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Hi, can you make an FDAR or PDAR out of this case? Just not 'difficulty in breathing
CASE # 2: RESPIRATORY DISTRESS IN THE NEWBORN
Setting: Hospital
Chief Complaint: “My baby is not breathing well”
Vital Signs: HR: 145bpm; RR: 45bpm
History Present Illness: The patient was born via cesarean section 1 hour ago to a G1P0 mother with no gestational complications at 39 weeks. The mother has routine prenatal care and no medical problems during her pregnancy. The mother states that the patient appears not to be breathing well.
Physical Examination:
- General: Awake and alert
- Head: No hematoma, No Concussion
- Chest: Ribs can be seen between breaths, (+) Intercostal retractions
- CVS: S1S2 (+) tachycardia, no murmurs/rubs/gallops
- Lungs: (+) Crackles bilateral
- Abdomen: Soft, non-tender, non-distended, (+) bowel sounds
- Extremities: no cyanosis noted
Step by step
Solved in 2 steps
- Hello, may I ask what can be the problems or foci in this PDAR from this case? CASE # 2: RESPIRATORY DISTRESS IN THE NEWBORN Setting: Hospital Chief Complaint: “My baby is not breathing well” Vital Signs: HR: 145bpm; RR: 45bpm History Present Illness: The patient was born via cesarean section 1 hour ago to a G1P0 mother with no gestational complications at 39 weeks. The mother has routine prenatal care and no medical problems during her pregnancy. The mother states that the patient appears not to be breathing well. Physical Examination: General: Awake and alert Head: No hematoma, No Concussion Chest: Ribs can be seen between breaths, (+) Intercostal retractions CVS: S1S2 (+) tachycardia, no murmurs/rubs/gallops Lungs: (+) Crackles bilateral Abdomen: Soft, non-tender, non-distended, (+) bowel sounds Extremities: no cyanosis notedPatient’s Profile: A 22-year old woman in her 2nd pregnancy has arrived in the labour ward at 38 weeks 3 days. She had a normal delivery 18 months ago. This pregnancy has been complicated by persistent vomiting until 20 weeks and more recently by anemia. She reports contractions commencing approximately 4 hours ago. She took paracetamol at home and tried to relieve the pain with a bath, but now she feels she cannot cope with the pain. She had a show 2 days ago but has had no bleeding since then and has not noticed any vaginal leak. She has felt the baby moving normally all day. Physical Examination: BP is 110/58 mmhg, heart rate is 98/min. The presentation is cephalic with 2/5 palpable abdominally. Uterine contractions are palpable and the uterus is non-irritable. On vaginal examination, the cervix is 5 cm dilated and the head is 1 cm above the ischial spines. The fetus is right occipitotransverse with mild caput and molding. The membranes are intact but rupture…Case #2Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years, but quit 3 years ago. Mr. H suggests hypoxemia and respiratory alkalosis which might be an indication of serious illness such as pulmonary embolism. Part 1: His arterial-venous oxygen content (Ca-vO2) difference is 5.73 mL/dL Part 2: His extraction ratio (ER) 0.276 or 27.6% What is clinically happening to the patient? Please explain.
- Case #2Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years, but quit 3 years ago. Part 1: What is his arterial-venous oxygen content (Ca-vO2) difference? Part 2: Calculate his extraction ratio please.Case #2Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough,hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years, but quit 3 years ago.Blood work values on room air:Blood Gas Blood Gas Arterial Venous pH 7.51 7.40 PaCO2 30 mmHg 45 mmHg PaO2 60 mmHg 30 mmHg HCO3 24 mEq/l 21 mEq/l BE - 1 - 4 SaO2 90% 60% Hb 15 g/dl 15 g/dl Part 1: Interpret the ABGPart 2: What is the arterial- venous oxygen content (Ca-vO2) difference for this patient?Question: Can you make an Overall and Summary of the given Case Scenario? INFANT WITH TETRALOGY OF FALLOT Case Scenario: Baby Pearl, a 9-month-old girl presents to the emergency department with his mother,who reports episodes of tachypnea, cyanosis, and irritability during feeding. The mother explainsthat these episodes have become more frequent, with baby Pearl becoming more cyanotic aroundthe mouth and fingers especially when crying (tet spells) when she was around 7 months old.These episodes resolve spontaneously but are occurring every few days. The mother breastfeeds every 3 hours, but sometimes takes a long time to feed. She alsoobserved that baby Pearl becomes diaphoretic with feeding, and stops frequently to catch herbreath while feeding. She reported to the nurse that vomiting the milk (sometimes goes out fromthe nose) and becomes more frequent after feeding. The patient currently appears comfortable,with no signs of respiratory distress, fever, or neurological impairment.…
