: Scenario G.S., a 36-year-old secretary, was involved in a motor vehicle accident; a car drifted left of the center line and struck G.S. head-on,
: Scenario G.S., a 36-year-old secretary, was involved in a motor vehicle accident; a car drifted left of the center line and struck G.S. head-on, pinning her behind the steering wheel. She was intubated immediately after extrication and flown to your trauma center. Her injuries were found to be extensive: bilateral flail chest, torn innominate artery, right hemothorax and pneumothorax, fractured spleen, multiple small liver lacerations, compound fractures of both legs, and probable cardiac contusion. She was taken to the operating room for repair of her injuries. In OR. she received 36 units of packed RBCS, 20 units of platelets, 20 units of cryoprecipitate, 12 units fresh frozen plasma, and 18 L of lactated Ringer’s solution. G.S. was admitted to the ICU postop, where she developed adult respiratory distress syndrome (ARDS). 1 1. What is ARDS? ARDS refers to Acute Respiratory Distress Syndrome where the air sacs of the respiratory system are fluid filled leading to difficulty in breathing. This is a severe condition which requires immediate care otherwise will be life threatening. The risk factors for this patient are any infection in the blood post operatively, motor vehicle accident, hemothorax and pneumothorax o a
xx, x A.H.A. Аавьсах Аавьсах Аавьс. Аавьсet Аав Normal No SpacHeading 1 Heading 2 Title Font Paragraph Styles 2. What are the risk factors for developing ARDS? Which does G.S. have? The risk factors for this patient are any infection in the blood post operatively, motor vehicle accident, hemothorax and pneumothorax. CASE STUDY PROGRESS G.S. has been in ICU for 6 weeks, and her ARDS has almost resolved. She is transferred to your unit. You receive the following report: She is awake, alert, and oriented to person and place and can move both of her arms and wiggle her toes on both feet. Heart tones are clear, vital signs are 138 90, 88, 26, 99.3 F(374C bilateral radial pulse 31 and foot puises by Doppler only. All of her incisions and Incerations live healed. She has bilateral chest tubes to winter suction with closed drainage, both dressings are dry and intact. She has a duodenal feeding tube, Foley catheter to down drain, od a double lumen PICC line R.
Case Study 31 Fracture – Word Elizabeth Bravo Layout References Mailings Review View Tell me what you want to do – 14 * 1, x’ ,史,A,同 == 1.2。 AaBbccde Aalboete AaBbc Aabbcc AaB Aalbe T Normal 1 No Spac. Heading! Heading 2 Title Subtit Font Paragraph Styled 3. What additional information will you require during this report? O E –
NA NEWER VIEW нер Tell me what you want to do AN Aa ….!! XA.-A.- — Аавьсер | Аавьсабе Аавьс. Аавьсаг Аав аавьсер Normal No Spac… Heading 1 Heading 2 Title Subtitle font Paragraph Styles CASE STUDY PROGRESS You complete your assessment of G.S. You note shortness of breath (SOB), fine crackles throughout all lung fields posteriorly and in both lower lobes anteriorly, and coarse crackles over the large airways. 4. What is the significance of the fine and coarse crackles in G.S.’s case? 2 do
Case Study 31 Fracture – Word Elizabeth Brave Aguilen Tell me what you want to do Layout References Mailings Review View ANA.. 21 XA. A. Aalbox AaBbccbe AaBbct AaBbcc AaB Aabeer te I Normal No Spa Heading 1 Heading 2 Title Subtitle Sul Font Paragraph Styles 5. The nurse from the previous shift charted the following statement: “Fine and coarse crackles that clear with vigorous coughing.” Based on your knowledge of pathoplıysiology, determine the accuracy of this statement. 6. It is time to administer rosemide Lasix) 40 mg IV push (IVP). What effect, if any, will forosemide have a OS’s breath sound”
Layout References Mailings Review View Tell me what you want to do 14 Аавьсах Аавьссос Аавысі Аавьсах Аав давьса Normal 1 No Space Heading Heading 2 Tele XX &·中.A.= == =,,,, Subtitle Font 19 Paragraph Styles 8. Keeping in mind that you are about to administer furosemide (Lasix), which laboratory values concern you, and why? 9. Given the laboratory values listed, what action would you take before administering the furosemide (Lasix and why? a o
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