...Hyperlipidemia * HTN * BPH Surgeries * None Problems at Birth: Patient reports that she was a full term healthy baby; 7lbs 8oz. Denies any problems at birth. Childhood Illnesses: The patient reports having had chicken pox. Immunizations: Patient claims to be up to date on all immunizations. Last flu shot (Fall of 2014) He denies any international travel or related immunizations. Family Health History: None Social History/Health Maintenance Activities: A.A. is married and lives with his wife. Retired engineer. Inactive lifestyle. Has a daughter that lives in Kansas. * Tobacco * Quit smoking 10 years ago. 2 pk/day x 50 years * Alcohol * Patient reports no alcohol use. * Diet * Patient reports a “regular diet”, “orders take-out often and drinks 4-6 diet cokes each day. * Exercise * Patient reports no regular exercise. * Colon * Patient denies any colon problems. He reports having a “normal” BM once daily or every other day. * Dental * Patient reports annual dental appointments. No complaints. * Skin * A.A. reports no regular dermatology appointments. He reports wearing sunscreen with prolonged sun exposure. * Eyes * Patient claims to have “good” vision. He does not report wearing glasses/contacts. Reports having last eye appointment last year. * Safety * Patient reports wearing seatbelt when in an automobile and...
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...Running head: CASE STUDY LS Mental Health Case Study LS Nicole Castro College of Southern Nevada Division of Nursing Mental Health Nursing Clinical NURS 243C-S10 Micki Lin Mongogna-Alarcon, MA, BSN, RN October 18, 2010 Mental Health Case Study DM Demographic Data: LS is a 44 year-old female of African and Hispanic decent. She was born in California but moved to Las Vegas as a teenager. She stated that she attended Clark High School and went to a “stewardess college” in California. She worked as a stewardess for 4 years and quit in 1986. Her father was African-American and her mother is Hispanic. She has 4 brothers and 2 sisters. She is married and lives with her husband and his son in their private home. She has two children, fathered by her ex-husband, who are now in custody of LS’s mother. Her children were taken away from her, by the court, due to her abuse of drugs and alcohol. LS stated that her father abused alcohol and that all of her brothers and sisters abused drugs and were diagnosed with bipolar disorder. LS stated that she started noticing symptoms of what she thought was depression 6 years ago but was diagnosed with bipolar disorder in 2005. Her chart stated that she has had an 11 year history of bipolar disorder. Presenting Problem: LS stated that she had not been taking her medications for four days because her husband forgot to pick up her medications from the pharmacy. However, her chart stated that she was off of her medications...
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...headaches. Headache is a pain in the head or upper neck. The intensity varies according to the seriousness of the underlying causes. When the structure inside the brain (which is sensitive to pain) is over-exercised headache results – it’s then headache all you have in your head....
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...Laparoscopic right colon resection possible ostomy. Patient was able to answer most of the questions. His wife translated whatever needed more explanation. Client’s Current Health Status b. Chief Complaint: Patient stated his chief complaint was that the doctor advised surgical removal of a polyp. “I went to the doctor because of my age {56} for a colonoscopy and the doctor said I had 3 polyps. The doctor got the other two polyps but said he must cut out the polyp or it will rupture in the colon” c. Presenting Symptoms: No apparent evidence of pain. The onset of his diagnosis began when A.G. was having a diagnostic test done. A.G. went to the doctor on January 23 for a routine colonoscopy and found out during the test that the third polyp was too big, but benign. A.G. states “The location of the polyp was in the right side. It is localized in a small area, a couple of inches of the bowel” A.G. states he feels no pain. Due to the location of the bowel, there are no signs or symptoms that A.G. can detect without the aid of a diagnostic test. A.G. did not have any symptoms associated with the diagnosis with the condition: no alteration in bowel movement, no sensations, or discharges that would alarm the him. No other signs or symptoms were present. The only treatment for this condition is surgery. Due to the location of the polyp, surgery was the only answer. A.G. did not...
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...identify at least one national organization that addresses HIV. Causes and mode of transmission of HIV are sharing drug needles with someone who is infected with HIV as well as having unprotected sexual intercourse (oral, anal, vaginal), contact with semen, infected blood (blood transfusions), pregnancy, childbirth and or breastfeeding. You cannot get infected with HIV by consensual contact such as holding or shaking hands, hugging, kissing, breathing the same air or using the same water or being bitten by the same insect. Symptoms vary but most of the people with HIV will have flu-like symptoms in about a month or so when the virus enters the body. These symptoms would be like aches and pain in the muscles, fever, sore throat, headache, joint pain, swollen lymph glands usually around the neck area called...
