[SOLVED] Mr. Coles, a 60 year-old-male, was brought into the ER

[SOLVED] Mr. Coles, a 60 year-old-male, was brought into the ER

SCENARIO—TWO
Mr. Coles, a 60 year-old-male, was brought into the ER.  He is a construction worker who was involved in an accident at the job site.  He has obvious severe head and neck trauma—his scalp and neck were badly lacerated and he has an impacted skull fracture, he remains in a comatose state. His initial urine lab test was within normal limits. A Complete Blood Count (CBC) was done and his hematocrit was 30%. When his blood was sent for “typing”, it agglutinated with anti A and anti B serum. Further testing was done and revealed that Mr. Cole’s blood lacked the Rh factor.
Question 1: Explain the term “blood typing”, what is the purpose of this test and how is it completed.  What do Mr. Coles results indicate? 
Question 2: If Mr. Coles is requiring a blood transfusion, what blood group(s) and type(s) can he receive? Why?
 The physician discovered that Mr. Coles was the great-great-great grandson of Queen Victoria.  So, his fracture was repaired without further delays and the following orders (and others) were given:

  • Transfuse 2 units of blood
  • Check and record vital signs; report any adverse reactions
  • Apply pressure bandage to any bleeding episodes immediately

 Question 3: Explain the hereditary blood disorder that Mr. Coles has inherited.  How will that affect his current treatment?
Question 4: Describe 2 types of transfusion reactions.  What are the symptoms, why do they happen and what are possible consequences?
On the second day of his hospitalization, the nurse noticed the following on Mr. Coles:

  • Rapid heart rate, nervousness, and hand tremors
  • Skin warm and flushed
  • Sweating and rapid respirations

Upon receiving this information, the physician ordered further blood tests to be done. Lab test confirms the diagnosis of over activity of an endocrine gland.
Question 5: What would you say Mr. Coles’ hormonal problem is and what is the cause of his signs and symptoms? Explain your answer.
 


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