John Smith, a 44-year-old African American male, is admitted to the Medical ICU with a diagnosis of malignant hypertension and kidney failure. He has experienced malaise, dry itchy skin, 2+ generalized edema, and decreased urine output over the last 3 weeks. His past medical history includes Type II Diabetes mellitus (diagnosed 9 years ago), non-adherent dietary choices including high carbohydrate and protein choices, and a daily diuretic medication prescribed five years ago for his hypertension. He wights 80 kg and is being treated with a sodium nitroprusside (Nipride) drip of 50mg/250 ml ED5W. The drip is being titrated to maintain his systolic blood pressure at 120 mmHg. A dual lumen catheter is placed for hemodialysis. Serum blood values include blood urea nitrogen (BUN) 175 mg/dL, creatinine 12.4 mg/dL, potassium 6.9 mEq/L, and carbon dioxide (Co2) 11 mEq/L, and a GFR of 26
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