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Week 13 MODS
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by Anita Hartati
| 11 Questions
1
1 pt
Mr Pitt is a 72 year old male who presented to hospital post trauma.
Mechanism of injury: Low speed pedestrian vs car.
DAY 5 after admission his observations are as follows
A own airway, speaking in single words
B RR 34 BPM, unable to deep breath/cough, SpO2 89%. Increased work of breathing noted. Noted to have intercostal, substernal and supraclavicular retractions.
C HR 140 BPM, BP 85/45, peripherally cool
D GCS E 3, V 4, M 6
E Temperature 38.6
F Urine output less than 30mls/hr. IV NaCl running at 100mls/hr
G BGL 12.2mmol/l

Explain the pathogenesis of his deteriorating Breathing.
What is your nursing strategy to improve his Breathing?
2
1 pt
C HR 140 BPM, BP 85/45, peripherally cool

Explain the pathogenesis of his deteriorating Circulation.
What is your nursing strategy to improve his Circulation?
3
1 pt
D GCS E 3, V 4, M 6

Explain the pathogenesis of his deteriorating GCS.

4
1 pt
E Temperature 38.6

Explain the pathogenesis of his fever.
What is your nursing strategy to relieve his fever?
5
1 pt
F Urine output less than 30mls/hr. IV NaCl running at 100mls/hr

Explain the Renin-Angiotensin-Aldosterone System (RAAS) that led to his oliguria.
What is your nursing strategy to improve his Fluid status?
6
1 pt
F Urine output less than 30mls/hr. IV NaCl running at 100mls/hr

Explain the pathogenesis of his high Glucose level.
What is your nursing strategy to improve his Glucose level?
7
1 pt

What is his metabolic status? (respiratory/metabolic/mixed and acidosis/alkalosis)

8
1 pt
What caused his PaCO2 to be high?
9
1 pt
What caused his HCO3 to be low?
10
1 pt
Why is his PaO2 low?
11
1 pt
Why is his Lactate level high?
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