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Julie a 16-year-old primigravid comes to the prenatal clinic for her monthly check-up. She has gained 20 lb from her 30-36 weeks, with edema of the face and hands. She is diagnosed as having severe preeclampsia and was referred to the high-risk Obstetrical Unit. The client's weight increase is most likely due to:
a. Hypertension
b. Obesity
c. Overeating
d. Fluid retention
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- A 46-year-old woman is experiencing fatigue and weight gain despite decreased food intake. Her hair is thinning and her skin is very dry. She reports that she has had mild swelling in her legs. She also reports feeling irritable and depressed. Laboratory tests reveal a low serum T4 level and an elevated serum TSH level. What is the likely diagnosis and what information can the nurse provide to the patient about her condition?Anna is a 45-year-old female that presented to her physician’s office for her annual check-up. Anna has a history of diabetes, obesity, and noncompliance with diet and medications to control her diabetes. She a single mother of three teenagers and smokes regularly. During the history review, Anna shares with you that she has not been feeling like herself for the past six months, she has been unusually tired and thought that she felt a lump in her right breast during a self-breast exam around that same time. She stated, “I am very busy with my children; I haven’t had time to get it checked out.” She has recently been experiencing right nipple pain. Anna has a positive family history of breast cancer; both her mother and grandmother have been treated for breast cancer. Anna has never had a mammogram. During the breast examination, the practitioner palpated a lump in Anna’s right breast. No discharge from the nipple was observed. Anna’s right breast was tender upon palpation. No…Anna is a 45-year-old female that presented to her physician’s office for her annual check-up. Anna has a history of diabetes, obesity, and noncompliance with diet and medications to control her diabetes. She a single mother of three teenagers and smokes regularly. During the history review, Anna shares with you that she has not been feeling like herself for the past six months, she has been unusually tired and thought that she felt a lump in her right breast during a self-breast exam around that same time. She stated, “I am very busy with my children; I haven’t had time to get it checked out.” She has recently been experiencing right nipple pain. Anna has a positive family history of breast cancer; both her mother and grandmother have been treated for breast cancer. Anna has never had a mammogram. During the breast examination, the practitioner palpated a lump in Anna’s right breast. No discharge from the nipple was observed. Anna’s right breast was tender upon palpation. No…
- Patient is a 55 year old female with a diagnosis of diabetes. She was diagnosed when she was 50 aftershe changed jobs and became more sedentary and which also resulted in a poor diet. She currentlyoverweight with a BMI of 32.Allergies NKDACurrent MedicationsMetformin 1000 mg BIDLisinopril 10 mg once dailyPMH Propranolol 10 mg TIDDMHTN1. What type of diabetes does she have?2. Describe the mechanism of action of metformin. In which patients is metformin contraindicated?3. List some non-pharmacologic measures that can lower her blood sugar?4. List the long term complications of DM5. What role does Lisinopril have in patients with DM?6. What concerns do you have with the propranolol?7. Despite her medication regimen, her blood sugar has been very, very high and her physician decidedto start a long acting insulin. Which insulins are long acting?A 40-year-old woman comes to the physician for a health maintenance examination. She does not smoke or drink alcoholic beverages. Physical examination shows no abnormalities. Laboratory studies show: Serum Urea nitrogen Glucose, fasting Creatinine Cholesterol, total Triglycerides Urine Blood Glucose Ketones 17 mg/dL 151 mg/dL 1.2 mg/dL 188 mg/dL 163 mg/dL negative 1+ negative This patient is at increased risk for developing which of the following renal abnormalities during the next 20 years? A) Crescentic glomerulonephritis B) Hyperplastic arteriolosclerosis C) Membranoproliferative glomerulonephritis D) Minimal change disease E) Nodular glomerulosclerosis F) Renal cell carcinomaMrs. Mardigrascia, a G1PO pregnant comes for prenatal consult in the Martinez Medical Clinic. History reveals that she takes vitamin supplements because she is afraid of getting sick. The nurse counsel her to avoid taking which of the following? A. VITAMIN A B. VITAMIN C C. FOLIC ACID D. BETA CAROTENE E. VITAMIN E
