1. 16-month-old girl was transferred to a pediat ric emergency depart.pdf
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1. 16-month-old girl was transferred to a pediat ric emergency department (ED) by ambulance from another hospital's ED for fever and seizure. Prior to arrival, the accepting doctor obtained the brief history that this girl had no known past medical history and was witnessed to have a tonicclonic seizure at home lasting 20 minutes. The seizure stopped without intervention prior to arrival to the outside ED. The patient had a recorded temperature of 103F and otherwise ageappropriate vital signs. Her left pupil was 2m and reactive; her right pupil was 5mm, nonreactive, and appeared to be slightly extorted and depressed. One hour after the patient's arrival in the ED, and 30 minutes after the mannitol and hypertonic saline administration, the patient's repeat vital signs were: a temperature of 102F, a heart rate of 96 beats / min, a blood pressure of 105/70mmHg, a respiratory rate of 25 breaths / min, and an oxygen saturation of 98% on the ventilator. Her pupils appeared to be normalized to 3mm, both were reactive, and pupillary tracking appeared normal. At this point, she was deemed stable to go to magnetic resonance imaging (MRI). ease describe the pupillary presentation of the patient (unequal, not reactive to light, extorted and pressed). Where in the CNS could a lesion be present which would cause this presentation? Draw d label an image showing this lesion. 10pts.
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16-month-old girl was transferred to a pediatric emergency department.pdf
16-month-old girl was transferred to a pediatric emergency department (ED) by ambulance from
another hospital's ED for fever and seizure. Prior to arrival, the accepting doctor obtained the
brief history that this girl had no known past medical history and was witnessed to have a
tonicclonic seizure at home lasting 20 minutes. The seizure stopped without intervention prior to
arrival to the outside ED. The patient had a recorded temperature of 103F and otherwise
ageappropriate vital signs. Her left pupil was 2mm and reactive; her right pupil was 5mm,
nonreactive, and appeared to be slightly extorted and depressed. One hour after the patient's
arrival in the ED, and 30 minutes after the mannitol and hypertonic saline administration, the
patient's repeat vital signs were: a temperature of 102F, a heart rate of 96 beats / min, a blood
pressure of 105/70mmHg, a respiratory rate of 25 breaths / min, and an oxygen saturation of 98%
on the ventilator. Her pupils appeared to be normalized to 3mm, both were reactive, and
pupillary tracking appeared normal. At this point, she was deemed stable to go to magnetic
resonance imaging (MRI). - Please describe the histological structure of the blood brain barrier
(BBB) and its function in the central nervous system. Draw and label a diagram of the BBB. 10
pts.
Saline vs air
A 67-year-old female presented with back pain and underwent an epidural steroid injection using air for the loss of resistance technique. Twenty minutes later, she developed numbness, weakness, and a headache. A CT scan revealed pneumocephalus. Pneumocephalus occurs when air enters the cranium and can be caused by introducing air into the epidural space. Using saline instead of air during epidural procedures reduces the risk of pneumocephalus.
Toxic cases emergency
ا.د/هند الهلالي "ورشة عمل
Principles of poisoning management
الورشة التي قدمت يوم الثلاثاء 8 ابريل 2014 في دار الحكمة بالقاهرة
من فعاليات مشروع اعداد طبيب حكيم ناجح بالتعاون مع معتمد باتحاد الاطباء العرب
و ضمن موديول الطوارئ و التخدير و العناية المركزة
Febrile seizures
- A 2-year-old boy presented to the emergency department after experiencing a seizure associated with a fever of 104°F. His examination in the emergency department was normal.
- Febrile seizures are relatively common in young children, occurring in 4-8% of children between the ages of 6 months and 6 years. They are generally self-limited and do not require extensive evaluation unless prolonged or focal.
- The diagnosis of a febrile seizure must consider the possibility of central nervous system infection as the underlying cause, though for this patient the examination was normal and he likely experienced a simple febrile seizure.
CASE STUDY—BEWARE One Emergency May Hide Another!A hospital sub
CASE STUDY—BEWARE: One Emergency May Hide Another!
A hospital submitted a report to the State Board of Nursing reporting that an RN had been terminated after the death of a patient following surgery for a tubal pregnancy.
THE NURSE'S STORY—SALLY SIMMS, RN
I had worked the medical-surgical units at the General Hospital ever since graduating from my nursing program 4 years before. This was the worst night, the worst shift, of my nursing career.
I was assigned to care for eight patients that night, which is not an unusual number of patients, but they all were either fresh post-ops or so very sick. Four patients had just had surgery that day. One patient was on a dopamine drip to maintain his blood pressure, so he needed frequent monitoring. One patient was suspected to have meningitis, one patient had pneumonia, and a patient with suspected histoplasmosis completed my assignment.
One of my post-op patients was Betty Smith, a young woman in her early thirties who had laparoscopic surgery late in the day. She had been transferred from the recovery room late in the evening shift and was very uncomfortable when I first made my rounds. At 12:05 am, I called Betty's physician because she was vomiting and thrashing in bed. Per his order, I medicated the patient with Phenergan.
The next time I checked on Betty, she seemed to be more comfortable, but I realized that her IV had infiltrated. I was really overwhelmed with meeting the needs of all my patients, so I asked Joan Jones, the charge nurse, to restart Betty's IV. It was about 2:00 am when Nurse Joan restarted the IV.
I had been able to pretty much stay on top of everything at that point in the shift, and by 2:30 am I had assessed all my patients, given pain medications, and called four physicians to update them regarding their patients and for various orders. I thought things were settling down. I thought wrong.
Mrs. Holmes, the patient with histoplasmosis, seemed a bit off from when I had cared for her the previous two nights. Mrs. Holmes' vital signs were unstable and her O2 saturation was only 80%. I notified her physician and he ordered stat arterial blood gases. The lab called with the results, and they were alarming. Mrs. Homes was losing ground, and her physician ordered us to transfer her to the ICU. I was preoccupied with accomplishing the transfer and accompanied Mrs. Holmes to the unit. I returned from the ICU at about 3:50 am.
On my return, I first checked the patient who was on dopamine, medicated another patient for pain, and did visual checks on the rest of the patients who all seemed to be sleeping. I began my charting.
At 6:05 am, I went to start IV antibiotics on Betty's roommate, and to my horror discovered Betty was not breathing. I called the code. The first time I discovered that Betty had had a low blood pressure and elevated pulse was when I checked the vital signs sheet when the ER physician (who responded to the code) asked how Betty's vital signs had been during the shift ...
