extremities; necrotic digits

General appearance

Weight loss and muscle wasting; temperature <36°C or >38°C

PSYCHOSOCIAL. The patient with MODS may be fully conscious, partially conscious, or unconscious. If the patient is oriented, she or he is likely to be very anxious and fatigued and also confused, lethargic, or comatose. Assess the patient's ability to cope with a prolonged life-threatening illness and the changes in roles that a severe illness brings. The patient may experience fear because of a real threat to her or his life.

Diagnostic Highlights

General Comments: Diagnostic data are collected to establish the dysfunction of each of the body's systems (Table 4).


Normal Result

Abnormality with Condition


Complete blood count

Red blood cells (RBCs): 4.0-5.5 million/pL; white blood cells: 4500-11,000/pL; hemoglobin (Hg): 12-18 g/dL; hematocrit (Hct): 37%-54%; reticulocyte count: 0.5%-2.5% of total RBCs; platelets:


Varies with condition: >12,000 mm3 or <4000 mm3 or >10% band cells (immature cells); RBCs, Hg, Hct, blood cells, Hg, Hct, decreased

Underlying disorder may cause alterations in blood cell counts; SIRS leads to production of inflammatory mediators and alterations in white blood cell counts; hematologic failure may lead to suppression of cell production

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