along with electrolytes and other intracellular proteins to leak in to circular system (Bagley et al, 2007). It is the result from the destruction of muscle fibers that make their way into the bloodstream, which take over the renal system hindering the kidneys ability to remove waste resulting in kidney failure (Owens, 2013). Rhabdomyolysis is rare and has not been fully documented. According to Efstratiadis et al, rhabdomyolysis was solely associated with crush injuries, but in recent studies, it appears to be five times more frequent in non-traumatic causes (2007). Damaging electrolyte disorders and acute renal failure may occur, leading to life-threatening situations. Some of the most common signs and symptoms of patients with rhabdomyolysis are colored urine, and muscle weakness is and Delayed Onset Muscle Soreness (DOMS). Rhabdomyolysis may develop in any circumstances where energy demands in muscles exceed the available energy supplies of the body. According to
“Drugs 2004: Steroids: Is Bulking Up Worth the Risk. “ World Book Science Year. 2009.
Hoover's right medial thigh to proximal groin. Her oxygen saturation was 97% with an oxygen support of 2 liters per minute. Multiple ecchymoses were noted around the hematoma, near Lovenox injection sites, on the right forearm, and on the surgical site of her right eyelid. She had a positive fluid balance of 485 during the first hospital day. A hemoglobin and hematocrit was ordered then and one hour after the fourth transfusion was ordered. (Norman Regional Health System 2 015-020
“Myotonic Dystrophy.” Human Diseases and Conditions. Ed. Neil Izenberg. Vol. 2. New York: Charles Scribner’s Sons, 2000.
For purpose of emphasis and understanding, some background information is needed to fully understand exactly what blood doping can do for an individual. In order for muscles to perform, they need a ready supply of oxygen. During high intensity exercise, oxygen is depleted and the body can not get enough oxygen to the muscle in order for them to perform their optimal potential. This lack of ability to get oxygen to the muscle is called oxygen debt and results in lactic acid being formed. Lactic acid is a waste product of anaerobic cellular respiration within the muscle tissue, which can cause muscle sourness that, usually, is felt after a hard or long workout. Fatigue usually sets in with the onset of lactic acid production. Oxygen is carried to the muscle by two delivery systems. Three percent of oxygen is carried in plasma and ninety-seven percent is in hemoglobin, the principal protein in erythrocytes (red blood cells). If hemoglobin amounts are increased, this will lead to increased oxygen levels that can be transported to the muscles. Allowing the muscles to become more fatigue resistant.
Tamparo, C. D. & Lewis, M. A. (2011). Diseases of the human body. Philadelphia, PA: F.A. Davis Company.
Abstract: Since the beginning of sports competition, athletes have always looked for some kind of an edge over their competitors. They will do whatever it takes to be one of the elite and that includes injecting supplements into their bodies to make them bigger, stronger, and faster. Steroid use is probably one of the most common drug misuses in sports competition. Athletes found that with anabolic steroids one could become a better athlete twice as fast. Not until 1975 was the drug first banned from Olympic competition because of the health risks it produced. Shortly thereafter, the rest of the sports world did not allow anabolic steroids as well. With the use of steroids no longer permitted athletes began to look for other alternatives. On the rise is two substances called creatine and androstenedione, both of which are sold over the counter. These two performance enhancers have only had minimal testing done on them, excluding the long-term effects, simply because they haven't been around long enough. Creatine and androstenedione have been said to produce results like steroids without the side effects. The truth is they do produce side effects and irregular muscle growth. By banning the use of performance enhancing drugs, just like steroids, sports competition will have a much healthier and fairer environment to participate in.
The renal disease are common nowadays .The acute renal failure is a medical term means that the kidneys stopped from working and not able to clear toxins from body ,not able to maintained a stable electrolyte balance inside the body and not able to secret the extra fluid as urine outside the body. The renal replacement therapy (RRT) or dialysis has been discovered on 1913 by Able, Rowntree and Turner in London, UK.
Robsin, David. "A history lesson in bodybuilding" www.bodybuilding.com. 21 march. 2005. Bodybuilding.com. 15 Feb. 2014 .
Bratton, R. L., Whiteside, J. W., Hovan, M. J., Engle, R. L., Edwards, F. D. (2008). Diagnosis
Note: This response sheet is for educational purposes only and should not be taken as a clinical diagnosis. Results need to be confirmed by professionals qualified in your state/province.
Every year high school, college, and professional athletes try to get just ?a little bigger,??a little stronger,? and to increase the amount of weights they lift by, ?just a few pounds.? To achieve these goals athletes often turn to anabolic steroids to aid them in achieving their goals. Anabolic steroids are a quick, but dangerous way to increase muscle mass, and they can carry many risks including some life threatening side affects. Years after taking steroids athletes can live to have serious heart problems, sterility, or possibly not even live, all because of foolish decisions they made in the past. These potentially fatal drugs are not widely known by young athletes at all, because they don?t know about the risks that can go along with them. In school, every student is taught about marijuana, cocaine,heroin, sex, liquor, and all those other health risks, but they?re never taught about ?roids? or ?juice.? (slang words for steroids) That should be changed, because it is known that student athletes often use steroids, not knowing the risks. Many times they take the risk because they hear about professional athletes taking steroids. But, despite their widespread use in sports, steroids can have more negative than positive effects on athletes of all types. Steroids are chemical substances that can be made naturally by the body or produced synthetically. There are many different types of steroids that are used for different things other than just athletes enhancing muscles. For example, there are types of steroids that can be used by women as birth control pills, and other types that are used for menopause treatment. The abuse of steroids is almost always found to be in the case of athletes, and that is the focus of this paper. ?All anabolic steroids are synthetic compounds whose molecular structure is similar to that of the natural male sex hormone testosterone. Testosterone affects development of the male body in two important ways: it has an anabolic effect - increases growth, especially of muscular and skeletal tissue - And an androgenic effect - increased development of male sexual characteristics. Anabolic steroids are constructed stythetically in such a way that they maximize the anabolic effect of testosterone while minimizing the androgenic effect.? The way that steroids work can easily be interpreted by a foo...
Dunn, George et al. National Strength and Conditioning Association. National Strength and Conditioning Association Journal. 7. 27-29. 1985.
In today’s age, performance enhancing drugs have become more advanced than just some special herbs and spices. Scientists today have found ways to manipulate elements to help provide muscle mass and stamina. Some types of performance enhancing drugs are human growth hormones (HGH), testosterone boosters, anabolic steroids etc. When taking HGH, a person might experience results such as an increase in muscle mass, an increase in bone density, and a reduced fat content in the body (Freudenrich). The same results could be found when you take anabolic steroids. Anabolic steroids have been sought after to athletes and bodybuilders because they increase the size and strength of muscles. They also increase aggressiveness and competitiveness, which can be desirable traits in sports (Helmenstine). On different occasions such as a cyclist or a long distance runner, these athletes will store some of their red blood cells when their hemoglobin is high. The athlete will then train and work as usual, but right before the athlete competes they will transfuse the blood they took out back into their body therefore creating more red blood cells to ...