...C.C. is a previously healthy 27-year-old man admitted to the critical care unit after an accident in which he was hit by a car and dragged along the pavement for nearly 100 feet. He suffered a frontal contusion, fractured clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and buttocks. He was tachycardic, hypotensive, unresponsive, and ventilating poorly when admitted. He was placed on a mechanical ventilator and given IV fluids for shock. C.C. responded well to fluids, with an increase in blood pressure and an improvement in urine output. 1. Based on his case history and responsiveness to fluid therapy, what type of shock was C.C. experiencing? Hypovolemic shock 2. What other clinical findings would be helpful in confirming the type of shock? Capillary refill, tenting on skin turgor, pale skin due to perfusion, and may feel dizzy, faint, nauseated, or very thirsty. 3. Because of his many open wounds and invasive lines, C.C. is at risk for sepsis and septic shock. What clinical findings would suggest that this complication has developed? Bacteremia, high fevers, hot, flushed skin, elevated heart rate, hyperventilation, altered mental status, swelling, and low blood pressure 4. What is the link between sepsis and multiple organ dysfunction syndrome (MODS)? Sepsis causes MODS because the inflammatory and anti-inflmammatory reactions in the body, which cause the clotting cascade to be more active. Resulting in multiple thrombi forming throughout...
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...What Is A Nurse? A nurse is many things these days. Nurses play many roles in the healthcare setting. From a caregiver to a care manager, nurses are the heart and backbone to those who need medical attention. Not anyone person can be a nurse. It takes a special kind of person with traits that show sympathy, understanding, and positivity. Bibliography Arizona-Unknown, U. o. (Uknown). 6 Personality Traits of Successful Nurses. Being a nurse means that you are a decision maker, caregiver, communicator, manager of care and a teacher to patients. Nurses are the ones who spends the most time with each individual and knows the most about them. As a nurse we must be able to multitask. Nurses have more than one patient which means that they are responsible for knowing each individual's history, treatment, and the things that make them unique from the next. Nurses must be able to handle pressure in times of trouble. Nurses must learn how to manage stress because if the nurse is stressed and flustered, then the patient may feed off that emotion. It is the nurses responsibility to be the advocate for patients. Doctors may or may not know the patient except by their charts. Nurses know all aspects of each individual and what makes them tick. When asked what are the characteristics or traits of nurse there are so many things people can say. According to The University of Arizona, nurses should be tenacious gregarious, methodical, optimistic, patient, and empathetic. These traits...
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...This is the second case study that is required for the class. Please submit a paper (doesn’t have to be long; you could even give me bullet-point answers to the questions listed below) that answers all of the questions posed after Case Study 1. I have included an easy second case study which, if you complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and responding to Case Study 1 is required work for the course. The extra credit, which is not required, will be worth a total of 10 points. Both are due at the beginning of class on Tuesday, March 10, 2015. Case 1 R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2 = 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist and theophylline to manage his respiratory disease. At this clinic visit, it is noted on a chest x-ray that R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia. Discussion Questions 1. What clinical findings are likely in R.S. as a consequence of his COPD? How would these differ from those of emphysematous COPD? Chronic Obstructive Pulmonary Disease (COPD) is comprised primarily of two related diseases: Chronic Bronchitis...
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...This is the second case study that is required for the class. Please submit a paper (doesn’t have to be long; you could even give me bullet-point answers to the questions listed below) that answers all of the questions posed after Case Study 1. I have included an easy second case study which, if you complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and responding to Case Study 1 is required work for the course. The extra credit, which is not required, will be worth a total of 10 points. Both are due at the beginning of class on Tuesday, March 10, 2015. Case 1 R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2 = 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist and theophylline to manage his respiratory disease. At this clinic visit, it is noted on a chest x-ray that R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia. Discussion Questions 1. What clinical findings are likely in R.S. as a consequence of his COPD? How would these differ from those of emphysematous COPD? Chronic Obstructive Pulmonary Disease (COPD) is comprised primarily of two related diseases: Chronic Bronchitis...
