Case Study Shock, Respiratory and Urinary

CASE HISTORY 2 The patient was a 19-year-old male who was brought to the emergency room by his sister. He gave a 24-hour history of dysuria and noted some “pus-like” drainage in his underwear and on the tip of his penis. Urine appeared clear, and urine culture was negative although urinalysis was positive for leukocyte esterase and multiple white cells were seen on microscopic examination of urine. He gave a history of being sexually active with five or six partners in the past 6 months. He claimed that he and his partners had not had any sexually transmitted diseases. His physical exam was significant for a yellow urethral discharge and tenderness at the tip of the penis. (A Gram stain done in the emergency room is shown in Fig. 1). He was given antimicrobial agents and scheduled for a follow-up visit 1 week later. He did not return. QUESTIONS: What pathogen caused the disease? Briefly describe the epidemiology and pathogenesis of this disease. What is the morphology and staining…

Patient D: 38 y/o male vegetarian. Complains of mild irritation during urination. Urine volume 1.1 liters/24 hours. Microscopic examination of urine revealed many small pyramid shaped crystals. 1) List the abnormal findings. 2) What is your diagnosis? 3) What might have caused this disease? 4) How does diet affect urine? 5) Have you ever tried drinking 12 large glasses of water in a day? Why would drinking water be helpful to this individual?

Web Assignment 1. Conduct online research on benign and malignant kidney tumors. Prepare a PowerPoint presentation on the following: Learning Ob Kidney cancer stages Risk factors for kidney cancer

A. Terminology Write the term defined below in the answer column. 1. Inflammation of the kidney (general). 2. Albumin in the urine. 3. A measure of the concentration of solutes in urine. 4. Erythrocytes in the urine. 5. Inflammation of the urinary bladder. 6. Most abundant inorganic compound in urine. 7. Leukocytes or pus components in the urine. 8. pH range of normal urine. 9. Hemoglobin in the urine. 10. More than a trace of glucose in the urine. 11. Ketones in the urine. 12. Inflammation of the kidney involving glomeruli. 13. Accumulations of materials hardened in tubules. 14. Most abundant nitrogenous waste. 15. Excessive urine production. 16. Bile pigment in the urine. 17. Inflammation of the urethra. 18. Kidney stones. 19. Little or no urine production. 20. Most abundant inorganic solute in urine. B. Clinical Significance Select the name of the possible clinical condition from the list below that is indicated by the urinalysis results. Write your answer in the answer column.…

Question: Can you make a list of Nursing Diagnosis related to the given Case Scenario below?   INFANT WITH TETRALOGY OF FALLOT    Case Scenario: Baby Pearl, a 9-month-old girl presents to the emergency department with his mother,who reports episodes of tachypnea, cyanosis, and irritability during feeding. The mother explainsthat these episodes have become more frequent, with baby Pearl becoming more cyanotic aroundthe mouth and fingers especially when crying (tet spells) when she was around 7 months old.These episodes resolve spontaneously but are occurring every few days. The mother breastfeeds every 3 hours, but sometimes takes a long time to feed. She alsoobserved that baby Pearl becomes diaphoretic with feeding, and stops frequently to catch herbreath while feeding. She reported to the nurse that vomiting the milk (sometimes goes out fromthe nose) and becomes more frequent after feeding. The patient currently appears comfortable,with no signs of respiratory distress, fever, or…

◄ Mail AA 12:05 s-pdx-prod.inscloudgate.net Case Study Shock and Multiple Organ Dysfunction Syndrome 1. A S, is a 77-year-old male patient admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. 2. Patient has Foley catheter in place with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. 3. The patient is confused, afebrile, and hypotensive. BP 82/44 mm Hg. RR 28 breaths/min and the pulse oximeter reading is at 88% room air. Physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. 4. The patient developed diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for…

CASE: URINARY TRACT INFECTION A 27-year-old woman comes in with a prescription for nitrofurantoin tablets 50 mg q.d.s. for three days and requests to speak with the pharmacist. She explains that her doctor tested her urine with a "colored strip" and diagnosed her with a urinary tract infection (UTI). She is experiencing significant discomfort when urinating due to a burning/stinging sensation, and her doctor has advised her to purchase Effercitrate over the counter. A friend suggested she also buy cranberry juice.   6. Aside from nitrofurantoin, list and describe other antibiotics used to treat urinary tract infections. 7. What lifestyle advice can be offered to patients with cystitis? 8. The following are some UTI myths; discuss whether they are true or not. a. UTIs are spread through sexual partners.b. A UTI can be avoided by drinking cranberry juice.c. UTIs can be avoided by wiping from front to back, avoiding tight clothing, and urinating after intercourse.d. A high salt diet…

