Hemorrhagic Shock Case Study
A 37-year-old female presents to the emergency department weak, pale, A&O, with severe RUQ pain. She states that the following. “I have been taking a lot of ibuprofen for this abdominal pain. I went to my doctor but he told me it was psychological.”
The paramedic has a PIV #18 RAC infusion with 1 L. NS wide open and O2 @ 2 lpmNC.
V.S. T. 97.0, 120 bpm, RR 24, BP 80/50, SaO2 95%.
1. What assessment and interventions will the ED staff do next?
The ED staff should prioritize
2. Write a list of physician orders that the RN should anticipate?
Stat labwork is sent and results are called to the ED RN.
3. What are the assessment goals for this patient?
4. Initially the patient improves after the MD orders are implemented. However the patient relapses and codes at 20:00. Discuss what may have happened.
|Blood Type A+||=|
|Total white blood cell (WBC) count = 7,400 WBCs /mm3||(normal = 4,000 to 11,000)|
|Differential WBC count revealed 59% neutrophils||(normal = 55-70%)|
|Hematocrit = 54%||(normal = 42-54%)|
|Hemoglobin = 9.0 gm / dl||(normal = 14-18 gm / dl)|
|Sodium (Na+) = 150 mEq / L||(normal = 136-145 mEq / L)|
|Potassium (K+) = 5.1 mEq / L||(normal = 3.5-5.1 mEq / L)|
|Chloride (Cl–) = 104 mEq / L||(normal = 96-106 mEq / L)|
|BUN = 27 mg / dl||(normal = 6 – 23 mg / dl)|
|Creatinine = 1.9 mg / dl||(normal = 0.7 – 1.5 mg / dl)|
|Glucose = 165 mg / dl||(normal = 70 – 160 mg / dl)|
|SGPT = 41 IU / L||(normal = 0-33 IU / L)|
|SGOT = 48 IU / L||(normal = 0 41 IU / L)|