Case #1 A 12-year -old boy is scheduled to have a tonsillectomy and came in for pre -op lab work . T

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Case #1 A 12-year -old boy is scheduled to have a tonsillectomy and came in for pre -op lab work . There is a family history of bleeding disorders , but the mother was unsure of the diagnoses in the family members . The following lab results were obtained : RBC 4.7 Na 140 PT 12 WBC 5.0 K 3.0 PTT 64 high Hgb 14.0 100 17 HCT CO2 25 MCV 82 Gluc MCH 28.0 Bun MCHC 35 Creat 0.8 1. What is the first test that should be performed next and why? 2. Ask the instructor to record the result of that test below. 3 What test (s) should be performed next and why? 4. Ask the instructor to record the result of that test(s) below 5. What is the most likely diagnosis ? 6. What do you think should be done to treat /prepare the patient for surgery ? Case 2 72 yearold man came in for pre-op work for gallbladder removalHis patient history DVT a heart replacement years ago, mild dementia and an enlarged in to the recent diagnosis of gall stones pre – op lab work results are recorded below RBC 3.2 Na 140 PTT 20. INR 2.3 WBC 4.8 K3.0 PTT 20 INR 2.3 Na 140 PT WBC 4.8 K 3.0 PTT 32 Hgb 11.5 CL 100 TT 16 HCT 33 CO2 25 MCV 79 Gluc 85 MCH 28.0 Bun 20 MCHC 32 Creat 1.8 high 1 What is the first test that should be performed next and why ? high 2 Ask the instructor to record the result of that test below . 3 What test (s should be performed next and why ? 4. Ask the instructor to record the result of that testis below 5. What is the most likely diagnosis ? 6. What you think should be done to treat / prepare the patient for Case # 3: 45- year-old man, a known Hemophilia A patient has been admitted for a bleeding crisis. On admission , the following lab results were obtained PT 12 PTT > 120 FXIII activity 30% The patient was given Factor concentrate transfusions The following day his activity level was 120 % and his bleeding continued 1. What is the first test that should be performed next and why ? 2. Ask the instructor to record the result of that test below 3. What is the most likely diagnosis 4. What be done to treat the continued bleeding ?
SCIENCE
HEALTH SCIENCE
NURSING
NUR 277

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