Grizzlyadamz

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1. After an IM, vitals to be assessed after 15 min

   Grizzlyadamz replied to RUBYMARTINEZ's topic in Student Assist

   1st semester students probably aren't familiar with shock yet, (I know I certainly wasn't). Better to ask Ruby: Why does the patient become flushed? What's the body doing that makes the skin change color? Now think about what would happen in a severe...

2. Massive PE hemodynamics

   Grizzlyadamz replied to Grizzlyadamz's topic in Student Assist

   Certainly, here's about half the article: Sample image. Looks like they don't specify how much IVF is ordered so-- Makes sense, thanks to both of you!

3. Massive PE hemodynamics

   Grizzlyadamz replied to Grizzlyadamz's topic in Student Assist

   I understand they're different. I'm asking, wouldn't a big PE which mimics right-sided MI or cardiac tamponade in regards to the patient's hemodynamic changes be ill-treated by attempted fluid resuscitation? Wouldn't that just put them into fluid ove...

4. Massive PE hemodynamics

   Grizzlyadamz posted a topic in Student Assist

   Alright, so, a patient gets a big 'saddle embolism' that restricts blood flow to both of the lungs. This would present like cardiogenic shock, correct? In particular, something like cardiac tamponade. MAP would drop due to a decreased CO, heartrate w...

5. Wheezing questions

   Grizzlyadamz replied to Grizzlyadamz's topic in Student Assist

   So does lactate only really rise with inadequate perfusion, or can an anaerobic septicemia cause it as well? Also, do blood cultures always catch the bacteria causing the SIRS, (assuming it's not viral), or can they (the bacteria) remain relatively l...

6. Wheezing questions

   Grizzlyadamz replied to Grizzlyadamz's topic in Student Assist

   Lactate was normal but they suspected a false low due to 'NAPQI & NAC'. (something about acetaminophen poisoning?)

7. Wheezing questions

   Grizzlyadamz replied to Grizzlyadamz's topic in Student Assist

   Also, if mucolytics & drainage aren't advisable (patient has HTN & is being watched for possible sepsis, so I'm guessing it might go uncontrolled), would a cough suppressant be a bad idea? The patient stated that they had difficulty sleeping ...

8. Wheezing questions

   Grizzlyadamz posted a topic in Student Assist

   Hey everyone, looking to absorb some experience while I'm working on my paperwork. I had a middle-aged patient recently who came in complaining of SOB. RR & HR were elevated, spO2 was low and they had a loud expiratory wheeze (audible in all 5 lo...

9. Need help interpreting ICU ABGs

   Grizzlyadamz replied to Grizzlyadamz's topic in Student Assist

   Patient wasn't on a vent, and metabolic acidosis is 100% one of their main diagnoses. At least a few hours earlier, the low CO2 was the compensatory mechanism for an excess of lactic acid, and I figured the low bicarb level had been contributing to t...

10. Need help interpreting ICU ABGs

    Grizzlyadamz posted a topic in Student Assist

    Alright, here are the most recent labs. Patient was probably on O2 when these were taken. pH: 7.43 pO2: 115 (H) pCO2: 18.5 (V-L) HCO3: 12 (L) BE: -10.7 (L (base deficit)) O2 saturation: 100 Several hours earlier, the patient was in metab...