Answered: Based on the image case scenario given.…

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Based on the image case scenario given.

Trace the flowchart pathophysiology of the disease in relation to the patient’s case and explain why its happen.

Transcribed Image Text:evidence of a traumatic brain injury. He underwent posterior wiring and fusion. His acute hospital course was complicated by recurrent mucous plugging, aspiration pneumonia and urinary tract infection. He subsequently underwent placement of a tracheostomy tube and a nasogastric tube feeding. He was discharged after 3 months of being hospitalized with in-situ Shirley's tracheostomy tube, indwelling catheter (because of care problems) with no other complications at that time. To date, he was readmitted in the ICU with multiple pressure sores, pneumonia, sepsis and high blood pressure of over 150 mmHg with bradycardia. IV infusion of Zosyn (piperacillin-tazobactam) 4.5 g/100 mL according to the culture and sensitivity was started. The patient was also administered anti-hypertensive agents like nifedipine 10 mg/tab 1 tablet daily dose increased to 10 mg t.i.d. Over the next several days, his medical condition improved considerably but his systolic blood pressure was swinging between 150 mmHg to 190 mmHg and pulse rate was persistently below 60/min. His upper and lower limbs motor and sensory function showed no improvement. His vital capacity was less than 2000 ml. He was also noted to be developing increased spasticity. Multiple pressure ulcers were noted over the right scapula (3-4 cm), pre-sacral (6-7 cm) and over the right greater trochanter (4-5 cm) by and was prescribed with hydrofiber and vacuum dressings. During this time period, he developed flushing over the head and neck. He has a condom catheter drainage at his request. His blood pressure cannot be controlled, which sometimes approached systolic blood pressure190 mmHg even with nifedipine 10 mg t.i.d; pressure was not controlled satisfactorily and didn't fall below 150 mmHg. Mr. Assimo is complaining of persistent throbbing headache after being started on nifedipine, and as such, was shifted to perindropril 4 mg o.d and chlorthiazide 250 mg o.d. Baclofen was prescribed with the initial dose of 10 mg t.i.d, which was gradually increased to 20 mg t.i.d. ECG showed normal rhythm. All other blood investigations like renal profile, lipid profile, liver enzymes were within normal ranges but albumin was only 20 gm/Cl and was prescribed with a high protein diet, vitamins and mineral supplements to build up patient's general conditions.