- CASE SCENARIO -DELIVERY ROOM Patient Susan is a 47 years old, G2P1 female who is living with her family at Silay City. She is a high school graduate, non-smoker, non-alcoholic and no allergies reported. Patient Susan was admitted to the labor room with the chief complaints of bright red profuse vaginal bleeding. She is in her third trimester of pregnancy, vaginal examination done by Dr .Torres revealed 5cm cervical dilatation with no labor pain .Dr. Torres ordered as follows; to start IVF of D5LR 1liter x 30gtts./min., O2inhalation @ 2 l/min via nasal cannula, Vital signs and FHB monitoring q 30mins. Put on bedrest. Patient Susan's vital signs upon admission: BP-90/60 mm/Hg Temperature-37 degree Celsius PR-90 bpm RR-30 cpm FHB-130 bpm@ left lower quadrant. As a student nurse, based on the case scenario above: 1. Formulate 1 possible nursing diagnosis in the case scenario given( 1Actual/1Risk)CASE SCENARIO -DELIVERY ROOM Patient Susan is a 47 years old, G2P1 female who is living with her family at Silay City. She is a high school graduate, non-smoker, non-alcoholic and no allergies reported. Patient Susan was admitted to the labor room with the chief complaints of bright red profuse vaginal bleeding. She is in her third trimester of pregnancy, vaginal examination done by Dr .Torres revealed 5cm cervical dilatation with no labor pain .Dr. Torres ordered as follows; to start IVF of D5LR 1liter x 30gtts./min., O2inhalation @ 2 l/min via nasal cannula, Vital signs and FHB monitoring q 30mins. Put on bedrest. Patient Susan's vital signs upon admission: BP-90/60 mm/Hg Temperature-37 degree Celsius PR-90 bpm RR-30 cpm FHB-130 bpm@ left lower quadrant. As a student nurse, based on the case scenario above: 1.What are the clinical manifestations present in your patient?CASE SCENARIO -DELIVERY ROOM Patient Susan is a 47 years old, G2P1 female who is living with her family at Silay City. She is a high school graduate, non-smoker, non-alcoholic and no allergies reported. Patient Susan was admitted to the labor room with the chief complaints of bright red profuse vaginal bleeding. She is in her third trimester of pregnancy, vaginal examination done by Dr .Torres revealed 5cm cervical dilatation with no labor pain .Dr. Torres ordered as follows; to start IVF of D5LR 1liter x 30gtts./min., O2inhalation @ 2 l/min via nasal cannula, Vital signs and FHB monitoring q 30mins. Put on bedrest. Patient Susan's vital signs upon admission: BP-90/60 mm/Hg Temperature-37 degree Celsius PR-90 bpm RR-30 cpm FHB-130 bpm@ left lower quadrant. As a student nurse, based on the case scenario above: 1.What will be your impression about the condition of your patient? 2.What are the clinical…
- CASE SCENARIO -DELIVERY ROOM Patient Susan is a 47 years old, G2P1 female who is living with her family at Silay City. She is a high school graduate, non-smoker, non-alcoholic and no allergies reported. Patient Susan was admitted to the labor room with the chief complaints of bright red profuse vaginal bleeding. She is in her third trimester of pregnancy, vaginal examination done by Dr .Torres revealed 5cm cervical dilatation with no labor pain .Dr. Torres ordered as follows; to start IVF of D5LR 1liter x 30gtts./min., O2inhalation @ 2 l/min via nasal cannula, Vital signs and FHB monitoring q 30mins. Put on bedrest. Patient Susan's vital signs upon admission: BP-90/60 mm/Hg Temperature-37 degree Celsius PR-90 bpm RR-30 cpm FHB-130 bpm@ left lower quadrant. As a student nurse, based on the case scenario above: 1.What will be your impression about the condition of your patient?S B is a 54-year-old Latina female who went to her healthcare provider with complaints of heartburn, dysphagia, nausea, and chest pain. She feels bloated and obtains little or no relief from over-the-counter antacids. Her past medical history includes 2-pack-a-day cigarette smoking, stressful job, and chronic use of NSAIDs for chronic back pain. 1.What is the recommended diagnostic test to diagnosis GERD? Why?Patient's Profile: A 22-year-old woman in her 2 pregnancy has arrived in the labor ward at 38 weeks 3 days She had a normal delivery 18 months ago. This pregnancy has been complicated by persistent vomiting until 20 weeks and more recently by anemia. She reports contractions commencing approximately 4 hours ago. She took paracetamol at home and tried to relieve the pain with a bath, but now she feels she cannot cope with the pain She had a show 2 days ago but has had no bleeding since then and has not noticed any vaginal leak. She has felt the baby moving normally all day. Physical Examination: BP is 110/58 mmHg, heart rate is 98/min. The presentation is cephalic with 2/5 palpable abdominally, Uterine contractions are palpable and the uterus is non-irritable. On vaginal examination the cervix is 5 cm dilated and the head is 1 cm above the ischial spines. The fetus is right occipitotransverse with mild caput and molding. The membranes are intact but rupture spontaneously during…