Activity 1.2 DISCUSSION FORUM – FEVER Based on the clinical information provided: 1. What is the most likely cause of this patients fever? As stated on the clinical assessment, Sam has recorded a temperature of 37.8oC, “body temperature averages 37C +/- 0.5C and with a range of 35.8-38.2C” as published in (Marieb & Hoehn, 2011, p950), so I would assess Sam’s temperature as initially a low grade fever. As the majority of fevers in hospitals are due to infections (Marshall, 1993, p208). Low-grade fevers can occasionally accompany serious medical conditions with symptoms such as Sam’s difficulty breathing, confusion, decreased levels of consciousness and rapid heart rate. http://www.healthgrades.com/symptoms/low-grade-fever The case study states Sam’s has a condition of insulin dependent diabetes and her complaint to her friend, of burning and frequency when going to the bathroom, we could provisionally diagnosis a probable urinary tract infection as a underlying trigger for the fever (Marshall, 1993, p274). With two arterial blood gases attended and some of the results listed. These results are showing a more acidosis level and with our pH low the PaCO2 low and also HCO3 low, Sam’s decreased level in the glascow coma scale and tachycardia we could consider a hyperglycaemic metabolic or ketosis acidosis and commence corrective treatment immediately( Roman,M,2008, p268). Or is the fever, a stress response from Sam’s body due to an acidotic level and her body’s demands
With the early vomiting, we could expect Mr. K. B’s serum pH to be between 7.4 and 7.45. (VanMeter, Hubert p 32)
How would you have expected Cari’s decreased Pco2 and alkaline blood pH to have affected her
A diagnosis of sepsis includes a suspected or confirmed infection that is usually accompanied by a body temperature above 101 F (38.3 C) or below 96.8 F (36 C), a heart rate higher than 90 beats a minute and/or a respiratory rate above 20 breaths per minute.
Per PA Wu, your labs were normal except your blood sugars. Your A1c level is 0.1 higher than the last time you had it drawn and it consider to be in the pre- diabetic range. Please eat a low carb diet and include exercise in your daily regimen.
The possible causes of this acid base imbalance are the vomiting and the overuse of antacids. As the name implies it is bicarbonate which has been added to the body. The vomiting reduces the extracellular fluid and this in turn leads to a release of angiotensin and aldersterone. This release then increases the bicarbonate absorption and increased hydrogen ion and potassium excreted. This patient may also have hypokalemia which is very common in metabolic alkalosis and would need to be replaced if it occurred ( Thomas, 2015). The respiratory rate would also slow to try and compensate for the alkalosis.
His abnormal results were: urine protein presence, blood urea nitrogen 37 mg/dL (high), creatinine 1.9 mg/dL (high), chloride level 110 mmol/L (high), calcium level 8.3 mg/dL (low), total protein 5.6 g/dL (low), and albumin 2.7 g/dL (low). Normal levels of these results are: absence of protein in urine, blood urea nitrogen 8-21 mg/dL, creatinine 0.61-1.21 mg/dL, chloride level 97-107 mmol/L, calcium level 8.2-10.2 mg/dL, total protein 6-8 g/dL, and albumin 3.4-4.8 g/dL (Bladh et al., 2013). These abnormal lab results can be caused by and related to many
Assessment – If as a paramedic you suspect sepsis then you should question the patient if they have been recently been hospitalized or have had medical procedures that may be invasive performed on them or treatments or medications that may have weakened their immune system. Look for the prehospital criteria that point you in the direction of sepsis, so temperature above 38oC or below 36oC, respiratory rate of 20 or more, and heart rate above 90 beats per minute. Ask the patient if they have been recently diagnosed with an infection or illness. There are some different diagnoses that may have some similar signs and symptoms as sepsis; these include other infections, diabetic ketoacidosis, a myocardial infarction, and a pulmonary embolism. To rule some of these out you can perform some simple tests like listening to lung sounds, 12 lead if they have chest pain, and smell or breath (ketoacidosis would be fruity). Ultimately however the only way to get the diagnosis is through blood tests and scans. For this patient you should do the regular assessment you do for every patient as well, so take vitals, get their information (ex: SAMPLE and OPQRST), SpO2, and 4
The tests came back and nothing seemed to stick out. Her glucose level was slightly elevated but not enough to cause the lethargia and inappetence she was exhibiting. Dr. Brian Stockinger told the keepers to keep an eye on her and watch for developing signs or signs of improvement. A few days later, the keepers had noted in the reports that she has
After examining the acid-base gas levels, the patient is diagnosed with metabolic alkalosis with partial compensation because of the increase of base components due to baking soda consumption and the decrease of acid components by excessive vomiting. The patient’s pH level is 7.48, which is above the normal range of 7.35-7.45 labeling it a base. A base lowers the amount of free hydrogen ions in solution and although a weak base, it can prevent major changes in the body fluid pH. An example of a weak base is bicarbonate or HCO3 which levels are high as well at 34mEq/L. The normal range for HCO3 is 22-24. The PaCO2 level of 55mmHg is labeled an acid due to its high level. The normal range is 35-45 with less than 35 resulting in alkalosis and greater than 45 as acidosis. The acid-base balance of the blood has an excess of base resulting in alkalosis. Alkalosis is a decrease in the free hydrogen ion
The fever could be the result of infection caused by kidney stones. Sometimes patients don't have a fever but they feel groggy.
The acid base balance is a homeostatic process that aides the body in maintaining a pH in the arterial blood between 7.35-7.45 (Patient, 2015). The body works together through multi-systems to ensure that acidity or alkalinity never take over within the blood. The purpose of the following paper is define the classification of the acid-base balance, define the factors from the case study, explain the pathophysiology, describe the compensatory mechanisms, pharmacological interventions, and the educational needs of patients with an imbalance.
Our first thought of fever is the association with a common cold, but in some cases fever can be symptoms of other types of infections. The human body is a complex and sophisticated machine, in which all of the components must maintain a complex balance in order to ensure optimal function. This is known as homeostasis and there are various homeostatic variables in which temperature is one of them. Homeostasis ensures that the body’s internal environment is kept at fairly constant/stable core properties. A fever is usually triggered by an infection and is a natural inflammatory response. Fever is an elevation in the body temperature that is caused by cytokine-induced upward displacement of the hypothalamic thermoregulatory center (Mattson-Potth,2014). A fever is caused by numerous types of microorganisms and substances called pyrogen. When these pyrogens release chemicals into the bloodstream, the human resets the hemostat to a higher temperature. The following paper will explain how fever is often related to a bacterial infection, clinical manifestations of localized inflammation, blood work order when there is a suspected bacterial infection and manifestation of a systematic response to an infection.
Fever in children is a typical side effect of various restorative conditions, most strikingly irresistible maladies. In spite of not being characteristically risky, it can cause uneasiness in parents and caregivers alike, and it is one of the main reasons why parents look to medical care. Evidence-based guidelines reliably express that the side effect of fever does not require treating and, therefore, the point ought to be to distinguish those children with a serious ailment and heightened comfort instead of standardizing temperature (National Institute for health and care excellence, NICE 2014). Moreover, there is confirmation that as a feature of the intense stage reaction, fever might really be beneficial in advancing recuperation from various conditions. In spite of this, there is considerable confirmation from numerous countries, that nervousness around fever and the standard utilisation of antipyretics is high (Purssell 2014).
What is your differential diagnosis for this patient? Include at least 5 infectious diseases and the rationale for each choice.