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Patho Case Study

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C.C. is a previously healthy 27-year-old man admitted to the critical care unit after an accident in which he was hit by a car and dragged along the pavement for nearly 100 feet. He suffered a frontal contusion, fractured clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and buttocks. He was tachycardic, hypotensive, unresponsive, and ventilating poorly when admitted. He was placed on a mechanical ventilator and given IV fluids for shock. C.C. responded well to fluids, with an increase in blood pressure and an improvement in urine output.

1. Based on his case history and responsiveness to fluid therapy, what type of shock was C.C. experiencing?
Hypovolemic shock

2. What other clinical findings would be helpful in confirming the type of shock?
Capillary refill, tenting on skin turgor, pale skin due to perfusion, and may feel dizzy, faint, nauseated, or very thirsty.

3. Because of his many open wounds and invasive lines, C.C. is at risk for sepsis and septic shock. What clinical findings would suggest that this complication has developed?
Bacteremia, high fevers, hot, flushed skin, elevated heart rate, hyperventilation, altered mental status, swelling, and low blood pressure

4. What is the link between sepsis and multiple organ dysfunction syndrome (MODS)?
Sepsis causes MODS because the inflammatory and anti-inflmammatory reactions in the body, which cause the clotting cascade to be more active. Resulting in multiple thrombi forming throughout the body. The thrombi can effect multiple organs, which by definition would be MODS. the hypotension and hypoxia causes the release of free radicals which also damage the tissues throughout the body, including the organs.

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