Question

In: Nursing

A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services...

A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate. The roommate states that he does not know how long the patient had been lying there. Patient received naloxone in the field and has become responsive. He complains of burning pain over his left hip and forearm. Evaluation in the ED revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm. EKG demonstrated prolonged PR interval and peaked T waves. Serum potassium level 6.9 mEq/L.

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

  • The role genetics plays in the disease.
  • Why the patient is presenting with the specific symptoms described.
  • The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
  • The cells that are involved in this process.
  • How another characteristic (e.g., gender, genetics) would change your response

Solutions

Expert Solution

Naloxone is used in case of opioid overdoses and substance abuse, as it blocks the effects of the opioids.

Opiods slow breathing and an overdose may cause the breathing to stop.

The burning pain of his left arm and hip area, and on examination necrotic tissue over greater trochanter and forearm suggest rhabdomyolysis in the area. This is commonly seen in case to substance abuse.

This further lead to an elevated serum potassium level of 6.9m Eq/L. This indicates hyperkalemia.

This high serum potassium level further lead to cardiac dysrythmia, as is evident from the EKG.

Role genetics plays in the disease:

Genetic causes of rhabdomyolysis include

-metabolic myopathy

- disorders of intramuscular calcium release

- mitochondrial disorders

-muscular dystrophies

The specific symptoms presented by the patient:

Initially unresponsive due to opioid overdose leading to depression of breathing, became responsive as naloxone was administered which reversed its effects.

Burning sensation over left hip and forearm due to necrosis in the region (possibly used as injection sites), leading to rhabdomyolysis.

Physiologic response to the stimulus presented in the scenario:

The patient became responsive upon receiving naloxone as it is a non selective and competitive opioid receptor antagonist which reverses the depression of the central nervous system and respiratory system caused by the opioids.

Nightingale answered 2 years ago
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