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...exchanges/hr Mask, N95 for TB DROPLET think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19 P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus Private Room or cohort Mask 1 CONTACT PRECAUTION MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis SKIN INFECTIONS VCHIPS V - varicella zoster C - cutaneous diphtheria H - herpez simplex I - impetigo P - pediculosis S - scabies 1. Air/Pulmonary Embolism (S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) --> turn pt to left side and lower the head of the bed. 2. Woman in Labor w/ Un-reassuring FHR (late decels, decreased variability, fetal bradycardia, etc)...
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...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 cava (IVC) filter. TC’s past medical history is rather extensive and includes the following: Lupus; Crohn’s Disease; hypertension; hypothyroidism; depression;...
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...- negative pressure with 6-12 air exchanges/hr Mask, N95 for TB DROPLET think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19 P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus Private Room or cohort Mask 1 CONTACT PRECAUTION MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis SKIN INFECTIONS VCHIPS V - varicella zoster C - cutaneous diphtheria H - herpez simplex I - impetigo P - pediculosis S - scabies 1. Air/Pulmonary Embolism (S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) --> turn pt to left side and lower the head of the bed. 2. Woman in Labor w/ Un-reassuring FHR (late decels, decreased variability, fetal bradycardia, etc) --> turn on left side (and give O2, stop Pitocin, increase IV...
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...Description: Rheumatoid arthritis and osteoporosis HISTORY: Mrs. Wright is a 53-year old female who visited Dr. Curtis on 9/21/2013 for devastating pain dealing with her rheumatoid arthritis. She was diagnosed with rheumatoid arthritis on 4/2/2010 by Dr. Ruppert. She was later diagnosed with osteoporosis on 8/5/2010. Along with her arthritis pain, she has other conditions such as: Raynaud syndrome, irritable bowel syndrome-associated constipation (IBS-C), gastroesophageal reflux (GERD), and chronic urinary tract and upper respiratory infections. She has gained weight because of the lack of exercise she has performing. Wright complains she is too tired to work out and gets tired throughout the day performing normal activities. She also insists she cannot work out because she always gets hot flashes from her menopause and is simply too hot to work out. Wright also explained she lives alone and cannot always go to see a physician because she cannot get someone to drive her there. She is no longer taking the three medications, hydroxychloroquine, methotrexate, and prednisone, prescribed by Dr. Ruppert. She explains she had experienced intolerable side effects, including reflux, alopecia, and severe photosensitivity. Dr. Ruppert ordered a comprehensive laboratory evaluation and identified the following: IgG4 food-specific antibodies, essential fatty acid and amino acid imbalances, nutrient and essential element deficiencies, and dysbiosis, in addition to elevated antinuclear...
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...Case Study James Morasco College of Southern Nevada – Nursing 211 Clinical Professor Judith Alewel, MSN, RN October 15, 2012 Introduction AV is a 57 year old male whom presented to the Emergency Department of Valley Hospital Medical Center in Las Vegas, NV on September 7, 2012 with the classic signs and symptoms of a left-sided middle cerebral artery (MCA) infarct and was admitted to the medical intensive care unit (MICU). These signs included left sided facial drooping, non-reactive left pupil, right sided weakness in the upper and lower extremities, and the inability to speak. Along with the signs and symptoms of the stroke, a 12-lead EKG revealed that he also has atrial fibrillation. The initial computerized tomography (CT) scan of his brain revealed nothing, but a subsequent MRA (magnetic resonance angiogram) concluded that he did, in fact, have an occluded branch of the left MCA that eventually converted to become hemorrhagic and he was admitted to the MICU. The MRA also found a persistent left trigeminal artery, which is insignificant to his presenting disease process. Along with all of this, a two dimensional echocardiogram revealed some significant hearts problems that will be discussed later. I cared for this patient during the clinical shift on September 18, 2012. History and Physical The only history and physical that was available in this patient’s chart was some narrative comments from his daughter notated by the physician, and this is most likely due to...
