A 5-week-old male child presents to the healthcare clinic with projectile vomiting and dehydration. The patient’s mother states that the patient began forcefully vomiting after feedings yesterday, but was previously healthy with no medical conditions or allergies.
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1. A 5-week-old male child presents to the healthcare clinic with projectile vomiting and dehydration. The patient’s mother states that the patient began forcefully vomiting after feedings yesterday, but was previously healthy with no medical conditions or allergies.
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- 1. In a single day, two female students and one male student sought treatment at a university health clinic, complaining of acute diarrhea, nausea, and vomiting. No blood was found in their stools. One of the women was found to have a urinary tract infection. all three had eaten lunch at a nearby health food store the previous day. The man had a turkey sandwich with tomato, sprouts, pickles, and sunflower seeds. One woman had a pocket sandwich with turkey, sprouts, and mandarin oranges; the other woman had the lunch special, described in the menu as a “delightful garden salad of fresh organic lettuces, sprouts, tomatoes, and cucumbers with zesty raspberry vinaigrette dressing." all had bottled water to drink. Which of the foods is the most likely source of the infections? What media would you use to culture and isolate enteric contaminants in the food? 3. Which enteric bacteria could cause these symptoms? How did the woman likely acquire the urinary tract infection? What is the likely…A 52-year-old patient has just arrived in the Emergency Department with complaints of severe abdominal pain, nausea, and vomiting over the last few days. His abdomen is distended. He has poor skin turgor and dry mucous membranes. He has not urinated since yesterday. He has felt “dizzy” and “weak” all evening. He thought it might be the flu, but decided to come in because the stomach pains were getting worse. He has signed informed consent for treatment and labs have been drawn. Opening Questions How did the scenario make you feel? Scenario Analysis Questions* PCC/EBP/S When reflecting on the care of Stan Checketts, what are signs and symptoms you can assess in the next patient you care for who might be at risk for dehydration? EBP/QI Discuss signs and symptoms of hypovolemic shock. PCC/EBP Discuss assessment and expected findings in a small bowel obstruction. PCC/S/I/EBP What key questions does the nurse ask in an acute abdominal pain assessment? PCC/EBP/S In evaluating…Case 5: A middle-aged woman came was rushed to the emergency room at 4 pm complaining of abdominal pain, fever, nausea and vomiting and mild diarrhea. Suspecting a food-borne illness, the physician asked her to give an account of what she'd consumed today for breakfast, lunch and snacks. The woman responded that she'd only had time for a quick breakfast this morning at 7:30 am and that her 'over-easy eggs' were more 'sunny-side up', but that she ate them anyway because she'd be late for work otherwise. Along with her unsatisfactory eggs, she'd had some unbuttered wheat toast and a large glass of apple juice. Lab examinations of her stool specimens showed the presence of a wide variety of Gram negative bacilli. Using the information given in the case history, you should answer the following questions. 1. What is the name of disease the woman (other than food poisoning) and what is the infectious agent that caused it? 2. Is this an example of an infection or an intoxication? Why? 3. What…
- 10. A 68-year-old woman comes to the physician for a follow-up examination after a routine endoscopy for dyspepsia showed large esophageal varices. She has a 25-year history of type 2 diabetes mellitus. She also has hypertension and hyperlipidemia. She does not have any history of liver disease, blood transfusions, or intravenous drug use, and she does not drink alcohol. Her current medications are 81-mg aspirin, insulin, lisinopril, and simvastatin. She appears alert. She is 168 cm (5 ft 6 in) tall and weighs 110 kg (242 lb); BMI is 39 kg/m². Physical examination shows scattered spider angiomata over the chest and upper extremities. Abdominal examination shows no ascites. The spleen tip is palpated 4 cm below the left costal margin. Laboratory studies show. Hemoglobin Hematocrit Mean corpuscular volume Platelet count 12.2 g/dL 36% 102 μm³ 92,000/mm³ 1.8 mg/dL Serum Total bilirubin AST 65 U/L ALT 85 U/L Ferritin 62 ng/mL Hepatitis B surface antigen negative Hepatitis B surface antibody…A 39 yearold woman comes to the clinic complaining of diarrhea and abdominal pain. “I feel so weak.” She reports having four to five loose, occasionally bloody stools per day for the past two weeks, with abdominal cramping beginning over the past 48 hours. She has been self-treating with occasional other-the-counter (OTC) antidiarrheals without success. She denies recent antibiotic use. She complains of severe fatigue. She gave birth to her third child 6 weeks ago. She is not breast feeding. A complete blood count, blood chemistry (including electrolytes, renal function tests and blood glucose) and serum iron is ordered along with stool cultures, colonoscopy and upper gastrointestinal (UGI) endoscopy with small bowel follow-through. Lab Data: Sodium 140 mmol/L Potassium 3.5 mmol/L Chloride 105 mmol/L Urea 3.57 mmol/L Serum creatinine 115 µmol/L Glucose 7.8 mmol/L Iron 4.3 µmol/L Hb 132 g/L Hct 0.39 L/L WBC 7.68 x 109 with normal differential She…23. A 