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- Patient R., 32 y/o, was delivered with complaints of fatigue, decrease of appetite, intensification of pigmentation in the open areas of the body, palms of the hands, cyanosis, losing weight, nausea and vomiting. The symptoms began to aggravate during 1-2 weeks after acute poisoning. Objectively: arterial pressure – 60/30 mm column of mercury, pulse – 140 beats/minute, skin turgor is lowered, the colour is dark with intense pigmentation of the elbows, scars, skin folds on the palms; clearly low levels of sodium and chlorine, high levels of potassium in the blood; glycemia – 4.3 mmol/l. What is your diagnosis?A. Addisonian crisisB. Uremic coma C. Brain comaD. Acute cardio-vascular insufficiencyE. Hypoglycemic comaPatient R., 45 y/o, has an enlargement of the right lobe of the thyroid gland , in which a round soft and elastic growth can be palpated; the growth is neither fused with the surrounding tissues nor painful. Lymphatic nods are not palpated. Clinical examinations and laboratory tests show no disruption of the thyroid function. What diagnosis can be suspected?A. Nodular thyroid glandB. Toxic goiter (Grave’s disease)C. Autoimmune thyroiditisD. HypothyroidismPatient X- diagnosed with G6PD deficiency since birth, was prescribed with cotrimoxazole for UTI. She did not reveal her diagnosis to her physician. After 3 days, she began experiencing paleness and easy fatigability, when she went back for a follow-up, her RBC count was low. Which sets of laboratory and diagnostic parameters must be done to monitor the patient’s response to therapy? a. CBC, urinalysis, WBC with differentials and electrolytes b. CBC, urinalysis, serum creatinine, WBC differential, ALT c. CBC, urinalysis, fecalysis, ECG, ALT and AST, d.CBC, urinalysis, serum creatinine, ECG
- 11:11 Back CASE #3DISCUSSI... Case #1 Patient is an 89 year old male admitted with Hyperkalemia, ESRD, HTN, and Bladder Cancer. Patient's past medical history includes recurrent bladder carcinoma, CVA, hernia repair and hemodyalisis. Patient was admitted due to weakness and 2 weeks of diarrhea for which he had refused to be dialyzed for 7 days. Patient lives s at home with wife and daughter who are both his healthcare surrogates. Based on patient's poor prognosis, oncologist had recommended on previous admissions that patient be made Hospice Care with comfort measures. Case #1 Cont. Daughter and wife have refused Hospice care and want patient to be dialyzed and continue aggressive treatment to include full resuscitation if cardiopulmonary arrest. Daughter and wife have requested all physicians to refrain from speaking to patient about his prognosis. At t this time all physicians have followed daughter and wife's request not let patient know that his cancer has returned, except for the…Prescibed The physici severe Inflammatium. The medicationis available pouder in a vial that confains o-59 After recenstitution, each Sml will confain 0-59 of solu - medrolo Huw many mLs wnd the nurse draw up to give the prescribed duse ? 125mg of Sulu -medrol for aJohn Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: Preventing complications of surgery is an important part of all surgical patient care. What preoperative While Mr. Doe is in the Operating Room, what considerations will be taken to ensure Mr. Doe’s safety and positive outcome? Identify 2 IntraOp nursing diagnoses for Mr. Doe teaching does Mr. Doe require in order to prevent complications? Give 3-4 examples)
- Patient aged 40 years, having BMI -35. For this patient among them which option you recommend for this patient? And support your answer why you recommend? Please shortly answer at your own easy words. Answer should be to the point. 1) High dose estrogen + older Progestine. 2) Low dose estrogen + newer Progestine. 3) Progestine onlyPATIENT PRESENTATION Chief Complaint The patient is currently unresponsive. Somnolence and “talking out of her head.” History of Present Illness Ruth Assefa is a 67-year-old female resident of Addis Ababa, Yeka Sub City who presents to the Emergency Department of Tikur Anbessa Specialized Hospital with a 3-day history of worsening confusion and somnolence. Prior to her delirium, she also complained of headache and stiff neck. None of her friends/families have reported any signs or symptoms of illness, but her 10-year-old grandson who visited last week was recently diagnosed with pneumonia. She has a history of seizure disorder and one of her friends reported that she may have had some seizure-like activity yesterday. Past Medical History Type 2 DM diagnosed 1 year ago Stroke at age 60, no residual neurologic deficits Seizure disorder following stroke Depression diagnosed at age 62 following the death of her husband Family History Father had CAD, deceased from MI at age 72. Mother had…DENGUE QUESTIONS 1. What results in the combo test would show that the patient has primarydengue virusinfection? Why?2. What results in the combo test would show that the patient has secondary denguevirusinfection? Why?3. How does the virus cause decrease in platelet count?4. What is break bone fever in dengue virus infection?5. Why are Aedes mosquitoes preferred by dengue virus?
- A 62-year-old male, his back has been red and swelling for 1 week. At first it was a small piece of skin induration of about 3×2cm, with multiple pus spots, then the skin swelling area expanded, infiltrating edema appeared, local pain increased, the surface skin was purple-brown with area about 6×5cm, the body temperature was 39.2℃, and he had diabetes history for 10+ years. The following treatment measures are incorrect for this patient: Remove pus and inactivated tissue The incision line should exceed the edge of the lesion The incision can be filled with yarn One-stage suture of the incision Make a "++" incisionA 67 years old female patient. She presented to her GP last week, complaining of a very strong headache, followed by dizziness. The symptoms had resolved by the time she could see the GP, who was concerned enough to request a CT of her head and neck. Diabetes mellitus Type 2: Management: metformin 1000mg, daily enalapril 10 mg daily rosuvastatin 10mg, daily Atrial fibrillation (AF) Management: apixaban 2.5 mg, BD sotalol 40 mg, BD Cigarette smoking: 20 - 30 cigarettes/day, quit 5 years ago. She underwent a CT scan of the head and neck, but the results were normal. the patient was assessed as requiring changes to her hypertension & AF management and the following changes made: enalapril ceased the following medications commenced or changed; irbesartan/ hydrochlorothiazide 300/25, daily amlodipine 5mg, daily apixaban 5mg, BD This morning patient woke up at 0600 hours with a 5/10 headache. At 0700 hours she began to feel weak in her limbs, and her headache increased to…29 yo female PTC with a 3 day history of sore throat, fatigue, fever, and swelling in the neck and underarms. Patient denies having been around anyone who was sick. Patient reports reduced appetite but no vomiting Vitals: 116/72, Temp 101.2, RR: 16 rpm, O sat: 99% Pulse: 89 bpm Physical findings reveals an erythematous pharynx with 3+ tonsils with bilateral exudates and palatal petechiae Anterior and posterior cervical lymphadenopathy and axillary lymphadenopathy present Abdominal: no abdominal tenderness or organomegaly 1. What do you want to do next? 2. Using the grading scales how likely is it that this patient has strep throat?