Why? d. What teaching interventions would you provide to the client after the change in prescriptions you recommended? (List at least 3 interventions) 2. Mary S. is an attorney (who is 48 years old) who has suffered from epilepsy for about 25 years and is taking the medication phenytoin. You are looking at her electronic medical record and note she has missed several of her quarterly MD appointments.
She also consumes one to two drinks of brandy per week. She has owned a gas station for the past 12 years. She is single and not sexually active. Data Obtained From Nursing Assessment System review reveals a thin woman with complaints of increasing fatigue and weakness for the past 3 to 4 months, increased frequency of bowel movements—now “watery”—hyperactive bowel sounds, 9-pound weight loss over the past six weeks with a noticeable increase in appetite—“I’ve lost weight without even trying”—and slight hand tremor. Ms. Kissinger complains “my eyes look like they are bulging.” .
“By 7 p.m., Newton-Wellesley had treated 72 runners, mainly for dehydration” (DeMarco, Smith 1). All runners seemed to be on the same boat, suffering from dehydration “ ‘It was too hot.’ Said Komen, who spent about and hour getting treatment for dehydration” (DeMarco, Smith 1). Some common symptoms of heat exhaustion may include nausea, fatigue, exhaustion, lightheadedness and possibly heat cramps. In severe instances the athlete may suffer from heat stroke, which may become deadly (Dehydration: Curse of). “New research on athletes’ perceptions of sweat loss and fluid consumption shows ho critical it is for active people to drink on a schedule to prevent dehydration” (Quinn 1).
E) Difficulty swallowing. Feedback: CORRECT Difficulty swallowing can accompany a brain attack (stroke), placing the client at risk for aspiration. Points Earned: | 1.0/1.0 | | Correct Answer(s): | A, B, E | The ED physician has completed an assessment. Gail is sitting at the bedside while the ED nurse continues to assess Nancy every 15 minutes. 2.
S3 and dysrhythmias Laboratory findings * 1. ECG- the ST segment is ELEVATED. T wave inversion, presence of Q wave * 2. Myocardial enzymes- elevated CK-MB, LDH and Troponin levels * 3. CBC- may show elevated WBC count * 4.
Cardiac Case Study S.P. is a 75-year-old female who presents to the provider's office with fatigue. Subjective Data PMH: HTN, hyperlipidemia, MI 3 years ago Fatigue started about a month ago, getting worse Relieved with rest, exacerbated with activity Denies chest pain Ankles swollen Objective Data Vital signs: T 37 P 112 R 18 BP 110/54 Lungs: bilateral lower lobe crackles O2 Sat = 94% Skin = cool to touch CV = heart rate regular, positive peripheral pulses, ECG = no changes +2 edema bilateral ankles Medications: Metoprolol 20 mg per day, 325 mg of aspirin per day 1. What other questions should the nurse ask about the fatigue? o Normal pulse for adult is 60-100 o Bilateral lung crackles o Asprin helps prevent
Ultrasound (of the abdomen) or a Diagnostic paracentesis: ultrasound to see what is causing the distention of the abdomen, Paracentesis: fluid removal, the wave test was positive Additional blood work- Liver function tests, coagulation tests, CBC w/diff.. 4. Identify 7 treatment options and or medications that should be considered with rationale. Each treatment option with rationale is worth 2 points. Paracentesis- drain fluid Intubation- ICP related complications may require mechanical ventilation and it may be necessary to initiate hyperventilation therapy. ICP catheter- to decrease ICP Vitamin therapy/ Nutritional referral- because of her BMI and nutritional status r/t her pathologies.
Correct Answer(s): DEthical-Legal ConsiderationsSince Kat's respiratory status has stabilized, she undergoes an open reduction and internal fixation of the pelvis. Following surgery, Kat receives patient-controlled analgesia for 24 hours. When this prescription is discontinued, a new prescription is written for Morphine 2 mg every 4 hours PRN.The nurse caring for Kat is concerned about the amount of opioid analgesics that Kat has received since her fracture occurred. The nurse administers a dose of normal saline IV the next time Kat requests pain medication and reports to the charge nurse that the client indicates that she is pain free.22. What action should the charge nurse implement?
The only “prokinetic” (meaning it increases the tone and motility of the GI tract) agent currently available. Used for GERD, N/V, diabetic gastroparesis, and postoperative emesis. A common side effect is DIARRHEA and will likely need to hold the medication if diarrhea occurs. A more troublesome side effect with long-term use is tardive dyskinesia, a movement disorder that is usually permanent. • S=“Statins”.
Neurological Disorder Case Study - Meningitis The nurse is caring for a 21-year-old female college student who presents to the emergency department (ED) with complaints of “bad” headache pain, nausea, vomiting and neck tightening. She states, “My sinuses were bothering me last week, but I thought I was getting better until this morning.” No past surgical history noted, has recurrent sinus infections, and denies drug use, but is a social drinker on the weekends. Physical assessment findings are as follows: T – 100.8 F, P – 104, R – 24, B/P – 122/78 Alert and oriented X3 – person, place and time with periods of confusion and agitation over last 4 hours Lung sounds slightly diminished at the bases Mucous membranes dry and capillary refill <3 seconds Assessment of cranial nerve XI elicited severe pain response Pain to neck worsening and unequal pupillary responses are noted 4 hours after admission Lumbar puncture was prescribed and results are: Turbid appearance WBC - 560 cells/µL Glucose - 20 mg/dL Protein - 510 mg/dL Other diagnostic test results CT scan identified no obstruction to flow of CSF Define the key terms below: * Meningitis - see pgs. 1451 – 1455 in Lewis (8th edition) Critical Thinking Questions: 1. Define meningitis?