Answer to Question 1
Potassium: high d/t fluid shifts and sodium/potassium balance
Glucose: high d/t gluconeogenesis and glycogenolysis from inflammatory response (pt also has history of T2 diabetes)
Phosphate: fluid shifts and electrolyte balance
Protein, albumin, prealbumin: low because these are negative acute-phase proteins and synthesis rate decreases during metabolic stress
CPK: a cell isoenzyme that can be elevated with systemic inflammation
ALT, AST, Lactate dehydrogenase: elevated due to potential damage from sepsis (e.g. leukocytes damaging the hepatocellular membranes, apoptosis related to the immune response, or tissue ischemia due to microvascular obstruction).
Cholesterol, LDL, TGs: increased d/t increased lipolysis during inflammatory response (pt also has PMH of hyperlipidemia)
WBC: indicator of infection; leukocytes destroy and remove foreign materials, microorganisms, and cell debris
HbA1C: elevated due to T2DM
Hgb, Hct: low d/t recent resection of stomach and decreased area for absorption of iron
CRP: acute-phase protein increased with inflammation
Fibrinogen: acute-phase protein increased with inflammation
Lactate: byproduct of lipolysis that accumulates in the blood during the inflammatory response and is an indicator for tissue hypoxia; is a marker for metabolic stress
Ferritin (low)/Transferrin (high): due to iron-deficiency anemia from malabsorption from Roux-en-Y
Answer to Question 2
Flu-like symptoms, nausea: associated with the infection and inflammatory response
Acutely short of breath: fluid overload due to inflammatory response and third-spacing of fluids
The shift of fluid into the lungs and other third spaces occurs due to the increased vascular permeability consistent with the inflammatory response.
Mechanical ventilation: difficulty breathing due to accumulation of fluid and inflammatory response
Temp 102.5, heart rate 98, respiratory rate 23: consistent with inflammation and sepsis
2+ pitting edema: indication of third spacing and fluid overload
Ecchymosis, petechiae: indicators of internal hemorrhaging, potentially caused by fluid overload and vascular permeability
Rapid respirations with rales: the excess fluid in the lungs can cause the rales
Diminished pulses bilaterally: with increased fluid retention, pulses become more difficult to palpate
The patient and his family meet with the nurse to discuss progress on the patient care plan.
Pulmonary function test: spirometry. (a) Normal respiratory volumes, as measured during spirometry.
The biochemical reactions of near-infrared light
Tag identify that the power has been removed and service work is being done.
The U.S. military uses its own marking system to identify explosive hazards (left), chemical hazards ...
Testing client’s ability to identify sharp sensations