Buyere’s case study 6 and 13

Buyere’s Case study 6

Hypovolemic Shock

Patient Case Question 5.

The arterial blood gas results are improving. This is because as observed from the initial assessment of the vital signs and the subsequent assessment, the oxygen saturation as measured by the SaO2 results show an improvement from 84% to 95% with the administration of oxygen. Further, the blood pH has reduced to within normal range indicating a reduced blood concentration of carbon dioxide(Kobayashi, Costantini, & Coimbra, 2012).

Patient Case Question 6.

Based on urine output rate, the patient is in the decompensated class of hypovolemic shock. This is based on the fact that the urine output rate has returned to normal with the infusion of the intravenous fluids. The kidneys therefore have resumed normal functions(Annane, 2013).

Patient Case Question 7.

Pathophysiology of the abnormal BUN and Cr in hypovolemic shock.

As the body loses fluid through bleeding, the immediate response include the shunting of blood from the peripherals to the central organ systems. This is also coupled with the reduction in blood flowing through the renal tubules and hence reduce urine output. Since all other functions of the body, including deamination of proteins are also taking place, thus releasing creatinine and urea into the blood, the reduced urine output causes abnormal accumulation of these compounds in the blood(Kobayashi et al., 2012).

 

Buyere’s case study 13

Bacteria Pneumonia

Patient Case Question 1.

The patient is suffering from a community-acquired infection. This is because the infection already manifests at admission. Nosocomial or hospital-acquired infection are those whose symptoms appear 48hours after admission(Prina, Ranzani, & Torres, 2015).

Patient Case Question 2.

Lethargy refers to a mild or moderate impairment of consciousness that may be as a result of mental fatigue or brain dysfunction. Lethargy leads to reduced concentration and alertness(Reznicek, Mason, Kaul, Saint, & Bloch, 2011).

Patient Case Question 4.

From the calculations, the patient’s Pneumonia Severity of Illness score is 189 points. This implies that she is in the risk class V with a mortality risk rate of 27-29%. Hospitalization of the patient is highly recommended at this score based on the severity of the symptoms observed(Loebinger & Wilson, 2012).

Patient Case Question 5.

From the assessment and the laboratory results, although the severity score is high and the white blood cells are slightly elevated, the patient may benefit more from treatment outside the hospital. This is because she is vulnerable and her condition may worsen with the risk of nosocomial infections(Loebinger & Wilson, 2012).

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