. A 19-year-old male with known generalized epilepsy was brought tothe emergency department for convulsive status epileptics. He hashad nausea, emesis, and a low grade fever for the last 5 days and hasbeen unable to take his home antiepileptic drug. He is havingongoing low amplitude, rhythmic clonic movements of his bilateralarms and legs. His vitals are as follows: heart rate 86, blood pressure106/68, SpO, 100% on 2 L nasal canula, temperature 100.2°C. EMSadministered 2 mg of lorazepam and had cessation of clonicmovements but still altered and not back to baseline mental state.What is the next best medication treatment for this patient?A. Intubate the patient and start propofolB. Monitor the patients for few hours and order EEGC. Additional lorazepam to dose of 0.1 mg/kg followed byfosphenytoin with loading dose of 15 mg/kg IVD. Obtain CT head to further evaluate the etiology and rule outstructural abnormalities

Status epilepticus is very common public health issue in the United States. Status epilepticus is a…

Answered: A 19-year-old male with known…

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 45-year-old man had a 10-day history of appetite loss, flu-like symptoms, and nausea. He noticed that upon urination, his urine had been dark in color over the past 4 days. On examination, he had tenderness in his upper right quadrant of his abdomen. Laboratory tests show: Total Bilirubin- 4.5 mg/dL Direct Bilirubin- 2.5 mg/dL Indirect Bilirubin- 2.0 mg/dL 1. What is the clinical importance of the result of: a. Total Bilirubin b. Direct Bilirubin c. Indirect Bilirubin 2. What does the dark-colored urine indicate? 3. What is the diagnosis of the patient? 4. What other tests are needed to be done to support your diagnosis?
Clinical case: Mrs. P, patient with neurological signs suggesting meningitis . Your 45 year old patient (who has recently moved from Great Britain where sey were born and raised) presents with severe headaches, stiffness in the neck, confusion and drowsiness. • You suspect meningitis, a life threatening infection of the tissue surrounding the brain and spinal cord. • You take a cerebrospinal fluid (CSF) sample from the patient and send it to the micro lab for examination and culturing. • Later that day the micro lab reports that no bacteria nor fungi were observed on a direct smear of the CSF. In 3 days, the lab reports that no The lab also ran PCR for the most common viruses causing meningitis and all were negative. • ELISA's checking for helminth and protozoal infections were also negative. • Blood work suggests there is no immune response to the pathogen causing the patients clinical signs and symptoms. nor fungi grew in cultures. Based on these results, you believe the pathogen…
Note: Repost, need other solution. Thank you THE NERVOUS/NEUROLOGICAL SYSTEM Client Profile: Mrs. Seaborn is a 43-year-old woman who presents to the emergency department with complaints of weakness of the left side of her face. She is married and is an interior decorator who owns her own business. Earlier today she was working at a client's home when she started to have increased facial weakness and was unable to taste her lunch. She states a history of two days of numbness in her forehead. Case Study: Mrs. Seaborn's vital signs are temperature 98.2°F, blood pressure 148/60, pulse 83, and respiratory rate of 26. She is fearful, crying, and states, "My mother died of a stroke, I am sure that is what is going on. Am I going to die?" She complains of pain behind and in front of her left ear. She is exhibiting unilateral facial paralysis. Her left eye is drooping and she says it feels dry. Her inability to raise her eyebrow, puff out her cheeks, frown, smile or wrinkle her forehead is…
A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film? What is the clinical significance of the platelet count? NOTE: If you could answer all the questions please. Thank you!
Note: Repost, need other solution. Thank you THE NERVOUS/NEUROLOGICAL SYSTEM Client Profile: Mrs. Seaborn is a 43-year-old woman who presents to the emergency department with complaints of weakness of the left side of her face. She is married and is an interior decorator who owns her own business. Earlier today she was working at a client's home when she started to have increased facial weakness and was unable to taste her lunch. She states a history of two days of numbness in her forehead. Case Study: Mrs. Seaborn's vital signs are temperature 98.2°F, blood pressure 148/60, pulse 83, and respiratory rate of 26. She is fearful, crying, and states, "My mother died of a stroke, I am sure that is what is going on. Am I going to die?" She complains of pain behind and in front of her left ear. She is exhibiting unilateral facial paralysis. Her left eye is drooping and she says it feels dry. Her inability to raise her eyebrow, puff out her cheeks, frown, smile or wrinkle her forehead is…
