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Critical care Q

Nurses   (741 Views | 12 Replies)

hellohobbit has 1 years experience .

1,353 Profile Views; 77 Posts

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!

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DextersDisciple has 7 years experience as a BSN, RN.

314 Posts; 4,003 Profile Views

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

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

4 Followers; 6,611 Posts; 68,694 Profile Views

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? 

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hellohobbit has 1 years experience.

77 Posts; 1,353 Profile Views

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.

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ICUman has 5 years experience and specializes in Cardiac Cath Lab.

1,660 Posts; 54,156 Profile Views

The creatinine and hemoglobin levels you listed are typos. 

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hellohobbit has 1 years experience.

77 Posts; 1,353 Profile Views

^it's Canadian values oops

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

4 Followers; 6,611 Posts; 68,694 Profile Views

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).

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

4 Followers; 6,611 Posts; 68,694 Profile Views

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)

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

4 Followers; 6,611 Posts; 68,694 Profile Views

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?

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dream'n has 27 years experience as a BSN, RN and specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

1,065 Posts; 15,014 Profile Views

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

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Pixie.RN has 12 years experience as a MSN, RN, EMT-P and specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

8 Followers; 32 Articles; 13,353 Posts; 130,372 Profile Views

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

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1,200 Posts; 8,056 Profile Views

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.

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