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CEN and TCRN Rhabdomyolysis and Compartment Syndrome


1. Rhabdomyolysis

a. S/S: myalgia (muscle pain), dark red or brown urine.

b. DX: elevated CK, myoglobin, and K+ levels.

c. TX: IVF’s, urine alkalization with sodium bicarbonate, mannitol, dialysis, goal is UO of 100 to 300 ml/hr.

d. Complication – Acute tubular necrosis, hyperkalemia.


2. Compartment syndrome

a. S/S: pain out of proportion, unrelieved by analgesia, on passive movement, shiny taut skin; most occur in lower leg or forearm. Weak or absent pulses are an ominous sign.

b. TX: keep extremity in neutral position (level of heart) if intracompartmental pressure is > 20 mmHg, possible fasciotomy if pressure is > 30.


Resources

· Emergency Nurses Association. Trauma Nursing Core Curriculum, 8th ed., 2019.

· Kent, Kendra. Trauma Certified Registered Nurse Examination Review. Springer, 2017.

· Sheehy, S. Sheehy’s Manual of Emergency Care, 7th ed. Elsevier, 2013.

· http://www.emdocs.net/em3am-rhabdomyolysis/

· http://www.emdocs.net/emdocs-cases-evidence-based-recommendations-for-rhabdomyolysis/

· https://emcrit.org/ibcc/rhabdo/


#CEN #TCRN #nursepassologist #certificationmentor #pdbnurseeducationllc

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