Reference no: EM133334349
Assignment:
Assessment
Sam is 20 years old and has been admitted to the hospital for a large bowel obstruction. Sam was diagnosed with cystic fibrosis at the age of 2. His parents are very worried about him at this time. During surgery, he had 4 liters of blood loss and was admitted to the ICU where you work. He was intubated at time of admission.
Assessment:
Vital Signs: B/P 90/45, HR 116, T 98.9, RR 16
Weight: 150 pounds, Height: 6 foot
Neuro: Lethargic but opens eyes to voice
Respiratory: Lungs diminished in bases bilaterally
Vent: SIMV TV 650, FiO2 70%, RR 16, PEEP 5
ABG: pH 7.30, PaCO2 46, Bicarb 22, PaO2 70
PaO2/FiO2 ratio 100
Cardiac: Heart tones normal
GI: Bowel sounds absent
GU: Foley in place with 40ml/hr, Urine yellow and clear
Lab Values prior to surgery: NA 137 meq/L, K 3.9 meq/L, CL 100 meq/L, Mg 2 meq/L, WBC 12,000 mm3, H/H 15 g/dl and 42%, Lactic Acid 20 mg/dl,
CXR: Ground glass appearance in lower lobes
- How can genetic testing be used to make predictions? What are legal issues associated with genetic testing? What are ethical issues associated with genetic testing
- What is the pathophysiology of Cystic Fibrosis? Both Pulmonary and GI systems.
- Sam is in the early stages of ARDS. What manifestations do you see that would indicate this finding (be specific to Sam)?
- What is the Pathophysiology of the 3 stages of ARDS?
- What are your top 3 nursing priorities with rationale at this time? (These must be discussed in detail to get full points)
- Use ADPIE to write a plan for Sam for the next 12 hours. You will only need to include a nursing diagnosis, 3 interventions with rationale, and a goal. You must NOT use a risk for diagnosis.