Case scenario:Client ERIC RAYMOND, 12 years old from CAA HOUSING, MANUYO DOS, Las Pinas City, was admitted in the hospital due to high grade fever for 4 days. Vital signs taken are as follows: BP 110/60, RR is 14, PR is 78 and Temp is 38.5. high grade fever Weight is 45kgs. Eric Raymond is known to have allergic reactions to eggs and seafoods but no known allergies to any medication. CBC / Platelet counts were requested laboratory test was done.Client Eric Raymond was admitted under the care of Dr. Rod Buenavista. Admitting diagnosis is Dengue Fever.Dr. Buenavista ordered the following. Start IVF of 1L of D5.09 NaCl to be infused for 8 hours. IVF started at 9amGive Acetaminophen 500mg q 4hrs.Repeat Platelet count after 8 hoursGive one common problem for client in Intravenous therapy and list 2 independent nursing interventions you can do to manage the problem
Mr. Hooke a 35 y/o male presented himself in the clinic complaining of shortness of breath and having fevers for the past few weeks. He is known to be infected with HIV for almost 2 years already. He returns to HIV clinic at different intervals for follow-up. He has been on stable antiretroviral therapy consisting on didanosine, stavudine, and indinavir for the past year. Patient history revealed that he is unsure about his immunization status, and thinks he got them as a child. Physical Examination as follows: General: thin, anxious, acutely ill-appearing, young white man with tachypnea Neck/LN: slight cervical lymphadenopathy, thyroid normal Lungs/Thorax: CTA, slight axillary lymphadenopathy Labs Chest X-ray: Bilateral subtle infiltrates Bronchoscopy with BAL: positive for the presence of a unicellular eukaryote, a yeast-like fungus Assessment: breakthrough opportunistic infection question: What drug, dosage form, schedule, and duration of therapy are best for treating this…
A 60-year old male patient, right-handed, single, tricycle driver is diagnosed with R CVD infarct, at day 5 post-ictus. On personal social history, the patient is living in a bungalo house with his 70-year old sister and her 20-year old son. Upon evaluation, the patient is awake, dysarthric, but manages to follow commands. The following are the pertinent physical examination findings: Shallow R nasolabial fold, fair gutturals, lingual, (+) gag reflexTone and reflex: hypotonic, hyporeflexive left upper and lower extremitiesMotor: MMT 0/5 left upper and lower extremities, 5/5 on right upper and lower extremitiesSensory: 50% deficit on left upper and lower extremitiesOther systemic physical examination findings were unremarkableFunctional assessment: moderately assisted in all ADLs The patient will be progressed from bed mobility skills to transitions to sitting. How will this be instructed?
A 54-year-old man presents with a 12-hour history of headache, confusion and declining consciousness. His wife says that he has recently completed oral chemotherapy for an ‘indolent form of leukemia’. Examination reveals him to be responding to painful stimuli but not to verbal commands. He has bilateral axillary and inguinal lymphadenopathy. He is clinically jaundiced and anemic. His spleen is palpably enlarged. He has neck stiffness, generalized hyper-reflexia and bilateral up going plantar reflexes. Fundal examination is normal, and there are no focal neurological signs. Full blood count shows: Hemoglobin (Hb) 7.5 g/dL White blood cells (WBC) 37 × 109/L (lymphocytes 86%) Platelets 26 × 109/L What blood component is best to harvest to find out the patient’s disease? Why lymphocytes are prevalently seen in the peripheral blood film? What is the clinical significance of the platelet count?
The patient was a 13-month old child who, on the day of admission, seemed fine according to his mother except for a runny nose and a low-grade fever (which she treated with Tylenol). Later in the day, while riding in the car with his mother, he suddenly had a grand mal seizure with shaking of the arms and legs. The seizure lasted 2 minutes. She called an ambulance. The emergency medical technicians found him limp, unresponsive, and apparently post ictal (post seizure state). In the emergency room he had a second seizure. On physical examination, he had a temperature of 39.5 ° C, and a pulse of 160 BPM. He was noted to be lethargic, but his neck was supple. Except for a runny nose, the rest of his physical examination was normal. Blood and urine cultures were obtained to rule out sepsis, and the child was begun on IV ceftriaxone (rocephin). His vaccination record is incomplete, but his mother insists that he is up to date on all vaccines. The patient's mental status did not improve…
A 60-year old male patient, right-handed, single, tricycle driver is diagnosed with R CVD infarct, at day 5 post-ictus. On personal social history, the patient is living in a bungalo house with his 70-year old sister and her 20-year old son. Upon evaluation, the patient is awake, dysarthric, but manages to follow commands. The following are the pertinent physical examination findings: Shallow R nasolabial fold, fair gutturals, lingual, (+) gag reflexTone and reflex: hypotonic, hyporeflexive left upper and lower extremitiesMotor: MMT 0/5 left upper and lower extremities, 5/5 on right upper and lower extremitiesSensory: 50% deficit on left upper and lower extremitiesOther systemic physical examination findings were unremarkableFunctional assessment: moderately assisted in all ADLs The short-term goal for the patient is to be minimally assisted in bed mobility. What are two bed mobility activities to teach this patient to achieve this goal.

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