This 65-year-old chronic cigarette smoker for the past 40 years was admitted to the hospital with acute exacerbation of her chronic obstructive pulmonary disease. She has a history of anxiety syndrome due to hypothyroidism, and is maintained on medications for both the anxiety and the hypothyroidism. No symptomatology at the time of admission. On hospital day two, she developed extreme anxiety and a psychiatric consultation was ordered. What codes are assigned in this case? ICD-10-CM Codes with POA Indicator -
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- A lethargic 22-month old black female was presented by her mother to the emergency room at 2:15am on a Sunday. The child had a history of a runny nose, hoarse cough and low-grade fever (-99F) for the past 48 hours. The mother was concerned about the forced and noisy breathing of the child. The pediatrician examined the child and found cloudy eyes and mild inflammation of the ears, but no overt signs of bacterial infection (no significant changes in the eardrums). The throat of the child was red and coated with mucus. The larynx was swollen and raw. The physician performed a rapid Strep test and found it was negative. Throat swabs were taken for culture. The physician placed the child in a room with a warm vaporizer for about 30 minutes. This dramatically improved the breathing of the child. 1. What is the infectious agent that caused this case? 2. Do you believe that this is a bacterial or viral disease? Why? 3. What further treatment is indicated for this case?It’s Day One in the St. Mary’s ER for nursing student, Toni Santos, as he embarks on clinical rounds with his preceptor, Nurse Martinez. His bond with a patient presenting suspicious lung-related symptoms takes him by surprise, as does his family’s. He is 56 symptoms are coughing and having trouble breathing, wheezing for about two weeks. He was a heavy smoker, dranks alcohol, and use heroin four year prior. Mr. Jones was severely overweight. The clinical manifestations for Mr. Jones were: the chronic cough, wheezing, hoarseness in the voice, and the lesion in the right upper lobe the x-ray revealed. Possible treatment/management is to stop smoking, lifestyle changes, chemotherapy, immunotherapies, radiation and eventually going in for surgery for either a wedge resection or lobectomy on the right lung,A risk factor... Increases the chance of a disease or condition developing. Yup! It increases the chances of developing a disease or condition. Mr. Jones’ risk factors are... Alcohol…Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 1. His wife tells you that he has started having hallucinations. Which medication might be causing this?Discuss why this happens.Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 5. List some general education points regarding sleep hygiene
- Mr. Cardia has been admitted to your ward and care is assigned to you. Information from the history you have taken includes reporting 4 days of anorexia, nausea, vomiting, and occasional diarrhoea before he sought medical attention. His wife says he'd started falling asleep frequently, looked pale, and mentioned seeing yellow spots. Current medications: 0.25 mg of digoxin once a day and 20 mg of frusemide twice a day for heart failure. Vital signs: BP 110/60 P 46 RR 26 T 36.5 What may the signs and symptoms indicate? (two words)Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia Do you have any concerns about his pain medication?Patient is a 38 year old female indicating to her psychiatrist feelings of: emptiness, helplessness, hopelessness, and a deep sense of guilt for no apparent reason. She also mentioned having low energy, (not wanting to cook for her family or wanting to be intimate with her husband). The patient indicated not caring for any of her regular hobbies or anything pleasurable, difficult concentrating, and even not remembering details. She is having problems sleeping and even contemplated going to bed and overdosing (just once)
- A 65-year-old woman gives a 1- to 2-month history of progressively cold and numb fingertips. The symptoms are persistent but episodic. She is a non-smoker. She also has a history of leukemia. Her feet are normal, and physical examination is otherwise unremarkable. All pulses are present. Her blood count and peripheral blood smear show: Hemoglobin (Hb) 90 g/L White blood cells (WBC) 14.6 × 109/L (neutrophils 67%) Platelets 1246 × 109/L Giant platelets RBCs (vary in size) Neutrophils (irregular forms) Other tests are normal What possible developments in hematology might help diagnose the patient? List all that apply. What are the terminologies in Hematology that are aligned with the patient’s case? List all that apply and explain why. By reviewing the timeline history of hematology, what are the specific contributions that will help solve the patient’s disease? List all that apply and explain why. NOTE: Kindly answer all the questions please. Thank youA 65-year-old woman gives a 1- to 2-month history of progressively cold and numb fingertips. The symptoms are persistent but episodic. She is a non-smoker. She also has a history of leukemia. Her feet are normal, and physical examination is otherwise unremarkable. All pulses are present. Her blood count and peripheral blood smear show: Hemoglobin (Hb) 90 g/L White blood cells (WBC) 14.6 × 109/L (neutrophils 67%) Platelets 1246 × 109/L Giant platelets RBCs (vary in size) Neutrophils (irregular forms) Other tests are normal What possible developments in hematology might help diagnose the patient? List all that apply. What are the terminologies in Hematology that are aligned with the patient’s case? List all that apply and explain why. By reviewing the timeline history of hematology, what are the specific contributions that will help solve the patient’s disease? List all that apply and explain why.Patient John lives at home with his child Sam. John has a history of Alzheimer’s Disease, NIDDM, AF, GORD, CCF, mild depression, and previous hernia and AAA repair and one week ago was diagnosed with advanced CA of the liver and metastases in the pancreas, lungs, and brain. Two weeks ago, John was bought into ED by his daughter with a history of new confusion, fevers, and rash, refusing diet and fluids for the previous two days and was jaundiced in colour. Jo deteriorated with sepsis. He experienced a cardiac arrest in ED. Following resuscitation, John was transferred to intensive care. He underwent further investigations and was diagnosed with advanced CA of the liver with metastases in the pancreas, lungs, and brain. John’s family then requested no further active treatment and asked that he be discharged home with support from the community nurses. Find 2 nursing problems with high priority for John and For the nursing problem of highest importance: Establish a minimum 3 goals for…
