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- Pt who was at home treating her right foot infection with VNA support. VNA recommended she return to the hospital because she was not caring for herself. The pt has not been able to get up and walk around including going to the bath. She complains of discomfort with swallowing and so she is not consistently taking her medication. She denies chest pain and shortness of breath. She is dysphagia, stage 2 plantar heel ulcer and at her butt. Has bruises on both hands, both legs is discolor and peeling. High fall risk and wear diapers. Pain is 7 on a scale of 0-10 at her coccyx wound. Normal bowl sounds and lungs sounds and heart sound. Cellulitis of right lower extremities. Cardiac diet and hypertension. Base on this information please do the concept map in the imagePt who was at home treating her right foot infection with VNA support. VNA recommended she return to the hospital because she was not caring for herself. The pt has not been able to get up and walk around including going to the bath. She complains of discomfort with swallowing and so she is not consistently taking her medication. She denies chest pain and shortness of breath. She is dysphagia, stage 2 plantar heel ulcer and at her butt. Has bruises on both hands, both legs is discolor and peeling. High fall risk and wear diapers. Pain is 7 on a scale of 0-10 at her coccyx wound. Normal bowl sounds and lungs sounds and heart sound. Cellulitis of right lower extremities. Cardiac diet and hypertension. Vitals at 800: Vitals at 11:20Am: Pulse: 99 HR: 72 SPO2: 99. BP: 144/97 BP: 135/82. R: 17 Temp: 95:4 HR:70 R: 16 Base on the information above can you please do a intervention for each body system. Neurological, Musculoskeletal, cardiovascular, respiratory, integumentary, GI, GU Patient…A 57 year-old male patient who has a longstanding history of hypertension, type 2 diabetes and hyperlipidemia. He presents with a chief complaint of nausea, shortness of breath, lower extremity edema and abdominal swelling. He is 5 feet and 6 inches tall and weighs 77.7 kilograms (Body Surface Area: 1.90). His blood pressure is 165/92 mmHg, heart rate is 97 beats per minute. Blood has drawn and urine is collected for various clinical chemistry tests. Laboratory Data Urine Creatinine: 88 mg/dL Urine Volume: 3,777 mL/24 hrs Plasma Creatinine: 4.75 mg/dL Urea Nitrogen: 170 mg/dL Blood Uric Acid 11.7 mg/dL Questions: 1. Given these data, what is the Creatinine Clearance of this patient? What are the possibilities for his lower extremity edema? What is/are the probable cause/s for the elevated Creatinine and Urea N? 2. 3.
- Mr. Reddy is a 62 yo presenting to ED at 1500hrs. He was preparing the gas cylinder for a Sunday BBQ when it suddenly exploded while he was trying to connect the hose. Family standing by tried to extinguish the fire with their hands and tried to remove his clothing. Burns 30% TBSA – Face, hands, bilateral lower limbs. Complaints of severe pain and burning 10/10. Past Medical History: Hypertension, Type II DM Regular medications – Candesartan 8mg, Glimepiride 4mg, Metformin 500mg and Pravastatin 20mg. Fully vaccinated against COVID. Airway. - Patent, superficial burns to right side of face Breathing. - Spontaneous, RR-22mt, SPO2-92% RA, air-entry equal Circulation- Lower limb odema, cap refill 3 seconds, bilateral dorsal pedis pulses weak. BP- 88/50 mmHg, HR- 127/mt, sinus tachycardia, Disability - GCS-15 E4V5M6, PEARL- 3mm, Exposure - Temperature 35.9 deg Celsius. Full thickness burns to right lower limb and right arm, partial thickness burns to left lower limb, bilateral hands.…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…A 24-year-old male presented with confusion, shortness of breath, and painful calves. It was reported by a friend that he had been lying on the floor for several hours. He was a known intravenous heroin and alcohol abuser. On examination he appeared dehydrated and cold (tem- perature 35°C); his pulse was 75/minute and blood pres- sure 110/70 mmHg. Intravenous injection sites were apparent. His urine was dark coloured. His chest was clear. Arterial blood gases were done in the casualty department and a blood sample was sent to the pathology department and gave the following results (reference ranges are given in brackets): Arterial blood pH PCO₂ PO₂ HCO3- Serum Sodium Potassium Creatinine Calcium Albumin Phosphate Creatine kinase C-reactive protein 7.276 4.82 KPa 12.7 kPa 18.0 mmol/L 138 mmol/L 7.6 mmol/L 236 μmol/L 1.66 mmol/L 32 g/L 2.43 mmol/L >140,000 U/L 73 mg/L (7.35-7.45) (4.7-6.0) (12.0-14.6) (24-29) (135-145) (3.8-5.0) (71-133) (2.10-2.55) (35-50) (0.87-1.45) (55-170) (<10) The…