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...Signature Assignment: Chronic Obstructive Pulmonary Disease Case Study Case Study R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2= 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist and Theophylline to manage his respiratory disease. At this clinic visit, it is noted on a chest x-ray that R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia 1) What clinical findings are likely in R.S. as a consequence of his COPD? 2) How would the consequences of the COPD of R.S. (identified in question 1) differ from those of emphysematous COPD? 3) Interpret R.S.’s laboratory results. How would his acid-base disorder be classified? What is the most likely cause of his polycythemia? 4) What is the rationale for treating R.S. with Theophylline and a ß2 agonist? 5) What effects would his respiratory disease have on his cardiovascular function? ANSWERS: 1) 1. And 2. He is likely to have diminished breath sounds. He may or may not have wheezing depending upon the degree of bronchoconstriction and will almost certainly have crackles and bronchial breath sounds over the RLL. Since he is polycythemic and has hypoxemia, he...
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...Danya Bocarsly Case Study #1 Patho-Pharmocalogy Mr T is a 67 year old retired Navy veteran. He has been taking simvastatin for 2 years to treat elevated cholesterolemia. During a recent visit to a 24 hour acute care clinic in a local mall he was prescribed clarithromycin for an acute sinus infection. Two days later Mr T arrives in the emergency room complaining of generalized muscle pain, muscle weakness and dark colored urine. Tests revealed myoglobin in the urine and a serum creatinine of 186 micromol/l (usual baseline for this patient was 90 micromol/l). A diagnosis of rhabdomyolysis is made. 1. Create a pharm card for each medication listed in the case. Include drug generic name, routes of administration, indication/uses, side effects, contraindications, drug interactions, food interactions, method of metabolism drug generic name routes of admin Indication/ uses side effects contra-indications drug interactions food interactions method of metabolism method of excretion...
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...Berlin Herrera Unit 1 Case Study F.C. is a 54-year-old man with a history of chronic heavy alcohol use. He has frequent bouts of gastrointestinal bleeding for which he has been hospitalized on six separate occasions over the years. He continues to drink and exhibits most of the common manifestations of alcoholic cirrhosis. He was recently hit by a car and was hospitalized for a broken leg. He appeared to be under the influence of alcohol at the time of the accident and had a blood alcohol level of 0.18. F.C.’s family reports that his mental functioning has deteriorated significantly over the past few months. Discussion Questions 1. What are the common manifestations of alcoholic cirrhosis? Which of these are secondary to hepatocellular failure? Which are secondary to portal hypertension? Common manifestations of alcoholic cirrhosis are as follows: * Jaundice: yellow pigmentation of the skin caused by hyperbilirubinemia. This condition is secondary to hepatocellular failure because the bilirubin metabolism becomes impaired due to malfunction of liver tissue. * Spontaneous Bacterial Peritonitis: acute bacterial infection of ascetic fluid caused by contamination of dialysate. This condition is considered secondary to portal hypertension because the normally, the fluid passes the portal vein into the liver to be killed off, but with a fluid back up, bacterial infection grows due to the increased fluid retention within the portal vein. * Hepatic Encephalopathy:...
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...K.H. has been exposed to many risk factors associated with hypertension. Given the fact that he is of older age, K.H. is more at risk because the 1risk of high blood pressure increases as you age. High blood pressure is more common in males at his 2age. High blood pressure is particularly common among African-Americans, so the fact that K.H. is African American poses a higher risk. His heart rate is normal and the description does not indicate family history of hypertension, but it is noted that K.H is 30 pounds over his ideal weight. Persons who are overweight have a higher risk of developing hypertension. Due to the fact that K.H. has been placed on a salt restricted diet, it is safe to assume that he was consuming high amounts of sodium in his diet prior, which is a primary risk factor of hypertension. K.H.âs has a systolic pressure is 135 and the diastolic pressure is 96. This is stage 1 hypertension. The rationale for treating the patient with an ACE inhibitor is that Angiotensin II needs to be controlled because that is what ultimately is narrowing the blood vessels and causing the blood pressure to increase. An ACE inhibitor slows the production of Angiotensin II. The mechanism of action includes the modification of the production of Angiotensin II. This is a vasoconstrictor. Vasoconstriction is what leads to the elevation of B/P. Angiotensin II is made from angiotensin I through the means of the angiotensin converting enzyme. ACE inhibitors impede the activity of...
