CASE STUDY 2:(re)Sam Smith is a 57-year-old male, who lives alone in a large city in New Jersey. Sam hadrecently been feeling weaker and noticed he was having difficulty picking up his pen or lifting acup of coffee. Sam decided to schedule an appointment in the Federally Qualified Health Centerat which you are employed. After seeing the Nurse Practitioner and multiple tests, Sam isdiagnosed with Amyotrophic Lateral Sclerosis (ALS). After receiving the diagnosis and someliterature to read, Sam schedules a follow up appointment to discuss his options further. Samreturns to the center in a few days and informs you he has been reading about ALS online andknows that it is a terminal disease. Sam states he does not have family nearby and does notwant to be a burden on any of his friends. Sam is exhibiting signs of depression and asks youabout ending his life. He has read about the laws in New Jersey and would like to know how hegoes about getting the medication.1. What are your responsibilities in this situation2. What role does the nurse play in the decision-making process?3. What are the ethical dilemmas4. What are the legal steps that should be taken5. What counseling should the patient receive

Case summary: Sam Smith is a 57-year-old man living alone in a large city in New Jersey. Sam…

Answered: Sam Smith is a 57-year-old male, who…

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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Q1) A 50 year old Caucasian male who presented to physical therapy with severe upper extremity pain and radicular symptoms into his right forearm and hand that occurred from a traumatic accident 11 months ago. The patient is a correctional officer and while on the job, a metal hatch fell on his outstretched right arm proximal to the acromion process. Imaging two months post injury showed no fractures or nerve damage at the neck or shoulder. The primary complaint was the extreme constant pain he experienced in his right upper trapezius, anterior right shoulder, right lateral forearm, and first and second digits of his right hand. There is no Tinel's sign and electrodiagnostic studies are normal. a)What is the possible diagnosis of patient?
Ricky, a 55-year-old man presented to hospital's emergency room with severe, radiating substernal pain. He was overweight (BMl = 40) , however all other vital signs including cardiological assessments were normal. He admitted to imbibing excessive amount of alcohol the night before. He reported no overt use of nonsteroidal anti-inflammatory drugs (NSAIDs) but indicated that he sometimes experiences a burning sensation in your chest with difficulty in swallowing and regurgitation of food or sour liquid. The doctor prescribed omeprazole and directed him perform an upper endoscopy (a)Identify the cause of Ricky's pain and justify you answer. (b) Briefly outline the mode of action of omeprazole in alleviating his symptoms.
Johnny is 7 years old and in the first grade. He has trouble sitting still, often loses things, is very loud, and acts very impulsively. Your evaluation has determined that he meets criteria for ADHD. His parents are coming to your office tomorrow to discuss the results. How do you tell them? What if they feel that they’ve done something wrong? Do you recommend psychotherapy? Do you recommend medication?
Ms. M is 42 years old and has had rheumatoid arthritis for six years. At baseline, her fingers are stiff and show slight ulnar deviation. She has come to see you as she is currently experiencing an exacerbation, and her wrists are red and swollen. She finds it to be painful when something such as clothing touches the skin over her wrists. Her elbows and knees are also stiff and painful, especially after she has been resting. She is feeling extremely tired and depressed and has not been eating well. Describe the pathophysiologic process that leads to the appearance and the pain occurring at her wrists. Is this an acute or chronic process? Could it be both? Describe the pathophysiology contributing to the stiff, deformed fingers. What terms can be used to describe this?
You are the palliative care nurse. Mrs. Jones has been living with congestive heart failure for some time and has been receiving palliative care in the home setting for about a year. Her activity tolerance has decreased to the point she can only move from one room to the other in in her home with her oxygen at 4 liters. She is able to sleep in her recliner. Increasing ascites has made it difficult for her to eat. She tells you she is 'totally exhausted' almost all the time. She has been in and out of the hospital with exacerbations three times in the last six months. Each time she comes home she says she 'feels worse'. Today during your home care visit, Mrs. Jones brings up hospice care. 1. How would you explain the difference between palliative care and hospice care? Mrs. Jones tells you she would like her daughter to hear more about hospice care. The daughter is present at the next home care visit (two weeks later). The daughter becomes upset and makes it very clear that she thinks…
Rick Andrew, a 45-year-old male client who had a cerebral vascular accident 1 week ago, is admitted to the rehab unit. The neurological deficits include the following: right arm paralysis, right leg weakness, right-sided homonymous hemianopsia, dysphagia, and expressive aphasia. The RN needs to manage the nursing care for the client’s neurological deficits. What nursing management does the client need? Explain how to prevent shoulder subluxation from occurring.
Explain the importance of geriatrics as a specialty in medicine.
Kelly is a 36-year-old female who has a history of type 2 diabetes, several respiratory infections as a child, and two full-term pregnancies (5 and 7 years ago). Two days ago, she began feeling a burning sensation when urinating. Her pain is progressively getting worse. Kelly assumes that she has a urinary tract infection (UTI) and makes an appointment at her primary clinic to seek relief.Kelly will likely be prescribed short-course antibiotics for treatment. She may also be prescribed an analgesic. How would this help her, physiologically?
Zoran Solano, a 20-year-old man was brought into the Emergency Department (ED) after an accident whilst riding on an electric scooter. He was stabilised and transferred to the Orthopaedic Ward for surgery in the morning. BACKGROUND Zoran Solano was out partying with his friends, celebrating a birthday in the Valley. According to his cousin, Eyad, Zoran started drinking at 5pm that day and by the time they left the club around 2am, Zoran was very intoxicated. As they were walking out of the club, Zoran decided to jump on an electric scooter that was parked outside the club. Eyad started running after Zoran, and he saw Zoran weaving in and out of cars on the road at a high speed. Eyad saw Zoran barely manage to avoid fully hitting the concrete column of a building but he jumped off the electric scooter and landed in an awkward position. ASSESSMENT GCS: 15/15, both pupils: 3 equal and reactive to light, moving both upper limbs and right leg in normal strength, left leg no movement (due to…
You are a nursing student who is assigned to a busy medical-surgical unit that specializes in the care of patients with various neurologic disorders. One of your patients for the day is Mr. Choudhary, a 56 year old South Asian male with a primary diagnosis of cerebrovascular accident of hemorrhagic origin. You enter the room to conduct your morning assessment and you find that Mr. Choudhary is non-verbal but does seem to understand you. How do you think Mr. Chowdhary feels being unable to verbalize with you? How do you think you may best conduct your assessment while still being therapeutic to your non-verbal patient? How could you modify your assessment to be more certain that your non-verbal patient understands you?
You are being dispatched for a report of a possible stroke. You arrive at a modest private residencewhere you and your partner are met by a woman identifying herself as the patient’s wife.She informs you the patient is in the basement and begins to lead the way. As she escorts youdownstairs, she says, “We had both been taking a nap. I woke up about 15 minutes ago and he wasalready awake sitting on the couch, but he wouldn’t answer my questions.”Once in the basement, you find an approximate 49-year-old male patient who is conscious and seatedon the couch. You estimate him to be over 6 feet tall, weighing roughly 240 pounds and you observe heseems to be favoring his left hand and has a slight offset to one side of his mouth.The patient is not drooling and seems to be swallowing easily. You do not see any evidence ofrespiratory distress or an inability to protect his airway. He is calm but makes no attempt to speak andcan follow commands.You attempt to obtain a SAMPLE history by using…
the practical nurse (pn) is monitoring a clients neurological status following a closed head injury. Which assessments should the PN include? Select all that apply A Vital sign measurement. B Carotid pulse rate. C Consciousness level. D Jugular vein distention. E Pupillary reactions.

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