Case 1
You’re on shift in the emergency department, when you get handed an ECG to review by one of the nurses. They tell you that the patient has been feeling unwell for a couple of days and the ECG was performed as the patient mentioned they had felt some palpitations. There was no mention of chest pain.
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Question 1 of 5
1. Question
What might these abnormalities indicate?
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Question 2 of 5
2. Question
You go to see the patient, who is a 72 year old lady. She tells you she has had a stomach ache for the last couple of days and feels generally unwell, which she has put down to not eating or drinking very much over this time as she feels nauseous. She has a history of high blood pressure and has still tried to take her normal medications.
The lab has phoned to alert you to some abnormal blood results, which are listed here. You decide to move the patient into a monitored bed in the resus area.
Blood test results show:
Na 136 K 7.2 Creatinine 156 Hb 13.2 WCC 8.7 Platelets 362 A blood gas shows:
p02 12.5Kpa pC02 4.5 Kpa pH 7.34 K+ 7.2 mmol/L HC03- 18 mmol/L Glucose 4.2 What steps should be taken to manage this patient (choose two)?
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Question 3 of 5
3. Question
Which three sets of biochemical parameters must be closely monitored over the next few hours?
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Question 4 of 5
4. Question
Considering the patient’s history, how might the hyperkalaemia have developed assuming she had normal renal function?
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Question 5 of 5
5. Question
The patient’s potassium and ECG remain abnormal in spite of comprehensive medical management. What may be required?
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