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- I have case study revion question. the quesion is A 25-year-old female presented to her 28 week antenatal appointment with the complaint oflethargy. It was noted the patient appeared pale. A full blood count was taken. blood flim of pateint has been attached. so the pateints heamoglobin was low heamatcrit was low MCV was low MCH was low But RDW (RED BLOOD CELL DISTRUCTION WAS high) at 17% i have conlcuded that she has microcytic anmeia. Struggling on dicussing a diffrential diagonsis part. Give a detail diffrentianl diagnosis. and what treaments can be given.A physician orders cepepime 0.15g IV q 12h.The nurse has the following vial of cefepime and the package insert for the drug .How many mls will the nurse administer◄ Mail AA 12:05 s-pdx-prod.inscloudgate.net Case Study Shock and Multiple Organ Dysfunction Syndrome 1. A S, is a 77-year-old male patient admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. 2. Patient has Foley catheter in place with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. 3. The patient is confused, afebrile, and hypotensive. BP 82/44 mm Hg. RR 28 breaths/min and the pulse oximeter reading is at 88% room air. Physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. 4. The patient developed diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for…
- Ordered; Nozinan 1'/2ounces subcut daily divided Into do ses for delirium lagitation• 3. Av ailable: NOzinan 2mg /ml Admiristered datly dose is Administered darly dose isCerritos College Health Occupations Division PHAR 64 Name: Date/Time: /0930 Medication Order Ceftriaxone 50 mg/kg syringe IV Push q24h. Infuse over 5 mins. Start infusion stat. Medical Orders Patient Information Kiera Totah 6 y/o female Wt: 20 kg Pharmacy Copy Pharmacy carries: Ceftriaxone 1 g is to be reconstituted with 9.6 mL of sterile water for a final concentration of 100 mg/mL • Stability: IN 0.9% NaCI: 48 hours 1. Perform Calculations: Volume to be added to given IVP mL 2. Prepare IV & label for one dose 3. Perform hand washing 4. Garb 5. Retrieve necessary materials 6. Clean the hood 7. Prepare IV using sterile technique INTRAVENOUS SOLUTION ADDITIVES Date: Room No: Patient Name: Time Prepared: Drugs Added: IV No. By: BUD: Initials:Give me a rationale about this case scenario CASE SCENARIO #2 – The Client with Cognitive Disorder (Delirium) Meredith, who is 75 years old, and frail is admitted to the hospital with a fractured hip. She undergoes surgery to repair the hip and subsequently is sent to a general surgical unit. She appears alert and oriented, although she is in pain. She is receiving intravenous fluids and has an indwelling urinary catheter, both of which are to be discontinued in the morning. The evening of the first postoperative day, Meredith tells the nurse that bugs are on the walls and that she wants to leave this place. The nurse questions her and records that Meredith is no longer oriented to place or time: she also is having visual hallucinations. During the questioning, Meredith becomes mildly agitated and tells the nurse to get out. The nurse notifies the physician of the change in Meredith’s mental status. The physician orders CT Scanning to rule out a possible injury sustained in the…
- scenario NAME OF PATIENT TIME OF EXTRACTION PLASMA CONCENTRATION OF PARACETAMOL (mcg/mL) CD 6:55 PM 120 EF 8:15 PM 55 GH 9:20 PM 42 IJ 11:30 AM 6 KL 12:40 AM 20 MN 4:30 AM 38 OP 6:15 AM 58 QR 7:20 AM 67 ST 8:40 AM 23 UV 9:05 AM 14.5 CD, a 5 year male was discovered by his mother holding a half-filled bottle of Paracetamol 500mg tablets at 6 AM. EF, a 16 year-old female was brought in by her roommate who found her inside the bathroom holding blister pack around 3 PM. GH, a 2 year-old male was given 2 tablets of Paracetamol 250mg by his mother at 8:30 AM. IJ, a 6 year-old male mistakenly took the drug for candy. According to his mother, he took the tablets at around 11 PM yesterday. KL, a 16 year-old female intentionally took 46 tablets of Paracetamol 500mg at 4 PM. MN, a 40 year-old took 20 tablets at around 12 PM. OP, a 6 year-old male received a miscalculated dose of Paracetamol IV at…*****Case Analysis Patient ID: A.C, a 4 year old female from Daraga Albay. History source – Mother 100 % reliability. Chief compliant: Persistent vomiting. History of present illness: 2 weeks PTA the patient experienced abdominal pain with painful urination. No fever, no vomiting, nor watery stool. No medication nor consult was done. 7 days PTA, the patient presented with an episode of vomiting with the passage of live worms. She also experiences abdominal pain without passage of stool for 2 days. 6 days PTA, the abdominal pain was persistent and with several episodes of vomiting but no passage of live worms. A few hours of PTA, the persistence of abdominal pain, increased frequency of vomiting, and presence of abdominal distention prompted them for a consult. Past medical history: (+) Bronchial asthma with last attack 1 month ago. (-) Heart disease. Family history: (+) DM, maternal and paternal side. (-) Cancer, cardiac disease, kidney, and asthma. Birth and Maternal history: 24…Patient is a 78 y/o male with a history of COPD & HTN. He smokes 1 – 2 packs/day & requires oxygen athome. He presents to the ER with increased SOA (shortness of air), fever, and worsened cough withthick sputum production. The physician in the ER diagnosis him with pneumonia and starts him onprednisone and clarithromycin, an antibiotic AllergiesPenicillin (hives,shortness of air,swollen tongue andthroat)Current MedicationsTiotropium (Spiriva®) inhaler I puff PO once dailyTheophylline (Theo-DUR) 300mg PO BIDLisinopril 10 mg PO dailyAlbuterol MDI (Proventil®) 2 puffs q 2-4 hours as needed for SOAPrednisone 50 mg daily x 7 daysClarithromycin (Biaxin) 500mg PO BID x 7 daysPMH COPDHTN 1.using Clinical Pharmacology (Reports->Drug Interaction Reports) as a reference, discuss the druginteraction between theophylline and clarithromycin.2. What are the common side effects of theophylline?3. What is the mechanism of action of tiotropium (Spiriva®)?4. What are long-term complications /…
- Case 2 A 45-year-old male patient visits the hospital with a 3-month history of upper abdominal pain associated with nausea. Pain is worsened whenever he drinks alcohol, soda or even coffee. He is a smoker and a moderate alcohol drinker. He denies use of NSAIDs. Physical assessment and vital signs are normal. However, there is notable epigastric tenderness from the abdominal examination. His stool is also heme positive. CBC shows a mild hypochromic, microcytic anemia. Endoscopic examination reveals diffuse gastritis and ulcer. A gastric biopsy is then ordered by the physician. 1. What organism is most likely to be seen from the gastric biopsy? Identify the specific type of ulcer to complete the diagnosis. 2. Provide other clinical test to facilitate rapid detection of this organism. Describe briefly the procedure.3. Enumerate factors which contribute to the organism’s ability to colonize the stomach. 4. If left untreated, what other long term complications could this organism cause?Patient Case Question 11. Identify five elevated laboratory test results that are consistent with a diagnosis of bacterial endocarditis. Patient Case Question 12. Explain the pathophysiology for any three of the five elevated laboratory results identified in Question 11 above. Patient Case Question 13. Identify two subnormal laboratory results that are consistent with a diagnosis of bacterial endocarditis.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…