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- CASE STUDY 15.4 A disoriented 58-year-old man with a history of poorly controlled diabetes mellitus and chronic obstructive pulmonary disease presents to the ED. The patient has been smoking cigarettes for many years. He has been taking steroid medications for his pulmonary disease. Physical examination shows that he is slightly febrile, lethargic, and respiratory failure. A diagnosis of meningitis is being considered. A lumbar puncture is done, and cerebrospinal fluid (CSF) is collected for a smear and culture. Laboratory Data A CSF specimen is collected and sent to the laboratory. A cytocentrifuged preparation of the CSF is stained, using calcofluor white for yeast by staining the yeast cell walls. The smear shows encapsulated, thick-walled budding yeasts. A cryptococcal antigen test is completed and is positive. The culture of CSF identifies Cryptococcus neoformans. Multiple Choice Questions Fungi are widespread in the environment but rarely cause central nervous system (CNS)…Case Study: A 52 year-year old man with a history of AIDS, hypertension, diabetes mellitus, and alcohol abuse was found unconscious in his home by his roommate. In the emergency department, he was hypotensive (103/60 mm Hg), febrile (temperature 101F), and unresponsive. Computed tomoggraphy scan of the abdomen showed choleccystitis and gallstones. Laboratory data are listed. The patient was diagnosed with acute renal failure. He was administered intravenous fluids; BUN fell to 68 mg/dL and creatinine fell to 2.2 mg/dL. The patients blood culture report was positive for e. coli. He was treated with tobramycin and cefepime. The patient continued to deteriorate and died 5 days after admission. Cause of death was multiorgan failure secondary to AIDS, sepsis, and alcoholic cirrhosis. DATA TABLE Drugs of Abuse Negative Urinalysis Serum ethanol 84mg/dL Hemoglobin Positive…Case Study A 35 year old male is the driver of a vehicle observed to 'drift' off the shoulder of an interstate highway, and with no evidence of breaking strikes an abutment of a bridge at about 35 mph. The driver is belted and air-bags deploy. He is found to have NO vital signs when paramedics arrive several minutes after the impact, and the patient is pronounced dead. Autopsy shows abrasions on the chest, and several fractured ribs with no associated hemorrhage. NO contusions are present in the brain, but a large amount of subarachnoid blood is present, associated with a ruptured aneurysm of the anterior communicating cerebral artery. Cocaine metabolites are found on urine drug screen. NO drugs are present in the blood. What is the probable Cause and Manner of Death? In many jurisdictions, this case would have been signed out as blunt force trauma due to automobile collision, and no autopsy would have been performed. Why is it important to conduct a complete autopsy in all sudden…
- Case Study #1: Ms. C is a 19-year-old college student. She was brought to the ER with symptoms of nausea, vomiting and gastric pain, and diarrhea for two days. Upon interview, the patient revealed that she ate street foods a few hours before the symptoms developed. She is dehydrated with a urine output of 500 ml/day, pale and dry skin, her temperature is 38.2 C, and stool culture revealed Salmonella infection. She was given IV fluids and loperamide. Make a SOAP (Subjective, Objective, Assessment, and Plan) Chart for this case. What is salmonellosis? What causes it? How is it diagnosed? What are the Symptoms? How is it managed? Discuss how salmonellosis can be prevented.5. Nursing questions What is the significance of the lesions present on a patient?Case Study 1 Morphine Suspension (1 mg/mL) One of your long-term patients who you have known for many years has progressed to end-stage prostate cancer and been placed on a palliative care program. The currently commercially available morphine liquids he has been using contain a flavouring agent that makes him nauseous. His Physician has requested you compound a morphine liquid for him without flavour as his pain is well controlled on this medication and he does not want to change to another pain reliever. Your pharmacy team and the Physician would like to make his end-of-life process as comfortable as possible. A formulation for a suspension appears to be a good option to try. RX: Morphine liquid 1 mg/mL Sig: Take 1-2 mL q1h prn Mitte: 100 mL Formulation: Morphine HCl 10 mg Glycerol 1 mL Compound Hydroxybenzoate Solution 0.1 mL Purified water to 10 mL Use within 1 month. What special prescription requirements will you need from the doctor? Can he prescribe refills over the…
- #9.NURSING QUESTION Identify sites for assessing temperature, pulse,and blood pressure.?Case Study 3 – Congestive Heart Failure Dottie is a 78-year old CHF patient. She has been exercising with your facility for several years now. She had a CABGx3 in 2020. She came in today with a 5 lb. weight gain since yesterday when she weighed on her home scale this morning. Her meds include- Lipitor, Procardia, and Lasix. (Cholesterol, Calcium channel blocker Hypertension, and Diuretic, respectively) Her blood pressure is 132/88 and her HR = 102; Her weight is 196, up from 191 when last measured. She is a pleasant, overweight individual who enjoys walking on the treadmill and visiting with other members of your facility. 1. What are specific considerations for someone with CHF and exercise? How is the exercise prescription any different from the apparently healthy adult prescription? 2. What is your biggest concern with Dottie today and how would you handle this concern(s)?Case Study 2Respiratory DrugsBrett is a 12 y/o boy with a history of asthma, diagnosed 2 years ago. He is an outgoing, active boy and participates in a swim club and soccer, but he has a difficult time adjusting to the limitations of his asthma. He has learned to control acute attacks by using albuterol (Proventil) metered-dose inhaler, and because his asthma is often triggered by exercise, he has been using a budesonide (Pulmicort) inhaler and taking montelukast (Singulair). After competing in his swim meet at the local indoor pool, Brett began experiencing respiratory distress. He alerted his coach, who retrieved the albuterol inhaler from Brett’s backpack. After two inhalations, Brett was still in distress and the rescue team was called.On admission to the emergency department, Brett is in obvious distress with pulse oximeter readings of 90% to 91%. He has nasal flaring and bilateral wheezing is heard in is his lung fields, pulse rate is 122 beats/min, and he is orthopneic.…
- Case Study #1: Ms. C is a 19-year old college student. She was brought to the ER with symptoms of nausea, vomiting and gastric pain and diarrhea for two days. Upon interview, patient revealed that she ate street foods a few hours before the symptoms developed. She is dehydrated with urine output of 500 ml/day, pale and dry skin, her temperature is 38.2 C, and stool culture revealed Salmonella infection. She was given IV fluids and loperamide. 1. Make a SOAP Chart for this caseCase Study Link: https://telegra.ph/Case-study-10-09 (Please read it before answering)1. QUESTION:What information systems are implemented by JurongHealth? Describe the input, processing, and output of any one such system.Case Study: The following 5 questions correspond with the case study described below. Jason is a 52-year-old Asian American male visiting his doctor for a routine exam. He works as a warehouse manager and mentions that his job is very stressful. He also states that he wishes he could be more physically active during the day. Question: Jason’s BMI is 29 and his waist circumference is 39. What is Jason’s weight classification? Considering his anthropometric measures, what is Jason’s likely risk for weight associated diseases?