Question: Can you make an Overall and Summary of the given Case Scenario?   INFANT WITH TETRALOGY OF FALLOT  Case Scenario: Baby Pearl, a 9-month-old girl presents to the emergency department with his mother,who reports episodes of tachypnea, cyanosis, and irritability during feeding. The mother explainsthat these episodes have become more frequent, with baby Pearl becoming more cyanotic aroundthe mouth and fingers especially when crying (tet spells) when she was around 7 months old.These episodes resolve spontaneously but are occurring every few days. The mother breastfeeds every 3 hours, but sometimes takes a long time to feed. She alsoobserved that baby Pearl becomes diaphoretic with feeding, and stops frequently to catch herbreath while feeding. She reported to the nurse that vomiting the milk (sometimes goes out fromthe nose) and becomes more frequent after feeding. The patient currently appears comfortable,with no signs of respiratory distress, fever, or neurological impairment.…

CASE STUDY: Patient X, 3-year-old female came in because of difficulty of breathing. Condition started 4 days prior to admission when periorbital edema was noted which progressed and became generalized. Condition was associated with nonproductive cough & low-grade fever, relieved by Paracetamol. Three days. prior to admission, tea colored urine was noted. There was neither dysuria nor urinary frequency. Two days prior to admission, consult was sought with a private physician and was given Amoxicillin 53 mg/kg/day. Few hours PTA, patient was noted to be dyspneic hence consultation was sought at emergency room and subsequently admitted. Past Medical History: No previous admission. No allergic reaction. Family History: Denies of any heredofamilial diseases. Personal/Social History: Patient was delivered at home assisted by a hilot by NSVD with no complication. Breastfeeding was given until 11 months old and solids were started at 6 months. Immunization: Complete primary immunization…

Case Study: A 52 year-year old man with a history of AIDS, hypertension, diabetes mellitus, and alcohol abuse was found unconscious in his home by his roommate.  In the emergency department, he was hypotensive (103/60 mm Hg), febrile (temperature 101F), and unresponsive.  Computed tomoggraphy scan of the abdomen showed choleccystitis and gallstones.  Laboratory data are listed. The patient was diagnosed with acute renal failure.  He was administered intravenous fluids; BUN fell to 68 mg/dL and creatinine fell to 2.2 mg/dL.  The patients blood culture report was positive for e. coli.  He was treated with tobramycin and cefepime.  The patient continued to deteriorate and died 5 days after admission. Cause of death was multiorgan failure secondary to AIDS, sepsis, and alcoholic cirrhosis. DATA TABLE Drugs of Abuse              Negative             Urinalysis Serum ethanol                   84mg/dL            Hemoglobin                Positive…

UTI Case scenario J.D, a 26 year old female, presents to the urology clinic for the first time. She was referred bythe primary health care provider for recurrent urinary tract infection with gross haematuria.Her presenting complaint includes a four week (4/52) history of urinary frequency andurgency, lower abdominal pain, intense vaginal pain (worse during intercourse). She reportsthat she has a history of inflammatory bowel disease, seasonal allergies and is on anxiolyticsdue to her stressful personal life. She reports occasional lightheadedness and fatiguability.Her diet consists of very little vegetables, a lot of spicy, fried foods and has coffee five timesdaily. She has three sexual partners. J.D brought a letter from her referring doctor stating that her urinalysis with MCS(microscopy, culture and sensitivity) have always been negative; she has been treated withfluconazole 150mg po (OD) STAT and a 14 day course of fluconazole, without resolution ofsymptoms. A KUB ultrasound and…

case discussion: 72 yr old, male with history oif diabetes, PAD, HTN and CKD. Recently admitted for C-diff diarrhea and was started on vancomycin and discharged home. He now present to ER (7 days later) with left lower leg sweeling nd erythema and as such was diagnosed with cellulitis. He is not septic or ill-appearing so as an APN/APRN( Advance Practitioner Registered Nurse), you decide to discharge him with oral antibiotics. In regards to the principles of PHARMACOKINETICS(absorption, distribution, metabolism and excretion), what are the key considerations when treating this patient and why are they so important?

Case 2 A 45-year-old male patient visits the hospital with a 3-month history of upper abdominal pain associated with nausea. Pain is worsened whenever he drinks alcohol, soda or even coffee. He is a smoker and a moderate alcohol drinker. He denies use of NSAIDs. Physical assessment and vital signs are normal. However, there is notable epigastric tenderness from the abdominal examination. His stool is also heme positive. CBC shows a mild hypochromic, microcytic anemia. Endoscopic examination reveals diffuse gastritis and ulcer. A gastric biopsy is then ordered by the physician.  1. What organism is most likely to be seen from the gastric biopsy? Identify the specific type of ulcer to complete the diagnosis.  2. Provide other clinical test to facilitate rapid detection of this organism. Describe briefly the procedure.3. Enumerate factors which contribute to the organism’s ability to colonize the stomach. 4. If left untreated, what other long term complications could this organism cause?