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...E.O. is an 8-year-old girl with a history of asthma and allergy to bee stings. She has been brought to the clinic complaining of a throat infection. Her health care provider prescribes a course of penicillin to manage her current infection and cautions her parents to watch her closely for a reaction. Discussion Questions 1. What type of reaction is the health care provider concerned about and why? The type of reaction that the health care provider is concerned about is an allergic reaction to the penicillin. Since E.O is already allergic to bee stings and has a history of asthma, which are both Type I hypersensitivities, it is very likely that E.O could have an allergic reaction to the penicillin. Since penicillin is found in cow milk and the patient could have been exposed to it through milk, breast milk, or in utero, E.O could become sensitized to it. If E.O is further exposed to the allergen (being that her health care provider prescribed her penicillin), there could be an allergic reaction to it. Exposure to penicillin can result in the degranulation in mast cells and the release of histamine, which could cause the reaction, which is even more likely since E.O has two Type I hypersensitivities. 2. Explain the role of IgE and mast cells in type I hypersensitivity reactions. Why might E.O. react adversely to the antibiotic with the first use? During sensitization, IgE antibodies bind to the surface of mast cells, which makes the mast cells “sensitized.”...
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...1. What risk factors for primary hypertension are evident from K.H.’s history and physical data? K.H. is a 67 year old African American male, his ethnicity and age are non-modifiable risk factors, which means it is circumstances that he cannot change. Unfortunately African Americans are more susceptible to hypertension and after 55 years old there is a 90% chance that Americans regardless of ethnicity will develop hypertension. According to a PowerPoint from Dr. Marian, HSC 3211 on Hypertension, the ethnicities most likely to have hypertension are as follows: African American > Puerto Rican > Hispanic American > Caucasian > Cuban American. K.H. is also overweight by 30 pounds. Obesity is a leading cause of hypertension because excess weight makes it more difficult for the heart to pump blood throughout the body as efficiently as it would if K.H. was not overweight. He has already started lifestyle modifications such as a salt-restricted diet in hopes of lowering his blood pressure. Sodium causes the muscles around blood vessels to becomes stronger and thicker as a result of trying to ease the extra burden the arteries are experiencing. However, this is not a good thing because it causes the arteries to become more narrow thus raising one’s blood pressure even higher. With this evidence, it is important that K.H. stay on his salt-restricted diet if he hopes to lower his blood pressure and avoid other organ damage from excess salt. K.H. has high blood pressure at 135/96...
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...After reading E.O’s chief complaint, we can deduce from the past medical history of bee string allergies and asthma that E.O responds to particular allergens with a undesirable hyperactive immune response. This oversensitivity is called type I hypersensitivity and is mediated by immunoglobulin E. (2) E.O visited the physician complaining of a throat inflammation/infection. The physician prescribed her penicillin but being aware of her undesirable cascade of immune responses, he is wary of another allergic reaction that is indeed worsened in patients with asthma. (7) The release of IgE results in binding to immune cells such as mast cells, lymphocytes, basophils..etc. (1) The bindings of IgE to these cells in high risk (asthmatic) patients are at increased risk for anaphylactic shock than those without pre-existing conditions. (4)(7) Unfortunately, penicillin is notorious for reactions such as anaphylactic shock and if the patient is taking it for the first time, symptoms may not show up until the body has formed antibodies and once exposed the second time, attack commences and unforeseen systemic symptoms occur. (6) IgE is one type of antibody produced by B cells and plasma cells that can be found binding tightly to mast cell receptors in the mucosal tissues where it acts as a receptor.(7) Once allergen or antigen has entered the patients system, IgE isotypes make plenty of IgE antibodies on the first exposure and these antibodies will bind to their designated mast cells once...
