ACUTE CARE CASE STUDY
Patient and Setting: CM is a 45-year-old man, on an inpatient surgical unit
Chief Complaint: Sudden onset of nausea/vomiting, some difficulty breathing, change in status
History of Present Illness: CM is in hospital, day 2 post-ORIF fractured femur with significant haemorrhage and other soft tissue injuries, sustained in an MVA. CM reports that his feet are swelling, (+) fatigue, (+) nausea and vomiting, and (+) SOB. He has also noticed a decrease in urine output , although he reports he has not been eating or drinking much.
Medical History: Hypertension (×5 yrs), MVA
Surgical History: N/A (other than current hospitalization)
Family History: Mother: DM; Father: died at age 50 due to MI
Social History: Ethanol intake: Nil; tobacco: once/month
Lisinopril 40 mg PO BID for 5 years
ASA 81 mg po daily
Rosuvastatin 20mg po daily
Amlodipine 10 mg PO QD for 2 years
Ibuprofen 800 mg PO TID for back pain
Centrum One 1 tab PO QD
Allergies: Morphine (tongue swelling, itching, rash, SOB)
GEN: Well-developed, nourished man
VS: BP 190/100, HR 83, RR 26, T 37.3°C, Wt 80 kg, Ht 182 cm
CHEST: Small crackles, rales, and wheezing
EXT: Bilateral LE swollen with fluid, 3+ pitting edema
NEURO: A & O ×2 (place, time)
Results of Pertinent Laboratory Tests, Serum Drug Concentrations, and
Na 132 K 5.9
Hgb 88 Hct 0.34 Creatinine 189 BUN 23
Blood Gas: pH 7.3; pCO2 40; HCO3 18; pO2 97
Urine Output: 300 mL/24 hr
1. Identifies all of the assessment/lab findings in CM that are consistent with fluid overload, and provides a comprehensive pathophysiologic rationale for these findings
2. A comprehensive of the type of anemia and the etiology & associated symptoms
Note: please add the citation or website you get the information as I have to cite them for my assignment. Please answer these 2 questions with great detail as they are worth 10 marks each for the case study above for the pathophysiology class. Thank you so much.
Ans) Anemia (also spelled anaemia) is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen.
- CM reports that his feet are swelling, (+) fatigue, (+) nausea and vomiting, and (+) SOB.
- Fluid overload (hypervolemia) causes decreased hemoglobin concentration and apparent anemia: General causes of hypervolemia include excessive sodium or fluid intake, sodium or water retention and fluid shift into the intravascular space.
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