Mr. McClaren is a 48-year-old man who is admitted to the emergency department (ED) with abdominal pain and general weakness. He reports that he drinks “one bottle of scotch whisky every week for the past one year, and one to two cans of beer during the weekends.” For the past three months, his condition has started to deteriorate. His wife claims that “he has not been eating well for the past three months”. Mr. McClaren reports he has passed dark red stool on three occasions – the last one being just one day before coming to ED. On examination, Mr. McClaren has an enlarged abdomen with tenderness upon palpation. He also presents with the following clinical manifestations: peripheral edema, pale yellow skin color, dry mucus membranes and body weakness. The physician suspects that Mr. McClaren has hepatic cirrhosis. His vital sign findings include: Temperature 37.8 Celsius, BP 94/52, Pulse 110, Oxygen saturation 94%. From your nursing classes, you know that some of the treatments Mr. McClaren may receive are paracentesis, ultrasound and CT scan of the abdomen, as well as vitamin K administration.
The suspected complications observed in the patient are
Mr. McClaren is a 48-year-old man who is admitted to the emergency department (ED) with abdominal...
Mr. McClaren is a 48-year-old man who is admitted to the emergency department (ED) with abdominal pain and general weakness. He reports that he drinks “one bottle of scotch whisky every week for the past one year, and one to two cans of beer during the weekends.” For the past three months, his condition has started to deteriorate. His wife claims that “he has not been eating well for the past three months”. Mr. McClaren reports he has passed dark...
Mr. J. is a 30-year-old electrical line worker brought to the emergency department by ambulance. Emergency medical service (EMS) personnel report that he was in a cherry picker which came in contact with an overhead 70,000-volt power line. He was unconsciousness at the scene, was apneic and intubated by EMS. On presentation to the ED, Mr. J. is noted to have areas of black charring on his right arm, axilla, and upper thighs. Issue Identification. Based on the above description...
Mr. Cruz is a 34 year old Mexican man who went to the Emergency Department (ED) because of several days of upper respiratory track symptoms. A chest x-ray revealed a small lung nodule of unknown significance. He was felt to have a viral syndrome and was given an appointment to follow-up in the pulmonary clinic in 10 days for further evaluation of the nodule. After missing his initial and two rescheduled appointments, one of the nurses called him home to...
Mr. Jimenez is a 61-year-old Spanish-speaking man who presented to the emergency room with his wife. His wife also speaks Spanish but does understand some English. Mr. Jimenez complains of nausea and vomiting for the last two days and symptoms of confusion. His blood glucose is 796 mg\deciliter. He has a past medical history of coronary artery disease (CAD) and hypertension (HTN). He has smoked one pack per day of cigarettes for the last 35 years as well as drinking...
An 83-year-old man is admitted through the emergency department after being found lying on the floor inside his home. He had fallen three days prior after tripping over rug in his kitchen. The local police department found him after the neighbors requested a welfare check. He was unable to reach food or water, head a large laceration to his forehead with dried blood, was incontinent of urine and stool, and had noted shortening and rotation to his left leg. Upon...
Mr John Norden is a 56 yr old man admitted to the ward with abdominal pain this morning. He has a history of frequent constipation, managed at home with a high fibre diet. Mr Norden tells you during the nursing assessment that he has not opened his bowels for the past four days. How to write a progress note about giving suppository and movicol.
John Mathis, a 73-year-old male, is treated in the emergency department (ED) for an infected wound on his right foot. John states he was walking barefoot and stepped on something sharp that cut his foot. He treated it with topical antibiotics, but it appears red and inflamed, with purulent drainage. John is admitted to the medical-surgical unit for inpatient wound care treatment. As part of the admission interview, the nurse asks Mr. Mathis and his wife how they would like...
Mr. Wilson, a 39-year-old man, comes to the clinic with pain on urination and frequent urination. He described pain as burning. He provides a history of sexual activity since age 20, and reports previous sexual contacts with two women and a man in the last three months. In addition, he reports that no barrier methods of protection were used at times in the last three months. Most recent sexual activity has been on the weekend. Currently, he is engaged with...
Mr. Bahr is a 59-year-old man who is undergoing an annual physical today. His past medical history includes hypertension which is well controlled with losartan (Cozaar), 50 mg taken once daily. During his last annual physical, his blood pressure was 128/78, and he had no concerns other than having to wake up to urinate once in the middle of the night. During today’s visit, his blood pressure is 126/80. He tells the nurse that he now has to get up...
A 48-year-old man presents to the emergency department with 2 days of crampy abdominal pain, nausea, vomiting, diarrhea, and fever. He has not had any blood in his stool. He denies contact with anyone with similar symptoms recently. He has not eaten any raw or unprocessed foods recently. The only food that he did not prepare himself in the past week was a breakfast of eggs “sunny side up” and bacon that he had at a diner the day before...