Mrs. Reyes, 71 yearsold, while doing household chores has fallen her front steps. She had a large bruise on her right temple and her right face and is brought to the emergency. Upon assessment her vital signs are HR 125; BP 110/76; RR 16; T 37.6C ; pain 4/10 Question: document a brief NEUROLOGIC exam on the patient
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Mrs. Reyes, 71 yearsold, while doing household chores has fallen her front steps. She had a large bruise on her right temple and her right face and is brought to the emergency. Upon assessment her vital signs are HR 125; BP 110/76; RR 16; T 37.6C ; pain 4/10
Question: document a brief NEUROLOGIC exam on the patient
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- Mrs. Reyes, 71 years old, while doing household chores has fallen her front steps. She had a large bruise on her right temple and her right face and is brought to the emergency department by ambulance. Upon assessment her vital signs are HR 125; BP 110/76; RR 16; T 37.6°C; and pain 4/10. Document a brief neurologic exam on this patient.Ben, 59 is an employee who works in a post office. He is 5ft. Tall and weighs 150 pounds. His vital signs are the following : T 36.3°C; HR 94;BP 135/85; pain level 0. At the clinic, he presents himself with a major complaint of "just not feeling well" Dusting ascultation, you hear a heart murmur. How would you identify Ben's heart murmur?SITUATION: Mr Chong was brought into Emergency Department (ED) last night by ambulance after collapsing at home. The ED Registered Nurse reported that Mr Chong was alert and orientated to person, time and place on admission. He has global aphasia, left gaze preference, right homonymous hemianopia (field cut), right facial droop, dysarthria, and right hemiplegia. CT angiography showed a left Middle Cerebral Artery (MCA) occlusion (Fig 1). 12-lead ECG showed Atrial Fibrillation (Fig 2). BACKGROUND Mr Chong has a past medical history of Coronary Artery Disease, Coronary Artery Bypass Grafting, Atrial Fibrillation and previous TIA (Transient Ischaemic Attack) three month ago. Mr Chong is retired and independent with activities of daily living. He speaks simple English. Mr Chong lives with his wife and two sons. ASSESSMENT His last Glasgow Coma Scale (GCS) is between 13-14 (disorientated and occasionally confused to time and place) and other vital signs are within normal limits. His BGL:…
- SITUATION: Mr Chong was brought into Emergency Department (ED) last night by ambulance after collapsing at home. The ED Registered Nurse reported that Mr Chong was alert and orientated to person, time and place on admission. He has global aphasia, left gaze preference, right homonymous hemianopia (field cut), right facial droop, dysarthria, and right hemiplegia. CT angiography showed a left Middle Cerebral Artery (MCA) occlusion (Fig 1). 12-lead ECG showed Atrial Fibrillation (Fig 2). BACKGROUND Mr Chong has a past medical history of Coronary Artery Disease, Coronary Artery Bypass Grafting, Atrial Fibrillation and previous TIA (Transient Ischaemic Attack) three month ago. Mr Chong is retired and independent with activities of daily living. He speaks simple English. Mr Chong lives with his wife and two sons. ASSESSMENT His last Glasgow Coma Scale (GCS) is between 13-14 (disorientated and occasionally confused to time and place) and other vital signs are within normal limits. His BGL:…Description Mr. Santos , a 52 year old overweight smoker and IT consultant suddenly felt intense chest pain characterized as heaviness over the chest and radiating to the left arm. He was brought to the emergency room. In the emergency room, he divulged that he had been having chest pains whenever he walked or went up the stairs. Upon physical examination, Mr. Santos was hypotensive. ECG revealed myocardial infarction with arrhythmias. 1. What factors present in Mr. Santos could have contributed to development of acute MI? 2. What is the term for the chest pains that Mr. Santos experienced during exercise? What is the pathophysiology of this? 3..Aside from ECG, what other diagnostic and laboratory work-ups need to be done to arrive at a diagnosis of acute MI? 4. What are the causes of MI? 5. Explain the pathologic processes that occur in Acute MI. 6. What drugs will probably be given to Mr. Santos? 