Critical care Q

Published

35 year old female came in with MVC from ER complaints of pain and discomfort in the abdo.

PMHX: IVDU, C-section, G3P3, Anemia

In total patient received Hydromorphone 2mg IVP x3 in ED, Fentanyl 100mcg IVP

VS: Temp 98, HR 40s Sinus Bradycardia, RR 36s, BP 110/60, Spo2 88% room Air

Labs include: Na135 K4.0 Glucose3.5 Creatinine90 Hgb80 PLT355 INR1.2

1) Please tell me what is happening to the patient?

2) What are your priority assessments?

3) Name your nursing interventions?

Need help with this interview question, thanks!

Up Vote Up Vote ×

This is clearly a poorly edited copy and paste homework question. do those lab values look normal to you? Why or why not?

4
Up Vote Up Vote ×
Specializes in Critical Care.

What are your thoughts so far?

By "came in with MVC from ER", do you mean the patient has now been admitted to an inpatient floor and is out of the ER?

2
Up Vote Up Vote ×

Besides low oxygen and brady, I dont see anything else concerning. Hgb is low but pt is chronic anemia. maybe sugar is a little low too.

Up Vote Up Vote ×

The creatinine and hemoglobin levels you listed are typos.

6
Up Vote Up Vote ×

^it's Canadian values oops

Up Vote Up Vote ×
Specializes in Critical Care.

To clarify for the rest of us Americans, a blood glucose of 3.5 is low end normal in Canada, they're tougher than we are (and they measure in mmol/L, normal is about 3 to 7).

1
Up Vote Up Vote ×
Specializes in Critical Care.
3 minutes ago, ICUman said:

The creatinine and hemoglobin levels you listed are typos.

Normal hgb in Canada is about 120-170, and normal creatinine levels are about 60-120 (different units of measurement than we use in the US)

1
Up Vote Up Vote ×
Specializes in Critical Care.
11 minutes ago, hellohobbit said:

Besides low oxygen and brady, I dont see anything else concerning. Hgb is low but pt is chronic anemia. maybe sugar is a little low too.

There was no imaging done?

1
Up Vote Up Vote ×
Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
55 minutes ago, hellohobbit said:

35 year old female came in with MVC from ER complaints of pain and discomfort in the abdo.

PMHX: IVDU, C-section, G3P3, Anemia

In total patient received Hydromorphone 2mg IVP x3 in ED, Fentanyl 100mcg IVP

VS: Temp 98, HR 40s Sinus Bradycardia, RR 36s, BP 110/60, Spo2 88% room Air

Labs include: Na135 K4.0 Glucose3.5 Creatinine90 Hgb80 PLT355 INR1.2

1) Please tell me what is happening to the patient?

2) What are your priority assessments?

3) Name your nursing interventions?

Need help with this interview question, thanks!

Take a look at the respiratory rate

1
Up Vote Up Vote ×
Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

High RR + low O2 + bradycardia = bad stuff happening. Physical exam? Lung + heart sounds? Imaging?

5
Up Vote Up Vote ×

If it’s a trauma was a FAST exam done? If there’s abdominal pain there’s probably some type of bleeding. I’m also guessing rib fractures which would explain your respiratory issues. A Hgb of 8 could be indicative of bleeding. I saw they have a history of anemia, but with abdominal pain, it makes me wonder.

With a positive FAST exam our patients would go directly for an ex lap before coming to us.

Up Vote Up Vote ×
+ Join the Discussion