[Verified Answer]: RT is a 36 year old male who was found…

RT is a 36 year old male who was found unresponsive on the side of the road on interstate-95 north in a remote part of northern Maine. RT was known to local law enforcement for previous drug-related incidents and arrests. RT lives with his mother and father in Aroostook County Maine. RT’s mother excessively uses alcohol but works part-time at a local potato farm. RT’s father previously worked at a paper mill in northern Maine. He has been out of work since the mill closed 6 years ago. RT started smoking and drinking alcohol when he was 14 years old. He dropped out of high school at 16, but an influential teacher convinced him to get his GED a year later. He gained some carpentry skills working for an uncle with a construction company. He earns money when he can get hired on construction jobs. RT began to excessively use alcohol in his early 20’s to cope with his anxiety and mood swings. He eventually started to use other substances which led to arrests and hospitalizations. Although RT had several girlfriends in the past, he never married. Clinical Course RT is still in the ICU where he develops pneumonia and bacteremia. The source of the bacteremia is believed to be from his skull fracture. He is treated with IV antibiotics vancomycin and cefepime. RT develops a hemorrhagic rash, his heart rate increases to 100 beats per minute and he becomes febrile with a temperature of 102 F. His blood pressure then drops to 75 mmHg. A vasopressor (epinephrine) is initiated for septic shock. RT develops ARDS (acute respiratory distress syndrome) and remains on tube feeding. Anthropometrics ● Height: 6’0” ● Admission Weight: 230 lbs ● Current Weight: 200 lbs (45 days since admission) ● Admission BMI: 28.5 kg/m2 ● Current BMI: 27.1 kg/m2 ● IBW: 165 lbs (Robinson formula) Diagnoses ● Primary ○ acute subdural hematoma ○ linear skull fracture ○ hypoxic brain injury second to opiate toxicity ● Secondary ○ T7 vertebra fracture ○ left humeral head fracture Lab Tests ● PCO2 (partial pressure of carbon dioxide) 28 mmHg ● WBC (white blood cell count)15000 mm/3 ● Serum lactate 6 mmol/L ● Toxicology positive for cotinine and ethanol on admission ● respiratory quotient < 0.7 Past Medical History Chronic back pain ADHD (attention deficit hyperactivity disorder) Bipolar disorder Anxiety Testosterone deficiency Hypertension Benign essential tremor Previous hospital admissions for substance use disorder and opiate dependence Medication phenytoin lamotrigine Dexamethasone Propofol Cefepime Vancomyocin Epinephrine Family Medical History RT's mother excessively uses alcohol and takes medication for type II diabetes mellitus and hyperlipidemia. RT's father takes medication for bipolar disorder and hypertension. He was recently treated for prostate cancer. Case Study Questions Download the Clinical Case Study Assignment template as a Microsoft Word document. Complete the narrative summary and compose your answers to the following case study questions, using the information in this case study and the relevant readings in Unit 5. Question 1: What is the difference between sepsis and septic shock? Describe the pathophysiology of each. Question 2: What are the potential sources of RT’s sepsis leading to septic shock? Be sure to consider sources of infection other than those listed in the case study. Question 3: How does septic shock lead to organ damage? Question 4: Discuss the pathophysiology of ARDS (Acute Respiratory Distress Syndrome).