HISTORICAL CASE STUDY #1 Failure to Adequately Monitor a Postsurg
HISTORICAL CASE STUDY #1: Failure to Adequately Monitor a Postsurgical Patient
DESCRIPTION OF THE EVENT
This error-event involved inadequate monitoring of a patient who had undergone an elective surgical procedure. A certified nursing assistant made a proximal error when she failed repeatedly to report abnormal vital signs to a registered nurse assigned to the patient. The patient was receiving narcotics via a patient-controlled infusion device. The patient was obese and had a large neck. He also had a history of sleep apnea. This combination of factors may have combined to cause respiratory depression that resulted in abnormal vital signs.
The nursing assistant's reporting was inadequate, and consequently the registered nurse was unaware of the patient's low blood pressure. The patient's condition subsequently deteriorated to the point where he was seriously compromised and near death, and may have been permanently harmed as a result.
DEMOGRAPHICS
This error-event occurred in a community hospital setting. In this event the investigation revealed that three people made errors that constituted unsafe acts and resulted in harm to the patient. These included the nursing assistant, the registered nurse (who was prepared at the associate degree level), the registered nurse in the charge/staff nurse role, and a board-certified surgeon.
The registered nurse and surgeon agreed to be interviewed, but the nursing assistant declined. Three additional people were indirectly involved and participated in the interview process. They were the oncoming registered nurse (prepared at the associate degree level of nursing), a registered (associate degree) respiratory therapist on duty, and the associate degree registered nurse house supervisor.
The root cause analysis group included two of the people who engaged in unsafe acts, one other person who was directly involved, and six additional people with expertise in the routine practices and processes of the surgical unit and related areas.
SETTING ELEMENTS
The incident occurred during one 12-hour shift between Friday at 7:00 pm and Saturday at 7:30 am. All of the individuals directly involved in the event were working a regularly scheduled shift. The two employees who carried out the unsafe acts were working the night shift. The surgeon involved in the case had not worked the night before.
BACKGROUND INFORMATION
In the hospital setting, patients often receive pain medication through a pump that provides a specific dose on demand with a programmed maximum dose allotment. The patient-controlled analgesia (PCA) pump is programmed to deliver specific, small dosages of the medication only when the patient pushes a specified button. Therefore, if the patient is unable to push the button, he/she does not receive any more of the medication via the pump.
NARRATIVE OF THE EVENT
A young man, Mr. Steve Goldberg, was admitted to a surgical unit at 6:00 pm after an elective laparoscopic gastric bypass surgical procedure. Mr. G ...
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Nursing Pharmacology Discussions.docx
1. The document describes several patient cases involving medication management and nursing care. Details are provided about the patients' conditions, medical histories, vital signs, lab results, treatments and nursing assessments.
2. Nurses are asked to answer questions for each case related to diagnoses, monitoring, patient education and medication management.
3. Lab results, provider orders and treatment plans are still pending or in progress for some of the patients.
Recommended
16-month-old girl was transferred to a pediatric emergency department.pdf
16-month-old girl was transferred to a pediatric emergency department (ED) by ambulance from
another hospital's ED for fever and seizure. Prior to arrival, the accepting doctor obtained the
brief history that this girl had no known past medical history and was witnessed to have a
tonicclonic seizure at home lasting 20 minutes. The seizure stopped without intervention prior to
arrival to the outside ED. The patient had a recorded temperature of 103F and otherwise
ageappropriate vital signs. Her left pupil was 2mm and reactive; her right pupil was 5mm,
nonreactive, and appeared to be slightly extorted and depressed. One hour after the patient's
arrival in the ED, and 30 minutes after the mannitol and hypertonic saline administration, the
patient's repeat vital signs were: a temperature of 102F, a heart rate of 96 beats / min, a blood
pressure of 105/70mmHg, a respiratory rate of 25 breaths / min, and an oxygen saturation of 98%
on the ventilator. Her pupils appeared to be normalized to 3mm, both were reactive, and
pupillary tracking appeared normal. At this point, she was deemed stable to go to magnetic
resonance imaging (MRI). - Please describe the histological structure of the blood brain barrier
(BBB) and its function in the central nervous system. Draw and label a diagram of the BBB. 10
pts.
Saline vs air
A 67-year-old female presented with back pain and underwent an epidural steroid injection using air for the loss of resistance technique. Twenty minutes later, she developed numbness, weakness, and a headache. A CT scan revealed pneumocephalus. Pneumocephalus occurs when air enters the cranium and can be caused by introducing air into the epidural space. Using saline instead of air during epidural procedures reduces the risk of pneumocephalus.
Toxic cases emergency
ا.د/هند الهلالي "ورشة عمل
Principles of poisoning management
الورشة التي قدمت يوم الثلاثاء 8 ابريل 2014 في دار الحكمة بالقاهرة
من فعاليات مشروع اعداد طبيب حكيم ناجح بالتعاون مع معتمد باتحاد الاطباء العرب
و ضمن موديول الطوارئ و التخدير و العناية المركزة
Febrile seizures
- A 2-year-old boy presented to the emergency department after experiencing a seizure associated with a fever of 104°F. His examination in the emergency department was normal.
- Febrile seizures are relatively common in young children, occurring in 4-8% of children between the ages of 6 months and 6 years. They are generally self-limited and do not require extensive evaluation unless prolonged or focal.
- The diagnosis of a febrile seizure must consider the possibility of central nervous system infection as the underlying cause, though for this patient the examination was normal and he likely experienced a simple febrile seizure.
CASE STUDY—BEWARE One Emergency May Hide Another!A hospital sub
CASE STUDY—BEWARE: One Emergency May Hide Another!
A hospital submitted a report to the State Board of Nursing reporting that an RN had been terminated after the death of a patient following surgery for a tubal pregnancy.
THE NURSE'S STORY—SALLY SIMMS, RN
I had worked the medical-surgical units at the General Hospital ever since graduating from my nursing program 4 years before. This was the worst night, the worst shift, of my nursing career.
I was assigned to care for eight patients that night, which is not an unusual number of patients, but they all were either fresh post-ops or so very sick. Four patients had just had surgery that day. One patient was on a dopamine drip to maintain his blood pressure, so he needed frequent monitoring. One patient was suspected to have meningitis, one patient had pneumonia, and a patient with suspected histoplasmosis completed my assignment.
One of my post-op patients was Betty Smith, a young woman in her early thirties who had laparoscopic surgery late in the day. She had been transferred from the recovery room late in the evening shift and was very uncomfortable when I first made my rounds. At 12:05 am, I called Betty's physician because she was vomiting and thrashing in bed. Per his order, I medicated the patient with Phenergan.
