The patient was in the hypovolemic shock stage upon admission. Criteria for judgment include pale complexion, cold and wet limbs, weak pulse, indifferent expression, low blood pressure (8⁄5.3Kpa), high heart rate (140 beats per minute), and rapid breathing (28 breaths per minute). These signs indicate inadequate perfusion due to significant blood loss from the injuries.
The patient did experience hypoxia upon admission, likely hypoxic hypoxia due to inadequate oxygen supply to tissues caused by reduced blood volume and decreased cardiac output resulting from the shock state.
Postoperatively, the restoration of normal blood volume and pressure may lead to a decrease in urine output due to fluid overload during surgery causing a physiological response of reduced urine production. Stress response and medications used during surgery can also affect renal function leading to decreased urine output.
On the fourth day after surgery, the sudden difficulty breathing with crackling sounds in both lung bases indicates respiratory failure, specifically hypoxic respiratory failure as evidenced by low PaO2 levels on blood gas analysis (6.65 Kpa or 50mmHg).
The patient does have electrolyte and acid-base balance disorders. High potassium levels (K+ 17.8mmol/L) indicate hyperkalemia while elevated creatinine levels (2400mmol/L) suggest metabolic acidosis possibly due to impaired kidney function or increased nitrogen load leading to elevated urea nitrogen levels (18mmol/L).
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