Niskayuna Hospital 1234 Meadowview Drive Niskayuna, New York (518)345-1000 REPORT May 7, 2010 McDonnell, Joseph CHIEF COMPLAINT: Numbness, partial paralysis of his left side of his face, crocodile tears, increased thirst, some loss of taste, and experiencing pain in both ears. HISTORY OF PRESENT ILLNESS: Mr. Joseph McDonnell is a 50 year old man with Type II Diabetes. He administers insulin as part of his treatment and tests his glucose levels regularly. He has no history of hypertension or stroke. He had Sarcoidosis three years ago and it was treated with Prednisone prescription at onset to control severe rash symptoms and then with Dexamethasone afterwards, to clear the redness, swelling and irritation.
Case Study #1: Patient on Hemodialysis A 47 year-old man is being sent back to the hospital unit after undergoing hemodialysis in the dialysis unit. The patient was initially admitted for pneumonia but has been receiving hemodialysis Mondays, Wednesdays, and Fridays for the past year for kidney failure. He has a functioning arteriovenous fistula on the left arm. On assessment a positive thrill and bruit are confirmed. The nurse from the dialysis unit informs the unit nurse assigned to the patient that 1 L of fluid was removed.
Last year, the patient was hospitalized more than 4 months total for the problem. He is from Atlanta. He is coming to visit his aunt accompanied with his mom and his sister. Patient states “he has to go to University Hospital Emergency Room for cyclic vomiting syndrome on Sunday 7/15/12 at 1pm. 2.
Although epoetin alfa has helped with end stage renal disease (ESRD) anemia significantly, there continue to be patients with ESRD who have anemia despite the use of epoetin alfa. This paper will address the administration of ascorbic acid and its effectiveness in increasing hemoglobin results in patients who are not responding to epoetin alfa use alone and will also discuss the adverse effects found in the addition of ascorbic acid. This paper will also summarize the research study used to obtain the information and discuss its significance in nursing. Background of Study The questions the researcher asked when researching this topic were. 1.
Clinical Worksheet Student Data to be collected prior to clinical from the medical record: Room 357 Age 66 Sex M Admit Date 06/25/2015 Admitting Doctor Admitting Diagnosis (es) CHF Exacerbation Allergies NKA Diet Cardiac, low cholesterol Code Status Full Code Intake and Output Measurement (q hr, q shift?) Strict I&O 1500ml/day Activity as tolerated Indicate other disciplines caring for patient (e.g. Physical therapy, speech therapy, dietitian, etc): Dietitian, Respiratory therapist What was your patient’s “chief complaint” that brought him/her to the hospital? Shortness of Breath Describe the event that leads to patient’s seeking hospitalization. (Read History and Physical and summarize important/relevant
Mary was pronounced dead. Doctors believed at first she had died from a stroke. However, over the course of the next three days, the death toll would rise. Extra- Strength Tylenol capsules tainted with cyanide would be responsible for Mary Kellerman and six more deaths.
Th e patient was cyanotic and was hypoventilating. Within 30 minutes of presenting in the ED, Dr. Westwood developed bradycardia with a BP of 90/50. Atropine was administered in response to the bradycardia. IV hydration, gastric lavage, and activated charcoal followed a presumptive diagnosis of tetrodotoxin poisoning based on the clinical presentation in the ED. Five hours after intervention, the following vitals were noted: • BP 125/79 • HR 78bpm • Oxygen saturation: 97% on room air Follow-up Within a few hours, Dr. Westwood’s condition improved and he was on his way to a full recovery.
4. A 68-year-old male presents to the office complaining of pronounced weakness on the right side of his body and slurred speech for the past 24 hours. Based on the examination, the physician orders an MRI to investigate a possible transient ischemic attack (TIA). The range of codes that would be used for this patient would be Codes 390-459 because the treating physician ordered and MRI to rule out a transient ischemic attack. These codes are for Diseases of the Circulatory System 5.
A famous wheelchair-using trumpet player named John Henry Giles loses his breath and collapses from a lack of oxygen while playing. At the hospital, House is intrigued that John Henry has been paralyzed for two years without sufficient explanation. Cuddy tells House that they are only treating John Henry for pneumonia, since his paralysis is treated by his doctor in California, Marty Hamilton. Foreman, who did a residency with Hamilton, is requested to lead the case. Hamilton had already diagnosed the paralysis as an effect of ALS, which would explain the pneumonia.
The cause of heart attacks and were looking at family history and blood tests 7. Following 5,209 people over a 20 year period 8. Invention of electronics/automobile and invention of the television 9. Heavier cholesterol and sweets/cigarettes 10. High blood pressure, high cholesterol, and smoking 11.