The next time I checked on Betty, she seemed to be more comfortable, but I realized that her IV had infiltrated. I was really overwhelmed with meeting the needs of all my patients, so I asked Joan Jones, the charge nurse, to restart Betty's IV. It was about 2:00 am when Nurse Joan restarted the IV.
I had been able to pretty much stay on top of everything at that point in the shift, and by 2:30 am I had assessed all my patients, given pain medications, and called four physicians to update them regarding their patients and for various orders. I thought things were settling down. I thought wrong.
Mrs. Holmes, the patient with histoplasmosis, seemed a bit off from when I had cared for her the previous two nights. Mrs. Holmes' vital signs were unstable and her O2 saturation was only 80%. I notified her physician and he ordered stat arterial blood gases. The lab called with the results, and they were alarming. Mrs. Homes was losing ground, and her physician ordered us to transfer her to the ICU. I was preoccupied with accomplishing the transfer and accompanied Mrs. Holmes to the unit. I returned from the ICU at about 3:50 am.
On my return, I first checked the patient who was on dopamine, medicated another patient for pain, and did visual checks on the rest of the patients who all seemed to be sleeping. I began my charting.
At 6:05 am, I went to start IV antibiotics on Betty's roommate, and to my horror discovered Betty was not breathing. I called the code. The first time I discovered that Betty had had a low blood pressure and elevated pulse was when I checked the vital signs sheet when the ER physician (who responded to the code) asked how Betty's vital signs had been during the shift ...
HISTORICAL CASE STUDY #1 Failure to Adequately Monitor a Postsurg
HISTORICAL CASE STUDY #1: Failure to Adequately Monitor a Postsurgical Patient
DESCRIPTION OF THE EVENT
This error-event involved inadequate monitoring of a patient who had undergone an elective surgical procedure. A certified nursing assistant made a proximal error when she failed repeatedly to report abnormal vital signs to a registered nurse assigned to the patient. The patient was receiving narcotics via a patient-controlled infusion device. The patient was obese and had a large neck. He also had a history of sleep apnea. This combination of factors may have combined to cause respiratory depression that resulted in abnormal vital signs.
The nursing assistant's reporting was inadequate, and consequently the registered nurse was unaware of the patient's low blood pressure. The patient's condition subsequently deteriorated to the point where he was seriously compromised and near death, and may have been permanently harmed as a result.
DEMOGRAPHICS
This error-event occurred in a community hospital setting. In this event the investigation revealed that three people made errors that constituted unsafe acts and resulted in harm to the patient. These included the nursing assistant, the registered nurse (who was prepared at the associate degree level), the registered nurse in the charge/staff nurse role, and a board-certified surgeon.
The registered nurse and surgeon agreed to be interviewed, but the nursing assistant declined. Three additional people were indirectly involved and participated in the interview process. They were the oncoming registered nurse (prepared at the associate degree level of nursing), a registered (associate degree) respiratory therapist on duty, and the associate degree registered nurse house supervisor.
The root cause analysis group included two of the people who engaged in unsafe acts, one other person who was directly involved, and six additional people with expertise in the routine practices and processes of the surgical unit and related areas.
SETTING ELEMENTS
The incident occurred during one 12-hour shift between Friday at 7:00 pm and Saturday at 7:30 am. All of the individuals directly involved in the event were working a regularly scheduled shift. The two employees who carried out the unsafe acts were working the night shift. The surgeon involved in the case had not worked the night before.
BACKGROUND INFORMATION
In the hospital setting, patients often receive pain medication through a pump that provides a specific dose on demand with a programmed maximum dose allotment. The patient-controlled analgesia (PCA) pump is programmed to deliver specific, small dosages of the medication only when the patient pushes a specified button. Therefore, if the patient is unable to push the button, he/she does not receive any more of the medication via the pump.
NARRATIVE OF THE EVENT
A young man, Mr. Steve Goldberg, was admitted to a surgical unit at 6:00 pm after an elective laparoscopic gastric bypass surgical procedure. Mr. G ...
recent updates Anaphylaxis and anaphylaxis shock.pptx
anaphylaxis is an antibody antigen reaction and commonly seen in the ER and ICU setup. in this presentation, there are updates regarding anaphylaxis (& shock) treatement.
Nursing Pharmacology Discussions.docx
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2. Nurses are asked to answer questions for each case related to diagnoses, monitoring, patient education and medication management.
3. Lab results, provider orders and treatment plans are still pending or in progress for some of the patients.
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1) 53 year old Native American female with history of osteoarthritis, depression, ADHD presented with altered mental status and psychosis 4 days after hip surgery.
2) On examination, she was agitated and diaphoretic with tremors in lower extremities and hyperreflexia. Labs showed elevated CK consistent with serotonin syndrome.
3) She was diagnosed with likely serotonin syndrome from an interaction between her antidepressants and possible amphetamine or THC use, and was admitted to the ICU.
10Running Head Modulo 2 Plan de Cuidado- (cuidado holíst
A 55-year-old woman was admitted to the intensive care unit (ICU) with vomiting, seizures, and probable aspiration. She has a history of hypertension, COPD, and a prior heart attack. Family reports she smokes daily and drinks alcohol continuously. In the emergency room, she presented with recurrent vomiting, seizures, respiratory distress, and anxiety. Labwork showed elevated liver enzymes and normal blood work. She was intubated and transferred to the ICU.
10Running Head Modulo 2 Plan de Cuidado- (cuidado holíst
10
Running Head: Modulo 2 Plan de Cuidado- (cuidado holístico)
Situación Hipotética
A 55-year-old woman admitted 2 days ago to the Intensive Care Unit. The admission diagnoses are: vomiting, seizures, and probable aspiration. She has a prior history of hypertension, COPD, and myocardial infarction with angioplasty performed six months ago.
Family members report that the client uses the following routine medications: Toprol 50mg 1 tab. daily, Lipitor 20 mg 1 tab. daily, Aspirin 81 mg 1ab. Daily, Plavix 75 mg 1 tab. daily; He smokes a daily pack of cigarettes since he was 30 years old. They also report that the patient drinks alcohol continuously; "In the last 3 days I have found her drunk in the house" said the woman's nephew.
The patient is 5'11'' and weighs approximately 180 pounds. Upon arrival at the emergency room she presents vital signs of: T-37°C, P-150/min., R-28/min. and B/P-193/124 mmHg. She is observed with recurrent vomiting and severe episodes of seizures, respiratory distress, and severe anxiety. Dr. Díaz orders ABG's which result in: pH-7.30, PaCO 2 -50 mmHg, PO 2 -81 mmHg and NaHCO 3 -23 mEq/L, Sat. 85%. The client is sedated with Propofol 5mL, for oroendotracheal intubation and transferred to the ICU area. Blood pressure after intubation medication decreased to 80/52 mmHg. She is restricted to patient per intubation protocol. Laboratory samples show elevated liver enzymes, elevated cholesterol and triglycerides, and normal CBC.