Urinary Incontinence Case Study: Mrs. Kingsley Mrs. Kingsley moved into Gardens on the Green Care Center this afternoon. Her husband of 54 years suffered a heart attack and died a month ago. Mr. Kingsley was Mrs. Kingsley’s primary caregiver for the last 3 years after Mrs. Kingsley had a stroke which resulted in limited mobility of her right arm and a slow gait. Mrs. Kingsley enjoys using her mind and enjoys being around other people, but she has been generally physically slower after her stroke. The Kingsleys have 3 children. The 3 adult children live out of town. They tried to coordinate home care for their mother over the last month after their father, Mr. Kingsley, died. But the care was fragmented at best. The children offered to have Mrs. Kingsley move in with them, but Mrs. Kingsley did not want to leave Evansville, the city where she grew up and where she raised her family. Mrs. Kingsley needs assistance with her activities of daily living. She needs assistance with dressing…

CASE ANALYSIS: Mr.  Willis, a 46-year-old mechanic, is referred to hospital by his primary care doctor. He gave a history of diarrhea and vomiting a week ago and now was complaining of headaches and feeling ‘lousy’. His doctor had given him metoclopramide and ferrous sulphate. Mr Willis  did not appear jaundiced although he said he had noticed his urine was unusually dark a few weeks ago. On examination, he was obese with a blood pressure of 120/80mmHg and had a pulse of 80. Rectal examination revealed black stools. He had a normal gastroscopy with three negative FOBs. His serum biochemistry showed a normal level of alanine transaminase and a slightly raised total bilirubin level. Mr Willis’ reticulocyte count was 13.5% (normal range: 0.5–1.5%). He was diagnosed with having G6PD deficiency, probably triggered by an infection.   How do you explain Mr Willis’ dark urine and dark stools?  Would Mr Willis benefit from any medication following admission? Explain your answer.  Why is it…

Health Care Problems Therapeutic Goal Therapeutic Recommendation Rationale Hypertension       Pokycystic Kidney Disease       Grave's Disease     C

The nurse is caring for an older adult who is receiv- ing oxybutynin (Ditropan) to reduce the occurrence of bladder spasms related to a UTI. For which side effect should the nurse assess the patient? 1. Diaphoresis 2. Palpitations 3. Gastric irritation 4. Orange-colored urine

CASE STUDY: Nelson Amoah, 54-year-old male presents to the emergency department with abdominal pain, nausea, vomiting, abdominal distension and constipation which started 3 days prior to presentation. He denied fever, chills and headache. Except for peptic ulcer disease, he is otherwise healthy with no previous surgeries. He is a smoker, smoking a little less than a pack a day for twenty-two years. On examination he was afebrile, with a heart rate of 120 beats/min, blood pressure 130/80 mmHg and respiratory rate of 22 cycles/min. Abdominal examination revealed mild distension with generalized guarding and marked rebound tenderness in the epigastrium. There were no palpable masses and bowel sounds were absent. Erect and supine abdominal and chest radiographs were normal. However, abdominal ultrasonography revealed free fluid throughout the abdomen and pelvis. a.       State at least FIVE questions that you would ask in analyzing Mr. Amoah’s pain b.      Identify all;…

Case Study #2Setting: University Hospital in Santiago de Compostela, Spain.Subject: 80-year old Caucasian man who developed a pancreatic pseudocyst after presenting with acute necrotizing pancreatitis.A biopsy of the pseudocyst was obtained following endoscopy using ultrasound fine needle aspiration. The tissue was sent to the hospital lab for analysis. The results follow. This is microbiology lab question

Patient Case Question 11. Identify five elevated laboratory test results that are consistent with a diagnosis of bacterial endocarditis. Patient Case Question 12. Explain the pathophysiology for any three of the five elevated laboratory results identified in Question 11 above. Patient Case Question 13. Identify two subnormal laboratory results that are consistent with a diagnosis of bacterial endocarditis.

CASE STUDIES 1. Faad the folowing case study and answer the questions A 49-year old female is admitted to the health care facility and scheduled for an pen laparotomy with possible hysterectomy. The patient is 5 feet. 3 inches tall, 160 pounds, with a BMI of 31.9. After spending a short time in the holding area, he patient is brought into the OR by the circulating nurse. The scrub has begun setting up the case She notes the patient's stature and requests extra clamps and sutures. The circulator states that sha will get these after the case is under way. After transfening the patient to the operating table and preparing the required documents, the nurse is ready to take a count with the scrub. All items are counted and recorded on the count sheet by the circulator. The surgical procedure was started on time and is progressing well. The surgeon has decided to go ahead with the hysterectomy. The circulator has opened extra ponges onto the back table and waits for the scrub to count them…