Sandra is a 31-year-old female with no children. She leads an active life and works outdoors while running her business as a landscape architect. Recently, she began to notice that she felt short of breath whenever she exerted herself and had developed a dry cough. She also noticed that her legs tended to swell over the course of the day and that she felt lethargic most of the time. Due to its sudden onset, Sandra thought maybe she had been working too hard and stayed on her feet too long during the day. However, the situation failed to resolve even after she reduced her workload and took a few days off to rest. Concerned, Sandra went to the emergency department of the local hospital. At admittance, Sandra’s vital signs (e.g. blood pressure, pulse rate, et cetera)were within normal limits for a woman her age. The ER orders a complete blood workup and becomes concerned when she sees Sandra’s test results. She immediately has Sandra admitted to the internal medicine wing of the hospital for further testing.
What may be Sandra’s problem? List additional laboratory (i.e. blood) and/or non-laboratory tests that could be ordered to confirm a diagnosis.
Based in her symptoms, the possible diagnosis is Congestive Heart Failure .
The Doctor may order in addition tu of Full Blood Count, urea and electrolytes, Glucose, Liver and thyroid function, Troponin blood test, Cholesterol level and Natriuretic peptides.
Non laboratory tests include Ecg, Breathing tests, Stress tests and Echo test to confirm the diagnosis.
Sandra is a 31-year-old female with no children. She leads an active life and works outdoors while...
Sandra is a 31-year-old female with no children. She leads an active life and works outdoors while running her business as a landscape architect. Recently, she began to notice that she felt short of breath whenever she exerted herself and had developed a dry cough. She also noticed that her legs tended to swell over the course of the day and that she felt lethargic most of the time. Due to its sudden onset, Sandra thought maybe she had been working too hard and...
D.W. is a 25-year-old married woman with three children under 5 years old. She was first seen by her physician months ago with vague complaints of intermittent fatigue, joint pain, low-grade fever, and unintentional weight loss. Her physician noted small, patchy areas of vitiligo and a scaly rash across her nose, cheeks, back, and chest at that time. Laboratory studies at that time revealed that D.W. had a positive antinuclear antibody (ANA) titer, positive dsDNA (positive lupus erythematosus), positive anti-Sm...
The patent was a 6-year-old female from North Carolina. She was in her usual state of good health until 10 days prior to admission, when she had a tick removed from her scalp. She developed a sore throat, malaise, and a low grade- fever 8 days after tick removal, she was seen by her pediatrician when she began developing a pink, .acular rash, which started on her palms and lower extremities and spread to cover her entire body. The pediatrician's...
Amy, a 34-year-old female, delivered a healthy baby at 39 weeks of gestation with an uncomplicated vaginal delivery following spontaneous initiation of labor. Her pregnancy was normal, and she did not experience any hypertensive episodes during the three trimesters. Her child, a baby boy, was a healthy weight at birth and was breast-feeding normally. Ten days following the birth, Amy was recovering well; her blood pressure was 120/80 mm Hg. This was Amy’s second pregnancy and birth. During her first...
Sally Morton, a 65 year old female diagnosed with major depression and suicidal ideation, is receiving home health nursing following a 5 day admission to a psychiatric hospital. She lives with her 75 year old partner and they have no children. This is Sally’s first admission for depression and her first referral for home care. The physician had ordered 20 mg citalopram per day and assessment of the client’s adjustment to home. She has no other medical problems but has...
Sally Morton, a 65 year old female diagnosed with major depression and suicidal ideation, is receiving home health nursing following a 5 day admission to a psychiatric hospital. She lives with her 75 year old partner and they have no children. This is Sally’s first admission for depression and her first referral for home care. The physician had ordered 20 mg citalopram per day and assessment of the client’s adjustment to home. She has no other medical problems but has...
Patient 1 is a 45 year-old male. He presented in the ER (with his wife) and was suffering from a high fever (>103°F) and severe diarrhea (more than 7 unformed stools/day) that started ~3 days ago. The stools contained blood and mucus. The patient was also severely dehydrated. The attending physician felt that the diagnosis of infectious bacterial colitis is likely and sent a stool culture to the pathology laboratory for diagnosis. The patient was given saline (IV) and anti-diarrhea...
Background Jeraldine Yates is a 70-year-old woman originally from Alabama. She lives alone and is able to manage herself independently. She is active in her community and church. Mrs. Yates was admitted to the hospital two months ago with heart failure. Since her discharge, a visiting nurse visits every other week to assess for symptoms of heart failure and see that Mrs. Yates is continuing to manage well on her own. Case Study The visiting nurse stops in to see...
Background Jeraldine Yates is a 70-year-old woman originally from Alabama. She lives alone and is able to manage herself independently. She is active in her community and church. Mrs. Yates was admitted to the hospital two months ago with heart failure. Since her discharge, a visiting nurse visits every other week to assess for symptoms of heart failure and see that Mrs. Yates is continuing to manage well on her own. Case Study The visiting nurse stops in to see...
Description: This patient story follows the care experience of four-year-old Noah and his mom, Tanya. A surgery, a series of miscommunications, and an early discharge from the hospital contribute to an adverse event that changes the family’s life forever. The patient story includes several discussion questions and concludes with an emotional video that gives readers Tanya’s perspective on the devastating experience. Noah Lord is born — by Cesarean section — on January 25, 1995. He is a healthy baby, meeting...