Mr. Li, a 70-year-old male, was brought into the ER after suffering trauma from a motor vehicle accident. It is obvious that he suffered severe head trauma—his scalp was badly lacerated and he has an impacted skull fracture, he remains in a comatose state. His initial lab test (urine) was within normal limits. A Complete Blood Count (CBC) was done and his hematocrit was 30%. When his blood was sent for "typing", it did not agglutinate with either anti-A or anti-B serum. Further testing was done and revealed that Mr. Li'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. Li's results indicate?
Question 2: What is hematocrit? If his hematocrit result is 30%, would you expect his hemoglobin determination to be low or high? Why?
Question 3: If Mr. Li is requiring a blood transfusion, what blood group(s) and type(s) can he receive? Why?
His fracture was repaired and the following orders (and others) were given:
Transfuse 2 units of blood
Check and record vital signs; report any adverse reactions
Question 4: Explain the rationale behind these orders.
On the second day of his hospitalization, the nurse reports that Mr. Li is breathing irregularly, his skin is dry and flaccid, and that she has emptied his urine reservoir several times during the day. Upon receiving this information, the physician ordered:
Blood and urine tests for the presence of glucose and ketones
Strict I&O (fluid intake and output recording)
Mr. Li is found to be losing huge amounts of water in the urine and the volume lost is being routinely replaced (via IV line). Mr. Li's blood test shows normal blood glucose levels and his urine test is negative for glucose and ketones. Relative to these findings:
Question 5: What would you say Mr. Li's hormonal problem is and what do you think caused it? Explain your answer.