Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as nausea weakness. Did also complain of worsening cough that was nonproductive as well as mild fever. CT chest was done in the emergency department which showed moderate right & small left pleural effusion with loculation bilaterally but decreased gas lucencies within the consolidated right upper lobe related to the previously demonstrated necrosis. She under went thoracocentesis on the right side and the pleural fluid was consistent with exudative effusion. Culture not growing any organism at this point. Restricted left arm AV fistula site, Type 1 diabetes, iron deficiency anemia, tobacco use, hypercholesteremia stage 1 wound coccx, fibroids, maintain on 3 liters NC. Pt is not in pain and had no bowl movement, no urine output due to dialysis. Congestive communication deficit, cardiac diet-fluid restriction. Mild Shortness of breath. Bowel sound present, lungs are clear. Please answer the questions base the the pt report, labs, and medications What is causing the abnormal lab values in YOUR PATIENT? 2. Are the abnormal lab values at the patient's baseline, or worse? 3. What labs that were drawn specifically correlate to your patient's medical diagnoses? 4. Trend labs, note which ones are getting better and why and which ones are getting worse and why. 5. What nursing interventions do you expect to complete to correct the abnormal lab value (s) in 'THIS patient?

Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as nausea weakness. Did also complain of worsening cough that was nonproductive as well as mild fever. CT chest was done in the emergency department which showed moderate right & small left pleural effusion with loculation bilaterally but decreased gas lucencies within the consolidated right upper lobe related to the previously demonstrated necrosis. She under went thoracocentesis on the right side and the pleural fluid was consistent with exudative effusion. Culture not growing any organism at this point. Restricted left arm AV fistula site, Type 1 diabetes, iron deficiency anemia, tobacco use, hypercholesteremia stage 1 wound coccx, fibroids, maintain on 3 liters NC. Pt is not in pain and had no bowl movement, no urine output due to dialysis. Congestive communication deficit, cardiac diet-fluid restriction. Mild Shortness of breath. Bowel sound present, lungs are clear. Please answer the questions base the the pt report, labs, and medications What is causing the abnormal lab values in YOUR PATIENT? 2. Are the abnormal lab values at the patient's baseline, or worse? 3. What labs that were drawn specifically correlate to your patient's medical diagnoses? 4. Trend labs, note which ones are getting better and why and which ones are getting worse and why. 5. What nursing interventions do you expect to complete to correct the abnormal lab value (s) in 'THIS patient?

Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as nausea weakness. Did also complain of worsening cough that was nonproductive as well as mild fever. CT chest was done in the emergency department which showed moderate right & small left pleural effusion with loculation bilaterally but decreased gas lucencies within the consolidated right upper lobe related to the previously demonstrated necrosis. She under went thoracocentesis on the right side and the pleural fluid was consistent with exudative effusion. Culture not growing any organism at this point. Restricted left arm AV fistula site, Type 1 diabetes, iron deficiency anemia, tobacco use, hypercholesteremia stage 1 wound coccx, fibroids, maintain on 3 liters NC. Pt is not in pain and had no bowl movement, no urine output due to dialysis. Congestive communication deficit, cardiac diet-fluid restriction. Mild Shortness of breath. Bowel sound present, lungs are clear. Please answer the questions base the the pt report, labs, and medications What is causing the abnormal lab values in YOUR PATIENT? 2. Are the abnormal lab values at the patient's baseline, or worse? 3. What labs that were drawn specifically correlate to your patient's medical diagnoses? 4. Trend labs, note which ones are getting better and why and which ones are getting worse and why. 5. What nursing interventions do you expect to complete to correct the abnormal lab value (s) in 'THIS patient?

Phlebotomy Essentials

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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Question

Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as nausea weakness. Did also complain of worsening cough that was nonproductive as well as mild fever. CT chest was done in the emergency department which showed moderate right & small left pleural effusion with loculation bilaterally but decreased gas lucencies within the consolidated right upper lobe related to the previously demonstrated necrosis. She under went thoracocentesis on the right side and the pleural fluid was consistent with exudative effusion. Culture not growing any organism at this point. Restricted left arm AV fistula site, Type 1 diabetes, iron deficiency anemia, tobacco use, hypercholesteremia stage 1 wound coccx, fibroids, maintain on 3 liters NC. Pt is not in pain and had no bowl movement, no urine output due to dialysis. Congestive communication deficit, cardiac diet-fluid restriction. Mild Shortness of breath. Bowel sound present, lungs are clear. Please answer the questions base the the pt report, labs, and medications What is causing the abnormal lab values in YOUR PATIENT? 2. Are the abnormal lab values at the patient's baseline, or worse? 3. What labs that were drawn specifically correlate to your patient's medical diagnoses? 4. Trend labs, note which ones are getting better and why and which ones are getting worse and why. 5. What nursing interventions do you expect to complete to correct the abnormal lab value (s) in 'THIS patient?

Glumeter
5-1=316
4-30 261
5-3-362
C02
5-1-28
5-2=24
5-3=26
ÉG FR
5-1-8
5-2-6
53-8
Patent Lobs
N₂
5-1-132
S-2-134
5-3 130
Са
51=89
5-2-7.21
S-3= 5.26
Temp=97.6
Bp: 118/64
Spo2 = 99
HR-82
h= 20
Anion GAP BUN Gratinine
5-1-53 51-5.73
52=71
5-2=7.21
5-3=45
5-3=5.26
5-1 = 12
S-2 = 15
5-3-12
AST-205-3
ALT= 365-3
Alkohne Phosphate = 108= 5-3
Protein 7.6-5-3
Albumin 3.1-5-3
Vitals at 8: Sa Bilindin 0.3=5-3
At 11:50AMS-3
Mg=2.0-5-3
MICH=27-1-5-3
MCHC 33-1-5-3
K
cl
5-1=92
5-1=4.8
5-2-4-9 5-2= 95
5-3 4.3
5-3-92
RDW-18-6-5-3
Platelels=333-5-3
Cordiet diet floid Restriction
WBC=82=5-3
HGB = 8.4-5-3
BP = 12/68 HOT = 25.1= 5=3
h=22
MCV-81-6-5-3
PLT=292 53
Temp 96.5
SPD2=97
HR=85
125-20
Sell

Medicatons
Gefeptime (Maxipione) injection (1.200
Acetaminopher (Tylend) 3.25 mg Toke 2(twe) fobs as needed for pain
Amlodipine (NorvVase)
9 Take 1 tab - Cheek Higblood pr
Aspirin Bling Chewable tablet > Blood thinner
Atorvastatin (Liptor) 40mg High Cholesterol.
B Complex with C 20-folic acid) Vitamin
(Triphrocops) Img capsule → Vatimin
Dextrose (Glutase 40%.gelkopter,
Dextrose 50%. injection 50ml
Gabapentin (neurotin) looma Aturo nelle pain
In Sulin glargine-ugn (semglee) injection & uint3
→ to gr
Loc tobacillus acidoph-L. bulgor (Floranex S100mp lhon cell B11)
• metotonin 3mg 7 For sleep
Pantoprazole (Protonix) Hong → Andreflux > Desophageal
Sevelomer Carbonate (Renkella) Stome) TID> for high blooch lus chayse
Vantom (in) (Vanco (in) 125ing Antibiotic for infection
Sodium Chloride (Ocean) 0.657. nasal s
Spray
Sochum Chloride 0.47% Sol P SomL with > mus lae cramps, dizzeress
Cefepime lg SolR loomy infections
Flud overload
Detalin

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