Esbl Ecoli Case Study Nursing

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows

Time line – the project will require a 12-month implementation time line to allow the team to compare the intervention on a monthly and on a quarterly basis.

Respond to the questions in the following ELNEC case study: Mr. Li is a 65-year-old Chinese-American man, diagnosed one year ago with lung cancer. The patient has been told by his family that he has a “lung disease.” Despite the fact that his disease is clearly advancing, the family insists that he not be told of his diagnosis or prognosis. Mr. Li is losing weight (20 lbs in the previous two months) and is having increasing back pain and difficulty swallowing. He lives with his wife in a second-floor apartment.

SCLC is a highly aggressive tumour with a propensity for early metastases and a high case-fatality rate. Systemic treatment with doublet platinum plus Etoposide ( cisplatin 60mg/m2 D1 or carboplatin AUC5 IV day 1 ,Etoposide100mg/m2 IV Day1 and 200mg/m2 oral day 2 and 3 is recommended for all stages of this disease and has been a standard first-line therapy for SCLC since the 1980s.(Hann 2008)

The patient is an 80-year-old female who is brought to the ED referred from the hemodialysis unit because they discovered a history of a fall from an upright position 2 days prior to her presentation. There is no further history available except from her sister who noted fall when the patient was tryng to to get some water. There was evidently no loss consciousness or seizure activity. The patient has severe underlying dementia cannot provide additional history. Her medical history is significant for diabetes mellitus, hypertension, end-stage renal disease, she has had previous TIA, anemia and peripheral arterial disease. Initial lab work up reveals her to be anemic with a hemoglobin 8.9, hematocrit 20.4, hyponatremic with a sodium 130, chloride of 89, and albumin of

The patient is an 80-year-old African American female unremarkable who presents to the ED complaining of inability to walk and loss of weight. She was sent in by her primary doctor, Dr. Nil. She also presents with some altered mental status. On presentation in the ED the patient is found to have a white count of 21,000, hemoglobin of 8.7, close follow up revealed a white count of 15.4 and hemoglobin dropped to 7.6. She has a left shift in her leukocytes and her platelets are increased. She is also noted to have iron deficiency anemia, acute kidney injury, as well as moderate to severe right-sided hydronephrosis with no clear explanation. Her urine culture is growing e coli with a fairly benign susceptibility pattern. However in view

The patient is a 97-year-old female who presents to the ED because of urinary incontinence with hematuria and vaginal bleeding. The patient is very weak, unable to walk prior to admission despite her 97 years of age she is able to ambulate her home with the assistance for walker. In the ED she was found to be positive for influenza. The rest of her medical history she is chronic kidney disease, increased lipids, she is anemic and has hypertension. Urologic consultation indicates that catheterization of her urine in the ED showed it to be amber. Besides having influenza she probably is having vaginal bleeding. I believe that this patient warrants acute inpatient hospitalization. She is 97 years of age with a multiplicity of comorbidities

The patient is a 58-year-old African American gentleman who presented to the ED with complaints of nausea, vomiting, diarrhea and generalized malaise associated with no fever, chills. The patient missed his dialysis treatment on Friday because he was not feeling well and he could not get himself to the dialysis center. The dialysis center rescheduled his treatment to Sunday but again he was unable to get himself to the center secondary to feeling generally weak. He denies any fever, chills or chest pain. His medical history is significant for diabetes mellitus, dyslipidemia, hypertension, renal failure, end-stage on dialysis. He also is partially deaf and blind. Initial laboratory work reveals him to have a CO2 of 20, BUN of 90, creatinine

The patient is 67-year-old gentleman who presented to the ED with 3 day history of rectal bleeding. He present the day of admission because the bleeding had gotten worse and it was frank blood. He was also having some epigastric pain. He has had rectal bleeding in the past. He has had polyps removed and he has also “had a vein clipped in Yugoslavia”. In the ED, he was initially hypotensive at 85/55 and tachycardic at 112. He was given normal saline and transferred to the intensive care unit. On presentation his initial hemoglobin is 11.9 and hematocrit of 35.8 and within approximately 3 ½ hours of admission his hemoglobin dropped to 10 3 and 31.4 and then subsequently to 9.5. I believe this patient's condition warranted inpatient admission

After returning to the unit after a few days off, I cared for the same patient on post-operative day 8. Upon assessing, the patient findings included; patient needed oxygen to ambulate to the bathroom and appeared very short of breath, low urine output, lungs with crackles throughout, low-grade temperature, brown drainage from abdominal incision

Theresa Camantiles was a 38 year old home maker and mother of 4 children. Keeping house and driving the children to activities kept her busy. To stay in the shape, she took aerobics classes at the local community center. The first sign that Theresa was ill was vague; she fatigued easily. However, within 6 months, Theresa was short of breath, both at rest and when she exercised, and she had swelling in her legs and feet. She then sought medical consult. On physical examination, she had distended jugular vein, liver was enlarged and had ascites in her peritoneal cavity and edema in her legs. A fourth

“Sixth or seventh grade education; housewife and mother of five. Breathing difficult since childhood due to recurrent throat infections and deviated septum in patient’s nose. Physician recommended surgical repair. Patient declined. Patient had one toothache for nearly five years; tooth eventually extracted with several others. Only anxiety is oldest daughter who is epileptic and can’t talk. Happy household. Very occasional drinker. Has not traveled. Well nourished, cooperative. Patient was one of ten siblings. One died of car accident, one from rheumatic heart, and one was poisoned. Unexplained vaginal bleeding and blood in urine during last two pregnancies; Physician recommend

She was not in pain and not in respiratory distress. She is a medium built woman with clinically adequate nutritional and hydrational status. There was no gross deformity and skin colour changes in this patient. No attachment of iv branula on her limbs.

Genitourinary: Patient denies flank pain, suprapubic or back pain, does not need assistant with peri care, goes to the toilet to urinate, the urine is clear yellow without any sediment, no dysuria or hematuria noted. History of one c- section 30 years ago, denies uterus or bladder prolapse. Patient stated menopause started 7 years ago, patient stated is not sexually active. No bladder scan performed in the course of rehabilitation stay.