REQUIREMENT: AA, is a 13-year-old young boy of Thai descent. AA has been admitted to the emergency room with chest tightness, shortness of breath, and wheezing. He had been playing basketball with his friends. AA has a history of asthma. His peak flow meter reading is 180. His normal is 425. His pulse oximetry is 90% on room air. His family members have alternately had "colds". AA used his Serevent inhaler at home prior to coming to the hospital but is not using it on a regular basis due to his mother utilizing alternative therapies to manage AA's asthma. His parents have accompanied him to the emergency room and speak limited English. 1. Discuss the specific respiratory assessment to the young boy, AA. 2. Explain the health education that the nurse would give to the AA and family members at the time of treatment commenced. [Total: 30 Marks]
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- A 53-year-old man is brought to the emergency department by ambulance because he is having difficulty speaking. The patient tried to explain to his wife that something was wrong, but he was unable to speak clearly. He is, however, able to communicate in writing. He has been on beta blockers to control hypertension and has type 2 diabetes that is being managed with diet and exercise. PHYSICAL EXAMINATION VS: T 36.5°C, P 85/min, R 18/min, BP 134/88 mm Hg, BMI 31 PE: The patient is anxious but able to respond to spoken commands. Reflexes are intact. LABORATORY STUDIES CT: Occlusion in the left hemisphere of a branch of the anterior main division of the middle cerebral artery supplying the frontal cortex. Based on that information, answer What does the physical tests results imply and why? Describe how the feedback loop/s involved were disrupted; What is the cause of this condition? What glands/organs are defective? What happened to this man that would explain his condition (summary)?…A 53-year-old man is brought to the emergency department by ambulance because he is having difficulty speaking. The patient tried to explain to his wife that something was wrong, but he was unable to speak clearly. He is, however, able to communicate in writing. He has been on beta blockers to control hypertension and has type 2 diabetes that is being managed with diet and exercise. PHYSICAL EXAMINATION VS: T 36.5°C, P 85/min, R 18/min, BP 134/88 mm Hg, BMI 31 PE: The patient is anxious but able to respond to spoken commands. Reflexes are intact. LABORATORY STUDIES CT: Occlusion in the left hemisphere of a branch of the anterior main division of the middle cerebral artery supplying the frontal cortex. Based on that information, answer What glands/organs are defective?A 53-year-old man is brought to the emergency department by ambulance because he is having difficulty speaking. The patient tried to explain to his wife that something was wrong, but he was unable to speak clearly. He is, however, able to communicate in writing. He has been on beta blockers to control hypertension and has type 2 diabetes that is being managed with diet and exercise. PHYSICAL EXAMINATION VS: T 36.5°C, P 85/min, R 18/min, BP 134/88 mm Hg, BMI 31 PE: The patient is anxious but able to respond to spoken commands. Reflexes are intact. LABORATORY STUDIES CT: Occlusion in the left hemisphere of a branch of the anterior main division of the middle cerebral artery supplying the frontal cortex. Based on that information, answer these questions: What does the physical tests results imply and why? Describe how the feedback loop/s involved were disrupted; What is the cause of this condition? What glands/organs are defective? What happened to this man that would explain his…
- A 53-year-old man is brought to the emergency department by ambulance because he is having difficulty speaking. The patient tried to explain to his wife that something was wrong, but he was unable to speak clearly. He is, however, able to communicate in writing. He has been on beta blockers to control hypertension and has type 2 diabetes that is being managed with diet and exercise. PHYSICAL EXAMINATION VS: T 36.5°C, P 85/min, R 18/min, BP 134/88 mm Hg, BMI 31 PE: The patient is anxious but able to respond to spoken commands. Reflexes are intact. LABORATORY STUDIES CT: Occlusion in the left hemisphere of a branch of the anterior main division of the middle cerebral artery supplying the frontal cortex. Based on that information, answer What is the long-term prognosis? What is the name of this disorder?Bradley Buchanan presents to the neighborhood nurse-run clinic with shortness of breath, a persistent cough with blood-tinged sputum, recent weight loss, and night sweats. On initial assessment, the client has a fever of 101.4°F and pain in his chest. His other vital signs are as follows: pulse 98 beats per minute; respirations 26 per minute; blood pressure 110/76 mm Hg; height 68 inches; and weight 140 pounds. Mr. Buchanan is 45 years old. He is employed as a dishwasher at a local restaurant and lives at the local shelter with his wife, who is 8 months pregnant, and his 13-year-old son. Mr. Buchanan