5.a) orthostatic hypotension is due to hypovolemic shock caused due to injury to the femoral artery which resulted in severe hemorrhage and blood loss .
b) elevated creatinine and BUN due to decreased blood supply to the kidneys as a result of blood loss .
c) elevated SGOT and SGPT due to liver injury as a result of less blood supply .
d) disorientation and lethargy is also due to decreased blood supply to the brain as a result of shock
e) decreased central venous pressure due to hypovolemic shock .
f) pale nail beds and mucous membrane due to loss of blood
g) ST segment depression as a result of ischemia
6. Patient is under acidosis as the pH is 7.28 ,HCO3 is 14 mEq and PCO2- 31mmhg and PO2 is 78mmhg .
pH and HCO3 less than the normal limits leads to metabolic acidosis
and PCO2 and PO2 more than the normal limits leads to respiratory acidosis
7. Poiseuilles formula -V = πpr2/ 8×fluid viscosity ×l
= In this case there is damage to the femoral artery which are caused change in the radius , pressure ,and fluid viscosity due to a six inch deep cut in the right femoral artery and severe hemorrhage.
8. Hematocrit is the measure of the red blood cells in the total volume of blood.
Trauma and Bleeding Chief Complaint: 31 year-old Afrian American male injured whilerok-climbing History of Present Ilness:...
Trauma and Bleeding Chief Complaint: 31-year-old Afican American male injured whilerok-climbing History of Present Ilness: This 31-year-old male was rock-climbing with two friendsat 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 that his...
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...
During transport to the hospital, vital signs were reassessed: HR 138, BP 75/50, RR 38 with confusion. She was diagnosed with hypovolemic shock and IV fluids were doubled. Blood samples were sent for typing and cross-matching and for both chemical and hematologic analysis. Labs Chemistry (Electrolytes) Levels 136 meq/L 3.5 meq/L 109 meq/L 37 mg/dL 1.9 mg/dL Glucose 157 mg/dL 9.0 mg/dL Hematologic (blood) Levels Hemoglobin (Hb) 8 g/dL Hematocrit (HCT) 25 % 178,000/mm3 6,3000/mm3 ABGS Pa02 53 mm Hg...
Brief Patient History Mr. V is a 42-year-old man with chronic viral hepatitis C. He has a Model for End-Stage Liver Disease (MELD) score greater than 25. Mr. V is in acute fulminant liver failure and is on the waiting list to receive a liver transplant. Mr. V was hospitalized 2 weeks ago with ascites, hepatorenal syndrome, and hepatic encephalopathy. He has been treated with diuretics, antibiotics, and laxatives. Before transplantation, he remained in the intermediate care unit and was...
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:...
Brief Patient History Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after emergency surgery for gunshot wounds to the abdomen. The surgical procedure was extensive and involved repair of a perforated bowel, splenectomy, and hemostasis. Mr. A’s mean arterial pressure (MAP) dropped below 65 mm Hg during resuscitation, and he received 9 units of packed red blood cells and 4 L of lactated Ringer solution intravenously (IV) to achieve hemodynamic stability. Clinical Assessment...
Brief Patient History Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after emergency surgery for gunshot wounds to the abdomen. The surgical procedure was extensive and involved repair of a perforated bowel, splenectomy, and hemostasis. Mr. A’s mean arterial pressure (MAP) dropped below 65 mm Hg during resuscitation, and he received 9 units of packed red blood cells and 4 L of lactated Ringer solution intravenously (IV) to achieve hemodynamic stability. Clinical Assessment...
Brief Patient History Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after emergency surgery for gunshot wounds to the abdomen. The surgical procedure was extensive and involved repair of a perforated bowel, splenectomy, and hemostasis. Mr. A’s mean arterial pressure (MAP) dropped below 65 mm Hg during resuscitation, and he received 9 units of packed red blood cells and 4 L of lactated Ringer solution intravenously (IV) to achieve hemodynamic stability. Clinical Assessment...
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...