... Investigating pleural effusion which is evident on chest radiographs should follow a stepwise approach to diagnosis. Diagnosis should always begin with the clinical history, physical examination, chest radiography and followed by thoracentesis. The next step is to differentiate the pleural fluid into transudate and exudates. Analysis of the pleural fluid can narrow the differential diagnosis. Establishment of diagnosis with the analysis of pleural effusion can be done in approximately 75 percent. The gross appearance of the fluid and biochemical parameters can be key to a direct diagnosis or can be process indicating the next step. If underlying cause can be sought with the help of biochemical...
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...Lung Abscess Background Lung abscess is defined as necrosis of the pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection. The formation of multiple small (< 2 cm) abscesses is occasionally referred to as necrotizing pneumonia or lung gangrene. Both lung abscess and necrotizing pneumonia are manifestations of a similar pathologic process. Failure to recognize and treat lung abscess is associated with poor clinical outcome. In the 1920s, approximately one third of patients with lung abscess died; Dr David Smith postulated that aspiration of oral bacteria was the mechanism of infection. He observed that the bacteria found in the walls of the lung abscesses at autopsy resembled the bacteria noted in the gingival crevice. A typical lung abscess could be reproduced in animal models via an intratracheal inoculum containing, not 1, but 4 microbes, thought to be Fusobacterium nucleatum, Peptostreptococcus species, a fastidious gram-negative anaerobe, and, possibly, Prevotella melaninogenicus. Lung abscess was a devastating disease in the preantibiotic era, when one third of the patients died, another one third recovered, and the remainder developed debilitating illnesses such as recurrent abscesses, chronic empyema, bronchiectasis, or other consequences of chronic pyogenic infections. In the early postantibiotic period, sulfonamides did not improve the outcome of patients with lung abscess until the penicillins and tetracyclines...
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...Case Study Pulmonary Tuberculosis Nursing Management 1 PULMONARY TUBERCULOSIS CATEGORY I, PLEURAL EFFUSION RIGHT ON TREATMENT, STATUS POST CHEST TUBE THORACOTOMY INSERTION Nursing Management of a Pulmonary Ward Patient Having Pulmonary Tuberculosis Category I, Pleural Effusion Right on Treatment, Status Post Chest Thoracotomy Tube Insertion S, J, S. Our Lady of Fatima University, Quezon City Nursing Management 2 Nursing Management of a Pulmonary Ward Patient Having Pulmonary Tuberculosis Category I, Pleural Effusion Right on Treatment, Status Post Chest Thoracotomy Tube Insertion Private P, A.B., a 25 year old male, single. He finished second year college (Bachelor of Science in Education). He lives in Barangay Monbon Irosin, Sorsogon City. Five months Prior to Admission, patient began to experience dry cough, general body malaise, back pain, low grade fever in the afternoon, hoarseness of voice and restlessness. At first, patient took solmux and amoxicillin three times a day for three days. The signs and symptoms still persisted. He sought consult to the Commission Army Station Hospital, Lucena City and underwent another chest x-ray and had nebulization to liquefy secretions. He then was advised to go home. His immediate superior (official) advised him to go to the Armed Forces of the Philippines Medical Center due to unavailability of a pulmonologist in the area. He then was transported via ambulance and was seen in Emergency Room and chest x-ray was...
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...This file is now being closed as Mrs. Schaefer has returned to her pre-injury status. The adjuster has review documentation and case management can close the file. SUMMARY Mrs. Schaefer was a restrained driver who was involved in a motor vehicle accident. Mrs. Schaefer rear-ended another vehicle and recalled having front-end damage and EMS. Mrs. Schaefer did have a positive LOC at the scene and was transported to the nearest hospital, which was Beaumont Botsford. Mrs. Schaefer recalls being evaluated by several physicians and having diagnostic testing. Upon arrival to the Emergency room (ER), her GCS (Glasgow Coma Scale) was 15. In the ER, Mrs. Schaefer reported neck and back pain, she had a 10cm superficial laceration to her right hip, left...
