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- 73-year-old male, post-op day 1, status post-carotid endarterectomy on the surgical unit, demonstrating signs of stroke. Suggest two interdisciplinary team members to assist with caring for the patient and provide a rationale for the importance of including them in the care of this patient.Mr S. is a 45-year-old man who has just been admitted to the ICU postoperative cardiac surgery. He has had an uneventful coronary artery bypass graft with no complications in the operating room. He is intubated and placed on complete mechanical ventilation. His vital signs are: blood pressure (BP) 150/90 mm Hg, heart rate 86 beats per minute, respiratory rate 12 breaths per minute, and temperature 35.3°C The target systolic BP for Mr S. is less than 130 mm Hg and the surgeon’s postoperative orders include BP medications and intravenous morphine sulfate for pain. In addition, the surgeon prescribes an nonsteroidal anti-inflammatory drug, ketorolac, to be administered to the patient once it has been determined that they are not bleeding excessively and have acceptable renal function. The ICU where Mr S. is admitted has a respiratory therapist (RT) on staff. This RT is aware that mechanical ventilation is very uncomfortable for patients. There is a standing order in the ICU that heart…Patient's Profile: A 22-year-old woman in her 2 pregnancy has arrived in the labor ward at 38 weeks 3 days She had a normal delivery 18 months ago. This pregnancy has been complicated by persistent vomiting until 20 weeks and more recently by anemia. She reports contractions commencing approximately 4 hours ago. She took paracetamol at home and tried to relieve the pain with a bath, but now she feels she cannot cope with the pain She had a show 2 days ago but has had no bleeding since then and has not noticed any vaginal leak. She has felt the baby moving normally all day. Physical Examination: BP is 110/58 mmHg, heart rate is 98/min. The presentation is cephalic with 2/5 palpable abdominally, Uterine contractions are palpable and the uterus is non-irritable. On vaginal examination the cervix is 5 cm dilated and the head is 1 cm above the ischial spines. The fetus is right occipitotransverse with mild caput and molding. The membranes are intact but rupture spontaneously during…
- Heart Failure Case Study James is a 70-year-old male brought to the emergency department (ED) by ambulance with complaints of shortness of breath. The patient's medical record shows a past history of hypertension, diabetes, MI X 2, congestive heart failure (CHF), and chronic renal insufficiency. Upon assessment, James has labored breathing at 36 breaths/min and tachycardia at 112 beats/min. His pulse oximetry is 90% on 40% oxygen via a face mask. Crackles are heard throughout his lungs. 1. List potential causes and risk factors for his condition. 2. Identify the typical symptoms of left-sided heart failure vs. right-sided heart failure with an "L" or an "R" or "B" for both. Cough Blood-tinged sputum Tachycardia Fatigue Nocturnal polyuria Exertional dyspnea Peripheral edema Crackles or wheezes Jugular venous distension Ascites and GI distress Orthopnea Cyanosis Paroxysmal nocturnal dyspnea The physician orders a chest x-ray, ECG, arterial blood gases (ABGS), and lab work to be done.…Nursing Management for preterm baby compared to normal babyM.H. is an 80-year-old Caucasian female who is married and lives with her spouse. She presents to your office today with her spouse, feeling “coocoo, I just don’t feel right.” Currently she is taking rosuvastatin prescribed by her cardiologist for hyperlipidemia and a daily 325 mg aspirin. She drinks 3–6 hard liquor drinks a day, 3–4 times a week in the evening, and has a 65-year smoking habit, currently smoking two packs per day (ppd). She has no known allergies. Past surgical history includes hysterectomy for a benign fibroid. Family history of breast cancer in three sisters, Type 2 diabetes and CVA in one sister, cancer of unknown origin in one brother. All siblings and parents are deceased. Her husband reports that she is hard of hearing. He feels that it is due to cerumen build-up in her ears. She refuses to have the buildup removed. Her husband is also worried about her memory—states that she “just does not remember things like she used to. She keeps asking me the same questions…
- Mr. X is a 64-year-old male admitted to the unit with acute myocardial infarction (AMI) after emergent left (L)-sided heart catheterization/percutaneous coronary intervention (PCI). Past history includes type 2 diabetes mellitus, heart failure, hypertension, andosteoarthritis. Home medications include furosemide (Lasix), digoxin (Lanoxin), captopril (Capoten), carvedilol (Coreg), Byetta (exenatide), metformin (Glucophage), and ibuprofen (Motrin).Clinical AssessmentTwenty-four hours after admission to the unit, Mr. X is alert; oriented to person, place, and time; and pain free. His only complaint is shortness of breath and swelling in his ankles, feet, and hands. Physical assessment reveals bilateral breath sounds with basilar crackles; dressing at catheter site; right femoral clean, dry, and intact; peripheral pulses 2+ bilaterally; and 2+ edema noted in lower extremities. Mr. X has a body mass index (BMI) of 35 kg/m2 and weighs 100 kg. IV fluids have been discontinued, and saline lock…Patient M., 36 y/o, was found in the street unconscious. The patient has a medical history of diabetes. There is a smell of alcohol from the mouth. The skin is moist, warm, arterial pressure -145/90 mm column of mercury, convulsive twitching of muscles. Breathing is shallow, eye ball tone is retained, pupils are dilated, hyperflexion. How would you treat this patients?A. Intravenous introduction of 40-80-100 ml 40% glucose solution B. Injecting 20 units of insulin subcutaneouslyC. Injecting 20 units of insulin intravenouslyD. Injecting 500 ml 5% glucose solution intravenouslyE. Injecting 500 ml 0.9% sodium chloride intravenouslyQuestion. Mr Jankovic a 78 years old male is admitted for a left total hip replacement. He underwent surgery and is now three days post operative, in the orthopaedic ward. He has gained a lot if weight over the past few years and has severe osteoarthritis in his hips. He also has had resection of a prostatic cancer that has no current treatment and has residual prostatomegaly. He has occasional angina, high blood pressure and obstructive sleep apnoea, using continuous positive airway pressure (cpap) machine infrequently as it dries his mouth and nose and the noise annoys his wife. Past medical history Osteoarthritis diagnosed 10 years ago Mild left cardiac failure and occasional angina diagnosed 2 years ago Hypertension diagnosed 5 years ago Frequent gout Surgical history Internal fixation left tibia and fibula following motorcycle accident at age 21 years. Appendectomy at age 23 years Resection prostatic carcinoma 7 years ago. Q1 Question 1. Mr Jankovic Is…