- Gloria Gonzales is a 56-year-old Hispanic female with a history of type 2 diabetes mellitus, obesity, and hypertension. She was admitted to the medical unit 2 days ago with chest pain that was unrelieved with three nitroglycerin sublingual. She has had the following lab work: CK, LDH, AST, troponin, lipid levels, and an ECG stress test. She is scheduled to have a cardiac catheterization in the morning. (Learning Objectives 1, 3, 4, 7, 12, 13) 1.Explain the rationales for the laboratory tests and ECG stress test. 2. What should the nurse do to prepare for the cardiac catheterization that is scheduled? 3. According to Mrs. Gonzales’ medical history, what has contributed to her myocardial infarction? 4. What should the nurse anticipate doing to prepare Mrs. Gonzales to be discharged?Patient A: Has Diabetes insipidus. They have polyuria and dilute urine. They present with some signs of sever dehydration including increased thirst, rapid respirations and rapid heart rate. Their blood pressure is low Patient B: Has Diabetes mellitus type 1. They are not taking medication for it. They are confused and lethargic. They are breathing heavy and fast and the breath has a fruity odor. They have polyuria and increased thirst. 4: For Patient A, the doctor orders a Head CT scan. She does not order this for Patient B. What would the doctor be looking for in the CT scan, and whywould this not be ordered for patient B?Patient A: Has Diabetes insipidus. They have polyuria and dilute urine. They present with some signs of sever dehydration including increased thirst, rapid respirations and rapid heart rate. Their blood pressure is low Patient B: Has Diabetes mellitus type 1. They are not taking medication for it. They are confused and lethargic. They are breathing heavy and fast and the breath has a fruity odor. They have polyuria and increased thirst. Explain the difference between diabetes insipidusand diabetes mellitus (I swear, if you write "The name", so help me...). This answer should address the cause for these two diagnoses and what organs or organ systems are at fault, or would be investigated for this disease.
- Gloria Gonzales is a 56-year-old Hispanic female with a history of type 2 diabetes mellitus, obesity, and hypertension. She was admitted to the medical unit 2 days ago with chest pain that was unrelieved with three nitroglycerin sublingual. She has had the following lab work: CK, LDH, AST, troponin, lipid levels, and an ECG stress test. She is scheduled to have a cardiac catheterization in the morning. 4. What should the nurse anticipate doing to prepare Mrs. Gonzales to be discharged?Mary is a 57 years of age female, who was recently diagnosed with high cholesterol after some routine bloodwork. She has diabetes mellitus Type II poorly controlled and a history of hypertension poorly controlled. Mary presented to the emergency department for epigastric discomfort described as an “ache” that has been intermittent for a couple of days. Mary has been a smoker, about 10-15 cigarettes per day for 30 years. She has been overweight most of her life and doesn’t exercise. Vital signs are T36.8 HR 172 RR 26 BP 94/52 SpO2 92% on room air. The point of care blood sugar is 16.4 mmol/L. Color is pale, diaphoretic, increased work of breathing with tachypnea. You start the cardiac monitor and observe the following rhythm. 6-sec rhythmA 56-year old maintenance worker, with a past medical history of insulin-dependent diabetes, CHF, and hypertension, presents to the emergency room with lightheadedness, lethargy, and periods of confusion. Patient family members found him unconscious outside. Wife states, “he’s been at it for over a week now” Medications: Insulin, Lasix, Digoxin, and Vasotec: Vitals on admission were as follows : Temperature/ Pulse/ Respirations /Blood Pressure36.7C 118 18 103/61On examination, the patient has slurred speech with decreased upper and lowermotor strength bilaterally 4/5. While examining the patient, he experienced lossof consciousness that lasted less than half a minute. The nurse drew labs,administered oxygen via NC, Established IV line access and placed the patient on a monitor. Lab resultsElectrolytes – in emergency roomHematocrit – 38%Hemoglobin 12 gm/dLPotassium 3.3 mEQ/LChloride 95 mEq/LSodium 147 mEQ/LPhosphorus 2.6 mg/dLBicarbonate 21 mEq/LCalcium 7.6 mg/dLBUN 46 mg/dLCreatinine…
