Case: You check the ammonia level of a client with hepatic dysfunction who is receiving lactulose and notes that the level is 75 mcg/ dL (45 mcmol/L). What should you do? Diagnosis: (NANDA Approved) PLANNING (SMART) Short term: Long term: PLANNING CRITERIA: Outcome statement clearly states (1) Goal/ Desired Outcome (2) Realistic (3) Priority

Case: You check the ammonia level of a client with hepatic dysfunction who is receiving lactulose and notes that the level is 75 mcg/ dL (45 mcmol/L). What should you do? Diagnosis: (NANDA Approved) PLANNING (SMART) Short term: Long term: PLANNING CRITERIA: Outcome statement clearly states (1) Goal/ Desired Outcome (2) Realistic (3) Priority

3-2-1 Code It

6th Edition

ISBN:9781337660549

Author:GREEN

Publisher:GREEN

Chapter10: Cpt Anesthesia

Section: Chapter Questions

Problem 14MC

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Mr. Jackson was hospitalized today for heart failure. The physician orders a loading dose of digoxin 0.75 mg to be given intravenously. The digoxin is available in a solution of 0.5 mg/mL. (Learning Objectives 2, 4, 6) 1. How many milliliters should the nurse prepare? 2. What should the nurse do before administering the IV dose? 3. If digoxin toxicity develops, what signs or symptoms might Mr. Jackson have? 4. How often should Mr. Jackson be monitored for signs of digoxin toxicity? 5. What conditions might increase Mr. Jackson’s likelihood of exhibiting digoxin toxicity?
Case of Antiplatelet Therapy: Mr. Mark Johnson (MJ) is a 58-year-old Caucasian male who has just undergone percutaneous coronary intervention with coronary artery stent placement. MJ has a history of diabetes and hypertension. MJ is placed on dual-antiplatelet therapy, including aspirin and prasugrel. Pharmacogenetic testing was performed and the results report is available (below, next page). The primary care prescriber wishes to change prasugrel to clopidogrel and you are consulted on this case. What is your recommendation for MJ? Explain in detail and based on scientific evidence.
MAKE AN SCIENTIFIC AND SITUATIONAL ANALYSIS OF THE SAID DX. dx: Imbalanced nutrition related to lack of knowledge about diet SCENARIO (for reference): Aubrey, 19 years old, an incoming college freshman student went to Ateneo De Manila Health Services for physical examination. The nurse gathered the following information: Height: 5 ft Weight: 48 kg Vital signs: Temp 37.2C, Pulse rate: 95 beats per minute, Respiration rate: 12 breaths per minute, and BP: 100/70mmHg. Family History of illness: Father (+) Hypertension (HPN), and Diabetes Mellitus (DM) Present Health History: Aubrey never experienced to get hospitalized as far as she can remember. Her mother ensures that she takes daily supplemental vitamins such as vitamin C and B complex, and every year she gets flu vaccine from their family doctor. During the interview with the nurse, Aubrey mentioned that she has no known allergies. She said “I don’t think I have any problems with my health. I am lacto-ovo vegetarian. Most of the time…
Situation: Mrs. Corona was diagnosed of Diabetes Mellitus Type II. She was admitted to the Emergency due to dizziness, headache frequency of urination at night and complained of very hungry. Her weight suddenly decreases for the past months from 140 lbs to 110 lbs also feeling tired and having dry skin. She sought admission due to the following signs and symptoms. Her hemogluco test (blood sugar) level is from 180 - 200mg / dl 2 hours after eating. The best and correct ecologic model for Mrs. Corona? a. Web Model b. Triangle model c. Wheel model d. All the choices
CASE STUDY: A patient who experiences a mild weight loss, vomiting and nausea. The patient later developed jaundice and an enlarged liver. These are results of the patient’s laboratory tests: *Cite references AST (SGOT) Significantly elevated ALT (SGPT) Moderately elevated Alkaline phosphatase Mildly elevated Albumin Decreased Globulin Increased Total serum bilirubin 20 mg/dL Conjugated bilirubin 10 mg/dL A. What is the clinical importance of the laboratory tests results of the patient? B. What would be the probable diagnosis of the patient? C. What is the prognosis of the disease?
A client is receiving an intravenous magnesium infusion to correct a serum level of 1.4 mEq/L. Which of the following assessments would alert the nurse to immediately stop the infusion? A. Absent patellar reflex C. Premature ventricular contractions B. Diarrhea D. Increase in blood pressure Rationale: Reference/s:
