solved

Question
Answered step-by-step
Asked by DeanFlamingoPerson20
James Bond, a 77-year-old man, is admitted to the intensive care unit (ICU) of Carrington hospital from the operating room. Earlier the same day, he had presented to the emergency department with abdominal pain. He previously worked for a British intelligence agency, now retired. His medical history included treated hypertension and hypercholesterolemia, diverticulitis, previous heavy alcohol (Martini- shaken not stirred) intake. In the emergency department, he was drowsy and confused when roused and was peripherally cold with cyanosis. He continually repeated the word “Vesper”. The systemic arterial blood pressure was 75/50 mm Hg, and the heart rate was 125 beats per minute. The abdomen was tense and distended. 1. Name 2 medications for hypertension and 2 medications for hypercholesterolemia this patient may be taking at home. (3 points) 2. What is diverticulitis? (4 points) 3. How do you explain his drowsiness, confusion, and cyanosis? (3 points) 4. In the ED, his BP is 75/50 and HR is 125. What does this signify at this point? How can this relate to abdominal pain and distention? (3 points) After the administration of 1 liter of intravenous crystalloid fluids, a computed tomographic scan of the abdomen showed extraluminal gas and feces consistent with a perforated sigmoid colon. He was treated with intravenous antibiotics and taken to the operating room for a laparotomy. During this procedure, fecal peritonitis from a perforated sigmoid colon was confirmed. A resection of the sigmoid colon was performed with creation of a colostomy and the peritoneal cavity was washed out. 5. He is given 1 L of IV crystalloid fluid. What kind of fluid is a crystalloid- hypertonic, hypotonic, isotonic? Why is he given a crystalloid? Name 2 crystalloid fluids. (3 points) 6. How would you explain a computed tomographic scan with contrast to a person with no medical background? What is the prep for the procedure? (4 points) 7. Why was IV antibiotics given after the results of the scan? (3 points) 8. What can cause a perforated sigmoid colon? (3 points) 9. What is a laparotomy? (3 points) On arrival in the ICU, he is still anesthetized, the trachea is intubated, and the lungs are mechanically ventilated with a fraction of inspired oxygen of 0.4; the arterial blood pressure is supported with a norepinephrine infusion. When the patient was in the operating room, he received a total of 4 liters of crystalloid. On his arrival in the ICU, the vital signs are a blood pressure of 88/52 mm Hg, heart rate of 120 beats per minute in sinus rhythm, central venous pressure of 6 mm Hg, and temperature of 35.6°C (96o F). An analysis of arterial blood shows a pH of 7.32, a partial pressure of carbon dioxide of 28 mm Hg, a partial pressure of oxygen of 85 mm Hg, Bicarbonate 20 mEq/L and a lactate level of 3.0 mmol per liter. 10. What does his ABG tell us? (3 points) 11. What does his lactate level confirm? (3 points) 12. A “family member”, only known as M, is at bedside- How do you explain to M what has happened (M has permission from the patient to receive his medical information)? (5 points)
SCIENCE
HEALTH SCIENCE
NURSING
NUR 243

******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT, DISCUSSION, ESSAY, HOMEWORK OR QUESTION YOU MAY HAVE. OUR PAPERS ARE PLAGIARISM FREE*******."