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Nursing: A Concept-Based Approach to Learning, Volume I, 3rd Edition Solution Manual

Improve your comprehension with Nursing: A Concept-Based Approach to Learning, Volume I, 3rd Edition Solution Manual, designed to make studying easier.

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MODULE 1: THE CONCEPT OF ACID–BASE BALANCEClinical Examples A–CClinical ExampleA(p. 7)JayJamesisa24-year-oldmanwho wasrockclimbingwithhisfriendsatanationalpark25 milesfromthenearesthospitalwhenhesuddenlylosthisfootingandslid20 feettotheground. Mr. Jameswasalertandorientedwhenhisfriendsreachedhim,andhecould moveallextremitiesquiteeasily.Hehadmultiplescrapesoverhisanteriorchestanda largegashoverhisleftthigh(nearthegroin),whichwasbleedingprofusely.Hisfriends madeamakeshifttourniquet,whichslowedthebleeding.Theyimmediatelycontactedthe parkranger,who securedahelicoptertoevacuateMr. Jamestothenearesthospital.Twolarge-boreIVs wereplacedineacharmin-flight,andnormalsalinewas administered.Theflightmedicplaceda100% nonrebreathingmaskon Mr. James.Mr. Jamesbecamedisorientedandconfusedduringtheflight.Mr. Jamesarrivedinthe emergencydepartment(ED)45 minutesafterthefall.On arrivalintheED,Mr. James islethargicbutresponsivetopainfulstimuli.Hehasmultipleabrasionsoverhischinand neck.Hispulseoximetryis99% on thenonrebreathermask,so theEDteamreplacesthe maskwithanasalcannulaat4 L/m.A repeatpulseoximeterreads95% saturation.Vitalsignsareasfollows:TO37.3°C (99.1°F):HR130 bpm;R30/min;andBP 100/60mmHg.Skiniscoolandclammy,nailbedsarepale,andmucousmembranesaredry. Allpulses arepalpablebutweakandthready.Lungsareclear,heartsounds regular.Outputviaurinarycatheterfor thepasthour is20 mL.Clinical Reasoning Questions Level IQuestion1Whatisthemostlikelycauseof Mr.James’shighheartrateandlowbloodpressure?Answer1Themostlikelycauseof thehighheartrateandlowbloodpressureisshockrelatedtolossof blood,whichcausescompensatoryhighheartrateandlowbloodpressurerelated tovolumeloss.Question2If you werethenurseassignedtoMr. James,whatwouldbeyour primaryconcernsatthistime?Answer2Theprimaryconcernswouldbelossof bloodandunstablevitalsigns.

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