So yesterday I was looking after this guy with rhabdo, who came in with a CK of 243,100 and I was wondering - what's the highest value you've seen? Not necessarily CK, any value.
An example, for example - I had a woman who had a glucose of 120.8mmol/L. I don't know how to translate that into the US scale, but the normal range is around 4 - 9 in a well-controlled diabetic.
Same patient, different admission - triglycerides 8.1 (0.0 - 2.0), cholesterol 22 (?
Highest K+? 7.6mmol/L (renal patient)
Urea - 48.6, creatinine 1.18!!! (same patient, normal levels in June this year)
OK, here's my third reply. Had an inmate who never exercised try to do 300 squats. Could only do 150. Complained to the nurse that his pee looked like coke. Rushed to the ER where I was working that day. MD did a CPK. What was it?
lowest BP after art line insertion 20/9. I am impressed that the resident go the line in. Pt died soon after. Family decided to withdraw care. Massive CVA. The stepdown nurses kept telling the docs something was wrong but no one would listen to them.
lowest manual BP 60 systolic. There was no diastolic, done with doppler, pt awake telling me she needed to have a BM. Pt ended up intubated and on levo. Pt died a few hours later.
We had a patient last week with a BP of 60/30 - she has Parkinson's and was being trialled on Apomine. Though postural hypotension's a known side effect, and though she had a systolic drop of 30mmHg at midday, the PM staff didn't check her BP all shift and did give antihypertensives at 20:00.
The good news is that she recovered her BP with bed tilting and gelofusine, and the nurse on the PM's had a formal warning.
The patient was diuresed and improved. I remember discussing it, in shock, with the charge nurse, don't remember too many other details about the patient. I think it was the admit lab.
PrisonrNurs
36 Posts
OK, here's my third reply. Had an inmate who never exercised try to do 300 squats. Could only do 150. Complained to the nurse that his pee looked like coke. Rushed to the ER where I was working that day. MD did a CPK. What was it?
250,000!!!!