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Mr. X is an 83-year-old married man. He has a history of severe osteoarthritis leading to bilateral hip replacement and one knee replacement. He has mild hypertension controlled by oral medication. At this time, he developed a severe urinary tract infection resulting in weight loss, fatigue and weakness. After stabilizing, he was sent to the skilled nursing unit of the hospital for 2 weeks until ready to go back home. Occupational therapists consulted with him and his wife during hospitalization.
He lives in a three-story house with the bedrooms on the top floor, kitchen and living room on the middle main floor and family room on the bottom floor. He has not driven since the last operation but would like to. He has smoked cigars for years and sits on the front porch to smoke. Physical therapists have come to the house three times a week for several months.
- How can you relate this scenario to the national or global health situation?
- Name the three types of healthcare agencies he has used. What are the strengths of each of these?
- What are the services being needed by Mr. X? What other members of the health care profession would most likely be on the team and why?
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- Mr. X is an 83-year-old married man. He has a history of severe osteoarthritis leading to bilateral hip replacement and one knee replacement. He has mild hypertension controlled by oral medication. At this time, he developed a severe urinary tract infection resulting in weight loss, fatigue and weakness. After stabilizing, he was sent to the skilled nursing unit of the hospital for 2 weeks until ready to go back home. Occupational therapists consulted with him and his wife during hospitalization. He lives in a three-story house with the bedrooms on the top floor, kitchen and living room on the middle main floor and family room on the bottom floor. He has not driven since the last operation but would like to. He has smoked cigars for years and sits on the front porch to smoke. Physical therapists have come to the house three times a week for several months. 1. Name the three types of healthcare agencies he has used. What are the strengths of each of these?Mr. X is an 83-year-old married man. He has a history of severe osteoarthritis leading to bilateral hip replacement and one knee replacement. He has mild hypertension controlled by oral medication. At this time, he developed a severe urinary tract infection resulting in weight loss, fatigue and weakness. After stabilizing, he was sent to the skilled nursing unit of the hospital for 2 weeks until ready to go back home. Occupational therapists consulted with him and his wife during hospitalization. He lives in a three-story house with the bedrooms on the top floor, kitchen and living room on the middle main floor and family room on the bottom floor. He has not driven since the last operation but would like to. He has smoked cigars for years and sits on the front porch to smoke. Physical therapists have come to the house three times a week for several months. 1. What are the services being needed by Mr. X? What other members of the health care profession would most likely be on the team…Mrs. C is a 50-year-old woman who presents with joint pain. She reports the pain has been present for about 2 years. The pain affects her hands and her wrists. She describes the pain as a “dull aching” and “a stiffness.” It is worse in the morning and improves over 2 to 3 hours. She says that on particularly bad days she uses aspirin with moderate relief. She is otherwise well, except for a history of mild hypertension managed with angiotensin-receptor blocker. She reports no other joint pain. She does not have a history of psoriasis. Her vital signs are: 37.1 C; B/P 128/84; P 84; R 14. There is a 2/6 systolic ejection murmur. Joint exam revealed limited range of motion of the MCPs and wrists bilaterally. There is swelling of the third and fourth MCP on the right and the third on the left. There is pain at the extremes of motion and a boggy quality to the joints. A detailed skin exam is normal. Rheumatoid arthritis (RA) is suspected. 1. What type of hypersensitivity is rheumatoid…
- Mr. Henry is a 50-year-old male who presents to the office for headaches. he has a known history of sinus infections when the seasons change, high blood pressure and depression. his medications include Lopressor 50mg, daily and Claritin 10mg daily. he has a family history significant for aneurysms and depression. His vitals are BP 196/86 right arm seated, HR 87 regular, RR 13, Temp 98 oral. What is a NANDA approved diagnosis you could give her?Mr. B is a 57-year-old man who was admitted yesterday after starting to pass black stools. He has a two-day history of severe stomach pains and has suffered on and off with indigestion for some months. He is a life-long smoker, with mild chronic heart failure (CHF) for which he has been taking enalapril 5 mg twice daily for 2 years. He also recently started taking naproxen 500 mg twice daily for arthritis. He works a stressful job and drinks large amounts of caffeinated coffee daily. Yesterday his hemoglobin was reported as 9.3 g/dL, hematoocrit 30%, RBC's 3.2, platelets 162, INR 1.1 with Liver Function Test normal. He was mildly tachycardic (110 bpm) and had a slightly low blood pressure of 100/77 mmHg and was given 1.5 L of saline. He has just returned from an endoscopy this morning and has been newly diagnosed as having a bleeding duodenal ulcer. They took a biopsy to determine if he is positive for H-pylori. He has been written up for his usual medication for tomorrow if he is…Mr. H is a 52-year-old male who presents to the emergency department. His left leg is in a cast, and he states that 1 week ago he was in an automobile crash and broke his upper leg. Since that time, he has had difficulty “getting around” and has mostly been lying on the couch watching television. On the evening of admission he noticed a sudden onset of dyspnea and chest pain. He denies having orthopnea, cough, hemoptysis, or wheezing. He smoked two packs of cigarettes a day for 19 years but quit 3 years ago. The ABG analysis of Mr. H suggests uncompensated respiratory alkalosis with mild hypoxemia, with base excess of -1 in her arterial side, whereas -4 in her venous side. Part 1: Her actual arterial-venous oxygen content difference (Ca-vO2) is 5.31 mL/dL. (Normal range considered here is 3.5 to 5 mL/dL) Part 2: Patient's actual oxygen extraction ratio (O2ER) was 29%. (Say normal range is 20-28%) What is clinically happening to the patient?