Introduction:
Aspiration pneumonia is caused by aspiration of oropharyngeal contents into the airways, leading to abscess lesions due to bacterial infection in the lower lung lobes. It generally occurs in patients with frequent seizures and loss of mental status, with impaired swallowing of food or loss of the gag reflex (Aspiration pneumonia, n.d.). In this work we will carry out the care plan and the nursing progress notes of a 55-year-old female patient admitted to the Intensive Care Unit with respiratory distress probably caused by pneumonia due to aspiration of her own vomit, leading her to a state of acute respiratory acidosis with adequate bicarbonate compensation by the kidney.
Care Plan:
Estimado
Diagnóstico de Enfermería
Expected results
Nursing Interventions
Evaluatión
domains
Needs
maladaptive behaviors
Focal Stimulus
Interventions
Scientific Rational
subjective data
Objective data
Domain 3: Elimination
Need 1: Breathe normally
The patient reports shortness of breath and that he is anxious
The patient is observed with labored breathing with RF at 28/min with abnormal arterial pH.
respiratory distress
(00030 Impaired gas exchange r/c ventilation-perfusion imbalance m/p shortness of breath, hypoxemia, and abnormal arterial pH.
The patient will recover her adequate ventilation after treatment, in a period of approximately 48 hours.
Domain 1: Security/ protection.
Need 1: Have no aspiration risks
Family me ...
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Toxic cases emergency
مشروع إعداد طبيب حكيم ناجح- المعهد العربي للتنمية المهنية المستدامة دورة الطوارئ و التخدير و الرعاية 8-4-2014
1.CC I have been having terrible chest and arm pain for the pa.docx
1.
CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”
HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.
Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl
His diagnosis is an acute inferior wall myocardial infarction.
1 of 2 Questions:
Why is HDL considered the “good” cholesterol?
QUESTION 2
1.
CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”
HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.
Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl
His diagnosis is an acute inferior wall myocardial infarction.
2 of 2 Questions:
Explain the role inflammation has in the development of atherosclerosis.
QUESTION 3
1.
A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.
Question:
What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?
1 points
QUESTION 4
1.
A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sen.
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CC I have been having terrible chest and arm pain for the .docx
Mr. Hammond, a 57-year-old African American male, presented to the emergency department with chest pain radiating down his left arm. His lipid panel showed high total cholesterol, LDL, triglycerides and low HDL. He was diagnosed with an acute inferior wall myocardial infarction.
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A 44 year old female presented to the emergency department after collapsing in the shower at home. On examination, she displayed signs of a right-sided stroke including weakness on her right side, facial drooping, and internuclear opthalmoplegia of the right eye. Imaging revealed a left lentiform nucleus and external capsule hemorrhage. She was treated for hypertension and transferred to the ICU of another hospital for further management.
0130 Admission nurses note (RN) Client arrived via EMS from lo.docx
0130: Admission nurses note (RN): Client arrived via EMS from long-term-care for evaluation of “low blood sugar.” Pt. arrived confused (alert and oriented X 1) and is a known diabetic. Finger stick was 45. Orange juice and crackers, given repeat finger stick 104. Pt now alert and oriented X 4. Report from the charge nurse at the long-term-care facility indicates that the client has been having frequent bouts of hypoglycemia.
0530: (RN) Foley catheter inserted for incontinence--pt. “too weak” to get up to the bathroom and is experiencing bouts of incontinence.
600 mL clear yellow urine noted. The nurse indicates that the ER is “very busy” and “short-staffed.” 0545 (Admitting Physician) See history and physical. Pt. admitted to the medical-surgical service for evaluation of recurrent hypoglycemia.
View the ER chart before the pt. is transferred to the floor:
0730: (RN) Report is given to RN on 3 North.
Emergency Department Chart
Client: Mabel Simpson
DOB: 4/23/1941
Admission Date 8/16/2019
Medical Diagnosis: recurrent hypoglycemia
Allergies: None
Vitals/ Data Collection:
Temp.- 97.3 PO
History:
Diabetes (insulin dependent)
Medications:
Insulin R titrated to finger sticks
Allergies:
None
Vitals/ Data Collection:
Pulse- 68
History:
Hypertension
Medications:
Furosemide 20 MG twice per day
Allergies:
None
Vitals/ Data Collection:
Respirations- 18
History:
Atrial Fibrillation
Medications:
Warfarin 5 Mg Mon, Wed, Fri 2 Mg Tues, Thurs
Allergies:
None
Vitals/ Data Collection:
Blood Pressure- 122/86
History:
Rheumatoid Arthritis
Medications:
Enalapril 5 Mg once per day
Allergies:
None
Vitals/ Data Collection:
No C/O pain
History:
Mild Heart Failure (class 1)
Medications:
Proventil inhaler as needed for wheezing
Allergies:
None
Vitals/ Data Collection:
Alert and oriented X 4
History:
Former Smoker- smoked 1 pack per day X 40 years- last smoked 10 years ago
Medications:
Methotrexate 2.5 Mg per day
Allergies:
None
Vitals/ Data Collection:
Lungs: No adventitious sounds
History:
Appendectomy as a child
Medications:
Tylenol 650 Mg as needed for pain or fever
Allergies:
None
Vitals/ Data Collection:
+ Bowel sounds
History:
Mobility (baseline): able to ambulate slowly with minimal assist
Clear yellow urine draining from Foley catheter in adequate amts.
Medications:
Allergies:
None
Vitals/ Data Collection:
Clear yellow urine draining from Foley catheter in adequate amts.
History:
Medications:
Allergies:
None
8/16/2019
10:00: (RN) Pt received on 3 North. Alert and oriented X 4. Fingerstick 81. Eating breakfast. Offering no complaints.
8/17/2019 (Medical Assistant)
0130: Sleeping Soundly
0700: (LPN) alert and oriented Finger stick 124. Offering no complaints. Medications given as ordered. Foley catheter draining cloudy yellow urine- RN notified.
1100: (Case Manager note): Pt. alert and oriented. Blood sugar stable. Will speak to the physician about discharge tomorrow morn.
