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- Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time, he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years but quit 3 years ago. The ABG analysis of Mr. H suggests uncompensated respiratory alkalosis with mild hypoxemia, with base excess of -1 in her arterial side, whereas -4 in her venous side. Part 1: Her actual arterial-venous oxygen content difference (Ca-vO2) is 5.31 mL/dL. (Normal range considered here is 3.5 to 5 mL/dL) Part 2: Patient's actual oxygen extraction ratio (O2ER) was 29%. (Say normal range is 20-28%) What is clinically happening to the patient?Anna who is 78 years old. She has vi. hemiparesis, but is taken out of bed twice a day and then sits in a chair. When you arrive on duty you discover that she has developed redness on her left heel which may be an incipient pressure ulcer as she is constantly rubbing her healthy foot against the sheet. She also has an arifu (skin break) on the sacrum (tailbone). She is incontinent of urine and stools (does not control urination or defecation). What can be done for her? a) Regarding the heel? b) Regarding the Turnip area?Clinical History:This 29-year-old male's illness began 10 weeks prior to death, with an episode of "flu". Two weeks later his urine became "smoky". He was found to have hematuria, albuminuria and elevated BUN (180 mg/dl). He died from a pulmonary embolus. Photos include throat photo, blood agar, and grain stain. What specimens should be taken, aside from blood? What tests should be run? Include both a rapid test option and a lower cost test option. What signs and symptoms should have alerted the patient to come in for testing during or after his viral flu episode? What was the most likely cause to the embolus? No references, just homework please include references
- A CST is assisting the surgeon on the midline closure of an episiotomy. The surgeon says, “Something’s wrong, but I can’t identify it.” The CST replies, “I’m worried also. Do you think she might have DIC (disseminated intravascular coagulopathy)?” The surgeon responds, “Why do you think that?” and the CST says, “I’ve seen this before, and the blood doesn’t look right. I placed some of the patient’s blood in a plain test tube 7 minutes ago, and no clot has formed.” The surgeon has the circulator page the attending obstetrician to the room and alerts the anesthesia care provider. The patient became slightly hypotensive, but the quick response of the OR team averted any serious complications. The patient was discharged several days later without further complications. What observation did the CST make that helped the patient in this case? Discuss whether the CSTs response was appropriate in this situation.Client number 1: 50-year old male who had a heart attack and stent placed with normal vital signs Client number 2: 46-year-old female with full-thickness burns to the leg who needs to have dressings changed Client number 3: 33-year-old male firefighter who has fallen and broken his right femur after surgery with pain in his leg Client number 4: 18-year-old male with wheezing and labored respirations unrelieved by an inhaler Client number 5: 74-year-old female with new onset dementia awaiting lab results Client number 6: 52-year-old female who has been recently diagnoses with diabetes type 2 and is getting discharged Describe the care that you will be delegating to the LPN and CNAClient number 1: 50-year old male who had a heart attack and stent placed with normal vital signs Client number 2: 46-year-old female with full-thickness burns to the leg who needs to have dressings changed Client number 3: 33-year-old male firefighter who has fallen and broken his right femur after surgery with pain in his leg Client number 4: 18-year-old male with wheezing and labored respirations unrelieved by an inhaler Client number 5: 74-year-old female with new onset dementia awaiting lab results Client number 6: 52-year-old female who has been recently diagnoses with diabetes type 2 and is getting discharged List the clients and care from the highest to lowest priority
- A client is at high risk of aspiration and is not expected to be able to eat table foods for several months. Which of the following does the nurse recognize is the preferred placement of a feeding tube? Question 23 options: a) Nasogastric b) Nasoduodenal c) Jejunostomy d) GastrostomyGiven the following body sites, identify whether venipuncture can be performed on the site indicated and give a brief explanation : B. Intravenous Fluid lineJohn Michael Jones was seen by Dr. Peters who has seen the patient previously in this office. History: Mr. Jones has been having a fever and shortness of breath the last two days. He is not on any present medications but has been taking an over the counter Nyquil, but this has not been working. Physical Examination: Dr. Peters listens to Mr. Jones chest and hears nothing of real concern. Dr. Peters tells Mr. Jones that he doesn't believe the patient has bronchitis but just the flu. Dr Peters documented he spent 12 minutes with the patient. Plan: Drink a lot of fluid, rest and return if it worsens. What is the correct E/M code for this scenario
- As a nursing student, what are the common experiences with ongoing management of an intrvenous line in the clinical setting?what is the nursing process in the following case scenario? Ms. Dela Cruz, 25 years of age, presents to the triage nurse at the local emergency department complaining of severe generalized abdominal pain. She describes it as sharp and intermittent. She states, “Over the last four (4) days, I haven’t been able to have a bowel movement.” She states that she is able to drink liquids and urinates without difficulty. Bowel sounds are present in all four (4) quadrants, however, they are hypoactive (decreased or quiet peristalsis). Abdomen is distended and firm to touch. She states, “Two weeks ago I feel that my back hurts. My doctor gave me a prescription of Tylenol #3 and I have been taking it every 6 hours for pain.” She denies pain at the present time. Abdominal x-ray reveals a large amount of stool in her lower colon. All other diagnostic tests are unremarkable.Mr. B is a 57-year-old man who was admitted yesterday after starting to pass black stools. He has a two-day history of severe stomach pains and has suffered on and off with indigestion for some months. He is a life-long smoker, with mild chronic heart failure (CHF) for which he has been taking enalapril 5 mg twice daily for 2 years. He also recently started taking naproxen 500 mg twice daily for arthritis. He works a stressful job and drinks large amounts of caffeinated coffee daily. Yesterday his hemoglobin was reported as 9.3 g/dL, hematoocrit 30%, RBC's 3.2, platelets 162, INR 1.1 with Liver Function Test normal. He was mildly tachycardic (110 bpm) and had a slightly low blood pressure of 100/77 mmHg and was given 1.5 L of saline. He has just returned from an endoscopy this morning and has been newly diagnosed as having a bleeding duodenal ulcer. They took a biopsy to determine if he is positive for H-pylori. He has been written up for his usual medication for tomorrow if he is…