Identify solutions on how you will solve the patient's problem. What may happen once you apply the given intervention/s? Discuss the theoretical outcomes of your intervention and cite reference journals to justify claims.
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Background: Margaret, a 35-year-old woman, who has history of hyperuricemia and gouty
arthritis experienced progressive shortness of breath for a week. Limited movement has been
complained by the patient because of her multiple painful swelling in her hands and elbows. She
has also mentioned new lesions in his ear lobes. The patient is a former smoker with 10 pack year
history and worked as a field laborer.
Doctor’s Diagnosis: Gouty arthritis
Nutrition:
Usual Dietary Intake:
24-hr recall:
Breakfast: Chickpea and legume salad, 1 cup non-fat milk
Snack: Bean sprouts, poached eggs, nut parfait
Lunch: Fried chicken sandwich from McDonald’s, French fries, 32-oz iced tea
Late afternoon: 2 c chips, 1 beer
Dinner: 1 breast, fried Fried Chicken, 1½ c potato salad, ¼ c green
bean casserole, ½ c fruit salad, 1 c baked beans, iced tea
Identify solutions on how you will solve the patient's problem. What may happen once
you apply the given intervention/s? Discuss the theoretical outcomes of your
intervention and cite reference journals to justify claims.
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Solved in 2 steps
- Background: Margaret, a 35-year-old woman, who has history of hyperuricemia and gouty arthritis experienced progressive shortness of breath for a week. Limited movement has been complained by the patient because of her multiple painful swelling in her hands and elbows. She has also mentioned new lesions in his ear lobes. The patient is a former smoker with 10 pack year history and worked as a field laborer. Doctor’s Diagnosis: Gouty arthritis Nutrition: Usual Dietary Intake: 24-hr recall: Breakfast: Chickpea and legume salad, 1 cup non-fat milk Snack: Bean sprouts, poached eggs, nut parfait Lunch: Fried chicken sandwich from McDonald’s, French fries, 32-oz iced tea Late afternoon: 2 c chips, 1 beer Dinner: 1 breast, fried Fried Chicken, 1½ c potato salad, ¼ c green bean casserole, ½ c fruit salad, 1 c baked beans, iced tea 4. One treatment for hyperuricemia is administration of xanthine oxidase inhibitors like allopurinol. What is the biochemical rationale for this treatment? Discuss…Mr. Reddy is a 62 yo presenting to ED at 1500hrs. He was preparing the gas cylinder for a Sunday BBQ when it suddenly exploded while he was trying to connect the hose. Family standing by tried to extinguish the fire with their hands and tried to remove his clothing. Burns 30% TBSA – Face, hands, bilateral lower limbs. Complaints of severe pain and burning 10/10. Past Medical History: Hypertension, Type II DM Regular medications – Candesartan 8mg, Glimepiride 4mg, Metformin 500mg and Pravastatin 20mg. Fully vaccinated against COVID. Airway. - Patent, superficial burns to right side of face Breathing. - Spontaneous, RR-22mt, SPO2-92% RA, air-entry equal Circulation- Lower limb odema, cap refill 3 seconds, bilateral dorsal pedis pulses weak. BP- 88/50 mmHg, HR- 127/mt, sinus tachycardia, Disability - GCS-15 E4V5M6, PEARL- 3mm, Exposure - Temperature 35.9 deg Celsius. Full thickness burns to right lower limb and right arm, partial thickness burns to left lower limb, bilateral hands.…Rashidah is a 55-year-old female who is experiencing acute chest pain and shortness of breath. She describes the pain as “pressure and squeezing.” When she becomes nauseous and light-headed, her son insists that he take her to the emergency room. Health History: She started smoking when she was 18, attempted to quit several times in her 40s, and had her last cigarette on her 50th birthday. She has been overweight for most of her adult life but has gained 20 pounds in the last few years, which increased her BMI to 34. The last time she had a physical exam was when she turned 50. Her vital signs and blood test results from that exam are listed below. BP: 178/90 HDL: 62 mg/dl LDL: 190 mg/dl Triglycerides: 174 mg/dl Total cholesterol: 252 mg/dl Fasting blood glucose: 128 mg/dl Given her last physical exam results, Rashidah’s physician believes she has likely had undiagnosed atherosclerosis for years. Briefly describe the pathophysiology of atherosclerosis.
