You are a new graduate nurse on your first rotation in a 30-bed specialist trauma ward. It is 0800hrs on your morning shift and you have been allocated the care of a 21-year-old female who has been on the ward for the last three weeks recovering from a mild closed head injury and multiple fractures (bilateral femurs and right tibia - all have been surgically repaired).
Past Medical History: No DM, Asthma as a Child
You are assisting the patient with showering when they have a tonic-clonic seizure, lasting for approximately 1-minute. You call for assistance and a set of observations are taken: GCS 8 (E1, V2, M5), SpO2 90% on room air , BP 130/70, HR 100, Resp rate 10 b/min and temperature 37.9.
|
Lab Results: ABG
|
UEC's
|
FBC
|
|
pH 7.30
|
Na 150 mmol/L
|
Hb 150 g/L
|
|
Pa02 60 mmHg
|
K 4.0 mmol/L
|
WCC 15 x 109/L
|
|
PaC02 50 mmHg
|
Cl 115 mmol/L
|
PLT 350 x 109/L
|
|
HC03 25 mmol/L
|
Urea 6 mmol/L
|
|
Creat 80 μmol/L
|
|
|
|
|
Questions
1. Based on the information given in the (above) case study start by prioritising and justifying your immediate care of this patient?
2. You also need to interpret both clinical and lab results, and
3. What physiological processes may be responsible for the abnormal clinical or lab results?