Case presentation
The document presents a case study of a 24-year-old female patient who was found unresponsive. Initial examination found the patient to have a Glasgow Coma Scale of 10/15, tachycardia, hypertension, and signs of respiratory distress. Laboratory tests revealed metabolic acidosis, elevated white blood cell count and creatinine, and rhabdomyolysis. Ultrasound showed signs of pregnancy. The patient was treated for pre-eclampsia with magnesium sulfate and antihypertensives, intubated, and underwent termination of pregnancy. She was admitted to the ICU and later discharged in good condition.
CASE PRESENTATION - Copy.pptx
A 26-year-old female presented with fever for 7 days and a recent seizure. Imaging showed venous sinus thrombosis involving the superior sagittal and right transverse sinus with hemorrhagic venous infarct in the right parietal lobe. She was treated with heparin and bridged to warfarin. Differential diagnoses included viral, fungal, or autoimmune meningoencephalitis. Further workup is needed to identify the underlying etiology such as infections, pregnancy/postpartum state, oral contraceptive use, dehydration, or prothrombotic conditions.
Case Study, Chapter 34, Management of Patients With Hematologic Neop.docx
Case Study, Chapter 34, Management of Patients With Hematologic Neoplasms
1. John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5)
a. What nursing management should the nurse provide the patient?
Explain the indication and action of the various medications ordered to treat the patient’s symptoms.
2. Susan Clare, age 38, is admitted to the medical oncology unit with acute myeloid leukemia (AML). She has many areas of ecchymosis and petechiae on her skin, as well as generalized pallor. She states she has lost 15 pounds in the last 2 months, and often has a low-grade fever. On physical assessment, you find her liver and spleen to be enlarged on palpation. (Learning Objective 3)
a. What laboratory results would you anticipate due to her ecchymosis and petechia?
Why would it be important to inspect her gums and teeth?
a. Why is her liver enlarged?
Case Study, Chapter 37, Management of Patients With HIV Infection and AIDS
1. The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center. (Learning Objectives 1 and 4)
a. What should the nurse include in the session considering the needs of the older population?
2. Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a pregnancy visit. The physician informs the patient that her HIV screen test is positive. The patient has no evidence of AIDS. The nurse provides patient education regarding what HIV is and what the clinical management entails. (Learning Objective 5)
a. What clinical management is recommended for the patient during the pregnancy to help decrease the risk of transmitting HIV to the unborn child?
The patient asks the nurse how zidovudine (Retrovir) will help her unborn child from getting HIV. How should the nurse respond?
What explanation about Retrovir should the nurse provide?
The patient asks the nurse if it will be safe to breast-feed her infant after the delivery. The nurse should provide what explanation?
a. The patient asks the nurse what testing schedule for the HIV antibody is needed after her baby is born. How should the nurse respond?
Case Study, Chapter 31, Assessment and Management of Patients With Hypertension
1. Joan Smith, 55 years of age, is a female patient who presents to the intensive care unit with the diagnosis of intracranial hemorrhage. The patient stopped taking her antihypertensives suddenly because of the cost of .
4. complex febrile fit
- FA, a 2-year-old Malay girl, was admitted to the hospital due to 3 episodes of seizures associated with 2 days of fever and vomiting.
- On examination, she was conscious and alert with no abnormalities detected. Tests ruled out metabolic causes and infection.
- She received antipyretics, anti-seizure medication, and antibiotics. No further seizures occurred and she improved with treatment. Her diagnosis was complex febrile seizures presumed to be caused by meningitis.
4. Complex Febrile Fit
This document presents a case report of a 2 year old Malay girl admitted to the hospital due to fever and vomiting for 2 days prior to admission and 3 episodes of seizures on the day of admission. Upon examination and investigation, she was diagnosed with complex febrile seizures presumed to be caused by meningitis. She was treated with antibiotics and anticonvulsants and discharged after 5 days with no further seizures and good response to treatment.
This is a Unfolding Case StudyPatient DetailsPrint Phase In.docx
This is a Unfolding Case Study
Patient Details:
Print Phase Info
|
Case Study History
Name:
James, Karen
Age:
57 Years
Gender:
Female
Karen James is a 57-year-old female who was admitted to the medical-surgical unit from her primary care physician’s office for treatment and evaluation of persistent and worsening influenza. She has a past medical history of asthma as well as depression and anxiety.
You are currently working on Phase 1. You have completed Phase 0 of this scenario.
Patient Details:
Print Phase Info
|
Case Study History
Name:
James, Karen
Age:
57 Years
Gender:
Female
Phase
1,
Wednesday
16:00
You have assumed care for Ms. James who is admitted to the medical-surgical unit for rehydration and management of respiratory distress.
Orient yourself to the patient and health record by locating the following pieces of information within the System Assessment Report and Patient Teaching, and type your answers in a Miscellaneous Nursing Note:
1). Run a report on all the System Assessments documented for the patient in the last 24 hours. You will need to go to Patient Charting > System Assessments > Show Saved Charting. What was documented for the respiratory effort? What was auscultated in the Lower Right Posterior lobe of the lungs? What was documented related to tissue perfusion?
2). What was the last documented temperature for Karen?
3). Does Ms. James use any sensory aides?
4) What does she rate her pain?
5) What is her MORSE Fall Risk Score?
Review the client's History and Physical, what indications can you see place this patient at risk for mobility issues or falls?
[LEARNER ACTION: In a misc nursing note identify risks for mobility and falls. Explain her score on the MORSE scale.]
When you are finished with this task, you may click Complete this Phase.
Patient Information
Chief Informant:
Patient
Chief Complaint:
Shortness of breath, productive cough
History of Current Problem:
Patient states she has had 3-week history of influenza. Has now developed a severe cough approximately 3 days ago with shortness of breath. Unable to sleep due to cough, which often causes bronchospasms. Patient also complains of fever, fatigue, and right-sided chest pain. Seen in urgent care 3 days ago and given Z-pack. No improvement in symptoms.
Allergies:
None known
Family History:
Mother died at age of 72 with breast cancer. Father is alive at the age of 79 and has congestive heart failure.
Past Medical History
Previous Illnesses:
Patient has asthma. Also states she gets bronchitis every 1-2 years.
Contagious Diseases:
None
Injuries or Trauma:
None
Surgical History:
Tonsillectomy and adenoidectomy as a child.
Dietary History:
Regular diet. Patient is 5'1" and 140 pounds. Has recently lost 20 pounds on Weight Watchers diet.
Other:
--
Social History:
No smoking, no drugs. Uses alcohol in social situations.
Current Medications:
Tylenol 650 mg PO every 4 hours PRN pain .