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...CASE STUDY 1 Acute coronary syndrome Patrick Gallagher Case outline Peter Brown is a 58-year-old gentleman who has experienced an episode of crushing central chest pain while at work. Peter works as a taxi driver and a colleague has taken him to the Accident and Emergency Department. On admission, Peter is sweaty, clammy, nauseated and short of breath. He is complaining of chest pain radiating to his left arm. This is Peter’s first presentation to hospital and he has no relevant past medical history. Peter smokes approximately 20–30 cigarettes per day and takes alcohol at weekends only. Peter is anxious and is concerned that his wife and children are informed. He also states his father died suddenly following a heart attack a number of years ago. Peter is immediately triaged and taken to the resuscitation room. You are the receiving nurse. Observations on admission include: Respiratory rate: 18 breaths per minute Oxygen saturations: 95% Blood pressure: 150/90 mmHg Pulse: 94 beats per minute Temperature: 37ºC. On admission to hospital an electrocardiograph (ECG) has been undertaken. Peter has been diagnosed with an anterior ST segment elevation myocardial infarction (anterior STEMI). Blood samples have also been drawn for urea and electrolytes (U&E), full blood picture (FBP) and highly sensitive troponin T. 1 Discuss Peter’s immediate problems and explain these using your knowledge of pathophysiology. A On admission to Accident and Emergency...
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...[pic] ICAK-USA Research The Following is a Compilation of Applied Kinesiology Research Papers Published in the Collected Papers of the International College of Applied Kinesiology for the year 2005-2006 -- Edited by Scott Cuthbert, D.C. Functional Systems Approach to Central Nervous System Evaluation Richard Belli, D.C., D.A.C.N.B. ABSTRACT Objective: This study investigates the clinical utility of testing functional systems within the central nervous system, compared to testing individual motor nerves with manual muscle testing. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: Chiropractic management was decided on by the treating chiropractor. A series of twelve tests were designed to discover disorders of functional systems within the CNS. The tests described were to evaluate the function of 12 systems: 1) spinal cord, 2) myelencephalon/reticular formation, 3) vagal system, 4) trigeminal motor system-muscles of mastication, 5) vestibulospinal system, and bulbo reticular area, 6) reticular formation, 7) diencephalons and gait locomotion system, 8) mesencephalon, 9) cardiac sympathetic autonomic system, 10) pyramidal system, 11) limbic system, 12) sensory system. Results: This chiropractic approach tests the nervous system after provocation of functional systems...
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...COLLABORATIVE BACHELOR OF SCIENCE IN NURSING PROGRAM (University of Windsor, Lambton College, St. Clair College – Windsor & Thames) Health Assessment NRS 63-166 Fall 2011 Site: St Clair College, Thames Campus Teaching Faculty Linda O’Halloran Phone: 519-354-9714 Ext. 3233 E-mail: lohalloran@stclaircollege.ca Office Hours: Monday’s 1100 – 1200, Tuesday’s 1000 - 1600 or by appointment Course Location Room 118 Course Times: Monday’s 1200 – 1400 – lecture Labs: weekly- either Monday or Tuesday as per your schedule Lab Teaching Instructor Maureen Eyres Andrea Reddam Vanessa Schinkel ©Collaborative BScN Program 2010 ALL RIGHTS RESERVED INTRODUCTION TO COLLABORATIVE BScN PROGRAM Mission Statement As partners, the Faculty of Nursing at the University of Windsor with St. Clair College (Windsor and Thames Campuses) and Lambton College (Sarnia) undertake the shared commitment to excellence in the preparation of Bachelor of Science in Nursing (BScN) candidates who embody our core values and the best elements of the art and science of nursing, education, leadership, research, and practice in their professional journeys. Vision EXCELLENCE in nursing education, practice, and research. Core Values ...
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.....this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley or for impaction 3. any of the mycin's..check for tinnitus or hearing loss 4. cloudy dialysate...always futher assess and...
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...intubate” (DNR/DNI). History of Present Illness Patient stated that she had woken up through out the night drenched in sweat and the inability to catch her breath. This is what brought her to the emergency department where she presented with difficulty breathing (dyspnea), and shortness of breath. Based upon how the patient presented and the results of the diagnostic tests that were conducted the patient was admitted to the progressive care unit of Banner Thunderbird. Diagnostic tests that were conducted was a chest X-ray, magnetic resonance imaging (MRI), and ultra sound to determine if there is a build up or either fluid and/or air in the pleural spaces of the lungs or a tumor that is causing the patient to have difficulty breathing. Non-imaging tests that are conducted would be a blood studies and arterial blood gas test. The blood studies would be able to dictate if the patient has a bacterial or viral infection, pneumonia, rheumatic fever, a pulmonary embolus, or lupus, and the arterial blood gas test will be able to show how well the lungs are taking in oxygen by measuring oxygen and carbon dioxide within the arterial blood that is drawn (Pagana & Pagana, 2010). After collecting the patients medical history, and the results of all the diagnostic tests that were conducted it was determined that the patient had air and fluid accumulation in the pleural spaces in the lungs and needed to have a ultrasound guided thorocentesis to collect a sample of...
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