Preventing complications of surgery is an important part of all surgical patient care. What preoperative While Mr. Doe is in the Operating Room, what considerations will be taken to ensure Mr. Doe’s safety and positive outcome?

Basic Clinical Laboratory Techniques 6E

6th Edition

ISBN:9781133893943

Author:ESTRIDGE

Publisher:ESTRIDGE

Chapter3: Basic Hemostasis

Section3.6: D-dimers

Problem 2.1CS

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N.H. is a 76-year-old male admitted to the hospital through the emergency department. He fell outside his home. It appears that he may have sustained a fracture to his left hip. He has a history of type 2 diabetes mellitus and has a 40 pack-year smoking history that is now complicated by chronic obstructive pulmonary disease. Data Collected (use only those that apply) Complains of excruciating pain and tenderness in left hip Pain not relieved with morphine BP 166/94 mmHg Diaphoretic and pale skin Respiratory rate 36; crackles, expiratory wheeze X-ray of left hip reveals extracapsular fracture Hematocrit 30%; hemoglobin 15g/dL; WBC 15,000/uL Discussion Questions: Considering the nursing process, list in order the steps in transferring patient from bed to chair post operatively.
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Patient R., 32 y/o, was delivered with complaints of fatigue, decrease of appetite, intensification of pigmentation in the open areas of the body, palms of the hands, cyanosis, losing weight, nausea and vomiting. The symptoms began to aggravate during 1-2 weeks after acute poisoning. Objectively: arterial pressure – 60/30 mm column of mercury, pulse – 140 beats/minute, skin turgor is lowered, the colour is dark with intense pigmentation of the elbows, scars, skin folds on the palms; clearly low levels of sodium and chlorine, high levels of potassium in the blood; glycemia – 4.3 mmol/l. What is your diagnosis?A. Addisonian crisisB. Uremic coma C. Brain comaD. Acute cardio-vascular insufficiencyE. Hypoglycemic coma
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S.R. is a 65- year-old woman who presents to the emergency department complaining of shortness of breath, productive cough, and swelling in both legs. The patient has a past medical history of congestive heart failure (CHF), hypertension, and diabetes. Vital signs are T 97.5, P 85, R 16, and BP 160/90. Physical exam reveals +2 edema bilateral lower extremities, heart rate and rhythm regular, and lungs with rhonchi in the bases. The patient is started on a nebulizer treatment, and an electrocardiogram has been ordered. What subjective information should the nurse obtain? The nurse is assessing the patient’s pulses. Which locations should the nurse check? What is the most likely cause of this patient’s shortness of breath, productive cough, and swelling in both legs
Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time, he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years but quit 3 years ago. The ABG analysis of Mr. H suggests uncompensated respiratory alkalosis with mild hypoxemia, with base excess of -1 in her arterial side, whereas -4 in her venous side. Part 1: Her actual arterial-venous oxygen content difference (Ca-vO2) is 5.31 mL/dL. (Normal range considered here is 3.5 to 5 mL/dL) Part 2: Patient's actual oxygen extraction ratio (O2ER) was 29%. (Say normal range is 20-28%) What is clinically happening to the patient?
Case Scenerio A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 2015, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with fast foods- pizzas and KFC. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon. He…
Mr. B is a 57-year-old man who was admitted yesterday after starting to pass black stools. He has a two-day history of severe stomach pains and has suffered on and off with indigestion for some months. He is a life-long smoker, with mild chronic heart failure (CHF) for which he has been taking enalapril 5 mg twice daily for 2 years. He also recently started taking naproxen 500 mg twice daily for arthritis. He works a stressful job and drinks large amounts of caffeinated coffee daily. Yesterday his hemoglobin was reported as 9.3 g/dL, hematoocrit 30%, RBC's 3.2, platelets 162, INR 1.1 with Liver Function Test normal. He was mildly tachycardic (110 bpm) and had a slightly low blood pressure of 100/77 mmHg and was given 1.5 L of saline. He has just returned from an endoscopy this morning and has been newly diagnosed as having a bleeding duodenal ulcer. They took a biopsy to determine if he is positive for H-pylori. He has been written up for his usual medication for tomorrow if he is…
Rheumatoid Arthritis Case StudyJoy G. is a 48-year old married mother of 3 active boys, ages 12, 15, and 18. She enjoys attending hersons’ sporting events and providing “Mom-Taxi” services for her sons and their friends. She also loves her part-time job as a hairdresser at a popular salon. Seven months ago, Joy began noticing stiffness in both hands in the morning that lasted longer and longer. Stiffness now lasted more than 1 hour every morning and included hands, wrists and ankles. She also had increasing difficulty standing for long periods at work or at home due to foot and ankle pain. She began taking ibuprofen 800mg 3 times daily and found it helped her get through her day with less pain and stiffness. Three months ago, Joy noticed pain in her right and left shoulders when she would cut or blowdry her client’s hair. She also began feeling extremely tired and short tempered. She had no energy to do her usual activities. Ibuprofen was no longer very effective for her pain or…
What complications is Mr. E at risk for following general anesthesia and a below-the-knee amputation (BKA)? Please explain Note: -Mr. E is a smoker, has heart disease and diabetes type 1 as well as PVD -This is during the postoperative Phase
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