Chapter 6, Problem 206R

case study of a violent client in a home care and how the situation was handled.

Patient K., 58 y/o, complains of weakness, muscle ache, loss of appetite, nausea, vomiting, aching bones, deterioration of memory and cramps. In anamnesis there is a record of the ulcerous disease of stomach, frequent pathological bone fractures. Objectively: the consciousness is clouded, the skin is dry of ashy gray colour, present deformity of the vertebrae bodies, "goose-stepping" gait, X-ray shows systemic osteoporosis. Heart sounds are dull, rhythmical, arterial pressure – 160/100, pulse – 56beats/minute. The level of calcium in the blood – 3.9mmol/l; hypophosphatemia, hyperphophaturia; glycemia – 4.8mmol/l. What are you going to do with this patient?A. Introducing 2-3 l of 0.9 % solution of sodium chloride and the potassium phosphate and sodiumB. Introducing 150ml of 4.5 % solution of sodium chloride, 100mg prednisolone C. Introducing 100mg prednisolone, 40g furosemide D. Introducing 1-2ml 0.5% solution of strophanthin, 100mg prednisoloneE. Introducing 40-60ml of 40% glucose…

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…