47. A 56-year-old man is admitted to the hospital because of a 1-week history of progressive nausea, anorexia, dyspnea, and lethargy. He has a 15-year history of type 2diabetes mellitus and hypertension. His respirations are 28/min, and blood pressure is 178/98 mm Hg. Physical examination shows jugular venous distention and pedaledema. Bilateral crackles are heard on auscultation of the chest. His serum creatinine concentration is 7.2 mg/dL. Which of the following is most likely to be decreasedin serum in this patient?A) Alkaline phosphataseB) 1,25-DihydroxycholecalciferolC) Parathyroid hormoneD) PhosphorusE) PotassiumF) Uric acid

Derangement in potassium regulation can lead to neuromuscular, gastrointestinal and cardiac…

Answered: A 56-year-old man is admitted to the…

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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A 60-year-old woman comes to the physician because of a 2-month history of shortness of breath and cough and a 2- week history of progressive swelling of her face. The cough is productive of approximately /4 cup of mildly blood-tinged, white-to-yellow sputum daily. She has had a 2.3-kg (5-Ib) weight loss over the past 4 months. She has a 15-year history of hypertension treated with enalaprl. She has smoked 1 pack of clgarettes daily for 45 years. Her pulse is 90/min and regular, respirations are 20/min, and blood pressure is 135/90 mm Hg. Physical examination shows edema of the face and neck and jugular venous distention. Breath sounds are mildly decreased throughout all lung fields, and there are no cardiac murmurs. Her serum sodium concentration is 125 mEq/L. Which of the following is the most likely direct cause of this patient's facial edema? A) Angioedema from angiotensin-converting enzyme (ACE) inhibitors B) Impaired cardiac filling from cardiac tamponade C) Increased vascular…
A young woman is brought to the emergency department by ambulance after a severe motor vehicle accident. She is unconscious. Her blood pressure is 64/40 mm Hg; heart rate is 150 bpm. She is intubated and is being hand-ventilated. There is no evidence of head trauma. The pupils are 2 mm and reactive. She withdraws to pain. Cardiac examination reveals no murmurs, gallops, or rubs. The lungs are clear to auscultation. The abdomen is tense, with decreased bowel sounds. The extremities are cool and clammy, with thready pulses. Despite aggressive blood and fluid resuscitation, the patient dies. Questions A. What are the four major pathophysiologic causes of shock? Which was likely in this patient? B. What pathogenetic mechanism accounts for this patient’s unresponsiveness? For the cool, paleextremities? C. What forms of hypovolemic shock may have been present in this patient? Why?
Case: A 37-year-old patient, a woman who has smoked for 10 years, consulted for malaise, headache, nausea, and fatigue. The medical examination found tendon xanthomas, skin xanthomas, signs of atherosclerosis. Laboratory test Glycemia 90 mg/dL, total cholesterol 560 mg//dL, TAG 230 mg/dL, cHDL 33 mg/dl. ACCORDING TO THE REPORTED DATA, CAN YOU FIND A MOLECULAR AND/OR BIOCHEMICAL EXPLANATION FOR THE REPORTED BIOCHEMICAL PARAMETERS AND RECORD IT IN A METABOLIC SCHEME THAT EXPLAINS SUCH ALTERATIONS?
A 6 month-old male infant is admitted to the hospital with diagnosis of recurrent pneumonia. His vital signs on admission: respiratory rate = 50 /min; heart rate = 170 beats/min; temperature – 102˚ F. Substernal retractions are prominent. Lung auscultation: bilateral wheezes and rhonchi. Medical history: this is a third admission since birth for pneumonia. His mother also states that he hasn’t gain body weight like her older child had at 6 months of age. How is this case consistent with cystic fibrosis diagnosis? What tests could be ordered to confirm the diagnosis? What interventions could help to alleviate respiratory distress?
What condition does this patient likely have?
A 56-year-old woman named Cranberry complained during her yearly physical examination of tiredness and difficulty concentrating. She attributed these symptoms to stress at work. She had gained weight over the last year and despite warm weather, she felt chilled without a sweater. Family history was significant for hypothyroidism in her mother and older sister. On physical examination she had a pulse of 58 bpm and a blood pressure of 138/88 mm Hg. Examination of her neck disclosed a small thyroid gland with a palpable pyramidal lobe and a firm, bosselated texture. Serum taken at this time demonstrated a total T4 of 7.0 mcg/dL and a TSH of 22.0 mcIU/ml. In addition, antithyroglobulin antibodies were positive at 1:640 and antimicrosomal antibodies were positive at 1:5120. These results supported the clinical impression of hypothyroidism; also, the texture of her thyroid gland and a positive family history suggested an autoimmune etiological factor. Create a Nursing Care Plan focusing…
A patient tells the nurse she is having pain in her rightlower leg. How does the nurse assess for the presence ofthrombophlebitis?a. By palpating the skin over the tibia and fibulab. By documenting daily calf circumference measurementsc. By recording vital signs obtained four times a dayd. By noting difficulty with ambulation
Pt who was at home treating her right foot infection with VNA support. VNA recommended she return to the hospital because she was not caring for herself. The pt has not been able to get up and walk around including going to the bath. She complains of discomfort with swallowing and so she is not consistently taking her medication. She denies chest pain and shortness of breath. She is dysphagia, stage 2 plantar heel ulcer and at her butt. Has bruises on both hands, both legs is discolor and peeling. High fall risk and wear diapers. Pain is 7 on a scale of 0-10 at her coccyx wound. Normal bowl sounds and lungs sounds and heart sound. Cellulitis of right lower extremities. Cardiac diet and hypertension. Base on this information please do the concept map in the image
A 3-year-old child is noted to have small pinpoint hemorrhages on the skin, appearing over the past 3 days. On examination the child's vital signs are normal. There are petechae over skin of extremities and trunk. A CBC shows Hgb 14.3 g/dL, Hct 43%, MCV 90 fL, platelet count 19,300/microliter, and WBC count 9370/microliter. This condition resolves over the next month without treatment. Which of the following is the most likely antecedent event for this child's illness? Acetylsalicylic acid (aspirin) ingestion Repetitive trauma Congenital HIV infection Upper respiratory infection Dietary cobalamin deficiency Sulfonamide ingestion
Answer the three questions
A 65-year-old male patient, Mr. Thompson, has been admitted to the medical-surgical floor with a diagnosis of congestive heart failure (CHF). He has a history of hypertension and type 2 diabetes mellitus. Upon admission, Mr. Thompson reports shortness of breath, fatigue, and swelling in his legs and feet. His vital signs are as follows: blood pressure 160/90 mmHg, pulse 102 bpm, respiratory rate 22 breaths/min, and oxygen saturation 92% on room air.As his nurse, you are responsible for performing a comprehensive assessment and initiating appropriate interventions based on your findings.Describe the initial nursing assessment you would perform for Mr. Thompson, detailing the specific aspects you would focus on given his diagnosis and symptoms.
A 48 year old female is admitted with the diagnosis of pancreatitis. She is complaining of nausea, vomiting and severe muscle weakness. The electrocardiogram shows frequent premature ventricular contractions. Her symptoms are most likely due to

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