Questions need to be answere. 1. What's the difference between conjugated bilirubin and direct bilirubin? 2. Whe does conjugated bilirubin need to be assessed? 3. What are the clinical manifestations that would indicate development of problem/complications.
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- From NTSA case study https://static.nsta.org/case_study_docs/case_studies/cystic_fibrosis.pdf Please help with questions 1 and 4 of part one 1. Discuss why Nancy might or might not want to know the results of her blood test for CF. 4. Should Nancy consent to the test? Provide the reasoning for your answer.NEONATAL INTENSIVE CARE UNIT (NICU) CASE STUDY NUMBER 2: Hyperbilirubinemia CLIENT PROFILE: Patient was a l-week-old infant in the level 2 NICU born at 37 weeks. This infant was initially born with indirect hyperbilirubinemia but now also has increasingly elevated level of direct bilirubin (see measurements in table below). Neonatologist requested conjugated and unconjugated bilirubin test due to increasing elevated level of direct bilirubin. Conjugated bilirubin test is not routinely performed in our hospital laboratory and needs to be send out. 3/6/18 3/7/18 3/9/18 3/10/18 3/12/18 Ref Range Bilirubin 1.0-10.5 9.2 8.7 10.8 10.2 8.6 total, neonatal mg/dL Bilirubin direct, neonatal 0.0 - 0.6 mg/dL 0.5 0.7 1.8 1.8 2.1 Pre-Assessment: 1. What's the difference between conjugated bilirubin and direct bilirubin? Assessment: (Information gathering through history, physical examination and testing) 2. When does conjugated bilirubin need to be assessed? 3. What are the clinical manifestations…tein X Case Studies.docx X + rl=https://wheatland.orbundsis.com/einstein-freshair/Videos/0216D9403D0ED43358766A676D8A4817/Case+Stuc TCentral | NBA... a Amazon.com: Onlin... (6) The Reason Why... Isaiah Blames Zora... Beyond The Lights... Case Study, Chapter 26, The Digestive System Mr. McArthur is hospitalized with pancreatitis and cholecystitis. Neither his gallbladdernor his pancreas are functioning normally at this time. The client is placed on a NPO (nothing by mouth) diet order, given intravenous fluids and pain medication. The nurse is aware that the pancreas has two functions: one being endocrine, secretion of hormones to assist with glucose control and the other being exocrine, aiding the digestive system. Mr. McArthur is scheduled for gallbladder removal in the morning to treat the cholecystitis. (Learning Objective 4) 1. The client asks what his gallbladder does. What is the nurse's best response? 2. The client also asks how the pancreas works to help with digestion. What…
- 29 yo female PTC with a 3 day history of sore throat, fatigue, fever, and swelling in the neck and underarms. Patient denies having been around anyone who was sick. Patient reports reduced appetite but no vomiting Vitals: 116/72, Temp 101.2, RR: 16 rpm, O sat: 99% Pulse: 89 bpm Physical findings reveals an erythematous pharynx with 3+ tonsils with bilateral exudates and palatal petechiae Anterior and posterior cervical lymphadenopathy and axillary lymphadenopathy present Abdominal: no abdominal tenderness or organomegaly 1. What do you want to do next? 2. Using the grading scales how likely is it that this patient has strep throat?Hemodynamic Monitoring Case Study: A 67-y.o woman is admitted to the ICU with a dx. of hypotension of unknown origin. She is presently unresponsive but is breathing spontaneously on her own. Lungs are clear, urinary output is 15ml in 8 hours, and her skin is cool. A PA catheter is inserted to obtain more information and guide therapy. The following information is revealed: BP 86/54mmHg PAWP 4mmHgP 118/min CVP 2mm/HgRR 30 breaths/min SVR 1393 dynesC.O. 3.5 L/min PVR 195 dynesC.I. 1.9 L/min SvO2 50%PA 24/10mmHg Which Values tell us about this patient's filling pressures/fluid status? Are these values adequate? Which Values tell us about this patient's contractility? Are these values adequate? Which values tell us about this patient’s vascular resistance? What is causing this patient's hypotension? Which initial therapy is appropriate?ction Section 1: Hem 17 of 145. 17. A 50-year-old man is brought to the emergency department because of a 2-hour history of severe confusion and trel cs of conec the past year. He is otherwise healthy. Physical examination shows no abnormalities except for confusion. His serum gjuse concertation S intravenous infusion of glucose. A CT scan of the abdomen shows a 4-cm lesion in the head of the pancreas. Which of the bowing the d OA) Carcinoma of the head of the pancreas B) Islet a cell adenoma OC) Islet 3 cell adenoma OD) Islet o cell adenoma تھے E) Pancreatic tumor and abscess
