Etorriegenk

Thank you every body I did the case study already

1. How should you prepare for this patient’s arrival? CASE STUDY PROGRESS K.L. arrives on your unit. As you help him transfer from the ED stretcher to the bed, K.L. becomes very dyspneic and expels 800 ml of maroon stool. 2. What are the first three actions you should take? CASE STUDY PROGRESS K.L. reports that he is getting nauseated but not thirsty. VS are 106/68, 116, 32. 3. What additional interventions would you need to institute? CASE STUDY PROGRESS Arterial blood gas (ABG) results are as follows (these results reflect values at sea level): pH 7.45, PaCO2 33 mm Hg, PaO2 65 mm Hg, HCO3 23 mmol/L, base excess [bE] +1.0, SaO2 91%. 4. Interpret the preceding ABGs. What do they tell you?

You are the nurse on duty on the intermediate care unit, and you are scheduled to take the next admission. The emergency department (ED) nurse calls to give you the following report: "This is Barb in the ED, and we have a 42-year-old man, K.L., with lower GI [gastrointestinal] bleeding. He is a sandblaster with a 12-year history of silicosis. He is taking 40 mg of prednisone per day. During the night he developed severe diarrhea. He was unable to get out of bed fast enough and had a large maroon-colored stool [hematochezia] in the bed. His wife 'freaked' and called the paramedics. He is coming to you. His vital signs [VS] are stable--110/64, 110, 28--and he's a little agitated. His temperature is 36.8° C. He hasn't had any stools since admission, but his rectal exam was guaiac positive and he is pale but not diaphoretic. We have him on 5 L O2/NC [oxygen by nasal cannula]. We started a 16- gauge IV with lactated Ringer's [LR] at 125 ml/hr. He has an 18-gauge Salem sump to continuous low suction; the drainage is guaiac positive. We have done a CBC with differential, chem 14, PT/INR and PTT, a T&C [type and crossmatch] for 4 units RBCs, and a urinalysis [uA]. He's all ready for you."