1. Joyce, an accident victim, was admitted to the hospital 3 hours ago. Her char

Question

1. Joyce, an accident victim, was admitted to the hospital 3 hours ago. Her chart indicates that she had been hemorrhaging at the scene of the accident. Joyce's nurse monitors her urinary output and notes that it is currently 12ml/hour. (Normal output is 30-50 ml/hour.) Explain why a person in such severe stress is likely to have decreased urinary output (oliguria).

Please I am looking for a different answer. This is the third time I am posting this question. I mainly need to know why a person in such severe stress is likely to have decreased urinary output (oliguria).

Explanation / Answer

Often patient will have a diminished urine output after a major operation.This may be due to fluid or blood loss and also due to response of adrenal cortex to stress.There is an increase in aldosterone release and ADH (anti diuretic hormone) in the first 24 hrs of surgery,this results in both salt and water retention.

In response to stress sympathetic nervous system delivers message down our spinal cord to various organs telling our heart to beat faster and stronger, our lungs to increase respiration etc.

In response to stress the posterior part of hypothalamus sends a nerve impulse directly to the center of the adrenal gland thats there on top of our kidneys. This signal causes adrenal gland to secrete epinephrine (adrenaline) and norepinephrine (noradrenaline). Norepiherine when released in the boold stream increases heart rate, blood pressure, triggers release of glucose, increases blood flow to skeletal muscles, inhibits voiding of bladder, and also causes release of renin and retention of sodium in the blood stream.

The anterior hypothalamus upon stress activation releases acompound called cortiotrophic release factor (CRF) that stimulates the pituitary gland to secrete adrenocortropic hormone (ACTH) into the blood stream. ACTH stimulates adrenal glands to release cortisol and aldosterone and aldosterone is one of the hormones that helps body retain sodium that allows retention of water in the blood increasing blood volume and pressure.

The hypothalamus working with pituitary also releases Vasopressin (ADH) and oxytocin,while in the blood these hormones primarily work on controlling the level of blood pressure (through smooth muscle contraction and water retention) in our body so that muscles and another important organs can get the oxygen and nutrients (due to faster and stronger beating of heart as well as increased blood volume and pressure due to water retention) they need under stress.

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