3:49 Back NUR 1208-PEDIA CASES.docx NUR 1208- PEDIA CASE SCENARIOS: 1. INFANCY A 19-year-old parent and infant arrive at the pediatric clinic for the infant's 2-month-old well visit. The parent looks tired and tells the nurse the baby "cries every evening for hours" and it is exhausting. The parent stopped breastfeeding, changed to formula, and then started rice cereal to see if that would help. It did not help. The parents report stools are daily and soft. Length, weight and head circumference remain at the previous percentiles. The infant displays a social smile. 41
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- 21% 7:59 +233 20 775 0585 Augnstaisug.59laMgh/portal UNIVERSITY OF GHANA 下吃 197 Case study on symptom management Madam FD 48 years was admitted to the hospital with the diagnosis of Metastatic Right Breast Cancer with metastasis to the Lung causing pleural effusion on the right chest. She reported with history of breathlessness for 2days, multiple lumps in the right breast & Chest wall spreading over the entire chest wall for the past 3 months, She has been unable to sleep for the past 3 weeks She had received a total of 14 cycles of Chemotherapy but due to COVID 19 restrictions she defaulted on her appointments. 1. Describe how you will assess the patient using the Edmonton Symptom Assessment system 2. What questions will you ask to further probe the symptoms reported? 3. What will be the goal and specific objectives for the care of madam FD 4. What physical examination findings will you report? Additional resources for assignmentSHOwl WORIINGS 1) A Physician orders gentamycin 50 mq lv qsh for achitd wsho weighs The recommended dosage for children is 3-6mg!uglday recommended minimum Gmaximum daily dos ages 43 1bs 9) what for this child? are the b) what are the recommended minimum and mascimum Single dosages for this child? c) Is the ordered dosageb safe?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
- Make a 1 FDAR. Use any focus from the given case except "boggy uterus". Case: Date/Time: 9/13/2022 @ 10:30 AM Admitted at 9:00AM a case of D.A.M., 30 years old, G2P1T1P0A0L1M0, at 39 weeksage of gestation, singleton from Balamban, Cebu, with chief complaints of stronguterine contractionsand severe labor pains. Upon IE, it was noted that cervix is fully dilated, 100% effaced and ruptured bag of water. After a while, she shouted: “Help, the baby is coming”. D.A.M. was immediately transferred tothe delivery room, mounted in the delivery table and prepared for imminent delivery. After 1 hour, she delivered per vagina a healthy baby boy. Oxytocin given 10 “IU” at right upper arm within 1 minute after delivery of the baby. 5 minutes after, fetal surface of the placenta was presented at the birth canal. Intact perineum. Vital signs within normal range. Uterus boggy (“not firm”) with fundus palpable at 1cm below umbilicus. Lochia rubra moderate. Patient appears sleepy.The American Academy of Pediatrics recommends that screen time for children between 2 and 5 years of age should be limited to ________ hours per day.Pregnancy Case Scenario A 35-year-old woman Gravida 1, Para 0, comes in for her 16-week prenatal visit for the first time. She has been suffering from nausea and vomiting since her sixth week, and while it has begun to get better, she still vomits two to three times a day. Her nausea is alleviated somewhat by sipping on hot coffee and sucking on candies. She has not been to the dentist in the past year, and she has not been able to regularly brush her teeth since the onset of vomiting, because the toothbrush in her mouth triggers her condition. She reports pain (toothache) when drinking hot tea or having ice cream. "Develop basic nursing care management for a healthy pregnancy based on the case scenario."
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia1. Discuss possible reasons this patient fell.2. List common side effects of Levodopa/Carbidopa3. He states that he doesn’t think his antidepressant is working. How will you address his concern?4. Which of his medications might be causing the insomnia? How could this be addressed?5. List some general education points regarding sleep hygiene.6. Do you have…Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomniaWhich of his medications might be causing the insomnia? How could this be addressed?Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 5. List some general education points regarding sleep hygiene
- Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia 1. His wife tells you that he has started having hallucinations. Which medication might be causing this?Discuss why this happens.Patient is a 70 year old male with Parkinson’s disease, depression, HTN, and insomnia. He fell at hometwo weeks ago fracturing his forearm and bumping his head. He states that he was going into the kitchento make breakfast and his slipper caught the corner of the floor rug. He has no known drug allergies.Allergies NKDA Current MedicationsLevodopa/Carbidopa (Sinemet®) 25/250mg po TIDFluoxetine (Prozac®) 20mg po daily at bedtime (started 2 weeks ago)Amlodipine 5mg PO once dailyKetorolac (Toradol®) 10mg po every 6 hours prn arm pain x last two weeksDiazepam (Valium) 10mg po at bedtime for sleepPMH Parkinson’s DiseaseDepressionHTNInsomnia Do you have any concerns about his pain medication?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…