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...Cigarette smoking is the most common lung irritant in the United States, but in rare occasions it may be caused by a genetic condition (National Institute of Health [NIH], 2013). When the AG-ACNP suspects COPD, he or she uses x-rays, chest CT scans and arterial blood gases (ABG) as diagnostic studies to gather information about the effects of the disease. The diagnostic studies additionally rule out other possible causes of the presenting symptoms. Pulmonary function tests (PFT) are necessary for a final diagnosis of COPD and to assess its severity. The most common PFT used to diagnose COPD is spirometry. This test measures the amount of air the patient can breathe out and how fast he/she can blow air out (National Institute of Health [NIH], 2013). Community Acquired Pneumonia. Pneumonia is an infection in one or both lungs caused by virus, bacteria, or fungi. Community acquired pneumonia (CAP) is pneumonia that developed outside of a hospital, nursing home, or long-term care facility, thus the name “Community Acquired”. According to the American Lung Association, pneumonia is diagnosed by gathering information from the patient’s sings and symptoms, physical examination, chest x-ray, and in some cases other tests such as CBC, sputum tests, and ABG. Common signs and symptoms of pneumonia include cough, fever, chills, and dyspnea. During the physical examination, adventitious sounds can be heard during auscultation of the lungs. A chest x-ray may show patchy opacities, lobar consolidation...
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...Ovarian Cancer Michelle Blevins Sullivan University HIM110X Pathophysiology with Pharmacology I March 3, 2014 Abstract Ovarian cancer is a growth of abnormal malignant cells that begins in the ovaries (women’s reproductive glands that produce ova). Cancer that spreads to the ovaries but originates at another site is not considered ovarian cancer. Ovarian tumors can be benign (noncancerous) or malignant (cancerous). Although abnormal, cells of benign tumors do not metastasize (spread to other parts of the body). Malignant cancer cells in the ovaries can metastasize in two ways: directly to other organs in the pelvis and abdomen (the more common way), through the bloodstream or lymph nodes to other parts of the body. While the causes of ovarian cancer are unknown, some theories exist: Genetic errors may occur because of damage from the normal monthly release of an egg. Increased hormone levels before and during ovulation may stimulate the growth of abnormal cells. Keywords: ovarian cancer, malignant, cells, metastasize Ovarian Cancer Ovarian Cancer is the most common cause of cancer death from gynecologic tumors in the United States. Malignant ovarian lesions include primary lesions arising from normal structures within the ovary and secondary lesions from cancers arising elsewhere in the body. Primary lesions include epithelial ovarian carcinoma, germ-cell tumors, sex-cord stromal tumors, and other more rare types. Metastases to the ovaries are relatively...
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...(Provide reference listing using APA format) Reference List Criteria for Case Study I. Introduction – purpose of paper A. Significance B. Objectives II. Assessment a. Include date of admission; date of care; allergies; history b. Address and list analysis of Gordon’s Functional Patterns (list all 11). Integrate treatments, meds, nursing implications, and related assessments in paper. Includes nutritional analysis. III. Literature Review (at least three resources at least one professional journal) a. Disease Description b. Diagnostic Confirmation c. Signs & Symptoms (textbook vs. patient’s actual symptoms being experienced) d. Treatment and Rationale e. Disease Outcome Expectations f. Rehab needs g. Related to client situation IV. Nursing Plan of Care a. Problems Prioritized (list 3 diagnosis) b. Actual Diagnosis c. Potential Diagnosis d. Outcome e. Goals (short and long term) f. Actions/actual diagnosis g. Actions/potential diagnosis h. Rationales (resources documented) i. Evaluation/Revision V. Discharge Planning a. Resources for coping b. Knowledge/Teaching c. Referrals/Continuing Care VI. Summary VII. Format a. Length of paper should be - between 15-20 pages typed b. APA format c. Cover page, reference page, etc… d. Grammar, punctuation, sentence structure, etc… Faculty Signature_______________________________________________ Date________________________________ Name__________________________ Semester______________________ |Criteria...
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...In 1990, Dr. Leo Galland presented a paper to the (ACoG) American College of Gastroenterology which demonstrated that in over half of the participants in his study had been misdiagnosed with irritable bowel syndrome. The study consisted of two hundred patients with complaints of chronic diarrhea, recurrent constipation and abdominal pain and bloating. Fully half of the study patients actually had Giardia parasite infections. Since that time, not much has changed according to Dr. Galland in his book, Four Pillars of Healing. Doctors are still failing to identify or even look for parasites, instead favoring the diagnosis of loosely defined syndromes. https://ibstreatmentcenter.com/ibs/intestinal-bacteria-yeast-candida-and-parasites/parasites...