48-year-old woman comes to the emergency department 2 hours after the sudden onset of severe flank pain. She also has a 2-month history of mild exacerbation of her baseline constipation. She has had no fever, chills, pain with urination, or increased urinary frequency. She has a history of infrequent urinary tract infections, with the most recent occurring more than 5 years ago. She has no personal or family history of renal calculi. Her pulse is 92/min, and blood pressure is 138/88 mm Hg. Physical examination shows no other abnormalities. Laboratory studies show: Serum Na* 144 mEq/L K+ 3.8 mEq/L CI- 100 mEq/L HCO₂- Ca2+ 27 mEq/L 10.6 mg/dL Urea nitrogen 19 mg/dL Creatinine Phosphorus Urine blood Which of the following is the most likely cause of these findings? A) Hyperoxaluria B) Hyperparathyroidism C) Hyperuricemia D) Hypervitaminosis D. E) Milk-alkali syndrome 0.8 mg/dL 2.9 mg/dL 2+
- 5. A 5-week-old male child presents to the healthcare clinic with projectile vomiting and dehydration. The patient’s mother states that the patient began forcefully vomiting after feedings yesterday, but was previously healthy with no medical conditions or allergies. What condition do you suspect this patient has? What symptoms lead you to that conclusion? What nursing interventions should be included in the plan of care to prevent dehydration in this patient?how do I identify the scenarios According to the different conditions? It is the night after Halloween and you have had a great night of gather treats from your local community! You notice that you have gotten a lot of sour candy in your bag this yearEvery time you eat a sour candy, you notice that your stomach feels nauseous. To help you out, your sister suggests that you to drink Gatorade to make your stomach feel better. You do this a total of 10 times (you eat sour candy, get nauseous, and drink Gatorade to feel better).After many trials of this, having some Gatorade starts to make you feel nauseous. Unconditioned Stimulus (UCS) Unconditioned Response (UCR) Conditioned Stimulus (CS) Conditioned Response (CR)A two-month-old boy was brought to the hospital because he vomited a large quantity of dark red material. Previously well, a few days earlier he had abruptly interrupted a crying episode and then appeared to have difficulty breathing. There were no recognized illnesses and no history of trauma or abuse. He was bottle-fed. Both parents smoked in the home, which was located in an area of the city characterized by substandard housing in poor repair. Three weeks before admission, their house became flooded during a storm. Cleanup had not yet been accomplished. On examination, the baby was well developed and nourished, and there was no evidence of trauma or infection. His breathing was labored. His white blood count was within normal limits, but he was moderately anemic. His blood clotted normally, but his blood oxygen was low. His chest X-ray showed patchy shadows consistent with fluid in the alveoli. The patient was initially placed on a respirator and treated in the intensive care unit…
- 158. A 3-year-old girl is brought to the physician because of a 4-day history of irritability, vomiting, decreased urinary frequency and volume, and diarrhea. She visited a local petting zoo with her family 1 week ago. Her temperature is 38°C (100.4°F), pulse is 100/min, respirations are 30/min, and blood pressure is 130/100 mm Hg. Physical examination shows pallor, petechiae over the chest, and mild abdominal tenderness. Laboratory studies show: A) Elastin B) Fibrin Hemoglobin Hematocrit C) Hemosiderin D) IgA E) IgE F) IgG Erythrocyte count Leukocyte count Reticulocyte count Platelet count Serum Urea nitrogen Creatinine Bilirubin, total Direct Indirect Lactate dehydrogenase 5.9 g/dL (N=11-15) 31% (N=28% -45%) 3.1 million/mm³ (N=3.9-5.31) 18,000/mm³ (N=6000-17,500) 4.5% (N=0.5% -1.5%) 52,000/mm³ (N=150,000-400,000) Direct antiglobulin (Coombs) test result is negative. A photomicrograph of a peripheral blood smear is shown. Acetaminophen, amlodipine, and fluid and nutritional support…An outbreak of gastrointestinal illness was reported in a day carecenter. Of 67 people, 14 came down with symptoms of nausea,cramps, and diarrhea within 2 to 3 hours of eating. Food itemsincluded fried rice, peas, and apple rings. Symptoms occurred in 14of the 48 who had eaten the fried rice and in none of those who had not eaten it. The rice had been cooked the night before andrefrigerated. The next morning, it had been fried with leftoverchicken and held without refrigeration until lunchtime.a. On the basis of symptoms and food types, what do you expect theetiological agent to be? b. What would you expect to culture from the food?c. To what other disease is this one similar?2. A client with a family history of kidney stones has come to a healthcare facility for an annual health checkup. The client has had two previous experiences with renal colic. The client states, “I really don’t ever want to experience that kind of pain again.” a. What factors should the nurse include when teaching the client about kidney stones for those with a family history of the same?b. What general measures should the nurse suggest to prevent formation of kidney stones? 3. A client who had a bladder tumor recently underwent surgery for removal of the urinary bladder with creation of an ileal conduit. An appliance is fitted over the surgical stoma.a. The nurse would monitor the client for which possible complications? b. What measures should the nurse include when providing postoperative care for this client?