- Rashidah is a 55-year-old female who is experiencing acute chest pain and shortness of breath. She describes the pain as “pressure and squeezing.” When she becomes nauseous and light-headed, her son insists that he take her to the emergency room. Health History: She started smoking when she was 18, attempted to quit several times in her 40s, and had her last cigarette on her 50th birthday. She has been overweight for most of her adult life but has gained 20 pounds in the last few years, which increased her BMI to 34. The last time she had a physical exam was when she turned 50. Her vital signs and blood test results from that exam are listed below. BP: 178/90 HDL: 62 mg/dl LDL: 190 mg/dl Triglycerides: 174 mg/dl Total cholesterol: 252 mg/dl Fasting blood glucose: 128 mg/dl Rashidah quit smoking 5 years ago but still suffered a myocardial infarction. She is tempted to start smoking again since quitting “obviously didn’t make me healthier.” What does research tell us about her future…A 62-year-old man is admitted to hospital with chest pain. The pain is in the center of the chest and has lasted for 3 h by the time of his arrival in the emergency department. The chest pain radiated to the jaw and left shoulder. He felt sick at the same time. He has a history of chest pain on exercise which has been present for 6 months. He has smoked 10 cigarettes daily for 40 years and does not drink alcohol. His father died of a myocardial infarction aged 66 years and his 65-year-old brother had a coronary artery bypass graft 4 years ago. Q1. Based on above finding what case it may be explain in detail with common symptoms and laboratory diagnosis?Pt who was at home treating her right foot infection with VNA support. VNA recommended she return to the hospital because she was not caring for herself. The pt has not been able to get up and walk around including going to the bath. She complains of discomfort with swallowing and so she is not consistently taking her medication. She denies chest pain and shortness of breath. She is dysphagia, stage 2 plantar heel ulcer and at her butt. Has bruises on both hands, both legs is discolor and peeling. High fall risk and wear diapers. Pain is 7 on a scale of 0-10 at her coccyx wound. Normal bowl sounds and lungs sounds and heart sound. Cellulitis of right lower extremities. Cardiac diet and hypertension. Base on this information please do the concept map in the image
- Pt who was at home treating her right foot infection with VNA support. VNA recommended she return to the hospital because she was not caring for herself. The pt has not been able to get up and walk around including going to the bath. She complains of discomfort with swallowing and so she is not consistently taking her medication. She denies chest pain and shortness of breath. She is dysphagia, stage 2 plantar heel ulcer and at her butt. Has bruises on both hands, both legs is discolor and peeling. High fall risk and wear diapers. Pain is 7 on a scale of 0-10 at her coccyx wound. Normal bowl sounds and lungs sounds and heart sound. Cellulitis of right lower extremities. Cardiac diet and hypertension. Vitals at 800: Vitals at 11:20Am: Pulse: 99 HR: 72 SPO2: 99. BP: 144/97 BP: 135/82. R: 17 Temp: 95:4 HR:70 R: 16 Base on the information above can you please do a intervention for each body system. Neurological, Musculoskeletal, cardiovascular, respiratory, integumentary, GI, GU Patient…A 56-year-old woman named Cranberry complained during her yearly physical examination of tiredness and difficulty concentrating. She attributed these symptoms to stress at work. She had gained weight over the last year and despite warm weather, she felt chilled without a sweater. Family history was significant for hypothyroidism in her mother and older sister. On physical examination she had a pulse of 58 bpm and a blood pressure of 138/88 mm Hg. Examination of her neck disclosed a small thyroid gland with a palpable pyramidal lobe and a firm, bosselated texture. Serum taken at this time demonstrated a total T4 of 7.0 mcg/dL and a TSH of 22.0 mcIU/ml. In addition, antithyroglobulin antibodies were positive at 1:640 and antimicrosomal antibodies were positive at 1:5120. These results supported the clinical impression of hypothyroidism; also, the texture of her thyroid gland and a positive family history suggested an autoimmune etiological factor. Create a Nursing Care Plan focusing…Mr. Grady, a 70-year-old male with a history of arthritis, is evaluated by his rheumatologist for a sudden onset of excruciating pain and classic symptoms of gout in the first metatarsal joint of the left great toe. He appears at the office using crutches to avoid bearing weight on his left foot. His vital signs are temperature 100.6, pulse 88, respirations 28, and blood pressure 164/92. He describes the level of his pain at 10 when not at rest. Mr. Grady’s left toe appears inflamed and is very tender to the touch. Diagnostic evaluation turns up urate crystals in the joint fluid, and a blood serum uric acid test indicates hyperuricemia. Mr. Grady mentions he and his wife have just returned from a cruise celebrating their fiftieth wedding anniversary. He states that he enjoyed lots of his favorite foods, including shrimp and steak, and that he drank a great deal of beer. His more recent medical history includes increasing obesity, poorly controlled high blood pressure, and kidney…
- a 53 year old man is brought to the emergency department because of a 2 hour history of loss of speech and paralysis . he is right handed. he has a 10 year history of hypertension , his pulse is 70/min and blood pressure is 170/106 mm hg. he cannot speak . Physical examination shows paralysis of the right side of the face. there is weakness of the right extremities, the upper extremity is weaker than the lower extremity . Deep tendon reflexes are absent on the right and normal on the left. A thrombus in which of the following arteries is the most likely cause of these findings . A) left anterior, B) right anterior cerebral , C)left middle cerebral , D) right middle cerebral , E) left posterior cerebral , F) right posterior cerebralHistory of present illness: Patient is a 67 year old thin Caucasian female presenting to her family practitioner with the main complaints of decreasing strength and moderate back pain that radiates from the back to the sides of the her body. Past medical history Irritable bowel disease. Right foot stress fracture last year while stepping off a small bench. Family history Father dies of a heart attack at age 80. Mother has a history of Osteoporosis. Social History Patient smoked 2 packs a week from age 25-50. Patient has a long history of alcohol use and abuse from age 20 to 45. She frequently got drunk during social occasions as well as during gatherings, as often as once a week. She stopped drinking 13 years ago. Sedentary life style Allergies None Medications Multivitamins Calcium 1200 mg/day Key Labs, images, or procedures performed in relation to current diagnosis. Bone Density: T score of -3.1 Estrogen levels: <30 pg/mL (decrease) Key Physical Examination…History of present illness: Patient is a 67 year old thin Caucasian female presenting to her family practitioner with the main complaints of decreasing strength and moderate back pain that radiates from the back to the sides of the her body. Past medical history Irritable bowel disease. Right foot stress fracture last year while stepping off a small bench. Family history Father dies of a heart attack at age 80. Mother has a history of Osteoporosis. Social History Patient smoked 2 packs a week from age 25-50. Patient has a long history of alcohol use and abuse from age 20 to 45. She frequently got drunk during social occasions as well as during gatherings, as often as once a week. She stopped drinking 13 years ago. Sedentary life style Allergies None Medications Multivitamins Calcium 1200 mg/day Key Labs, images, or procedures performed in relation to current diagnosis. Bone Density: T score of -3.1 Estrogen levels: <30 pg/mL (decrease) Key Physical Examination…