Patho for KSW???

[scrubs4me86]

Hello everyone!

I have been in clinical for 4 weeks and I'm trying to get the hang of care plans. I completely understand the concept, yet I keep getting my paper back with "needs improvement" and it seems like she uses her entire pen on my paper Anyway, this week, my primary medical diagnosis is "KSW RLQ abdomen." I know that means knife stab wound right lower quadrant of the abdomen, but I am lost as to what the pathogenesis for that would be!!! Please help!! The one comment that I have consistently gotten was that I need to be sure to take my patho to the CELLULAR level...Any help would be greatly appreciated!! Thanks!!

[Daytonite, BSN, RN]

a ksw (knife stab wound) is a traumatic injury to the tissues of the body.and to do the pathophysiology for this means you have to go to a pathophysiology book, probably the first chapters and read about cellular injury because that is what is going on in traumas like this. cells become injured and as a result are unable to perform their specific function depending on where they are located in the body. injured cells can do one of two things: (1) recover, or (2) die.

the most common biochemical mechanisms that occurs with cell injury is hypoxia where decreased amounts of oxygen in the injured area cause loss of hemoglobin, loss of red blood cells and/or ischemia in the area of the injury due to narrowing of the arteries and the presence of blood clots. in addition, potassium and sodium pour out of injured cells into the extracellular spaces leading to failure of the sodium-potassium pump and failure of sodium-calcium exchange which compromises atp production of the cells involved. this loss of atp production results in failure of the sodium-potassium pump allowing water to enter the cells which have now gained large amounts of sodium. the cells swell. calcium that builds up in injured cells goes directly into the mitochondria causing the mitochondria to swell and die. as cells continue to become more and more swollen with increased levels of electrolytes such as sodium and calcium other structures in the cells also become swollen until the cells eventually reach a point when they can no longer reverse this process and will die, or necrose.

if microorganisms are introduced into the tissues in question, the inflammatory response will take place. see the post at (https://allnurses.com/forums/f50/histamine-effect-244836.html) for an explanation of the pathophysiology of the inflammatory response. the inflammatory response precedes and goes hand and hand with infection.

[scrubs4me86]

I actually figured that out not too long after I wrote that post! My clinical instructor actually made a point to commend me on my patho today!! That made me super excited!! But, thanks for all the info!