7. Give some recommendations to prevent acute MI.Ralph , is 5 months post congestive heart failure (CHF), he is... Ralph , is 5 months post congestive heart failure (CHF), he is confined to a wheel chair due to advanced peripheral neuropathy and foot drop. His care is managed at home by a family nurse practitioner (FNP) who visits once a week and as necessary. On one of her visits, the FNP notes that Ralph has developed a Grade 3 sacral decubitus ulcer, lower extremity edema, and dyspnea while sitting. He is also confused and not oriented to person, place or time. Questions 1. 2. What risk factors for tissue break down are present? Explain in detail, the cellular changes that led to the sacral decubitus, now with necrotic dermal tissue. (Hint: the etiology and pathogenesis of the ulcer from injury to cellular death)
- Mr. Henry is a 50-year-old male who presents to the office for headaches. he has a known history of sinus infections when the seasons change, high blood pressure and depression. his medications include Lopressor 50mg, daily and Claritin 10mg daily. he has a family history significant for aneurysms and depression. His vitals are BP 196/86 right arm seated, HR 87 regular, RR 13, Temp 98 oral. What is a NANDA approved diagnosis you could give her?Mr. Reddy is a 62 yo presenting to ED at 1500hrs. He was preparing the gas cylinder for a Sunday BBQ when it suddenly exploded while he was trying to connect the hose. Family standing by tried to extinguish the fire with their hands and tried to remove his clothing. Burns 30% TBSA – Face, hands, bilateral lower limbs. Complaints of severe pain and burning 10/10. Past Medical History: Hypertension, Type II DM Regular medications – Candesartan 8mg, Glimepiride 4mg, Metformin 500mg and Pravastatin 20mg. Fully vaccinated against COVID. Airway. - Patent, superficial burns to right side of face Breathing. - Spontaneous, RR-22mt, SPO2-92% RA, air-entry equal Circulation- Lower limb odema, cap refill 3 seconds, bilateral dorsal pedis pulses weak. BP- 88/50 mmHg, HR- 127/mt, sinus tachycardia, Disability - GCS-15 E4V5M6, PEARL- 3mm, Exposure - Temperature 35.9 deg Celsius. Full thickness burns to right lower limb and right arm, partial thickness burns to left lower limb, bilateral hands.…Ms. Hall has an order for hydromorphone (Dilaudid), 2 mg,intravenously, q 4 hours PRN pain. The nurse notes thataccording to Ms. Hall’s chart, she is allergic to Dilaudid. Theorder for medication was signed by Dr. Long. What would bethe correct procedure for the nurse to follow in this situation?a. Administer the medication; the doctor is responsible formedication administration.b. Call Dr. Long and ask that she change the medication.c. Ask the supervisor to administer the medication.d. Ask the pharmacist to provide a medication to take theplace of Dilaudid.
- 73-year-old male, post-op day 1, status post-carotid endarterectomy on the surgical unit, demonstrating signs of stroke. Suggest two interdisciplinary team members to assist with caring for the patient and provide a rationale for the importance of including them in the care of this patient.Dr. Falcone is an emergency department physician who has just called the OR desk concerning a patient. He tells the charge nurse, “we have a 23-year old male patient status post MVA, no airbag deploy, moderate facial injuries, bruising and swelling about the left eye, diplopia and enophthalmos. CT confirmes left orbital floor fracture. Hell be up in 10 minutes.” If the fracture isn’t stable after being reduced, what instrument tray should the CST have available?History of Present IllnessTwo hours prior to admission, at 4am, patient Jake was jogging along LacsonStreet when a group of bystanders had approached him and stabbed himmultiple times. He claims that he does not know these people. He tried todefend himself resulting to multiple injuries in his upper extremities where hehad 3 lacerations, cheeks where he had a laceration on the left, right chest andright upper abdominal quadrant. Medications: Tetanus Toxoid 0.5 ml/amp, give 1 ampule via deep IM, now at right deltoid ATS 3,000 IU/amp, give 1 ampule via deep IM, now, ANST at left deltoid Piperacillin Tazobactam 2.25 grams/vial, give 1 vial via IV drip to run for 3 hours Q8H Tramadol 50 mg/amp, give 1 ampule very slow IV push now then Q6 PRN for pain Omeprazole 40 mg/amp, give 1 ampule via IVTT ODHS Latest Vital Signs : Blood Pressure: 90/60 mmHg Heart Rate: 121 bpm Respiratory Rate: 26cpm Temperature: 37.3 ⁰C Pain Scale: 10/10 NURSING CARE PLAN