A 34-year-old pedestrian was struck by an auto and thrown to the roadside.  She is found complaining of bilateral hip pain and is unable to move her legs.   Upon examination:   LOC – alert, oriented, anxious Airway – patent Breathing – slightly rapid but, adequate SpO2 – 93% on ambient air Circulation – rapid, weak radial pulse; pale, cool, diaphoretic skin; no external bleeding Signs of injury found during secondary assessment:  pelvic instability and crepitus accompanied by pain, deformity at L3.     Vital signs: BP – 90/60, pulse – 120, weak, regular, and respirations – 22, regular.   Treatment?   Rapid transport to level 1 trauma center.  Reassessment performed every 5 minutes.

Case Presentation Ms. Jimenez is a 56-year-old woman who has been having financial difficulties since her divorce five yea ago. She was recently involved in a motor vehicle crash (MVC) in which she drove over a curb and hi telephone pole. She did not sustain any significant injuries in the MVC. Two days ago, Ms. Jimenez daughter Maria returned home at 8:00 p.m. to find Ms. Jimenez sitting on the floor with a decreased lev of consciousness. Maria was able to shake her mother awake. With slurred speech, Ms. Jimenez told h daughter that she drank three large glasses of antifreeze (ethylene glycol) at around 7:00 p.m. Maria call 999 and emergency medical services transported Ms. Jimenez to the local emergency department. Case Progress It is forty-eight hours after her arrival in the emergency department. Ms. Jimenez has undergo twelve hours of emergency dialysis, has been extubated, and is medically stable for transfer to a medic. surgical nursing unit. A safety sitter remains in Ms.…

Mr. JKL is a 69 yr old white male complaining of shortness of breath during activities and sometimes at rest. He does not report any myocardial ischemia symptoms and is treated for hypertension and prostate cancer (diagnosed 5 years prior). The patient quit smoking 3 years ago and smoked on average 2 packs per day for 51 years. He was admitted to the hospital 4 months ago due to respiratory symptoms. The patient is not on supplemental oxygen, his oxygen saturation is 95%, and he reports some shortness of breath with a dyspnea rating of 5 (1-7 scale). The patient is sedentary, rarely walks outside of his home, and does not engage in sports or recreational activities. Mr. JKL's preexercise medical exam results: BMI = 31.8 Resting heart rate = 85 Blood pressure = 144/98 Enlarged anteroposterior chest diameter and decreased breath sounds and prolonged exhalation Current medications: Atrovent inhaler 8 puffs twice per day Doxapram HCL, 50 mg 3 times daily Furosemide, 40 mg 4 times daily…