Dyspnoea case based
This document presents 6 case studies of patients presenting with dyspnoea or shortness of breath. Case 1 describes a 72-year-old woman admitted to the hospital with fever and progressive shortness of breath with a history of rheumatoid arthritis. Case 2 involves a 45-year-old heavy smoker with increasing dyspnea, cough, and finger clubbing. Case 3 is about a 76-year-old man with exertional dyspnea and multiple conditions including myasthenia gravis. Case 4 presents a 48-year-old male with fever, cough, weight loss, and right-sided chest pain and shortness of breath. Case 5 describes a 66-year-old woman with increasing shortness
1. Describe how personal health practices and physical health influe.pdf
1. Describe how personal health practices and physical health influence the clients response to
illness.
2. Describe how cultural beliefs and practices affect mental health or illness.
Web Assignment
1. Summarize an Internet article discussing the importance of culturally competent nursing care.
1. Describe how personal health practices and physical health influence the clients response to
illness.
2. Describe how cultural beliefs and practices affect mental health or illness..
1. describe how language both reflects and influences the way differ.pdf
1. describe how language both reflects and influences the way different groups understand and
interpret the world.
2. recognize the difference between religions and religious movements around the world and
analyze their impacts on political and social life.
3. interpret the importance of space to religion in pilgrimages and sacred spaces in every culture.
2. recognize the difference between religions and religious movements around the world and
analyze their impacts on political and social life.
3. interpret the importance of space to religion in pilgrimages and sacred spaces in every culture..
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A 55-year-old woman was admitted to the intensive care unit (ICU) with vomiting, seizures, and probable aspiration. She has a history of hypertension, COPD, and a prior heart attack. Family reports she smokes daily and drinks alcohol continuously. In the emergency room, she presented with recurrent vomiting, seizures, respiratory distress, and anxiety. Labwork showed elevated liver enzymes and normal blood work. She was intubated and transferred to the ICU.
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10
Running Head: Modulo 2 Plan de Cuidado- (cuidado holístico)
Situación Hipotética
A 55-year-old woman admitted 2 days ago to the Intensive Care Unit. The admission diagnoses are: vomiting, seizures, and probable aspiration. She has a prior history of hypertension, COPD, and myocardial infarction with angioplasty performed six months ago.
Family members report that the client uses the following routine medications: Toprol 50mg 1 tab. daily, Lipitor 20 mg 1 tab. daily, Aspirin 81 mg 1ab. Daily, Plavix 75 mg 1 tab. daily; He smokes a daily pack of cigarettes since he was 30 years old. They also report that the patient drinks alcohol continuously; "In the last 3 days I have found her drunk in the house" said the woman's nephew.
The patient is 5'11'' and weighs approximately 180 pounds. Upon arrival at the emergency room she presents vital signs of: T-37°C, P-150/min., R-28/min. and B/P-193/124 mmHg. She is observed with recurrent vomiting and severe episodes of seizures, respiratory distress, and severe anxiety. Dr. Díaz orders ABG's which result in: pH-7.30, PaCO 2 -50 mmHg, PO 2 -81 mmHg and NaHCO 3 -23 mEq/L, Sat. 85%. The client is sedated with Propofol 5mL, for oroendotracheal intubation and transferred to the ICU area. Blood pressure after intubation medication decreased to 80/52 mmHg. She is restricted to patient per intubation protocol. Laboratory samples show elevated liver enzymes, elevated cholesterol and triglycerides, and normal CBC.
Introduction:
Aspiration pneumonia is caused by aspiration of oropharyngeal contents into the airways, leading to abscess lesions due to bacterial infection in the lower lung lobes. It generally occurs in patients with frequent seizures and loss of mental status, with impaired swallowing of food or loss of the gag reflex (Aspiration pneumonia, n.d.). In this work we will carry out the care plan and the nursing progress notes of a 55-year-old female patient admitted to the Intensive Care Unit with respiratory distress probably caused by pneumonia due to aspiration of her own vomit, leading her to a state of acute respiratory acidosis with adequate bicarbonate compensation by the kidney.
Care Plan:
Estimado
Diagnóstico de Enfermería
Expected results
Nursing Interventions
Evaluatión
domains
Needs
maladaptive behaviors
Focal Stimulus
Interventions
Scientific Rational
subjective data
Objective data
Domain 3: Elimination
Need 1: Breathe normally
The patient reports shortness of breath and that he is anxious
The patient is observed with labored breathing with RF at 28/min with abnormal arterial pH.
respiratory distress
(00030 Impaired gas exchange r/c ventilation-perfusion imbalance m/p shortness of breath, hypoxemia, and abnormal arterial pH.
The patient will recover her adequate ventilation after treatment, in a period of approximately 48 hours.
Domain 1: Security/ protection.
Need 1: Have no aspiration risks
Family me ...
Cases in infectious diseases.pptx
The patient is a 48-year-old man with a history of diabetes and kidney disease who presented with fever, rigors and hypotension. Blood cultures grew methicillin-resistant Staphylococcus aureus (MRSA) and he was admitted to the hospital. A transthoracic echocardiogram showed a vegetation on his mitral valve. He completed a 6-week course of vancomycin but presented again with MRSA bacteremia after completing antibiotics. Neither the patient nor surgeon wanted to proceed with valve replacement surgery.
UCMS:Final Integrated medical quiz 2018
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1.CC I have been having terrible chest and arm pain for the pa.docx
1.
CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”
HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.
Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl
His diagnosis is an acute inferior wall myocardial infarction.
1 of 2 Questions:
Why is HDL considered the “good” cholesterol?
QUESTION 2
1.
CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”
HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.
Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl
His diagnosis is an acute inferior wall myocardial infarction.
2 of 2 Questions:
Explain the role inflammation has in the development of atherosclerosis.
QUESTION 3
1.
A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.
Question:
What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?
1 points
QUESTION 4
1.
A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sen.
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Case 10 asks for the diagnosis of a condition associated with clubbing of the fingers and mentions two associated diseases.
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CC I have been having terrible chest and arm pain for the .docx
Mr. Hammond, a 57-year-old African American male, presented to the emergency department with chest pain radiating down his left arm. His lipid panel showed high total cholesterol, LDL, triglycerides and low HDL. He was diagnosed with an acute inferior wall myocardial infarction.
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A 44 year old female presented to the emergency department after collapsing in the shower at home. On examination, she displayed signs of a right-sided stroke including weakness on her right side, facial drooping, and internuclear opthalmoplegia of the right eye. Imaging revealed a left lentiform nucleus and external capsule hemorrhage. She was treated for hypertension and transferred to the ICU of another hospital for further management.
