A 7-year-old boy comes to the clinic with a chronic cough. His mother reports he has a cough most of the day and sometimes 2 or 3 nights a month. This has happened off and on for 1 year but worse in the Spring. He also coughs when he plays sports. After numerous lab and diagnostic studies, he was diagnosed with asthma. His personal best with a peak flow meter is 200. Detailed Soap note needed with Icd code and reflection of the dx and why the treatments and the dx were made
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- A 6-week-old male was brought into the office with a 2-day history of choking spells following a protracted (10 day) period of cold-like symptoms. The parents reported that now the infant would suddenly start coughing and could not seem to catch his breath. They became concerned today because the infant has also started vomiting shortly after these episodes. Copious mucous accompanies the coughing episodes. Upon examination his pulse and respiratory rates were elevated. His WBC was 15,500/ul with 70% lymphocytes. The nasopharyngeal swab did not grow any pathogens on routine lab culture. 16. The child is suffering from what disease? How do you know (hallmark)? Name two virulence factors for this pathogen leading to tissue damage. Why did the routine lab culture not show any results? (4A 50-year-old man who lives in Indiana comes to the physician because of a 1-month history of fever and nonproductive cough. He is a construction worker. His temperature is 38.4 C (101.1F), 84/min, respirations 14/min, and blood pressure is 110/70 mm Hg. Scattered crackles are heard over all lung fields. Bilateral interstitial infiltrates is seen on CXR. A photomicrograph of a specimen obtained via transbronchial biopsy is shown. The most likely causal organism in this patient has a cell wall composed of which of the following? A) N-Acetylglucosamine-N-acetylmuramic acid B) Cellulose C) Glucans D) Polyglutamic acid E) Teichoic acidA 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…
- Patient is a 78 y/o male with a history of COPD & HTN. He smokes 1 – 2 packs/day & requires oxygen athome. He presents to the ER with increased SOA (shortness of air), fever, and worsened cough withthick sputum production. The physician in the ER diagnosis him with pneumonia and starts him onprednisone and clarithromycin, an antibiotic AllergiesPenicillin (hives,shortness of air,swollen tongue andthroat)Current MedicationsTiotropium (Spiriva®) inhaler I puff PO once dailyTheophylline (Theo-DUR) 300mg PO BIDLisinopril 10 mg PO dailyAlbuterol MDI (Proventil®) 2 puffs q 2-4 hours as needed for SOAPrednisone 50 mg daily x 7 daysClarithromycin (Biaxin) 500mg PO BID x 7 daysPMH COPDHTN 1.using Clinical Pharmacology (Reports->Drug Interaction Reports) as a reference, discuss the druginteraction between theophylline and clarithromycin.2. What are the common side effects of theophylline?3. What is the mechanism of action of tiotropium (Spiriva®)?4. What are long-term complications /…Hello, I have this case: Mrs. Bean is a 60-year-old woman who recently spent 5 days in the hospital for pneumonia, where she received intravenous antibiotics and respiratory therapy. She was discharged 1 week ago and has been at home with her husband, who assists in her care. She has arthritis and typically is not very physically active. Mrs. Bean returned to her primary care provider for a checkup and complained of increasing difficulty breathing, headache, and coughing up yellowish- colored sputum. Can you help me to say What do you think the cues mean? (What do the signs and symptoms tell you) please? Thank you in advance!Female patient whose is a 13-year-old, was admitted to the hospital with complaints of progressive weakness and shortness of breath with minimal physical effort. She has experienced recurrent fevers reaching 38.8°C. Physical examination reveals a well developed teenage with good nutritional status and in no acute distress. There is no lymphadenopathy or organomegaly. Many petechial hemorrhages cover her chest and legs. Several bruises are found on her legs and thighs. Laboratory tests were ordered upon admission. The laboratory tests result were as the following: RBC 2.24 X1012 /l Hb 71 g/l PCV 24% Plt 8.0 X109/l WBC 1.2 X109/l Differential Segmented Neutrophils 2% Lymphocytes 94% Monocytes 4% Reticulocyte count 0.7% She was referred to a hematologist who ordered a bone marrow examination. Bone marrow biopsy showed a markedly hypocellular marrow with very few hematopoietic cells and…
