[Solved]: CASE STUDY 2 MS

CASE STUDY 2 MS. JIMENEZ (PART 1) 95 Questions 1. What is ethylene glycol? What products contain ethylene glycol? 2. Discuss the potential effects of ingesting ethylene glycol (antifreeze). 3. What is a “half-life”? Explain the half-life of ethylene glycol and how ethylene glycol is cleared from the body. the body. 4. Ms. Jimenez’s ethylene glycol level is 36 mg/dL. What is the lethal dose of ethylene glycol? 5. Discuss the rationale for why Ms. Jimenez is receiving 4-methylpyrazole. What is a drawback of this medication? 6. I effect ole i next most tret for ethylene glycol is not available, what is the poisoning? Discuss how this treatment is admin- istered and what should be monitored during administration. 7. If Maria had come home earlier and Ms. Jimenez was found within half an hour of drinking the anti- freeze, what three interventions could have been considered to decrease the progression of the toxic effects of the ethylene glycol? 8. Briefly describe the indication for each of the following medications Ms. Jimenez received during her initial medical treatment: thiamine, succinylcho- line chloride, levalbuterol, lorazepam, propofol, and eto te. 9. were intravenous (IV) fluids of normal saline with 2 ampules of bicarbonate at 125 mL per hour prescribed as part of the medical management of Ms. Jimenez? 10. Complete an analysis of Ms. Jimenez’s initial arterial blood gas (ABG) results while on 15 liters of oxygen via non-rebreather. Are her ABG’s consistent with those expected for a person with an ethylene glycol overdose? 11. Why was Ms. Jimenez intubated and placed on a mechanical ventilator? 12. Ms. Jimenez is on a mechanical ventilator set on assist-control of 14, respiratory rate of 28, volume 650, oxygen 40%, and a PEEP of 5. What does each ventilator setting indicate? 13. The respiratory rate on a mechanical ventilator is usually set between 10 and 14 breaths per minute. Why is the rate for Ms. Jimenez set at 28 breaths per minute? 14. Which of Ms. Jimenez’s laboratory results below are most significant in the determination of a diagnosis of ethylene glycol poisoning? Urinalysis: specific gravity of 1.010, small amount of occult blood, 3 to 5 white blood cells per HPF, a few bacteria per HPF, and a moderate amount of uric acid crystals and urine calcium oxalate crystals. • Urine culture & colony count was negative (no growth) • Serum osmolality is 392 mOsm/Kg • Bicarbonate of 7 mEq/L • Anion gap of 29 mEq/L • BUN of 25 mg/dL • Creatinine of 1.4 mg/dL 15. Explain how a Wood lamp could be used to help confirm the ingestion of ethylene glycol. 16. Briefly explain what Ms. Jimenez’s troponin, CPK, and CK-MB indicate. 17. Why did Ms. Jimenez’s prescribed laboratory tests include an assessment of her liver function? 18. What is a Quinton catheter and why was one inserted? 19. Prioritize three nursing diagnoses that are appropriate to include in Ms. Jimenez’s plan of care.