My pt died, lab results question?

[BinkieRN]

I had an 85 year old pt who I admitted for profound anemia. Blood had been ordered. All of the labs had been draw. I was doing the admission assessment when suddenly she coded and did not make it. Later I looked at her labs. WBC was 230,000. Troponin was 68. Myoglobin was 1141. The doctor said she died of an MI. I have never seen or heard of a WBC that high? Does that go along with an MI? or could she have been septic also? She did not have a temp. When she came in her 02 sat was 76%. She wanted to lie flat with the rebreather on at 100%. I encouraged her to raise the head of her bed and she refused. Can lying flat cause additional respiratory distress? Thank You.

[aeauooo]

Thanks for the learning experience!

Good job!

One thing to consider about rhabdo, even though it might not apply to your patient, is that it is frequently seen in people who were "found down" for an unknown period of time, i.e. people who have had stokes, drug overdoses, alcoholics - these are the people I usually see.

Muscle breaks down from lying in one position for too long, releasing myoglobin, rather than hemoglobin. The end result is essentially the same, without the anemia.

Remember to check the K - hyperkalemia is an indicator of renal failure and hypokalemia can precipitate arrhythmias. If you're a neuro nurse, you'll look at the Na before you look at the K.