- Patient B., 56 y/o, is complaining of weakness, muscle ache, paresthesia in the facial zone, lower extremities, tonic-clonic seizures, breathing difficulty. Anamnesis contains a record of previous subtotal resection of thyroid gland. Objectively: her consciousness is clouded, the skin is dry, cyanotic, “main d’accoucheur”(obstetrician’s hand) convulsions in the upper extremities swallowing function is disturbed, shortness of breath. Heart sounds are dull, rhythmical, arterial pressure – 115/55, pulse – 56 beats/minute. Positive Chvostek’s and Trusso’s symptoms. The level of calcium in the blood – 1.3mmol/l; hyperphosphatemia, hypocalciuria; glycemia –5.6mmol/l. What is your diagnosis?A. Hypocalcemic crisisB. Hypothyroid comaC. Kidney failureD. Hyperthyroid coma E. Brain comaM. J. is a 76-year-old woman who lives on the side of a very steep mountain. The home health nurse has visited her once a week for the last year. She has running water, electricity, and a coal stove with back-up oil heat for very cold winter nights. She uses the telephone for communication. She has diabetes mellitus, hypertension, hypothyroidism, and is in atrial fibrillation. She has never been in the hospital before. Her current medications include metformin (250 mg twice a day), losartan (50 mg/day), levothyroxine sodium (Synthroid) (50 mcg/day), digoxin (0.125 mg/day), furosemide (Lasix) (10 mg/day), aspirin (81 mg/day), simvastatin (20 mg/day), and warfarin (Coumadin) (4 mg/day, with 6 mg on Sundays). Allergies are to penicillin (hives) and to metoprolol (hypotension and dizziness). M. J. stopped smoking 5 years ago, but until then she smoked one-half pack a day. Last laboratory test results (1 week ago) were: hemoglobin A1C (Hgb A1C) 8.3, international normalized ratio (INR) 1.7,…M. J. is a 76-year-old woman who lives on the side of a very steep mountain. The home health nurse has visited her once a week for the last year. She has running water, electricity, and a coal stove with back-up oil heat for very cold winter nights. She uses the telephone for communication. She has diabetes mellitus, hypertension, hypothyroidism, and is in atrial fibrillation. She has never been in the hospital before. Her current medications include metformin (250 mg twice a day), losartan (50 mg/day), levothyroxine sodium (Synthroid) (50 mcg/day), digoxin (0.125 mg/day), furosemide (Lasix) (10 mg/day), aspirin (81 mg/day), simvastatin (20 mg/day), and warfarin (Coumadin) (4 mg/day, with 6 mg on Sundays). Allergies are to penicillin (hives) and to metoprolol (hypotension and dizziness). M. J. stopped smoking 5 years ago, but until then she smoked one-half pack a day. Last laboratory test results (1 week ago) were: hemoglobin A1C (Hgb A1C) 8.3, international normalized ratio (INR) 1.7,…
- The nurse is conducting health screening for osteoporosis. Which client is at greatest risk for developing this disorder? Question 21 options: a) A sedentary 65-year-old woman who smokes b) A 70-year-old man who consumes excess alcohol c) A 25-year-old woman who runs d) A 36-year-old man who has asthmaNath age14-year-old, has a compound fracture of the femur and is undergoing surgical repair. A few days after his surgery, he developed osteomyelitis/ infection of the bone. You were assigned to administer his medication. His medications are Clindamycin 500 mg TID times x 7 days and Morphine 5mg/tab 1 tab q6h prn for severe pain.M.H. is an 80-year-old Caucasian female who is married and lives with her spouse. She presents to your office today with her spouse, feeling “coocoo, I just don’t feel right.” Currently she is taking rosuvastatin prescribed by her cardiologist for hyperlipidemia and a daily 325 mg aspirin. She drinks 3–6 hard liquor drinks a day, 3–4 times a week in the evening, and has a 65-year smoking habit, currently smoking two packs per day (ppd). She has no known allergies. Past surgical history includes hysterectomy for a benign fibroid. Family history of breast cancer in three sisters, Type 2 diabetes and CVA in one sister, cancer of unknown origin in one brother. All siblings and parents are deceased. Her husband reports that she is hard of hearing. He feels that it is due to cerumen build-up in her ears. She refuses to have the buildup removed. Her husband is also worried about her memory—states that she “just does not remember things like she used to. She keeps asking me the same questions…