- Mr. Cardia has been admitted to your ward and care is assigned to you. Information from the history you have taken includes reporting 4 days of anorexia, nausea, vomiting, and occasional diarrhoea before he sought medical attention. His wife says he'd started falling asleep frequently, looked pale, and mentioned seeing yellow spots. Current medications: 0.25 mg of digoxin once a day and 20 mg of frusemide twice a day for heart failure. Vital signs: BP 110/60 P 46 RR 26 T 36.5 What may the signs and symptoms indicate? (two words)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?51 years old male, had a stroke, slurred speech, right facial droop, and right sided weakness. Patient is alert and oriented x6, has 6/10 pain in his knee ,lung is clear, wear glasses, use a hemi walker and wheel Past medical history High blood pressure, high cholesterol, depression, stroke, succidal thoughts/attempts. Other history Musculoskeletal self, bilateral knee pain Vital signs Blood pressure-112/67 Temperature 35.6C Pulse-60 Respiratory-18 Spo2-95% Please do a concert map base on the client information
- First part of the scenario Carol Brady is 65-year-old female who has been admitted to your ward overnight, following a fall from a ladder while she was cleaning windows at home yesterday. She has a fracture to her left tibia and a laceration above her left eyebrow, which received four sutures in ED. Her husband witnessed the fall and reports there was brief LOC. Phx: GORD, HT, Migraines. You receive the following information during handover: Carol slept well intermittently overnight, waking with complaints of a headache and pain at # site. Analgesia was given by RN at 0400hrs. Dressing insitu above left brow and POP insitu left leg. We have not been able to assess her mobility as she has been sleeping most of the night and didn't want to disturb her. Q1. Describe the nursing assessments you would perform on Carol The second part of the scenario During your nursing assessment you find the following: That Carol has complaints of a headache and 8/10 pain at # site. On…M. J. is a 76-year-old woman who lives on the side of a very steep mountain. The home health nurse has visited her once a week for the last year. She has running water, electricity, and a coal stove with back-up oil heat for very cold winter nights. She uses the telephone for communication. She has diabetes mellitus, hypertension, hypothyroidism, and is in atrial fibrillation. She has never been in the hospital before. Her current medications include metformin (250 mg twice a day), losartan (50 mg/day), levothyroxine sodium (Synthroid) (50 mcg/day), digoxin (0.125 mg/day), furosemide (Lasix) (10 mg/day), aspirin (81 mg/day), simvastatin (20 mg/day), and warfarin (Coumadin) (4 mg/day, with 6 mg on Sundays). Allergies are to penicillin (hives) and to metoprolol (hypotension and dizziness). M. J. stopped smoking 5 years ago, but until then she smoked one-half pack a day. Last laboratory test results (1 week ago) were: hemoglobin A1C (Hgb A1C) 8.3, international normalized ratio (INR) 1.7,…M. J. is a 76-year-old woman who lives on the side of a very steep mountain. The home health nurse has visited her once a week for the last year. She has running water, electricity, and a coal stove with back-up oil heat for very cold winter nights. She uses the telephone for communication. She has diabetes mellitus, hypertension, hypothyroidism, and is in atrial fibrillation. She has never been in the hospital before. Her current medications include metformin (250 mg twice a day), losartan (50 mg/day), levothyroxine sodium (Synthroid) (50 mcg/day), digoxin (0.125 mg/day), furosemide (Lasix) (10 mg/day), aspirin (81 mg/day), simvastatin (20 mg/day), and warfarin (Coumadin) (4 mg/day, with 6 mg on Sundays). Allergies are to penicillin (hives) and to metoprolol (hypotension and dizziness). M. J. stopped smoking 5 years ago, but until then she smoked one-half pack a day. Last laboratory test results (1 week ago) were: hemoglobin A1C (Hgb A1C) 8.3, international normalized ratio (INR) 1.7,…