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...Lung cancer arises from the epithelial of the respiratory track. Lung cancer is the most severe cancer compare to the other cases of cancer. Lung cancer is the number one killer in United States and the world. In this country alone, there are 219440 new cases yearly and 159390 death yearly which is almost 57% of death yearly form lung cancer. These cases of lung cancer account for 14% of all cancer in men and 15% in women every year. (McCance, Huether, Brashers, & Rote, 2010, p. 1299). Although tobacco smoking is the number causes of lung cancer, there are some new cases of lung cancer arising every year without any cause. Cigarette smoking accounts for almost 90% of all lung cancer (http://www.cdc.gov/cancer/lung/basic_info/index.htm) . Other causes of lung cancer can include radon, asbestos, second hand smoking, family history, diet and air pollution. Lung cancer arises from a single changed epithelial cell in the tracheobronchial airways. A carcinogen from cigarette smoke or other predisposing factor like inherited gene bind to a cell DNA and damages it thereby resulting in multiple genetic abnormalities in bronchial cell which include deletion of chromosomes, activation of oncogenes and inactivation of tumor suppressing genes. This damage results in cellular changes, abnormal cell growth and eventually a malignant cell. The DNA undergoes further changes and becomes unstable as the DNA is passed to daughter’s cell. With the accumulation of genetic changes, the pulmonary epithelium...
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...Critical Care Case Study Crystal Meyer Mohave Community College Nursing 222 Mrs. Michelle Christensen April 1, 2014 Critical Care Case Study ADMISSION TC is a 61-year-old English speaking Caucasian female born on April 29, 1952. She weighs 99.7 Kg and is 5 feet, 5 inches in height with a BMI of 35.84. On March 5, 2014, TC was brought into the emergency department after her daughter-in-law called 911 when she found TC unresponsive at home in her bathroom. When paramedics arrived, she was found to be cool, pale, and diaphoretic with oxygen saturations in the high 70’s. Emergency responders placed a non-rebreather high flow oxygen mask and her oxygenation began to improve with saturations in the low 90’s. Upon arrival to the emergency department, TC’s vital signs were as follows: T 97.4; P 97; BP 120/95 mm Hg; RR 15 per minute; and O2 sats of 98% via NRB oxygen mask on 8L. A chest x-ray (CXR) revealed no abnormality and lungs were determined to be grossly clear. However, TC was checked for a pulmonary embolism via a pulmonary artery angiogram with IV contrast and found to have a large clot burden with a small saddle embolism. TC also complained of right ankle pain. An X-ray of her right ankle revealed a distal tib/fib fracture, which was presumed to be related to her fall during her hypoxic episode. With these findings, TC was admitted to the Intensive Care Unit of Kingman Regional Medical Center and placed on an NPO diet in preparation for placement of an inferior vena...
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...incompatibility, the mother's immune system may launch an immune response against the red blood cells of the fetus through the placenta, resulting in the destruction of the red blood cells (hemolysis). In the destruction of the red blood cells, the fetus can develop anemia. The red blood cell destruction ranges from mild to very severe, and fetal death from heart failure can occur, as well as life-threatening problems for future pregnancies. The Rhesus system (Rh) blood group antigen is responsible for most of the fatal cases of erythroblastosis fetalis, hence, the term Rh incompatibility disease. However, other alloimmune antigens belonging to the Kell (K and k), Duffy (Fya), Kidd (Jka and Jkb), MNSs (M, N, S, and s), Diego, Xg, P, Ee, Cc antigen systems, as well as other antigens may also produce the disease. Incompatibilities of Landsteiner (A, B and O) blood group systems do not cause erythroblastosis fetalis. A French midwife reported the first case of HDN in a set of twins, in 1609. In 1932, Diamond and colleagues described the relationship of fetal hydrops, jaundice, anemia, and erythroblasts (immature red blood cells) in the blood circulation, a condition later called erythroblastosis fetalis. Levine later determined the cause after Landsteiner and Weiner discovered the Rh blood group system in 1940. In 1953, Chown subsequently confirmed the pathogenesis...
