Part I Sam is 20 years old

Part I Sam is 20 years old and has been admitted to the hospital for a large bowel obstruction. Sam was diagnosed with cystic fibrosis at the age of 2. His parents are very worried about him at this time. During surgery, he had 4 liters of blood loss and was admitted to the ICU where you work. He was intubated at time of admission. Assessment: Vital Signs: B/P 90/45, HR 116, T 98.9, RR 16 Weight: 150 pounds, Height: 6 foot Neuro: Lethargic but opens eyes to voice Respiratory: Lungs diminished in bases bilaterally Vent: SIMV TV 650, FiO2 70%, RR 16, PEEP 5 ABG: pH 7.30, PaCO2 46, Bicarb 22, PaO2 70 PaO2/FiO2 ratio 100 Cardiac: Heart tones normal GI: Bowel sounds absent GU: Foley in place with 40ml/hr, Urine yellow and clear Lab Values prior to surgery: NA 137 meq/L, K 3.9 meq/L, CL 100 meq/L, Mg 2 meq/L, WBC 12,000 mm3, H/H 15 g/dl and 42%, Lactic Acid 20 mg/dl, CXR: Ground glass appearance in lower lobes How can genetic testing be used to make predictions? What are legal issues associated with genetic testing? What are ethical issues associated with genetic testing What is the pathophysiology of Cystic Fibrosis? Both Pulmonary and GI systems. Sam is in the early stages of ARDS. What manifestations do you see that would indicate this finding (be specific to Sam)? What is the Pathophysiology of the 3 stages of ARDS? What are your top 3 nursing priorities with rationale at this time? (These must be discussed in detail to get full points) Use ADPIE to write a plan for Sam for the next 12 hours. You will only need to include a nursing diagnosis, 3 interventions with rationale, and a goal. You must NOT use a risk for diagnosis.

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