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Considering the condition of the patient and his anatomy and physiology, what are the reasons these symptoms arise?
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- 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 choicesA 56-year old maintenance worker, with a past medical history of insulin-dependent diabetes, CHF, and hypertension, presents to the emergency room with lightheadedness, lethargy, and periods of confusion. Patient family members found him unconscious outside. Wife states, “he’s been at it for over a week now” Medications: Insulin, Lasix, Digoxin, and Vasotec: Vitals on admission were as follows : Temperature/ Pulse/ Respirations /Blood Pressure36.7C 118 18 103/61On examination, the patient has slurred speech with decreased upper and lowermotor strength bilaterally 4/5. While examining the patient, he experienced lossof consciousness that lasted less than half a minute. The nurse drew labs,administered oxygen via NC, Established IV line access and placed the patient on a monitor. Lab resultsElectrolytes – in emergency roomHematocrit – 38%Hemoglobin 12 gm/dLPotassium 3.3 mEQ/LChloride 95 mEq/LSodium 147 mEQ/LPhosphorus 2.6 mg/dLBicarbonate 21 mEq/LCalcium 7.6 mg/dLBUN 46 mg/dLCreatinine…case discussion: 72 yr old, male with history oif diabetes, PAD, HTN and CKD. Recently admitted for C-diff diarrhea and was started on vancomycin and discharged home. He now present to ER (7 days later) with left lower leg sweeling nd erythema and as such was diagnosed with cellulitis. He is not septic or ill-appearing so as an APN/APRN( Advance Practitioner Registered Nurse), you decide to discharge him with oral antibiotics. In regards to the principles of PHARMACOKINETICS(absorption, distribution, metabolism and excretion), what are the key considerations when treating this patient and why are they so important?
- Case Scenario: Mrs. Martha went call you to pick up her medication. She was prescribed with the following Medications for Allergic Rhinitis from her Allergist: Levocetirizine 10 mg OD, Nafarin A 5 tabs every 6 hours as needed for nasal congestions with Body Malaise. She's been taking Betamethasone 5 mg tablet for a month now. She ask as well on her refill from Dr. Dave for her metformin 500 mg and Lisinopril 10 mg for her maintenance meds. Please assist Ms. Martha's medication management for Drug-Interactions.Case 1: 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. When checking the medications for Mr. Doe the evening before surgery, which orders increase the nurse’s concern? Insulin 6 units Regular with 15 units NPH subcutaneous q am. Aspirin 325mg PO q d. Pletaal 100mg PO BID Ativan 0.5mg IVP on call to OR in AM.CASE #4 : BLEEDING IN LATE PREGNANCY ( Abruptio Placenta) Setting: Hospital Chief Complaint: Vaginal Bleeding History Present Illness: A nulliparous woman who has presented with vaginal bleeding at 39 weeks, 5 days gestation. Booking BP = 123/72mmHg. Her last midwife visit was 10 days ago when BP = 130/76mHg. This evening she noticed a small gush of blood and discovered a bright red stain in her underclothes. She denies actual abdominal pain but reports some intermittent lower abdominal discomfort. The baby has been moving normally during the day. Physical Examination: She is warm and well perfused. Her BP = 158/87mmHg and Pulse Rate = 84bpm. The symphysiofundal height is 36cm and the fetus is cephalic with 3/5 palpable abdominally. Moderate uterine tenderness is noted. The uterus is soft but during the palpation two moderate uterine tightenings are noted. On speculum examination the cervical os is closed and there is a moderate amount of vaginal blood. LABORATORY Urinalysis…
- The doctor prescribes 10,000 units of heparin added to 500 ml of D5W at 1,200 units/hour. How many drops per minute should you administer if the I.V. tubing delivers 10 gtt/ml? : 1h child if the order callsCASE #1 Alicia is 48 year old female of 76 kilograms and height of 161.5 centimetres. Although she attempted reduced weight, but she has gained instead 11.4 kilograms in the previous months. She also sleeps for 14-16 hours a day. Her movements were slothful, and she has slight enlargement of the neck area, coarse textured hair and dry skin. When her blood sample was analyzed it showed that the hormone T4 (thyroxin) levels were 3.2 micrograms/millilitre which is lower than the normal range, 4.2-11.2 micrograms/millilitre. In addition to this her TSH (thyroid stimulating hormone) levels were high. In a power point presentation, per slide: 1. Determine the diagnosis for this case. 2. List signs and symptoms. 3. List possible causes of this case. 4. Identfify hormone involved and its origin and action. 5. Discuss possible treatment and prevention.CASE #1. Alicia is 48 year old female of 76 kilograms and height of 161.5 centimetres. Although she attempted reduced weight, but she has gained instead 11.4 kilograms in the previous months. She also sleeps for 14-16 hours a day. Her movements were slothful, and she has slight enlargement of the neck area, coarse textured hair and dry skin. When her blood sample was analyzed it showed that the hormone T4 (thyroxin) levels were 3.2 micrograms/millilitre which is lower than the normal range, 4.2-11.2 micrograms/millilitre. In addition to this her TSH (thyroid stimulating hormone) levels were high. 1. List possible causes of this case.
- SITUATION: Bella Bernardo 24 year old gravida 4 para 2 visits the prenatal clinic for her check-up. Her last LMP was August 21, 2020. Determine the age of gestation AOG] of the client on December 25, 2020. The nurse anticipates the following laboratory exams to be requested, except: a. Serum HBSAg b. Blood glucose level c. Urinalysis d. Complete blood countCASE #1. Alicia is 48 year old female of 76 kilograms and height of 161.5 centimetres. Although she attempted reduced weight, but she has gained instead 11.4 kilograms in the previous months. She also sleeps for 14-16 hours a day. Her movements were slothful, and she has slight enlargement of the neck area, coarse textured hair and dry skin. When her blood sample was analyzed it showed that the hormone T4 (thyroxin) levels were 3.2 micrograms/millilitre which is lower than the normal range, 4.2-11.2 micrograms/millilitre. In addition to this her TSH (thyroid stimulating hormone) levels were high. 1. Identfify hormone involved and its origin and action. 2. Discuss possible treatment and prevention.Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTN1. What type of diabetes does she have?2. Describe the mechanism of action of metformin. In which patients is metformin contraindicated?3. List some non-pharmacologic measures that can lower her blood sugar?4. List the long term complications of DM5. What role does Lisinopril have in patients with DM?6. What concerns do you have with the propranolol?7. Despite her medication regimen, her blood sugar has been very, very high and her physician decidedto start a long acting insulin. Which insulins are long acting?