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...Nursing Care Plan The patient is , a 72 year old man who has been admitted for dyspnea or shortness of breath. reported that he has been coughing for the past week and his coughing has accompanied sputum discharge. His past medical history includes emphysema and chronic bronchitis. He used to smoke but has stopped since a year ago for economical reasons as well as it is also bad for his asthma. His bowel movements have also been irregular since his admission. He also reported that he is feeling depressed and fearful about the future. Further examination revealed that he has crackles in his left lower lobe with diffuse expiratory wheezing throughout his chest. Chest percussion also revealed his left lower lobe to be dull. Needs / Problems Goals Interventions Evaluation Dyspnea or shortness of breath Use the visual analog scale (VAS) to make an objective assessment of dyspnea. The VAS is a 100-mm vertical line with end points of 0 and 10. zero is equated with no dyspnea and 10 is equated with the worst brethlessness the client has experienced ( & , 2004) Dyspnea is difficult to quantify and to treat (Potter & Perry, 2004). Interventions need to be individualized for each patient, and more than one therapy is usually implemented. The underlying process that causes or worsens dyspnea must be treated and stabilized initially. Three additional therapies have to be implemented: pharmacological measures, physical techniques,...
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...out idiopathic normal pressure hydrocephalus, by definition) 2 - Age under 40 (idiopathic normal pressure hydrocephalus unlikely) 2 - Asymmetrical or transient symptoms - Cortical deficits, e.g., aphasia, apraxia, or paresis - Lack of progression of symptoms (a controversial point, as authors differ on the period of time in which symptoms should be seen to progress) - Progressive dementia without gait disturbance (even if the ventricles are enlarged) • Laboratory o The differential diagnosis of gait disturbances includes: - Deficiencies of vitamin 86 and 812 o It is often not possible to distinguish normal pressure hydrocephalus from other causes of subcortical dementia by the clinical and radiological findings alone • Imaging o Imaging studies of the brain reveal ventriculomegaly without any marked degree of cortical atrophy 20 o Computerized tomography 13 - Typical Findings of normal pressure hydrocephalus include disproportionate widening of the ventricles in comparison to the cerebral sulci - A coronal section at the level of the posterior commissure reveals a narrow subarachnoid space surrounding the outer surface of the brain (a "tight convexity") and narrow medial cisterns - The third ventricle is usually enlarged as well, while the fourth ventricle may or may not be enlarged 14 - Thus, a Fourth ventricle of normal size in the presence of enlarged lateral and third ventricles need not indicate aqueductal stenosis and is a finding consistent with normal pressure hydrocephalus...
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...shaped, slow growing, aerobic bacterium called Mycobacterium tuberculosis, discovered by Dr. Robert Koch in 1882 which was also known as “Koch’s bacillus” while other TB causing bacteria are: Mycobacterium bovis, Mycobacterium africanum, Mycobacterium microti or Mycobacterium canetti, and it mainly hit the function of lungs. Mycobacterium avium complex doesn’t cause Tuberculosis in humans. This disease may circulate in different human tissues/organs by blood or lymphatic alleyways or enters into the person’s lungs through inhaling process in polluted air. SYMPTOMS There are two broad types of tuberculosis: * Latent TB Infection hit the body but bacteria remain inactive mode so usually no prompt symptom has been shown in such cases even person doesn’t feel sick. * Active TB In active TB condition infectious bacteria starts showing following illustrated symptoms within a week or month and infected person often feel sickness. Laterally in some circumstances Tuberculosis might be spread outside the lungs, symptoms may differ as per human organ get affected like: back pain in...
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...1. Congenital rubella: a) Has an incubation period of 7-10 days. b) May be complicated by polyarthralgia. c) Rarely causes deafness. d) Is an indication for termination if it occurs in the first two months of pregnancy. e) May cause prolonged jaundice. 2. Recognised causes of delayed bone age include: a) Hypopiturtarism b) Primary hypothyroidism c) Congenital adrenal hypoplasia d) Prolonged corticosteroid therapy e) Tuberculosis 3. Kwashiorkor: a) Hypothermia is a recognized complication T b) Edema is mainly due to protein losing enteropathy. T c) Measles is a recognized precipitant F d) The incidence is highest in the first two month of life F e) The birth of a second child to the mother may be a contributory factor F 4. At the age of eight months a baby can be expected to: a) Roll over from front to back T b) Sit up with a straight back T c) Pick a small bead between thumb and finger T d) Say up to five word clearly F e) Feed himself with a spoon F 5. if a child in the ward's develops measles, the following action are appropriate a) Close the wards to all admissions for one week F b) Actively immunized all the other patients against measles T c) Give gamma globulin to all patients who have not been immunized or had measles T d) Forbid visiting by the parents until the rash has gone F e) Give prophylactic antibiotics to all contacts at home T 6. Convulsion in the first week of life is characteristic of a) Hypocalcaemia T b) Post maturity...
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