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- A 40-year-old woman presents with a "skin rash." Questioning reveals easy bruising on minimal trauma, menorrhagia, and frequent| bouts of epistaxis. She is not taking any medications, and there is no history of toxic exposures. Physical examination reveals multiple petechial hemorrhages, most prominently on the dependent portions of the lower extremities. Splenomegaly is not detected. Laboratory studies reveal marked thrombocytopenia, and a bone marrow aspiration reveals increased numbers of megakaryocytes. Which of the following is the most likely mechanism of this disorder? Physical destruction of platelets while negotiating through partially block microvasculature. DIC with consumption of platelets and coagulation factors Myeloid stem cell suppression in bone marrow, with inability to produce platelets Intravascular spontaneous lysis of platelets due to increased osmotic fragility Antibody-mediated platelet destruction.Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 1. His wife tells you that he has started having hallucinations. Which medication might be causing this?Discuss why this happens.Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 5. List some general education points regarding sleep hygienePatient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia Do you have any concerns about his pain medication?
- A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film? What is the clinical significance of the platelet count?A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film? What is the clinical significance of the platelet count? NOTE: If you could answer all the questions please. Thank you!A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film?
- .. A 3-year-old boy, Jessie Jarnes is admitted at 0700hrs for elective adenotonsillectomy on the morning of surgery. Apart from chronic symptoms relating to enlarged tonsils and adenoids he is generally fit, well, alert and communicative Medical history: He has had 2 previous anaesthetics at age of 2 and 3 years old for cautery of nose to treat epistaxis. His mother was instructed that Jessie be nil by mouth (NBM) from 12midnight, but he has had nothing since 1830 his last night. He has been taken to the playroom. where he plays Nintendo with Captain Starlight At 1045hrs Jessie's mother returns him to his room. He is drowsy, confused, cold, clammy, and sweaty. He lies curled up with severe abdominal pain. His mother rings the call bel for the nurse. Q1. What would be your next nursing actions? Q2 Explain the pathophysiological changes that causes the patient fo be cold. clammy, and Sweaty q3. identify and provide rationale for two (2) priority care for this patient?A 35 year alcoholic male who had a heart surgery before was admitted with a three week history of fever and gum infection which leads to poor appetite since he cannot eat properly. On physical examination, his body temperature is at 39 degrees celsius. Pulse is 96 beats per minute, respiratory rate is 20 breaths per minute, and BP is 120/80 mm. There are many missing teeth with gingivitis and dental caries which gives off an unpleasant breath odor every time he speaks. He has with him a pack of sugar candies that he brought secretly. What type of infection is suggested by his foul breath? What group of organisms could be responsible for this patient's condition? What complications are associated with this infection?vA 13-year-old girl is brought to the emergency department 15 minutes after the sudden onset of shortness of breath. She has a 9-year history of episodes of soft tissue swelling, particularly involving her face and extremities, but without urticaria or erythema. Some of these episodes have been accompanied by acute abdominal pain with diarrhea. She has no history of severe or frequent infections. Her temperature is 37°C (98.6°F), pulse is 81/min, respirations are 20/min and labored with marked stridor, and blood pressure is 95/65 mm Hg. Physical examination shows marked facial edema. Treatment with danazol and stanozolol resolves her symptoms. The most likely cause of her which of the following substances? condition is a deficiency of Angiodema A) C1 inhibitor B) CD40 ligand-class switching C) Factor VIII (antihemophilic factor) DY IgA resp issues also NADPH oxidase respiratory hurst issue F) Plasminogen activator ↓ Azols helps in reduction of Ego sterol 091 by wholortus cyfockmome $450…
