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- *Case Study* A 2-year-old boy fell from a backyard gym set. His shoulder and upper arm became very swollen shortly after the fall. The boy’s mother took him to the emergency department a few hours after th incident because he was complaining of pain. On physical examination, the physician noted that large hematoma had formed in the upper part of the boy’s right arm. There was no history of surgery (he had not been circumcised), injury, or illness. The boy was receiving no medication. Emergency department treatment consisted of aspirating the hematoma Subsequent to this treatment, the boy began to bleed extensively. He was admitted to the hospital. The following laboratory tests were ordered: a hemoglobin and hematocrit, platelet count, and bleeding time. Because the bleeding continued, a type and crossmatch for two units of fresh blood were ordered on a standby basis. Additional information from the mother revealed that the boy’s cousin had “bleeding problem.” Laboratory Data…CASE STUDY # 2 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. 6. In the RBCS of the patient described above, which of the following would be expected ? A. ADP to ATP ratios would be elevated above normal. B. NADP+ would increase relative to NADPH. C. Ribulose 5-phosphate levels would decrease. D. NADH to NAD+ ratios would decrease. E. Methemoglobin levels would increase. Explanation for answer in no. 6:CASE STUDY #2 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 On the peripheral smear, there are many bizarre erythrocytes, including counts are normal. spiculated cells. A diagnosis of pyruvate kinase deficiency is made. 5. Since in this patient pyruvate kinase is abnormal not only is less pyruvate made but intermediates above pyruvate in the glycolytic pathway build up slowing the pathway. Which of the following products may not be made in the appropriate amounts in the RBC because of the deficiency of pyruvate A. Glucose B. Oxaloacetate C. acetyl-CoA D. Lactate Explanation for answer in no. 5: ?
- 14- The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction? 1.Stress 2.Trauma 3. Infection 4.Fluid overload 15-A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? 1.Injection of factor X 2.Intravenous infusion of iron 3. Intravenous infusion of factor VIII 4.Intramuscular injection of iron using the Z-track methodPatient M., 36 y/o, was found in the street unconscious. The patient has a medical history of diabetes. There is a smell of alcohol from the mouth. The skin is moist, warm, arterial pressure -145/90 mm column of mercury, convulsive twitching of muscles. Breathing is shallow, eye ball tone is retained, pupils are dilated, hyperflexion. How would you treat this patients?A. Intravenous introduction of 40-80-100 ml 40% glucose solution B. Injecting 20 units of insulin subcutaneouslyC. Injecting 20 units of insulin intravenouslyD. Injecting 500 ml 5% glucose solution intravenouslyE. Injecting 500 ml 0.9% sodium chloride intravenouslyCase Study 5:A 4-year-old boy was seen in the public health clinic because of intermittent bouts of diarrhealasting almost 4 weeks. The mother did not note any bright red blood in the stool. The child waspale, listless, and had a protuberant abdomen. He had a number of small erythematous vesicleson his feet. His mother said that he sometimes ate dirt and always had a good appetite. The familylived in a rural part and had a well from which they got their drinking water. This part of thecountry had only recently been connected to the local city’s sanitation system. The physicianinitially ordered a complete blood count with an elevated Eosinophil count. The physicianordered a stool culture for bacterial pathogens and stool examination. The bacterial culture wasnegative for enteric pathogens, but the stool examination revealed parasitic organisms and thepresence of Charcot-Leyden crystals. Diagnosis: Capillariasis Causative Agent: Capillaria philipinensis Case study presentation should…
- 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…Case study : Ms. X, a 32-year-old Hispanic woman, has had a history of intermittent pleuritic chest pain and joint pain for the past several years. Recently, she went to her physician because she noticed that an erythematous, butterfly-shaped rash had appeared on her face. Further lab tests indicated protein in her urine. Her blood test indicated the presence of numerous antinuclear antibodies, especially anti-DNA, and mature neutrophils containing nuclear material. A diagnosis of systemic lupus erythematosus (SLE) was made. Discussion Questions 1. Discuss possible reasons why SLE was not diagnosed earlier 2.Discuss how the presence of antibodies can cause such widespread damage in organ systems. 3. Discuss possible manifestations of SLE 4. Discuss treatments for SLE and a prognosis for the patient in this case.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 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…11:11 Back CASE #3DISCUSSI... Case #1 Patient is an 89 year old male admitted with Hyperkalemia, ESRD, HTN, and Bladder Cancer. Patient's past medical history includes recurrent bladder carcinoma, CVA, hernia repair and hemodyalisis. Patient was admitted due to weakness and 2 weeks of diarrhea for which he had refused to be dialyzed for 7 days. Patient lives s at home with wife and daughter who are both his healthcare surrogates. Based on patient's poor prognosis, oncologist had recommended on previous admissions that patient be made Hospice Care with comfort measures. Case #1 Cont. Daughter and wife have refused Hospice care and want patient to be dialyzed and continue aggressive treatment to include full resuscitation if cardiopulmonary arrest. Daughter and wife have requested all physicians to refrain from speaking to patient about his prognosis. At t this time all physicians have followed daughter and wife's request not let patient know that his cancer has returned, except for the…12-The nursing student is presenting a clinical conference and discusses the cause of B-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these? 1.A child of Mexican descent 2.A child of Mediterranean descent 3.A child whose intake of iron is extremely poor 4.A breast-fed child of a mother with chronic anemia 13- A child with B-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed? 1.Fragmin 2. Meropenem 3.Metoprolol 4.Deferoxamine