Based on this information and patient history you have concerns of alcohol use disorder and recommend a liver biopsy. At this time Ella is also referred to cardiology for an EKG and cardiac evaluation. A liver biopsy is performed and the following pathology is illustrated below. Pathology report: Alcohol-related steatosis consistent with small- and large-droplet fat. Fat accumulation is most prominent near the central vein (asterisk) and extends outward toward the portal tract with increasing severity. In this case, the fat extends into acinus zone 2 or the midzone of the hepatic lobule. This diagnosis is discussed with Ella and she wants to schedule a follow up to discuss her alcohol use, life-style modifications and counseling. Describe how alcohol consumption contributes to the pathology presented in the image above. Be sure to address the key terms listed below as part of your discussion; you may address additional etiologies as well. Acetoacetate…
HC is a 42-year-old male with hypertension (his average systolic/diastolic blood pressure is 147/92 mm Hg), who is referred to the outpatient clinic. Dietary recall shows that he consumes highly processed foods with added salt such as processed meats, canned foods, salty snacks, and he does not consume adequate amounts of fresh vegetables and fruits. d. What is the recommended optimal dietary intake for sodium and potassium for HC? e. What would be the major specific recommendations to modify HG’s current diet to improve management of hypertension? How would your dietary modification recommendations affect his intake of sodium and potassium?
Case Scenario: John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: Mr. Doe was very restless the evening before. He verbalizes to his wife that he is “scared to death” and worried about losing his foot. She asks the nurse what can be done to help him. How will the nurse address the psychological comfort of Mr. Doe? (Discuss in 2-3 sentences only)
Case Scenario: John Doe, 53y.o., has a history of Type I diabetes mellitus, cigarette smoking 40 pack-years, CAD, and PVD. Six weeks ago, he developed a wound in his left heel which measured 4cm by 2cm when he discovered it. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a BKA of the left lower extremity tomorrow at 10:00 am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. What preoperative testing is appropriate for Mr.Doe? (Give at least 4 priority examples) Note to Tutor: Thank you so much, Ma'am/Sir
A 53-year-old man is brought to the emergency department by ambulance because he is having difficulty speaking. The patient tried to explain to his wife that something was wrong, but he was unable to speak clearly. He is, however, able to communicate in writing. He has been on beta blockers to control hypertension and has type 2 diabetes that is being managed with diet and exercise. PHYSICAL EXAMINATION VS: T 36.5°C, P 85/min, R 18/min, BP 134/88 mm Hg, BMI 31 PE: The patient is anxious but able to respond to spoken commands. Reflexes are intact. LABORATORY STUDIES CT: Occlusion in the left hemisphere of a branch of the anterior main division of the middle cerebral artery supplying the frontal cortex. Based on that information, answer Identify current medication and for how long must they take the medication.
A 53-year-old man is brought to the emergency department by ambulance because he is having difficulty speaking. The patient tried to explain to his wife that something was wrong, but he was unable to speak clearly. He is, however, able to communicate in writing. He has been on beta blockers to control hypertension and has type 2 diabetes that is being managed with diet and exercise. PHYSICAL EXAMINATION VS: T 36.5°C, P 85/min, R 18/min, BP 134/88 mm Hg, BMI 31 PE: The patient is anxious but able to respond to spoken commands. Reflexes are intact. LABORATORY STUDIES CT: Occlusion in the left hemisphere of a branch of the anterior main division of the middle cerebral artery supplying the frontal cortex. Based on that information, answer What does the physical tests results imply and why? Describe how the feedback loop/s involved were disrupted; What is the cause of this condition? What glands/organs are defective? What happened to this man that would explain his condition (summary)?…