0130 Admission nurses note (RN) Client arrived via EMS from lo.docx
0130: Admission nurses note (RN): Client arrived via EMS from long-term-care for evaluation of “low blood sugar.” Pt. arrived confused (alert and oriented X 1) and is a known diabetic. Finger stick was 45. Orange juice and crackers, given repeat finger stick 104. Pt now alert and oriented X 4. Report from the charge nurse at the long-term-care facility indicates that the client has been having frequent bouts of hypoglycemia.
0530: (RN) Foley catheter inserted for incontinence--pt. “too weak” to get up to the bathroom and is experiencing bouts of incontinence.
600 mL clear yellow urine noted. The nurse indicates that the ER is “very busy” and “short-staffed.” 0545 (Admitting Physician) See history and physical. Pt. admitted to the medical-surgical service for evaluation of recurrent hypoglycemia.
View the ER chart before the pt. is transferred to the floor:
0730: (RN) Report is given to RN on 3 North.
Emergency Department Chart
Client: Mabel Simpson
DOB: 4/23/1941
Admission Date 8/16/2019
Medical Diagnosis: recurrent hypoglycemia
Allergies: None
Vitals/ Data Collection:
Temp.- 97.3 PO
History:
Diabetes (insulin dependent)
Medications:
Insulin R titrated to finger sticks
Allergies:
None
Vitals/ Data Collection:
Pulse- 68
History:
Hypertension
Medications:
Furosemide 20 MG twice per day
Allergies:
None
Vitals/ Data Collection:
Respirations- 18
History:
Atrial Fibrillation
Medications:
Warfarin 5 Mg Mon, Wed, Fri 2 Mg Tues, Thurs
Allergies:
None
Vitals/ Data Collection:
Blood Pressure- 122/86
History:
Rheumatoid Arthritis
Medications:
Enalapril 5 Mg once per day
Allergies:
None
Vitals/ Data Collection:
No C/O pain
History:
Mild Heart Failure (class 1)
Medications:
Proventil inhaler as needed for wheezing
Allergies:
None
Vitals/ Data Collection:
Alert and oriented X 4
History:
Former Smoker- smoked 1 pack per day X 40 years- last smoked 10 years ago
Medications:
Methotrexate 2.5 Mg per day
Allergies:
None
Vitals/ Data Collection:
Lungs: No adventitious sounds
History:
Appendectomy as a child
Medications:
Tylenol 650 Mg as needed for pain or fever
Allergies:
None
Vitals/ Data Collection:
+ Bowel sounds
History:
Mobility (baseline): able to ambulate slowly with minimal assist
Clear yellow urine draining from Foley catheter in adequate amts.
Medications:
Allergies:
None
Vitals/ Data Collection:
Clear yellow urine draining from Foley catheter in adequate amts.
History:
Medications:
Allergies:
None
8/16/2019
10:00: (RN) Pt received on 3 North. Alert and oriented X 4. Fingerstick 81. Eating breakfast. Offering no complaints.
8/17/2019 (Medical Assistant)
0130: Sleeping Soundly
0700: (LPN) alert and oriented Finger stick 124. Offering no complaints. Medications given as ordered. Foley catheter draining cloudy yellow urine- RN notified.
1100: (Case Manager note): Pt. alert and oriented. Blood sugar stable. Will speak to the physician about discharge tomorrow morn.
Case presentation
The document presents a case study of a 24-year-old female patient who was found unresponsive. Initial examination found the patient to have a Glasgow Coma Scale of 10/15, tachycardia, hypertension, and signs of respiratory distress. Laboratory tests revealed metabolic acidosis, elevated white blood cell count and creatinine, and rhabdomyolysis. Ultrasound showed signs of pregnancy. The patient was treated for pre-eclampsia with magnesium sulfate and antihypertensives, intubated, and underwent termination of pregnancy. She was admitted to the ICU and later discharged in good condition.
CASE PRESENTATION - Copy.pptx
A 26-year-old female presented with fever for 7 days and a recent seizure. Imaging showed venous sinus thrombosis involving the superior sagittal and right transverse sinus with hemorrhagic venous infarct in the right parietal lobe. She was treated with heparin and bridged to warfarin. Differential diagnoses included viral, fungal, or autoimmune meningoencephalitis. Further workup is needed to identify the underlying etiology such as infections, pregnancy/postpartum state, oral contraceptive use, dehydration, or prothrombotic conditions.
Case Study, Chapter 34, Management of Patients With Hematologic Neop.docx
Case Study, Chapter 34, Management of Patients With Hematologic Neoplasms
1. John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen, and Vicodin. (Learning Objective 5)
a. What nursing management should the nurse provide the patient?
Explain the indication and action of the various medications ordered to treat the patient’s symptoms.
2. Susan Clare, age 38, is admitted to the medical oncology unit with acute myeloid leukemia (AML). She has many areas of ecchymosis and petechiae on her skin, as well as generalized pallor. She states she has lost 15 pounds in the last 2 months, and often has a low-grade fever. On physical assessment, you find her liver and spleen to be enlarged on palpation. (Learning Objective 3)
a. What laboratory results would you anticipate due to her ecchymosis and petechia?
Why would it be important to inspect her gums and teeth?
a. Why is her liver enlarged?
Case Study, Chapter 37, Management of Patients With HIV Infection and AIDS
1. The nurse is planning to provide education on HIV infection transmission and prevention strategies at a local senior center. (Learning Objectives 1 and 4)
a. What should the nurse include in the session considering the needs of the older population?
2. Sallie Jefferies, 28-year-old patient, is at the obstetric clinic for a pregnancy visit. The physician informs the patient that her HIV screen test is positive. The patient has no evidence of AIDS. The nurse provides patient education regarding what HIV is and what the clinical management entails. (Learning Objective 5)
a. What clinical management is recommended for the patient during the pregnancy to help decrease the risk of transmitting HIV to the unborn child?
The patient asks the nurse how zidovudine (Retrovir) will help her unborn child from getting HIV. How should the nurse respond?
What explanation about Retrovir should the nurse provide?
The patient asks the nurse if it will be safe to breast-feed her infant after the delivery. The nurse should provide what explanation?
a. The patient asks the nurse what testing schedule for the HIV antibody is needed after her baby is born. How should the nurse respond?
Case Study, Chapter 31, Assessment and Management of Patients With Hypertension
1. Joan Smith, 55 years of age, is a female patient who presents to the intensive care unit with the diagnosis of intracranial hemorrhage. The patient stopped taking her antihypertensives suddenly because of the cost of .
4. complex febrile fit
- FA, a 2-year-old Malay girl, was admitted to the hospital due to 3 episodes of seizures associated with 2 days of fever and vomiting.
