By F.C. Oglesby
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Approximately 50% of patients who are diagnosed with a threatened abortion carry their pregnancies to term. Inevitable and incomplete abortions are considered obstetric emergencies. Intravenous (IV) fluids are started immediately for fluid replacement, and narcotic analgesics are administered to decrease the pain. Oxytocics, when given IV, help decrease the bleeding. With any type of abortion, it is critical to determine the patient’s blood Rh status. Any patient who is Rh-negative is given an injection of an Rho(D) immune globulin (rhoGAM) to prevent Rh isoimmunization in future pregnancies.
Elicit a patient history of muscle cramps, spasms, tingling (paresthesia) of the extremities, and circumoral (around the mouth) numbness. Other possible symptoms are nausea and vomiting, caused by a low potassium level. PHYSICAL EXAMINATION Metabolic Acidosis. Inspect the patient’s skin, noting if it feels warm. Note a flushed appearance. Assess the patient’s breathing pattern for Kussmaul’s respirations, a compensatory mechanism that the body uses to attempt to balance the pH by blowing off carbon dioxide.
The typical COPD patient is a middle-aged man with a history of smoking. Older children and adults are at risk for respiratory alkalosis with large-dose salicylate ingestion. The elderly are at an increased risk for respiratory alkalosis because of the high incidence of pulmonary disorders, specifically pneumonia, in the elderly population. Identification of a respiratory alkalosis may be more difficult in the older patient because the early symptoms of increased respirations and altered neurological status may be attributed to other disease processes.
An Examination of a Decision Procedure by F.C. Oglesby