is concerned that if he cannot go to work, he will lose the family’s only income. At this point, although Mr. Buchanan’s signs and symptoms and his purified protein derivative test results seem to indicate that he may have tuberculosis, the nurse must pursue further confirmation of the diagnosis. Questions for students: What would be the nurse’s next action? Should the nurse do any…A nurse is caring for a preschooler on the pediatric unit. Exhibit 1 Provider Prescriptions Day 1, 2350: Admit for observation. Obtain vital signs every 4 hr and PRN. Administer oxygen 2 L/min via nasal cannula to maintain oxygen saturation above 95%. Initiate saline lock. Administer ceftriaxone 250 mg IV every 12 hr. Administer acetaminophen oral suspension 240 mg every 4 hr PRN for temperature greater than 38° C (100.4° F). Place on regular diet and encourage oral fluids of preschooler's choice. Monitor intake and output every 8 hr. Exhibit 2 Assessment Day 2, 0030: Preschooler lying on bed, awake and alert. Breath sounds with wheezing auscultated on expiration on the right side. Nonproductive cough with no retractions or nasal flaring observed. Abdomen soft and nondistended, bowel sounds active in all four quadrants. Preschooler reports headache and pain in abdomen. Rates pain in abdomen as a 2 on a 0 to 10 FACES pain scale. Exhibit 3 Vital Signs Day 2, 0030: Temperature 38.1°…
- Child weighing 47 lbs is prescribed to receive 1 g of medication in 250 mL of D5W every 12 hours. Normal/safe dosage range is 35-45 mg/kg/day. Is the dosage prescribed within normal/safe range for the child?Mrs. Sara Jones, an 84-year-old,250 lbCaucasian female, is admitted to the unit for a hip fracture. She has been active and likes to garden. She does admit to smoking a pack of cigarettes a day. She also has a history of atrial fibrillation, which is why she receives Coumadin 2 mg every day. Mrs. Jones will require general anesthesia for her hip surgery. She is very apprehensive since being admitted 2 hours ago. (Learning Objectives 1, 2, 3, 4, 5, 7, 8, 9) 1. What risk factors for surgery does Mrs. Jones have? 2. What laboratory results of this client should the nurse review? Why? 3. Discuss what steps should be taken in preparing this client for the postoperative care.Case Study: A patient is brought by friends to the emergency department of the city hospital because he has been behaving strangely for several days. A known user of methamphetamine, he has not eaten or slept in 48 hours. His blood pressure is 160/100 mm Hg, heart rate 100, temperature 39°C, and respirations 30/ min. His arms show evidence of numerous intravenous injections. After evaluation, the man is given a sedative, fluids, a diuretic, and ammonium chloride parenterally. Based on your knowledge regarding pharmacokinetic principles, What is the purpose of giving ammonium chloride?
- Emergency Department Time: 1230 Carl Shapiro is a 54-year-old male who travels frequently on business. He is seeking care in the local Emergency Department, with complaints of dull aching chest pain and shortness of breath. He is out of state with no local physician He smokes less than a pack of cigarettes a day and drinks alcohol occasionally. He describes his work as "stressful. An IV of normal saline has been started and is infusing at 25 mL/hour. Basic metabolic panel, complete blood count troponin and CK-MB lab values are pending. what condition could he be experiencing.A nurse on a medical-surgical unit is caring for a client who is postoperative following an emergency appendectomy. Exhibit 1 Vital Signs Temperature 37.7° C(99.8°F) . Heart rate 82/min . Respiratory rate 16/min . Blood pressure 127/80 mm Hg . Oxygen saturation 99% on room air Exhibit 2 Assessment Height 157.5 cm (62 in) Weight 90 kg(198 lb) Bilateral lower extremities warm to touch, pedal pulses 2+ bilaterally. Spider veins noted on bilateral lower extremities. Distended veins noted on right lower extremity. Exhibit 3 Nurses' Notes Client reports pain at abdominal incision site as 4 on a 0 to 10 scale. Client also reports right lower extremity pain as 5 on a 0 to 10 scale, and itching. Reports that right lower extremity pain has been intermittent for about the last 2 months. Denies current left lower extremity pain.M.P. is a 45-year-old woman who presents to the family practice for a yearly check-up. Subjective Data Married Exercises daily Nonsmoker, never smoked Registered nurse in hospital setting Has two children who live at home No complaints at this time Objective Data Vital signs: T 36.7 BP 108/62 HR 62 Resp 14 Height: 5 feet, 7 inches Weight: 160 lb Immunizations: Up-to-date Medications: No medications, multivitamin daily Allergy to PCN = Hives Questions How should the nurse proceed with the physical exam? What interventions can help make the patient more comfortable during the physical examination? What pointers or tips can the experienced nurse give to a new nurse who wants to improve his or her technique? What are the components of the general survey? How should the nurse perform the abdominal assessment?