Study guidee

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Week 6 case study Scenario 1 D.W. is a 23-year-old married woman with 3 children under 5 years old. She came to her physician 2 years ago with vague complaints of (C/O) intermittent fatigue, joint pain, low-grade fever, and unintentional weight loss. Her physician noted small patchy areas of vitiligo and a scaly rash across her nose, cheeks, back, and chest at that time. Laboratory studies revealed that D.W. had a positive antinuclear antibody (ANA) titer, positive dsDNA (positive lupus erythematosus), positive anti-Sm (antismooth muscle antibody), elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and decreased C3 and C4 serum complement. Joint x-ray fi lms demonstrated joint swelling without joint…show more content…
Is that right?” How should you respond to his concerns? Scenario 2 K.D. is a 36-year-old gay professional man who has been human immunodeficiency virus (HIV) positive for 6 years. Until recently, he demonstrated no signs and symptoms (S/S) of acquired immunodeficiency syndrome (AIDS). The appearance of purplish spots on his neck and arms persuaded him to make an appointment with his physician. When he arrives at the physician’s office, the nurse performs a brief assessment. His vital signs (VS) are 138/86, 100, 30, 100.8° F. K.D. states that he has been feeling fatigued for several months and is experiencing occasional night sweats, but he also has been working long hours, has skipped meals, and has been particularly stressed over a project at work. K.D.’s physical examination is within normal limits (WNL) except for his rapid heart rate and respirations, low-grade fever, and skin lesions. The doctor orders a chest x-ray (CXR), CBC, lymphocyte studies, ultra viral load, Cytomegalovirus (CMV) assay, and a PPD (purified protein derivative) test. K.D. made an appointment to return in 5 days to discuss the results of his tests. Over the next 2 weeks, K.D. develops a fever of 101° F, nonproductive cough, and increasing shortness of breath (SOB). Late one night he becomes acutely SOB, so his roommate, J.F., takes him to the emergency department (ED) where he is subsequently admitted to the hospital with probable
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