1. The primary problem of the patient is hypovolemic shock as a result of severe hemorrhage due to the injury which he got during rock climbing .
2. The patient is a 31 year old African male who was rock climbing with his two friends in a national park , while climbing the patient suddenly lost his footing and slide 18 feet to the ground . The two friends who witnessed the accident said that he slid against sharp rock all the way down in a standing position and finally slumped on the ground .
3. The patient is in hypovolemic shock due to severe hemorrhage due to the deep cut of the femoral artery which had caused excessive blood loss and due to this patient is in shock . To compensate for this first of all bleeding has to be stopped by conducting the repair of femoral artery asa soon as possible or by other methods , multiple blood transfusions has to be done after doing cross matching and blood typing , IV fluids has to be administered for body fluid loss , patient has to be put in Trendelenburg position and continuous monitoring of the patients vitals has to be done to avoid complications and for early assessment of adverse event.
4. As the patient is in hypovolemic shock ,in hypovolemic shock one of the parameter which we assess to check the effects of IV fluid administration ,blood transfusion etc is urine output . Urine output should be 30 ml /hour ,it means patient has adequate input and output and is recovering from the shock .
Trauma and Bleeding Chief Complaint: 31-year-old Afican American male injured whilerok-climbing History of Present Ilness: This...
Trauma and Bleeding Chief Complaint: 31 year-old Afrian American male injured whilerok-climbing History of Present Ilness: This 31-year-old male was rock-climbing with two friends at a national park 14 miles away from the nearest hospital when he suddenly lost his footing and slid 18 feet to the ground. Both friends who witnessed the fall said that he slid against sharp rock all of the way down, landing almost in a standing-up position, finally slumping to the ground. They also said...
Trauma and Bleeding Chief Complaint: 31 year-old Afrian American male injured whilerok-climbing History of Present Ilness: This 31-year-old male was rock-climbing with two friends at a national park 14 miles away from the nearest hospital when he suddenly lost his footing and slid 18 feet to the ground. Both friends who witnessed the fall said that he slid against sharp rock all of the way down, landing almost in a standing-up position, finally slumping to the ground. They also said...
Hemorrhagic Shock Case Study A 37-year-old female presents to the emergency department weak, pale, A&O, with severe RUQ pain. She states that the following. “I have been taking a lot of ibuprofen for this abdominal pain. I went to my doctor but he told me it was psychological.” The paramedic has a PIV #18 RAC infusion with 1 L. NS wide open and O2 @ 2 lpmNC. V.S. T. 97.0, 120 bpm, RR 24, BP 80/50, SaO2 95%. 1. What...
CASE STUDY 6 A 28-year-old man presents to the emergency department with a complaint of abdominal pain. He appears quite ill with nausea, cold sweats, and tachycardia. He had taken aspirin when he started feeling sick. The patient appears slightly jaundiced and on further questioning admits that his urine had been dark and discolored that day. The preliminary impression was of acute appendicitis. Pertinent Hematology Results (refer to normal values in your text) WBC 6.3 x 10°/L RBC 1.00 x...
This is the case of a 4 year old boy who presents with the recent history of vomiting blood one week after a tonsillectomy. Two years ago he bit his tongue and it bled one week. His maternal grandfather has a history of frequent bleeding problems. His mother, father, and two sisters have no bleeding problems. INITIAL LABORATORY TESTS: Hct: 30.0% WBC: 5,300 mm³ Platelet count: 395,000 mm³ Bleeding time: normal Clot retraction: good at 2 and 24 hours PT:...
A 20 yr old male with a family history of Type I Diabetes was seen by his physician due to incessant thirst (polydipsia) and nocturnal urination (polyuria). A blood panel results are shown below Na (meq/L) HCO3 BUN - cr (meq/L) (mg/dL) Toggle Spell Checker (mg/dL) 3.5-5. 5 98-108 | 22-297-18 | 0.6-1.2 5 | 102 | 17 58 3.6 135-145 Normal Patient | 141 SGlucose: 520 Arterial pCO2 = 31 mm a) What is the most likely diagnosis for...
what could this 52 year old man possibly have?How the clinical history and the biochemical results aided your evaluation of the diagnosis. what is the underlying pathogenesis. What other conditions give rise to hyponatraemia and explain why these can be ruled out based on the clinical presentation. A 52-year-old man was admitted to A&E presenting with a fever nausea and vomiting that has lasted over 2 weeks. However, in the last few days he has become irritable and confused. ON...
A 43 year old female patient presents to the office with a surgical history of thyroidectomy and cc of “feeling cold” and fatigue. Examination revealed an overweight female with hyporeflexia, psoriasis, and cool skin. The patient has been taking Synthroid 25mg PO Daily as part of her treatment plan. The following blood work results were obtained: Thyroid Function Tests: T4: 4.5 µg/dl T3: 70 ng/dl TSH: 5.4 IU/L Electrolytes: Chloride: 100mEq/L Potassium: 4.9 mEq/L Sodium: 125 mEq/L Calcium: 11.2 mg/dl...
Adam is a 68-year-old male admitted to the hospital with a 1-month history of nausea, vomiting, and diarrhea resulting in weight loss and fatigue. He presents tachycardic with abdominal pain, fever, and chills. Adam is a retired engineer and lives at home with his wife. Anthropometric Data: Height: 165 cm (65”) Weight: 75 kg (165 lbs) BMI: 27.5 kg/m2 Weight History Usual body weight: 82 kg (180 lbs) 1 year ago Biochemical Data: Sodium 129 (135-145 mEq/L) Potassium 3.2 (3.6-5.0...
19-year-old non- ambulatory male with pneumonia Chief Complaint: 19-year-old non-ambulatory male with pneumonia. History: James Fenlow, a 19-year old male, is immobile and hospitalized for pneumonia. He has a long history of progressive weakening of his muscles. In the first year of his life, James reached many gross motor skill milestones, such as holding his head up, rolling over, sitting, and standing, at normal times. However, he did not walk until age 16 months, and by age two, started to...