1. Mr. C. is a 57-year-old businessman who was admitted to the surgical unit for treatment of a possible strangulated inguinal hernia.

Two days ago he had a partial bowel resection. Postoperative orders include NPO, intravenous infusion of D51/2 NS at 125 cc/hrleft arm, nasogastric tube to low intermittent suction. Mr. C. is in adorsal recumbent (supine) position and is attempting to draw uphis legs. He appears restless and is complaining of abdominalpain (7 on a scale of 010). Height: 188 cm (6 3) Weight: 90.0 kg (200 lb) Temperature: 37C (98.6F) Pulse: 90 BPM Respirations: 24/minute Blood pressure: 158/82 mm Hg Skin pale and moist, pupils dilated. Midline abdominal incision, sutures dry and intact Diagnostic Data Chest x-ray and urinalysis negative, WBC 12,000

2.Johti Singh is a 39-year-old secretary who was admitted to thehospital with an elevated temperature, fatigue, rapid, labored respirations; and mild dehydration. The nursing history reveals that Ms. Singh has had a bad cold for several weeks that just wouldnt go away. She has been dieting for several months andskipping meals. Ms. Singh mentions that in addition to her fulltime job as a secretary she is attending college classes twoevenings a week. She has smoked one package of cigarettes perday since she was 18 years old. Chest x-ray confirms pneumonia.

Physical Examination Height: 167.6 cm (56) Weight: 54.4 kg (120 lb) Temperature: 39.4C (103F) Pulse: 68 BPM Respirations: 24/minute

Blood pressure: 118/70 mm Hg Skin pale; cheeks flushed; chills; use of accessory muscles; inspiratory crackles with diminished breath sounds right base; expectorating thick, yellow sputum

Diagnostic Data Chest x-ray: right lobar infiltration WBC: 14,000 pH: 7.49 PaCO2: 33 mm Hg HCO3: 20 mEq/L PaO2: 80 mm Hg O2sat: 88%