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- Patient C., 32 y/o, was delivered unconscious to the intensive care department. The patient has a medical history of diabetes. Insulin was not found. The breathing is noisy, of Kussmaul’s type; acetone breath, the skin is dry, turgor is lowered, the facial features are sharp, periosteal reflexes are absent, eye ball tone is lowered. Blood contains 1.2 mmol/l of lactic acid (norm - 0.62-1.3 mmol/l), glycemia - 29 mmol/l. What kind of coma can be suspected?A. KetoacidoticB. Brain comaC. HyperosmolarD. HypochloremicE. LactacidemicJohn 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: Preventing complications of surgery is an important part of all surgical patient care. What preoperative While Mr. Doe is in the Operating Room, what considerations will be taken to ensure Mr. Doe’s safety and positive outcome? Identify 2 IntraOp nursing diagnoses for Mr. Doe teaching does Mr. Doe require in order to prevent complications? Give 3-4 examples)Patient C., 32 y/o, complains of excessive weight, shortness of breath, defective memory, performance decrement, feeling cold, emotional retardation. It is known from the case history that the patient is suffering from primary hypothyroidism. Objectively: the skin is dry, waxlike, swollen, periosteal reflexes are lowered, body mass index: 33.5 kg/cubic meter, TSH (thyroid-stimulating hormone) – 25 µU/dL (norm 0.5 -5.0). Obesity is homogenous. Arterial pressure: 150/100 mm column ob mercury. What type of obesity can be suspected?A. Endocrine hypothyroidB. Endocrine accompanying dysfunctions of hypothalamopituitary systemC. Alimentary constitutionalD. HypothalamicE. Androidal with the developed symptoms of metabolic syndrome
- MAKE AN ANALYSIS OF THE SAID DX. dx: Imbalanced nutrition related to lack of knowledge about diet SCENARIO: 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 I hang out with my friends for a tea or…RON is suspected of DKA. Formulate a plan of education for Ron's wife, so she will better understand his condition and be able to assist him to manage those days when is unwell. What areas would you cover? How would you ascertain her understanding?R9. N.H. is a 76-year-old male admitted to the hospital through the emergency department. He fell outside his home. It appears that he may have sustained a fracture to his left hip. He has a history of type 2 diabetes mellitus and has a 40 pack-year smoking history that is now complicated by chronic obstructive pulmonary disease. Data Collected (use only those that apply) Complains of excruciating pain and tenderness in left hip Pain not relieved with morphine BP 166/94 mmHg Diaphoretic and pale skin Respiratory rate 36; crackles, expiratory wheeze X-ray of left hip reveals extracapsular fracture Hematocrit 30%; hemoglobin 15g/dL; WBC 15,000/uL Do ASAP.
- 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)Think about the priorities inherent in the basic care and comfort needs of clients. After meeting the need for oxygenation, identify and briefly discuss the following: Discuss what actions a nurse could take to assist you with this change.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 10:00am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Question: During the admission assessment, the nurse questions Mr. Doe to determine if there is a latex allergy or sensitivity. Why is this essential to the patient’s safety? What symptoms would the nurse question Mr. Doe about in order to determine this? (Discuss in 3-5 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 10:00am. His meds include daily insulin, aspirin 325mg/day, Pletaal 100mg BID. Summary: Given case: 53 years old, male History of Type-1 diabetes mellitus, CAD ( Coronary Artery Disease) PAD ( peripheral artery disease) Cigarette smoking 40 packs per year COMPLAINTS: 6 weeks ago, he developed a wound in his left heel. Despite antibiotics, patient developed a gangrene infection. ADVISE: To undergo BKA ( Below knee amputation) of left lower extremities MEDICATION: Daily insulin, aspirin 325 mg /day, pletaal 100 mg BD Post-operative Data: Post-operatively, Mr. Doe goes to the Post Anesthesia Care Unit…Damage to the cerebral cortex may cause loss of Skilled movements in the absence of paralysis. T 4:21 PM /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: Dr. Ramos is Mr. Doe’s surgeon and Dr. Reyes is Mr. Doe’s anesthesiologist. Both come to see him and discuss the surgery the evening before. How does the nurse ensure informed consent? What must the patient consent to for the procedure to be done? (Discuss in 5-6 sentences)