Your pt is a 68 y/o male complaining diffuculty breathing for 2 days. He is sitting up conscious, alert, & oriented & apprears to be in mild respiratory distress. Physical examination reveals cool, dry, pink skin; he is thin & well defined accessory muscles, & you note diffuse wheezing to all lung fields. HR=102, BP=136/96, RR=20, SaO2=92%. The pt gives a 20 pack a year history of smoking. These findings are most typical of:
A) emphysema
You have applied a CC-oximeter to your pt & it is displaying an SpCO of 15%. Wh/ of the following is the most appropriate interpretation of this findings?
D) This is consistent w/ mild carbon monoxide poisoning.
Your pt is a 23 y/o femail in moderate respiratory distress, complaining of difficult breathing. She describes an acute onset of shortness of breath 15 minutes ago that has been getting progressively worse & has not responded to her Atrovent inhaler. Physical examination reveals cool, pale, & diaphoretic skin & clear lung sounds bilaterally. She has a history of asthma, is a smoker, & had breast reduction surgery yesterday. Medications include atrovent & albuterol inhalers & birth control pills. HR=129, BP=100/60, RR=26, SaO2=91%. In addition to 100% O2, wh/ of the following is the most appropriate treatment?
D) IV of NS w/ 250cc fluid challenge
A male pt w/ an acute exacerbation of his emphysema presents in severe distress w/ decreased air movement & diffuse inspiratory wheezes in all fields. HR=132, BP=142/88, RR=30, SaO2=88%. Wh/ of the following blood gas values is most likely?
A) PCO2 70mmHg
Your pt is a 16 y/o male who attempted suicide. He is unconscious & apneic, lying supine on a garage floor. The family states they found the pt unconscious in the front seat of a car that was running in an enclosed garage. HR=70, BP=100/60, RR=0. In addition to an IV of normal saline, wh/ of the following is the most appropriate?
C) Remove pt from the garage, initiate BVM ventilations w/ 100% O2, intubate & transport to a hospital w/ a hyperbaric chamber.
Wh/ of the following best explains the process of osmotic diuresis associated with hyperglycemia?
A) Glucose in the urine raises osmotic pressure inside the kidney tubule, drawing water into the tubule.
Your pt is a 45 y/o type I diabetic complaining of a 5 day history of abdominal pain, nausea & vomiting, increased urination & thirst. His skin & mucus membranes are warm & dry. HR=112 & regular, BP=94/60, RR=12 & regular. Your treatment for this pt would most likely include:
C) IV of NS 1-2L
You encounter a pt complaining polyuria, polyphagia, polydipsia, & abdominal pain. Based on these complaints, wh/ of the following would you also expect to find?
B) Kussmaul's respirations & fruity breath odor.
Your pt is a 72 y/o male who is conscious but lethargic & sitting in a chair. His son states that the pt has been a bit slow lately & has been gaining weight. The medical history includes hypothyroidism & myocardial infarction. The pt has been compliant w/ his Synthroid & has nitroglycerin for use as needed. The pt responds to verbal stimuli, is confused, has a large tongue, & pale, cold, doughy skin. His only complaint is constipation. HR=60, BP=112/80, RR=10 & shallow, SaO2=92%, temperature=88F, blood glucose=180 mg/gL. Your treatment should include:
C) O2, 4 lpm by NC
Hyperglycemia is most likely a result of damage to the pancreatic _____ cells?
B) beta
A pt presents w/ a history of frequent urination, signs & symptoms of dehydration, & blood glucose of 958 mg/dL. There is no acetone odor on his breath. To wh/ of the following can the absence of an acetone odor most likely be attributed?
A) The ability to use enough glucose to meet metabolic need.
