Case Study (HIV/AIDS) M.G. is a 36 year old gay professional man who has been HIV positive for 6 years. Until recently, he demonstrated no s/s of AIDS. The appearance of purplish spots on his neck and arms persuaded him to make an appointment with his physician. Upon arriving at the doctor’s office, the nurse performs a brief assessment.
Today Mr Gibson was admitted onto your ward after presenting to ED exhausted and in chest pain. Mr Gibson has also complained of a productive cough and pain on breathing in. He states that he has lost several kilos over the past two weeks. His vital signs include: • BP: 148/96 • RR: 28 bpm (shallow and on inspiration) • PR: 92 and weak • Temp: 38.9 • Weight: 78 kilos • Height: 174 cms • SaPO2: 92% (2L/min) His current medications include atenolol (antihypertensive) and Lipitor (reduces cholesterol) No known allergies. 1.
Discuss the nature of sleep (24 marks) Numerous things happen in your body while you sleep, we have many stages in which our body goes through in a 90 minute cycle. We have non-REM stages of sleep and REM stages of sleep. REM stands for rapid eye movement. You go through three phases before reaching REM sleep. Stage 1: Your eyes are closed, but it's easy to wake you up and this will last for 5 to 10 minutes.
Between 16 and 35 years and between 35 and 50 years During infancy babies sleep more than everyone else and have different sleep patterns. They tend to sleep for around 16 hours a day but it is not continuous. They wake every hour due to a shorter sleep wake cycle than adults and their sleep stages consist of quiet sleep and active sleep: these are immature versions of SWS and REM sleep. By the time they have reached 6 months, a sleep-wake cycle is established with 1 or 2 naps during the day and as a result periods of sleep then lengthen. By the age of 5 children have an EEG pattern which is similar and looks like those of an adult but they are still sleeping more than adults with an approximate time of 12 hours in sleep and they also have more increase with approximately 30% of the total sleep time being in REM.
(Not to be confused with an awaking of a sleeping person; such patients receive a score of 4, not 3.) 4. Eyes opening spontaneously Best verbal response (V) There are 5 grades starting with the most severe: 1. No verbal response
Case Study: I have had the opportunity to study the effectiveness of CH is on a child, for the purpose of the child’s privacy I will refer to him as Albert. Albert is 5 years old and has been using CH for 9 months as a means to sleep, due to an undiagnosed neurological problem that causes sleep apnoea, sedation has been necessary. Because of the sleep apnoea Albert also has a ventilator via tracheotomy so the importance of a respiratory side effect is very concerning. Because Albert has been using CH for such a long time his tolerance for the drug has got stronger and on occasions has been able to fight the intended purposes of CH for over an hour after administration, he has also been able to wake up after only 2 ½ hours sedation and would want to start playing. Due to this tolerance of CH the implication for using this drug long term and its habit forming side effect become a concern.
Outline and evaluate one or more biological rhythms (12 marks 4+8) An Ultradian rhythm is a biological rhythm that spans less than 24 hours such as the basic rest- activity cycles or the stages of sleep. Sleep consists of five stages and one cycle through these stages lasts for about 90 minutes. The first four stages are known as NREM sleep (non-rapid eye movements) and the fifth stage is called REM sleep (rapid eye movement) Stage one and two are characterised by a relaxed state. EEG shows alpha and theta brain waves during these stages and heart rate slows and temperature drops. Stage 3 and 4 also known as slow wave sleep (SWS) is characterised by delta brain waves, during these stages most of the body’s repair work is undertaken.
It's for this reason that out of the 16 hours a day an infant spends sleeping approximately 50% percent of this sleep in spent in REM stage - more than any other age group throughout the lifespan. This evidence also supports the restorative sleep theory. The sleeping patterns of an adolescent and a 25-year-old adult are much the same - both spend approximately 6 hours in NREM sleep, and 2 in REM sleep during a night. The difference, however between these two age groups is
The Five Stages Of Sleep Stage one: when you close your eyes, your body temperature drops and brainwaves become slower. You start to nod off, falling into a light sleep when stress hormones start to drop. Stage two: you've lost consciousness, your digestion slows down and functions like hearing are put on standby. Stage three: the first phase of deep sleep, which usually occurs within 15 minutes of falling asleep. Your muscles relax, your blood pressure and heart rate fall and your brain produces slow waves.
Running head: HIV Case Study I- HIV Case Study, Chapter 46 Learning Objectives: 2, 3, 4, 6, 7 Leslie Young, a 45-year-old male, returns to the clinic for a one-week follow-up visit for results of his confirmatory testing. He has continuing complaints of fatigue, cough, and lymphadenopathy. A buccal HIV test was done a week ago and found to be positive. Data Obtained From Nursing Assessment Vital signs: temperature, 99.1°F; pulse, 70; respiration, 16; blood pressure, 110/88 Reports progressively becoming more fatigued over past 6 months Divorced States “burning the candle at both ends” by working overtime Cough with onset 5 days before first visit Denies previous medical problems Physical examination within normal limits except for palpable nodes on the posterior neck, in both axilla and bilateral inguinal areas Lab Data Viral load: 10,000; CD4 T-cell count: 550 cells/mm3 CBC, chemistry panel, and UA all within normal limits Buccal HIV test positive one week ago; confirmed with Western blot test, and those results given at this visit Chest X-ray negative Plan Intervention at this visit is aimed at allowing Mr. Young to ventilate his feelings as well as providing referral to the local health department for informational classes. Mr. Young will return to the clinic in 1 month.