Day 2 in the ICU, a client in septic shock from a perforated…
Day 2 in the ICU, a client in septic shock from a perforated bowel is receiving IV vancomycin and prophylactic enoxaparin. The nurse notices blood seeping around the arterial line and new petechiae across the chest. Labs: platelets 38,000/µL, PT 23 seconds (prolonged), aPTT 72 seconds (prolonged), D-dimer markedly elevated, and schistocytes on the blood smear. Which disorder best fits these results?
Read DetailsTelehealth visit. A client started gemfibrozil for high trig…
Telehealth visit. A client started gemfibrozil for high triglycerides a month ago and still takes simvastatin 40 mg nightly. For 2 days the client has had aching calves and shoulders, trouble climbing stairs and tea-colored urine. Labs: CK 7,400 units/L (MM isoenzyme elevated), creatinine 1.5 mg/dL (0.9 last year), ALT within normal limits. Which conclusion is most likely?
Read DetailsOncology unit. Twelve minutes after a unit of packed RBCs is…
Oncology unit. Twelve minutes after a unit of packed RBCs is started for chemotherapy-related anemia (Hgb 6.8 g/dL), the client says, “Something feels wrong,” and reports flank pain and chills. Acetaminophen was given before the transfusion. T has risen from 98.6°F to 101.6°F (37°C to 38.7°C), HR from 84 to 122/min, and BP has fallen from 124/72 to 88/54 mm Hg. The urinary catheter bag holds red-brown urine. Which action takes priority?
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