Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN: 9780134580999
Author: Elaine N. Marieb, Katja N. Hoehn
Publisher: PEARSON
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Chapter 17, Problem 2CCS
20-Year-Old-Male with Abdominal Trauma
Richard Watkins, 20, fell off his roof while replacing some shingles. Upon arrival at the scene, paramedics make the following observations:
•Abdominal pain, right upper quadrant
•Cyanotic, cool & clammy skin
•Falling blood pressure, 100/60 mm Hg; rapid pulse, 100 beats/min
Paramedics start an IV to rapidly infuse a 0.9% sodium chloride solution (normal saline). They transport him to a small rural hospital where Mr. Watkins’s blood pressure continues to fall and his cyanosis worsens. The local physician begins infusing O negative packed red blood cells (PRBCs) and arranges transport by helicopter to a trauma center. She sends additional PRBC units in the helicopter for transfusion en route. After arrival at the trauma center, the following notes were added to Mr. Watkins's chart:
•Abdomen firm and distended
•Blood drawn for typing and cross matching: packed A positive blood cells infused
•Emergency FAST (focused assessment with sonography for trauma) ultrasound is positive for intraperitoneal fluid
A positive FAST scan indicates intra-abdominal bleeding. Mr. Watkins's condition continues to deteriorate, so he is prepared for surgery. The operation reveals a lacerated liver, which is repaired. Mr. Watkins’s vital signs stabilize.
2. NCLEX-STYLE Why was Mr. Watkins given PRBCs in addition to normal saline solution? What problem does the infusion of PRBCs address that the saline solution could not?
a. PRBCs help restore blood ion composition to normal.
b. PRBCs increase blood osmotic pressure, making the infused fluid stay in the vessels rather than move into the cells.
c. PRBCs enhance clotting, sealing off the injured vessels.
d. PRBCs contain hemoglobin, so they are able to carry oxygen to the tissues.
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18 year old male, brought in by ambulance following an alleged altercation where patient struck head on road curb at 2300 hrs.
Patient is denies loss of consciousness but unable to recall all events. Patient appears alert but teary and takes a couple of moments to answer questions.
On examination, 4cm laceration noted with slow ooze from wound. Dressing insitu. Vital signs and GCS recorded at 2325 hrs as per chart. No other obvious injuries.
Patient denies drug use, states has had approximately ‘five beers since 7pm’. Breath alcohol taken at 2330 hours 0.06%.
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Patient states is usually fit and well.
Past medical history
Childhood asthma, up-to-date with immunisations (last tetanus 12 months ago).Not on any medications and no known allergies.
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The decision is made to keep Zac in hospital overnight, for observation.
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Chapter 17 Solutions
Human Anatomy & Physiology (11th Edition)
Ch. 17 - Prob. 1RQCh. 17 - 2. The hormonal stimulus that prompts red blood...Ch. 17 - 3. All of the following are true of RBCs except...Ch. 17 - 4. The most numerous WBC is the (a) eosinophil,...Ch. 17 - 5. Blood proteins play an important part in (a)...Ch. 17 - 6. The white blood cell that releases histamine...Ch. 17 - 7. The blood cell that can become an...Ch. 17 - 8. Which of the following does not promote...Ch. 17 - 9. The normal pH of the blood is about (a) 8.4,...Ch. 17 - 10. Suppose your blood is AB positive. This means...
Ch. 17 - 11. (a) List the three major categories of formed...Ch. 17 - Prob. 22RQCh. 17 - Prob. 13RQCh. 17 - Prob. 14RQCh. 17 - Prob. 15RQCh. 17 - Prob. 16RQCh. 17 - 18. (a) Describe the appearance of platelets and...Ch. 17 - 19. (a) Define hemostasis. (b) List the three...Ch. 17 - Prob. 18RQCh. 17 - Prob. 19RQCh. 17 - Prob. 12RQCh. 17 - Prob. 20RQCh. 17 - 1. Cancer patients being treated with...Ch. 17 - Prob. 25RQCh. 17 - Prob. 21RQCh. 17 - Prob. 26RQCh. 17 - Prob. 27RQCh. 17 - 20-Year-Old-Male with Abdominal Trauma Richard...Ch. 17 - 20-Year-Old-Male with Abdominal Trauma Richard...Ch. 17 - 20-Year-Old-Male with Abdominal Trauma
Richard...Ch. 17 - 20-Year-Old-Male with Abdominal Trauma Richard...Ch. 17 - 20-Year-Old-Male with Abdominal Trauma Richard...
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