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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Similar questions

The practical nurse (PN) uses an ultrasound stethoscope to auscultate a client's left dorsalis pedis pulse. Where should the PN place the transducer?
Patient Scenario You believe that he is receiving less than optimal care because everyone is afraid of his family bringing a lawsuit. Mr. Spahn is a 49-year-old attorney who suffered a cerebral bleed. After his brain surgery, his surgeon informed the family that Mr. Spahn has massive, irreversible neurologic damage. In short, barring an act of God or nature he will have no meaningful recovery. His wife is already suing the first hospital that treated her husband because they delayed performing the appropriate diagnostic tests. She and her daughter complain frequently about the nursing care Mr. Spahn is receiving now, and no one wants to take care of him because they are afraid of being named in a lawsuit. Mrs. Spahn keeps a notebook in which she writes down the name of every caregiver who helps her husband. She has placed numerous calls to complain to administration about everything from the cleanliness of the room to a torn sheet. Implications for Nursing Advocacy How will you act if…
Mrs. Lin is 85 and very weak. She needs assistance to get out of bed, stand up, and walk. You are assigned to assist her to ambulate in the hall using a walker. As you walk down the hall, Mrs. Lin tells you she feels weak and faint. She loses her balance and begins to fall. Answer these questions to help you understand your role in assisting the client in ambulation. What assessments were made when she first sat on the edge of the bed? What preventive measures did you do before ambulating Mrs. Lin? As the support worker, what did you do when Mrs. Lin lost her balance? What techniques did you use to prevent injury to Mrs. Lin or yourself?
Postural tachycardia syndrome (POTS) is a form of orthostatic intolerance, the development of symptoms that come on when standing up from a reclining position, and that may be relieved by sitting or lying back down. The primary symptom of an orthostatic intolerance is lightheadedness, fainting and an uncomfortable, rapid increase in heartbeat (tachycardia), a common response to a rapid drop in blood pressure as mediated by baroreceptors in the carotid bulb and aortic arch. There are several inconstant secondary symptoms. A syndrome is simply a constellation of symptoms, not all of which may be present in all cases, and as is the case in POTS, a syndrome may also have a wide variety of underlying causes. A subset of POTS patients suffer from a low blood volume. Would you predict that this particular subset of patients has elevated or suppressed plasma levels of renin and aldosterone? Explain your answer. The nuance of dysregulation of the RAA axis is complex in these patients,…
John is a 55 year old officer with the Greenville Police Department who comes to the HPL for an evaluation. The plan is to complete an EKG stress test with John as part of the HPL assessment to determine if he is physically healthy enough to continue his job duties. His basic health information - resting BP: 128/86; HR rest: 75; Weight: 165lbs; BMI: 28.5 kg/m2. You inquire as to how he is feeling, and he responds that he had a cough, congestion, and body aches the day before but has taken some DayQuil to help him feel better. He says despite the cough and running nose he feels that he can exercise today. Would you test this person, yes or no? If yes, please indicate what protocol you would choose and whether or not the test would be maximal or submaximal? Please include your rationale.
Navrinder is a 50-year-old lawyer who work 50 to 60 hours per week. While eating breakfast Navrinder experienced sudden onset slurring of speech, had facial droop on his left-hand side with weakness in left side upper and lower limbs. Navrinder's wife, Hargeet spotted these sudden onsets of symptoms and immediately called for an ambulance, which arrived within 15 mins. Navrinder was brought to the Emergency Department (ED). Medical history: Hypertension- diagnosed 5 years ago Prediabetes- diagnosed 3 years ago Medication history: Telmisartan 40mg once a dayVital signs: Blood Pressure 145/90 mmHg, Heart Rate 92 bpm, Respiration Rate 20 bpm, SaO2 94% on Room Air Physical examination: — Confusion — Left Facial Droop — Slurred Speech — Left Motor Weakness: Upper Limb 0/5, Lower Limb 2/5 — Decreased Tone — Altered Sensation — Mild Left Sided Neglect Acute Assessment Scale: NIH Stroke Scale 19 Magnetic Resonance Imaging (MRI): Ischemic changes confined predominantly to the Right Middle…
1.)You are being dispatched for a report of a possible stroke. You arrive at a modest private residence where 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 you downstairs, she says, “We had both been taking a nap. I woke up about 15 minutes ago and he was already 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 seated on the couch. You estimate him to be over 6 feet tall, weighing roughly 240 pounds and you observe he seems 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 of respiratory distress or an inability to protect his airway. He is calm but makes no attempt to speak and can follow commands. You attempt to obtain a SAMPLE…
Lydia is a retired nurse. She is 63 years old. As a child she had rheumatic fever. At the age of 34 she had a mitral valve replaced. She is 10% over her ideal body weight. She used to be quite active when she was working, but she has slowed down a lot with retirement. She has noticed bouts of dizziness and sometimes she thought she was close to fainting. Other times her heart seemed to race. She thought that maybe she needed to see a cardiologist and so she set up an appointment for a cardiac evaluation. Her examination included x-rays, EKG, blood pressure measurement, and a full cardiac workup. The results showed a mild pulmonary congestion, an enlarged left atrium and ventricle. Cardiac output was 3.0 L/ min, blood pressure was 101/57, left atrial pressure was 17 mm Hg, and the right ventricular pressure was 44/8 mm Hg. The EKG indicated an atrial arrhythmia and there appeared to be some valvular regurgitation when the cardiologist listened to her heart sounds. Include references…
A 24-year-old female visits her GP after having been in an automobile accident three days prior. She reports that while driving in slippery conditions she rear-ended the car in front of her and she was then rear-ended by the car behind her. She was traveling at about 30 mph and her airbags did employ. She reports first responders found no injuries but advised her to follow up with her GP if she developed any unusual symptoms.The woman reports that she seemed fine after the accident but did wake the morning after with a bit of a stiff neck and a headache; she didn't feel this was unusual given the accident and went on about her day. At the end of the next day she had to carry heavy bags up two flights of stairs to her apartment and when almost to her door she felt a zing all the way down her right arm. She immediately put the bags down. When she lifted the bags again her right arm felt numb. She woke this morning with a very stiff neck, stiffness in her upper arm, and “tingles” in her…
CASE: A 19 year old Caucasian female from Canton, Ohio, is taken to her doctor’s office one afternoon by a co-worker after she had experienced stroke-like symptoms. Per the co-worker: the patient was working at her day job at Amazon, lifting boxes and placing them on conveyor belts. She was lifting a small box of “Keeping Up With the Kardashians” memorabilia, when she experienced the sudden onset of weakness in her bilateral upper extremities. Her co-worker noticed her friend standing in place with her arms extended and, confused, rushed her to the infirmary at the factory, after which she was told to go to her doctor. After questioning, the patient did state that she has experienced intermittent, occasional weakness which usually worsened as the day progressed. Throughout the day, she notices that her eyelids become progressively more droopy over time but that as she rests, her strength improves. After gathering this history, her physician decides to test her for a disorder known…

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