- Female patient whose is a 13-year-old, was admitted to the hospital with complaints of progressive weakness and shortness of breath with minimal physical effort. She has experienced recurrent fevers reaching 38.8°C. Physical examination reveals a well developed teenage with good nutritional status and in no acute distress. There is no lymphadenopathy or organomegaly. Many petechial hemorrhages cover her chest and legs. Several bruises are found on her legs and thighs. Laboratory tests were ordered upon admission. The laboratory tests result were as the following: RBC 2.24 X1012 /1 Hb 71 g/l 24% 8.0 X10/1 PCV Plt WBC 1.2 X109/1 Differential Segmented Neutrophils Lymphocytes Monocytes Reticulocyte count 2% 94% 4% 0.7% She was referred to a hematologist who ordered a bone marrow examination. Bone marrow biopsy showed a markedly hypocellular marrow with very few hematopoietic cells and there were no malignant cells present. 1- Connect these clinical symptoms with her laboratory-screening…This is a Respiratory Case Study. Gladys Young is a 68 year old female that resides in an Independent Living facility with her husband. She presents to her primary care physicians office with complaints of fever, chills, nausea and vomiting. She also states that she has had some mild hemoptysis occasionally with her persistent coughing. She has recently completed treatment with Chemotherapy for Breast cancer and is concerned that she may have an infection. You are the nurse caring for her. She is able to complete a sentence in its entirety, but she is persistently coughing during the history. She is a former smoker, she smoked ½ pack of cigarettes per day for 30 years and quit when she was diagnosed with breast cancer 6 months ago. She denies shortness of breath or chest tightness. She has not yet gotten her influenza vaccine, but did receive the Pneumovax vaccine last year. She has had problems with persistent coughing at night which has prevented her from getting a good night’s sleep…An 87-year-old woman with dementia lives in a nursing facility. A nurse notices that she has been coughing frequently and seems warm to the touch. She performs an evaluation on the woman and confirms a fever with a dry cough. She also notices that her throat seems inflamed and irritated. The woman is unable to answer questions about how she has been feeling lately to provide a history for the nurse. The nurse ensures that the woman is comfortable and returns to the nursing station to review that patient’s chart. The nurse finds that within the year that the patient has been in the nursing facility, she has had two respiratory infections diagnosed as pneumonia. The nurse calls the physician, worried that the patient may be developing pneumonia again. 1). Pneumonia is an infection of the lung that can be caused by a virus, bacteria, or fungi. What initial laboratory analysis would help to determine whether an infection is present? Please give a explanation a. Metabolic panel (clinical…
- An old patient suffers from difficulty in evacuation process and lose of weights. During the diagnostic procedures, the physician examine his bowel sounds and identify the presence of mild ascites. He also noted the following symptoms and signs: Phlebitis, Aphthous ulcer, episcleritis and spider naevus. His total bilirubin is 1.5 mg/dl , albumin is 4 g/dl and prothrompine time is 3 sec. laboratory measured In addition, skip lesions between healthy areas diagnosed during the study of the inside of view of the entire colon. A) Calculate and explain the scoring for the Child-Pugh Grading with this case and identify his class. B) Identify the specific types of diseases he is suffering from and the physical examination that used in this case.A 60-year-old man with a long history of cigarette smoking and chronic obstructive pulmonarydisease is hospitalized with increasing shortness of breath, increasing sputum production, andlow-grade fever over a three-day period. His blood pressure is 100/ 80mmHg, pulse is 110 perminute, respiratory rate is 28 per minute, temperature is 38. 2℃. The patient is mildly cyanotic. The following arterial blood gases were obtained on room air: CaO2max =20ml/dL, CaO2 =15ml/dL, PaO2,= 50mmHg, C(a-v)O2 = 4ml/dL. Questions :1.What is the most appropriate type of hypoxia for this patient?2. What are the common causes of this type hypoxia?3. What are the characteristic alterations of blood O2 in this type hypoxia?4. What is the colour of skin and mucous membranes in this type. 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?