C.W. receives a total of 4 units of packed red blood cells (PRBCs), 5 units of fresh frozen plasma (FFP), and several liters of crystalloids to keep his mean BP above 60 mm Hg.
On the second day in the MICU, his
total fluid intake is 8.498 L and output is 3.66 L. His hemodynamic parameters after fluid resuscitation are
pulmonary capillary wedge pressure (PCWP) 30 mm Hg and cardiac output (CO) 4.5 L/min.
Calculate his fluid balance and identify whether it is positive or negative.
Why will you want to monitor his fluid status very carefully?
Question 2Explain the purpose of the FFP for C.W.
Question 3What safety precautions should be considered in light of his prolonged PT and INR?
And how do you account for the elevated WBC count?
Thanks in advance :)
Question 4Evaluate this electrocardiogram (ECG) strip and note the effect of any electrolyte imbalances.
Attached the picture below.
Question 5As soon as you get a chance, you review C.W.'s admission laboratory results.
Laboratory Results
Sodium 138 mEq/L
Potassium 6.9 mEq/L
BUN 90 mg/dL
Creatinine 2.1 mg/dL
WBC 16,000/mm3
Hgb 8.4 g/dL
Hct 25
PT 23.4 seconds
INR 4.8
After examination of the lab results, are there any concerns with C.W.'s electrolyte levels?
Explain your answer.
In view of the previous laboratory results, what diagnostic test will be performed and why?
Question 6What is the most serious potential complication of C.W.'s bleeding?
Also can you calculate C.W's mean arterial pressure (MAP) and explain why this measure is important.
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