Case Study 1 Heart Failure

6. What laboratory tests should be ordered for M.G. related to the order for furosemide (Lasix)? (Select all that apply)

1. Question: Why does Gatto think that school is boring and childish? How does Gatto’s depiction of school compare with your own elementary and secondary school experience?

M. H. states that she is generally in good overall health. No cardiac, respiratory, endocrine, vascular, musculoskeletal, urinary, hematologic, neurologic, genitourinary, or gastrointestinal problems.

General Health State (present weight – gain or loss, reason for gain or loss, amount of time for gain or loss; fatigue, malaise, weakness, sweats, night sweats, chills ): She currently weighs 110lbs. No weight loss. She is well developed and nourished. No distress. States she has always been healthy, other than occasional constipation.

Objective She is currently on sliding scale insulin, 1200 Kcal diet, and Captopril 50 mg orally twice daily. She has high random blood glucose of 325 mg/dL. Her vital signs are generally normal except for BP (150/97mmhg). Physical exam revealed dry nasal and throat mucus membranes and mild cool leg edema. She is overweight with a BMI of 31kg/m2.

She denies heat intolerance, diarrhea, recent weight loss and excessive sweating. She denies excessive caffinated beverage intake.

On admission, she was lean, coherent, afebrile, had mild pallor, no lymphadenopathy, clubbing, cyanosis, icterus, no muscle tenderness, erythema, pulse rate was 82/minute, regular, adequate volume, BP was 130/80 mm

A review of her medical records indicates that she as admitted to the MMHS on 12/9/16 for unresponsive hypoglycemic episode. During this hospitalization she was treated for right basilar pneumonia and treated with antibiotic for her UTI and infection in the blister wounds that she has on her leg. Her blisters are a result of her history of bullous pemphigus. She was also admitted to Tradition medical center in January for exacerbation of her CHF. She suffer from poorly controlled DM type 2, which is treated with insulin, stable HTN, GERD which is stable and depression which is manage with medication.

Treatment of heart failure is guided by its etiology. In patients with congenital heart diseases like shunts or single ventricle physiology, therapeutic options typically include surgical repair of the cardiac lesion if possible. Timing is crucial in these cases depending on several factors like the size of the patients and the presence of favorable physiology before proceeding to corrective surgeries. Meanwhile, medical treatment helps in controlling signs and symptoms of heart failure. We will briefly discuss heart failure medications used in children.

Her medical history was significant for chronic kidney disease stage 4 on hemodialysis, hypertension, coronary artery disease, stable angina, respiratory failure on 2 L oxygen via nasal cannula, anemia in chronic kidney disease, and diabetes mellitus Type II with hyperosmolarity. She also had history of Staph epidermidis in June 2014.

When meeting with the family we were in the OBGYN’s patient room 101. The room is on the fourth story of DSN Memorial Hospital with windows looking outside to the east. The room is well lit and has a calming atmosphere to it. There are plenty of maternal magazines and pamphlets for the family and mother to read in regard to the mother, developing fetus, and newborn. The family present at this time was Katy’s husband John. John seemed to be an extremely supportive and loving husband to Katy. Katy was in the patient bed while the John sat in the chair next to the bed reading a magazine. When I introduced myself both Katy and John were extremely attentive and asked plenty of questions. When

A review of her medical records indicates that she since her last visit; she continues to have increased weakness and decreased appetite with no improvement. She continues to suffer from severe anorexia, chronic pain and weight loss.

A review of her medical records indicates that she has not had any significant health events such as hospitalization or infections since her last visit. Her chronic CAD, ADFT and chronic hyperlipidemia remain stable.

Many Canadians say it helps the economy and creates equal and local competition within the market. However, this common perspective is flawed. According to Ben Myers, SVP of Market Research and Analytics for Fortress Real Developments states how “foreign buyers are likely to pay more for the same home than a domestic purchaser, making them the marginal and very pivotal buyers. Marginal buyers tend to set prices in a market place” (Myers, 2016, p.13). If one is going to pay extra on an already expensive house in Canada, how can a Canadian's wage compare and compete with such high prices? The annual median family income in 2015 was only 79,930 in Vancouver, $78,280 in Toronto and $76,950 in Montreal (Stats Canada, 2017). In 1976, people

While working on this problem I learned a lot about basic properties of addition and multiplication, such as distributive property, inverse property, commutative properties, etc. What’s common about these problems is the order in which we are going to do the steps. The first step will always be to remove the parenthesis, which uses the distributive property. Second will always be combining like terms and adding related coefficients what we have been working on this week which is dealing with real numbers.