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- Patient B., 56 y/o, is complaining of weakness, muscle ache, paresthesia in the facial zone, lower extremities, tonic-clonic seizures, breathing difficulty. Anamnesis contains a record of previous subtotal resection of thyroid gland. Objectively: her consciousness is clouded, the skin is dry, cyanotic, “main d’accoucheur”(obstetrician’s hand) convulsions in the upper extremities swallowing function is disturbed, shortness of breath. Heart sounds are dull, rhythmical, arterial pressure – 115/55, pulse – 56 beats/minute. Positive Chvostek’s and Trusso’s symptoms. The level of calcium in the blood – 1.3mmol/l; hyperphosphatemia, hypocalciuria; glycemia –5.6mmol/l. What is your diagnosis?A. Hypocalcemic crisisB. Hypothyroid comaC. Kidney failureD. Hyperthyroid coma E. Brain comaUpon presentation:An 18-month-old female arrives by ambulance at the emergency department. Theparamedics report that there was no known history of any recent trauma, and no knownfever, vomiting, or other unusual behavior. There were no known ingestions ormedications in the household. There was no evidence of trauma.Interview and History:At 9 PM the previous night, Ella was described by her mother as appearing more quietthan usual. They had spent the day traveling from the grandmother's house and Ella hadbeen carsick so had not eaten very much during the day. When they got home, Ella hadsome water and went to bed. Ella slept longer than usual and was found unresponsive by her mother at 9AM; at this time her mother called 911.Follow-up tests:1. Blood glucose: 23 mg/dL (normal range 90 – 125 mg/dL)2. Repeat blood glucose: 50 mg/dL following administration of glucagon3. Urinary acids: Markedly elevated levels of glutaric, ethylmalonic, and dicarboxylicacids; ketones absent4. Serum free…Patient C: An 18 y/o healthy female presents for a routine physical examination. Patient has great difficulty producing a very small volume of urine despite not having urinated since early morning. During discussion with physician it is revealed that she has had only 2 cups of coffee and a donut to eat all day 1) What are the abnormal findings? 2) What is your diagnosis? 3)What suggestions might you have for this patient? 4) Why does the body form concentrated urine? and where in the kidney does urine concentration occur? 5) Why is an extended water fast a bad idea?
- Patient Profile: Stanley is a college student taking up engineering in one of the university in Metro Manila. He lives alone in the dormitory and his province is Bicol. He was diagnosed of Syphilis. History: -Stanley is a 19-year-old male who presents to the STD clinic because he’s - had a sore on his penis for one week. -Last sexual exposure was three weeks prior, without a condom. -No history of recent travel. -Predominantly female partners (five in the last six months), and occasional male partners (three in the 1-2 years). -Last HIV antibody test (two months prior) was negative. Reports three children with two different women. All children were in the province taking care of by his parents. He is single and always on the go to mingle. Physical Exam: -No oral, perianal, or extra-genital lesions. -Genital exam shows an uncircumcised penis with a lesion on the ventral side near the frenulum. Lesion is red, indurated, clean-based, and non-tender. -Two enlarged tender right…Shirley Smith Age: 52Race: CaucasianGender: FemaleHeight: 68 inchesWeight: 153 lb. (69.4 kg) Occupation: Retired Marital Status: Widowed Religion: AgnosticAllergies: None knownAddress: Assisted Living facilityImmunizations: Up to date HistoryShirley's husband died unexpectedly 2 months ago, which is the time she enteredan assisted living facility. Shirley states she has become depressed from the lossof her husband and the inability to physically do activities she desires due to theCOPD.Shirley presents to the ER with difficulty breathing and shortness of breath atrest, and increased fatigue. The patient is currently on 2 Liters of oxygen nasalcanula at all times. Shirley smoked cigarettes for 32 years and just recently quit 2months ago when she was put on full-time oxygen.Past medical history: hysterectomy at the age of 48, Gastroesophageal refluxdisease (GERD), and Atrial Fibrillation. MedicationsPrednisone (HOLD) 20 mg oral DailyPantoprazole 40 mg oral DailyWarfarin 5 mg oral…Shirley Smith Age: 52Race: CaucasianGender: FemaleHeight: 68 inchesWeight: 153 lb. (69.4 kg) Occupation: Retired Marital Status: Widowed Religion: AgnosticAllergies: None knownAddress: Assisted Living facilityImmunizations: Up to date HistoryShirley's husband died unexpectedly 2 months ago, which is the time she enteredan assisted living facility. Shirley states she has become depressed from the lossof her husband and the inability to physically do activities she desires due to theCOPD.Shirley presents to the ER with difficulty breathing and shortness of breath atrest, and increased fatigue. The patient is currently on 2 Liters of oxygen nasalcanula at all times. Shirley smoked cigarettes for 32 years and just recently quit 2months ago when she was put on full-time oxygen.Past medical history: hysterectomy at the age of 48, Gastroesophageal refluxdisease (GERD), and Atrial Fibrillation. MedicationsPrednisone (HOLD) 20 mg oral DailyPantoprazole 40 mg oral DailyWarfarin 5 mg oral…
- J.D. is a 64-year-old man who presents to the family practice complaining of increased urination at night. The patient has a past medical history of hypertension, hyperlipidemia, and coronary artery disease (CAD). Vital signs are T 97.5, P 85, R 16, and BP 120/60. What subjective information should the nurse obtain? The nurse is performing the physical examination of the patient’s genitals. What are the major structures of the male genitalia? The nurse needs to assess the patient for a hernia. What is the proper procedure for this assessment?How will you use the information to prepare for todays visit?Todays Visit: Chief Complaint "I am still recovering from my fall last monthDescription A-45-year-old woman presents complaining of fatigue, 30 pounds of weight gain despite dieting, constipation, and menorrhagia. On physical examination, the thyroid is not palpable: the skin is cool, dry, and rough: the heart sounds are quiet; and the pulse rate is 50 bpm. The rectal and pelvic examinations show no abnormalities, and the stool is negative for occult blood. The clinical findings suggest hypothyroidism. Questions A. What other features of the history should be elicited? What other findings should be sought on physical examination? B. What is the pathogenesis of this patient's symptoms? C. What laboratory tests should be ordered, and what results should be anticipated? D. What are the possible causes of this patient's condition? Which is most likely? E. What other conditions may be associated with this disorder?
- Mr. Avery had a stroke. He has hemiplegia, receptive aphasia, and dysphagia. Explain how you will plan to perform the care measures listed below. : 1 transferring him from bed to w/c 2.Communicating with him 3.Dressing and undressing him 4.Assisting him with food and fluids 5.Performing a safety check of the roomThe patient is to be discharged. Make a discharge planning for a patient with NSD. What Postpartal Discharge Instructions will you include?What are the Nursing care of the patient and family with the disorder/ disease of UTERINE RUPTURE?