Concept explainers
We have a new patient to consider today. Mr. Gutteman, a 70-year-old male, was brought into the ER in a comatose state and has yet to come out of it. It is obvious that he suffered severe head trauma-his scalp was badly lacerated, and he has an impacted skull fracture. His initial lab tests (blood and urine) were within normal limits. His fracture was repaired and the following orders (and others) were given:
Check qh (every hour) and record: spontaneous behavior, level of responsiveness to stimulation, movements, pupil size and reaction to light, speech, and vital signs.
Turn patient q4h and maintain meticulous skin care and dryness.
Explain the rationale behind these orders.
On the second day of his hospitalization, the aide reports that Mr. Gutteman is breathing irregularly, his skin is dry and flaccid, and that she has emptied his urine reservoir several times during the day. Upon receiving this information, the physician ordered:
Blood and urine tests for presence of glucose and ketones
Strict I&O (fluid intake and output recording)
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EBK ANATOMY & PHYSIOLOGY
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