- a 58-year-old Asian male .He visited his physician because he noticed dark colored lesions on his inner thighs, have increased in number, size. For the last three months he has been feeling weaker and more fatigued than usual; his weight dropped from 170 to 155 pounds. Xin’s blood was drawn and testing was conducted. His hematocrit was 45% and white-blood cell count was 2,500 white-blood cells/mm3, with the differential showing neutrophils 65%, lymphocytes 25%, monocytes 10%. A biopsy was taken of one of the discolored lesions and grown in cell culture. After three days of growth the cells were confirmed as coming from malignant cancerous tissue. A magnetic resonance image (MRI) of the area around the skin lesions on Xin’s inner thigh revealed enlarged lymph nodes, a sign of potential metastasis. What possible Diagnosis or disorders can you rule out for this paitentA 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…A 62-year old, recently widowed male Hispanic patient, KB. was brought in to the emergency department (ED) by his daughter for progressively worsening shortness of breath, fatigue, a lingering non-productive cough, and generalized edema. One month prior, he noticed dyspnea upon exertion, loss of appetite, nausea, vomiting and malaise, which he attributed to the flu. In the emergency department, he appeared anxious and pale, and had a dry yellow tint to the skin. He denied any chest pain, and he could not recall the last time he urinated. He has history of benign prostatic hyperplasia, diabetes mellitus type 2, hypertension, dyslipidemia, and renal insufficiency for the past two years. His ED assessment findings included: 1+ pedal edema, basilar crackles in the lungs bilaterally, and a scant amount of urine according to a bladder scan. His lab results indicated a glomerular filtration rate (GFR) of 12. Based on his subjective and objective symptoms, he was admitted with a diagnosis of…
- a 25-year-old female presented to her 28-week antenatal appointment with the complaint of lethargy, who was also noted pale. Discuss in detail the pathogenesis of microsystic anemia. dicuss 1 or more casue. Give examples, Provide a diagram to back answerBACKGROUND A 2-year-old black girl is being seen by the hematologist after her pediatrician found her to be severely anemic with splenomegaly and jaundice. Her mother gives a possible history of a “blood problem” in her family but doesn’t know for sure. Her hemoglobin electrophoresis was normal, and the complete blood count (CBC) revealed a normocytic anemia. The platelet and white blood cell counts are normal. On the peripheral smear, there are many bizarre erythrocytes, including spiculated cells. A diagnosis of pyruvate kinase deficiency is made. Pyruvate kinase deficiency (PKD) can be inherited in an autosomal recessive manner, which means that a child must inherit a gene with the disease-causing mutation from both parents in order for the disorder to be inherited. The PLKR gene regulates the synthesis of the pyruvate kinase enzyme, which is located in the liver and red blood cells. Pyruvate kinase deficiency (PKD) is a rare genetic disorder characterized by the premature…A 67 years old female patient. She presented to her GP last week, complaining of a very strong headache, followed by dizziness. The symptoms had resolved by the time she could see the GP, who was concerned enough to request a CT of her head and neck. Diabetes mellitus Type 2: Management: metformin 1000mg, daily enalapril 10 mg daily rosuvastatin 10mg, daily Atrial fibrillation (AF) Management: apixaban 2.5 mg, BD sotalol 40 mg, BD Cigarette smoking: 20 - 30 cigarettes/day, quit 5 years ago. She underwent a CT scan of the head and neck, but the results were normal. the patient was assessed as requiring changes to her hypertension & AF management and the following changes made: enalapril ceased the following medications commenced or changed; irbesartan/ hydrochlorothiazide 300/25, daily amlodipine 5mg, daily apixaban 5mg, BD This morning patient woke up at 0600 hours with a 5/10 headache. At 0700 hours she began to feel weak in her limbs, and her headache increased to…