- On examination, she was conscious and alert with no abnormalities detected. Tests ruled out metabolic causes and infection.
- She received antipyretics, anti-seizure medication, and antibiotics. No further seizures occurred and she improved with treatment. Her diagnosis was complex febrile seizures presumed to be caused by meningitis.
4. Complex Febrile Fit
This document presents a case report of a 2 year old Malay girl admitted to the hospital due to fever and vomiting for 2 days prior to admission and 3 episodes of seizures on the day of admission. Upon examination and investigation, she was diagnosed with complex febrile seizures presumed to be caused by meningitis. She was treated with antibiotics and anticonvulsants and discharged after 5 days with no further seizures and good response to treatment.
This is a Unfolding Case StudyPatient DetailsPrint Phase In.docx
This is a Unfolding Case Study
Patient Details:
Print Phase Info
|
Case Study History
Name:
James, Karen
Age:
57 Years
Gender:
Female
Karen James is a 57-year-old female who was admitted to the medical-surgical unit from her primary care physician’s office for treatment and evaluation of persistent and worsening influenza. She has a past medical history of asthma as well as depression and anxiety.
You are currently working on Phase 1. You have completed Phase 0 of this scenario.
Patient Details:
Print Phase Info
|
Case Study History
Name:
James, Karen
Age:
57 Years
Gender:
Female
Phase
1,
Wednesday
16:00
You have assumed care for Ms. James who is admitted to the medical-surgical unit for rehydration and management of respiratory distress.
Orient yourself to the patient and health record by locating the following pieces of information within the System Assessment Report and Patient Teaching, and type your answers in a Miscellaneous Nursing Note:
1). Run a report on all the System Assessments documented for the patient in the last 24 hours. You will need to go to Patient Charting > System Assessments > Show Saved Charting. What was documented for the respiratory effort? What was auscultated in the Lower Right Posterior lobe of the lungs? What was documented related to tissue perfusion?
2). What was the last documented temperature for Karen?
3). Does Ms. James use any sensory aides?
4) What does she rate her pain?
5) What is her MORSE Fall Risk Score?
Review the client's History and Physical, what indications can you see place this patient at risk for mobility issues or falls?
[LEARNER ACTION: In a misc nursing note identify risks for mobility and falls. Explain her score on the MORSE scale.]
When you are finished with this task, you may click Complete this Phase.
Patient Information
Chief Informant:
Patient
Chief Complaint:
Shortness of breath, productive cough
History of Current Problem:
Patient states she has had 3-week history of influenza. Has now developed a severe cough approximately 3 days ago with shortness of breath. Unable to sleep due to cough, which often causes bronchospasms. Patient also complains of fever, fatigue, and right-sided chest pain. Seen in urgent care 3 days ago and given Z-pack. No improvement in symptoms.
Allergies:
None known
Family History:
Mother died at age of 72 with breast cancer. Father is alive at the age of 79 and has congestive heart failure.
Past Medical History
Previous Illnesses:
Patient has asthma. Also states she gets bronchitis every 1-2 years.
Contagious Diseases:
None
Injuries or Trauma:
None
Surgical History:
Tonsillectomy and adenoidectomy as a child.
Dietary History:
Regular diet. Patient is 5'1" and 140 pounds. Has recently lost 20 pounds on Weight Watchers diet.
Other:
--
Social History:
No smoking, no drugs. Uses alcohol in social situations.
Current Medications:
Tylenol 650 mg PO every 4 hours PRN pain .
Dyspnoea case based
This document presents 6 case studies of patients presenting with dyspnoea or shortness of breath. Case 1 describes a 72-year-old woman admitted to the hospital with fever and progressive shortness of breath with a history of rheumatoid arthritis. Case 2 involves a 45-year-old heavy smoker with increasing dyspnea, cough, and finger clubbing. Case 3 is about a 76-year-old man with exertional dyspnea and multiple conditions including myasthenia gravis. Case 4 presents a 48-year-old male with fever, cough, weight loss, and right-sided chest pain and shortness of breath. Case 5 describes a 66-year-old woman with increasing shortness
Similar to 1. 16-month-old girl was transferred to a pediat ric emergency depart.pdf (20)
10Running Head Modulo 2 Plan de Cuidado- (cuidado holíst
10Running Head Modulo 2 Plan de Cuidado- (cuidado holíst
10Running Head Modulo 2 Plan de Cuidado- (cuidado holíst
10Running Head Modulo 2 Plan de Cuidado- (cuidado holíst
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1.CC I have been having terrible chest and arm pain for the pa.docx
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CC I have been having terrible chest and arm pain for the .docx
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0130 Admission nurses note (RN) Client arrived via EMS from lo.docx
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Case Study, Chapter 34, Management of Patients With Hematologic Neop.docx
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This is a Unfolding Case StudyPatient DetailsPrint Phase In.docx
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2. Qu tan bien ha dirigido James a su equipo?
3. Qu papel, si hubo alguno, jug el ambiente de trabajo abierto en el caso?
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Gestin de un equipo global: Greg James en Sun Microsystems, Inc. (A)
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tres horas de sueo.
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todo su equipo de implementacin de clientes de 45 miembros distribuidos en India, Francia, los
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porttil y abri su correo electrnico.
Re: HS Holdings
James revis su bandeja de entrada, reviviendo los eventos que lo haban sumido en esta situacin.
Seis das antes, haba recibido una serie de correos electrnicos enviados por su equipo. Rahul
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de los miembros del equipo de Ashok en Mumbai) y Nick Elliott y Robert Chan en Santa Clara
para rastrear el origen de la falla:
Para: Greg James (Gerente Global, Santa Clara)
Fw: FYI en re: HS Holdings
Fecha: lunes, 26 de mayo de 2008 06:58:40 PST
De: Robert Chan (Gerente de Cuentas de Ventas, Equipo de Santa Clara): V. Urgente Para:
Rahul Ashok (Gerente de Servicio al Cliente, Equipo de Mumbai)
REV: 1 DE NOVIEMBRE DE 2009
Ral,
Tenemos un gran problema con HS Holdings. Su servidor dej de funcionar el domingo a las
23:30 PST, y TIC [Technology Integration Company], su grupo de soporte tcnico, nos llam para
pedir ayuda. El problema estaba en un nivel crtico porque todo su sistema estuvo inactivo
durante dos horas. Esto fue un desastre para su negocio de banca en lnea. Ahora estn luchando
para responder a sus clientes que estn furiosos.
Tienen un contrato anual premium de software de Sun las 24 horas del da, los 7 das de la
semana, un servicio de $300 000, pe.
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these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
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