PBL discussion result

Page 1
What is Jonos problem?
Collapsed, skin felt very hot, convulsion, lacerated skin.
What are the possible causes?
Hyperthermia, dehydration.
Explain the method to measure humidity!
Using a hygrometer and further, make phsycometric
chart to know relative humidity.
What further information do you need to establish your
diagnosis?
Jonos temperature, blood pressure, respiratory rate,
pulse, urinalysis (and how much urine Jono can exrete).

Further Discussion
DariTubuh

25% ATP + 75%

Heat

Measuring metabolic activity by Metabolic Rate

Metabolic Rate = Energy Expenditure / Unit of Time
Kilocalories / Hour

What is
calorie?
Amount of energy
needed to raise the
temperature of one
kilogram water by one
degree celcius.
Nutrisionist / food
calorie
Equal to 1000 small
calories, so it called
Kilocalorie (Kcal)

Metabolic
Basal Rate

Basal
Things
Affecting
Metabolic
1. Fasting
Age,
that
weight,
factors
should
before
Rate
height,
bethe
done
sex,
measurement
emotional state

Measured in GI tract, rectal, or timpani.

35,5o in the
morning

37,7o in the
evening
Average: 36,7o
C

Variation between temperature:

Lowest at morning, highest at late afternoon.
Women temperature increases 0,5 degree from ovulation until menstruation.
Hard exercise elevates temperature until 40o degrees or more.
Older Colder

Heat Transfer
Heat transfer
Mechanism
by changing
from

Page 2
What is Jonos problem now?
Information

Jonos

Normal

Indicator

Respiratory
Rate

32/minute

15 20
/minute

Abnormal,
hyperventilati
on

Blood
Pressure

90/70 mmHg

120/80 mmHg A bit low, but

normal

Heart Rate

160 times /
minute

60 100
Abnormal
times /
minute
Also,
ventricle
GCS Spontaneous
9 Nystagmus and
15 disturbance
(excellent) in
Problems
contraction and relaxation.

What is the physiology of normal thermoregulation?

What is the mechanism to explain his problem?

Thermoregulation

Heat Exposure

Increase
blood flow,
increase
heat loss.

Decreas
e blood
flow,
decrease
heat
loss.

Mechanism that happens to

Jono

Heat is trapped inside

Page 3
What is pathophysiological response to hyperthermia?
Vasodilatation
Increased blood flow
Increased metabolic activity
Causing hipoglikemia and also increasing lactic acid, causing acidosis.

Increased respiratory rate

Due to increasing need of oxygen, increasing blood flow, and increasing
metabolic activity.

Increased sweating
Causing loss of fluid (hypovolemia) and salt Dehydration.

Decreased blood volume

Due to loss of fluid.

Decreased blood pressure

Causing lack of oxygen supply to brain collapse.

 How is the mechanism of

homeostasis in order to decrease the
body temperature?
(Already answered)
Why he has to be kept wet with tepid
water (not using ice water)?
What is your expectation from
further laboratory test?

Page 4
What do you interpret from the
laboratory result?
What are mechanism in response to
hypothermia?
What pathologic changes can occur
in the brain and kidney?

Hypothermia
Vasoconstriction