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- 1. A 3-year-old girl is brought to the physician by her mother because of a 2-day history of cough and runny nose. She attends a day-care center. The mother says that the patient’s appetite and activity levels are only mildly decreased and that she sleeps through the night. Her temperature is 37.8C (100 F) pulse is 100/min, and respirations are 19/min. Physical examination shows mildly injected conjunctivae, clear nasal discharge, and mild pharyngitis. A throat culture grows viridans streptococci. A heterophile antibody titer is negative. Which of the following is most likely the diagnosis?A. Common ColdB. Infectious mononucleosis c. croup d. pertussis e. streptococcal pharyngitis 2. A 33-year-old woman comes to the physician’s office because of increasing fatigue and shortness of breath over the past 2 years. She has also noted chest pressure with exertion and recently almost fainted while walking. Examination shows increased jugular venous distention, a right ventricular heave,…2. A 50-year-old male client comes to the clinic complaining of a scratchy throat and excessive sneezing. He states, “My nose is so stuffed up and my eyes are tearing so much that I feel like I’m crying.” Further evaluation reveals acute allergic rhinitis. a. What questions should the nurse ask the client to aid in determining the cause of the client’s symptoms?b. What instructions should the nurse provide the client to help him reduce future episodes of allergic rhinitis? 3. A client is undergoing treatment for chronic obstructive pulmonary disease (COPD) at a healthcare facility. He has acquired pneumonia and has increased cough and sputum production and intense dyspnea. Pleural effusion is detected in the lungs. The healthcare provider orders a thoracentesis be performed on the client. What points should a nurse keep in mind before and after a thoracentesis is performed on a client?. Howard Long, 50 years of age, is a male patient diagnosed with bronchiectasis. He has smoked 1 pack per day of cigarettes for 35 years. He has a long history of recurrent bronchial infections. He has a chronic productive cough with copious amounts of purulent sputum. The patient complains that he is short of breath, even at rest. He has clubbing of his fingers. The chest CT scan reveals bronchial dilation. (Learning Objectives 2, 5, and 6) a.How should the nurse explain to the patient and family the pathophysiology of bronchiectasis as it is related to the symptoms the patient is experiencing? b.How should the nurse explain to the patient and family the goals of medical management that may be used to treat bronchiectasis? c.What does the nursing management for bronchiectasis entail?
- CONCEPT MAPPINGCreate a CONCEPT MAP or DIAGRAM from among the following high-risk conditions. Choose THREE (3) conditionS from among the list below:1. Respiratory Distress Syndrome2. Meconium Aspiration Syndrome3. Sepsis4. Necrotizing Enterocolitis5. Persistent Pulmonary Hypertension in Newborns6. Retinopathy of prematurity7. Intraventricular Hemorrhage8. Intracranial Hemorrhage The components should include the following: 1) predisposing and/or precipitating factors; 2) a simple pathophysiology; 3) clinical manifestations; 4) diagnostic procedure (if applicable); 5) medical/surgical management; 6) nursing interventions and nursing diagnosis.3. A client is undergoing treatment for chronic obstructive pulmonary disease (COPD) at a healthcare facility. He has acquired pneumonia and has increased cough and sputum production and intense dyspnea. Pleural effusion is detected in the lungs. The healthcare provider orders a thoracentesis be performed on the client. What points should a nurse keep in mind before and after a thoracentesis is performed on a client?1.A nurse is providing care for an older adult who have been diagnosed with pneumococcal pneumonia. Which of the following signs and symptoms is the client most likely to encounter?
- CONCEPT MAPPINGCreate a CONCEPT MAP or DIAGRAM from among the following high-risk conditions. Choose only one (1) condition from among the list below:1. Apnea of Prematurity2. Respiratory Distress Syndrome3. Meconium Aspiration Syndrome The components should include the following: 1) predisposing and/or precipitating factors; 2) a simple pathophysiology; 3) clinical manifestations; 4) diagnostic procedure (if applicable); 5) medical/surgical management; 6) nursing interventions and nursing diagnosis.Eight-month-old Elvis is admitted for the first time witha diagnosis of acute bronchiolitis and is managed inside a mist tent. To prevent separation anxiety in Elvis, the nurse plans to: all of the above give Elvis his favorite stuffed animal wipe the tent's wall of moisture allow the mother to lift the tent's wall and help herself inside45. A 5-year-old girl with a history of recurrent infections since the age of 4 months is brought to the physician for a follow-up examination. She has had multiple episodes of pneumonia, sinusitis, otitis media, and diarrhea. She is at the 20th percentile for height and weight. Her temperature is 37.4°C (99.3°F). Mild crackles are heard bilaterally over the lower lung lobes. Laboratory studies show: Leukocyte count Segmented neutrophils Eosinophils 10,500/mm³ (N=5500-15,500) 57% 2% Lymphocytes 34% CD3+ T lymphocytes 67% CD19+ B lymphocytes 28% CD56+ natural killer cells 5% Monocytes 7% Serum IgA IgG IgM undetectable (N=14-159 mg/dL) 25 mg/dL (N=345-1236) 410 mg/dL (N=43-207) This patient most likely has an abnormality of which of the following immune system components? A) Activation-induced deaminase B) CD40 ligand OC) Class II MHC protein D) Common y chain of the interleukin-2 (IL-2) receptor E) Recombination-activating gene 1 F) Terminal complement
- 2. A25-year-old man with hereditary hemorrhagic telangiectasia comes to the physician because of a nosebleed for 2 hours. Physical examination shows nasal bleeding. The nasal mucosa s anesthetized with lidocaine, and clots are removed. Visible bleeding vessels are located in the posterior nasal cavity. These vessels are most likely branches of which of the folowing areres? OA) Facial B) Lingual OC) Maxiliary OD) Ophthalmic E) Superficial temporalConsent Case Study: A mother brings in her 14-year-old son, Branch, because he has had a nosebleed. She is concerned about it because they have been applying pressure by pinching it and the nosebleed won't stop. He has no history of nosebleeds. He has no significant medical history and no known allergies. He is on no medications. Mom and Branch deny trauma to the nose. He says he just woke up with a nosebleed and it won't stop. He tells you that the left side is the side that is bleeding. You recognize that simple pressure is not going to stop the nosebleed. You understand that this bleed needs further intervention. Vital signs: BP 110/70 P 84 R 14 T 97.8 oral Pulse ox 99% Prior to any type of procedure, you have the mother sign an informed consent. What are the three major areas you must discuss when doing any type of procedure?You obtain a SAMPLE history from the health aide which is as follows: S: Terrible cough x 3 days and a temperature of 101° F. Per the health aide, the patient had reported feeling pain when taking a deep breath when she last saw him. A: Shellfish M: Lisinopril, Aspirin, Ventolin Inhaler and Furosemide. P: Hypertension, Chronic Bronchitis, and an AMI 5 years ago. L: Unknown. The health aide reports he refused to eat during her last visit. E: Unknown During your assessment of his lung sounds, you hear rales and rhonchi bi-laterally in all fields. You obtain a full set of vitals which are: RR: 24 breaths per minute, labored and shallow RR: 120 beats per minute, week and regular BP: 68 by palpation Skins: mottled, cool, and clammy Pupils: PERL (sluggish) SpO2 Reading: 92% 1. What conditions or factors lead you to label the patient as critical? 2. How are you going to manage and care for this patient? 3. Based on the history, what type of shock are you suspecting the patient is…
