Ms. Murray’s autonomic status will result in which of the following?

Which electrolyte abnormality is most concerning for Mr. Thomas’ immediate safety, and why?

Ms. Jernigan has been taking the anticoagulant Coumadin. Which of the following indicates therapeutic anticoagulation on this medication?

What is the most likely reason for her clinical manifestations of bruising and nosebleeds?

Mr. Gibbs’ myocardial hypertrophy may be caused by which of the following?

Barbara Ewing is an 86-year-old female with a recent history of poor appetite, difficulty swallowing, and weight loss  Her medical history includes hypertension and coronary artery disease managed by medications and a stroke several years ago leaving her with left sided weakness and inability to walk  She is very shaky and has notable tremors of her upper extremities when she moves her arms. Atrophy of the left arm and leg is noted.  Ms. Ewing typically sits in a wheelchair most of the day, however lately she has felt too weak and has been staying in bed most of the time  Skin breakdown has developed on her coccyx and elbows with notable erythema, edema, warmth, tenderness, and yellow drainage  Ms. Ewing has not been able to rate her coccygeal pain using a pain scale, however she moans, cries, and pushes you away when her coccyx is touched  Otherwise, Ms. Ewing has intact, dry skin and mucous membranes, pitting edema of both legs and feet, and scant urine output.  Vital signs are:  38.7, 112, 26, 96/44.  The following laboratory values were assessed: Serum Electrolytes Na 155 mEq/L Cl  106 mEq/L K 2.9 mEq/L BUN     18 mg/dL Creatinine 1.1 mg/dL  CO2 19 mmol/L Ca        7.9 mg/dL Mag     1.7 mEq/L Phosphorous   4.7 mg/dL Glucose         185 mg/dL                Albumin   2.9 g/dL                          Lactic Acid   6.0 mEq/L  

Ms. Murray develops acute hypoxemia and a decreased level of consciousness. A subsequent ABG is ordered and drawn with the following results:  PaO2 – 50 mm Hg, pH 7.2, PaCO2 – 52 mm Hg, HCO3 – 24meq, and SaO2 – 80%, indicating which of the following?

Sustained hypoxia has the potential to result in which of the following?

Ms. Jernigan’s ABG reveals which of the following?

Mr. Collins is a 59-year-old male with a history of vomiting blood. He has been in good health except for hypertension and “stomach problems”, including chronic indigestion and heartburn, usually relieved with over-the-counter antacids. He reports a poor appetite and recent weight loss. Mr. Collins states that he has a very stressful job at times, and he jokes, “I knew this job would give me an ulcer”. Mr. Collins reports that last evening the heartburn was particularly bad, but he experienced relief after taking his antacids. He awakened early today with nausea, bloody emesis, weakness, and dizziness. He also reports black tarry stools. His wife drove him to the emergency room, where he was admitted with an upper gastrointestinal bleed. He is alert and oriented X3, breathing is quiet and unlabored. Skin and mucous membranes are pale and dry. There are 90 mL of dark, concentrated urine in a bedside urinal.  An endoscopy reveals esophageal metaplasia and numerous gastric and duodenal ulcers. A chest x-ray shows normal lung fields with myocardial hypertrophy. An electrocardiogram (ECG) shows sinus tachycardia with occasional Premature Ventricular Contractions (PVCs). Vital signs are:  36.9 C, 112, 30, 94/42, and 98% Oxygen saturation. The following laboratory values were assessed: Serum Electrolytes Na 130 mEq/L    Cl 89 mEq/L   K 6.2 mEq/L BUN 52 mg/dl   Creatinine 2.4  mg/dl   CO2 16 mmol/L Ca 7.6 mg/dL   Mag 1.5 mEq/L   Phosphorous 4.4 mg/dL Glucose 138 mg/dL   Albumin 3.0 g/dL   Lactic Acid 1.8 mEq/L