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...clinical findings are likely to be present with this type of heart failure? Orthopnea, cough, crackles in the lungs, fatigue, oliguria, increased HR, confusion and anxiety What compensatory mechanisms are likely to be operative in A.O. to enhance cardiac output? Increased Heart Rate and LV EDV What is the most likely cause of A.O.’s pedal edema? Right Sided heart failure What is the cause of A.O.’s exertional chest pain? Stable Angina Case 2 Questions: C.C. is a previously healthy 27-year-old man admitted to the critical care unit after an accident in which he was hit by a car and dragged along the pavement for nearly 100 feet. He suffered a frontal contusion, fractured clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and buttocks. He was tachycardic, hypotensive, unresponsive, and ventilating poorly when admitted. He was placed on a mechanical ventilator and given IV fluids for shock. C.C. responded well to fluids, with an increase in blood pressure and an improvement in urine output. 1. Based on his case history and responsiveness to fluid therapy, what type of shock was C.C. experiencing? Hypovolemic Shock 2. What other clinical findings would be helpful in confirming the type of shock? Low blood pressure, weak pulse, cyanosis of the lips and fingertips, shallow breathing 3. Because of his many open wounds and invasive lines, C.C. is at risk for sepsis and septic shock. What clinical findings would suggest that this complication has developed...
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...contemporary organizational issue you find intriguing. Use one field site or example for the entire paper. Also, be explicit about the level issue. For example, if you are using the concept of personality then it is an individual level issue. A list of concepts and their related levels is provided in a separate document. Focus of paper-related requirements: Outline: Submit a formal outline for your paper, complete with references. The purpose of the outline is to help you organize your content, which also results in increased clarity, improved logic, and better structure of the paper. There may be adjustments from this document to your final paper, but at this stage the paper should not require major revisions. Final Paper: Use a case study format for the structure of your paper. Identify and analyze issues using course concepts, and propose recommendations for the organization you are focusing on. Use of course concepts 1. Use a minimum of 8 concepts for the paper. Include a list of the concepts you used at the beginning of the paper. 2. Briefly define each concept you use within the text (a paragraph or two). 3. For each concept, write a diagnosis at one level (e.g., the person level). For example, you might write “The employee misses work frequently due to stress from conflict with her supervisor.” Note, stress and conflict would require definitions.) 4. For each concept, write a solution or solutions. Identify the level(s) you addressed in Step 2...
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...Calendar Overall for Case-Study Presentation & Mid-Term Exam – MGT 4760 (Strategic Management) Sem 1, 2012/2013 Sec 8 (M-W) No. | Week | Topics | Class Day | Date | Schedule | Details | | 1 | Chapter 1: The Nature of Strategic Management | 1- Mon 2- Wed | 10/912/9 | | | | 2 | Chapter 2: The Business Vision and Mission | 3- Mon 4- Wed | 17/919/9 | | | | 3 | Chapter 3: The External Assessment | 5- Mon 6- Wed | 24/926/9 | | | | 4 | Chapter 4: The Internal Assessment | 7- Mon 8- Wed | 1/103/10 | Quiz 1 (Chapter 1.2.3) | | | 5 | Chapter 4: The Internal Assessment | 9- Mon 10- Wed | 8/1010/10 | | | | 6 | Chapter 5: Strategies in Action | 11- Mon 12- Wed | 15/1017/10 | | | | | BREAK(22/10 – 28/10) | 13- Mon 14- Wed | 22/1024/10 | | | | 7 | Chapter 5: Strategies in Action | 15- Mon 16- Wed | 29/1031/10 | Case Presentation Session 1Case Presentation Session 2 | Group 1:L: Lia Hilaliah (Case Study 3)Group 2:L: Mas Syairah bte Mohamad (Case Study 5) | | 8 | Chapter 6: Strategy Analysis and Choice | 17- Mon 18- Wed | 5/117/11 | | (Mid-Term Exam 7/11 Wednesday)Seminar Room 1.1 | | 9 | Chapter 6: Strategy Analysis and Choice | 19- Mon 20- Wed | 12/1114/11 | Case Presentation Session 3Case Presentation Session 4 | Group 3:L: Mohamed Sheikh (Case Study 9) Group 4:L: Izzati Nor binti Salleh (Case Study 14) | | 10 | Chapter 7: Implementing Strategies: Management and Operations...
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...ARCTIC MINING CONSULTANTS Case Synopsis Arctic Mining Consultants is a mining company that deals with mineral exploration. In this case study, the project given is staking 15 claims in Eagle Lake, Alaska. The project Manager was Tom Parker, who has a wide experience and specialized knowledge in all nontechnical aspects of mineral exploration. He is a geological field technician and field coordinator for Arctic Mining Consultants. He assigned his previous field assistants John Talbot, Greg Boyce and Brian Millar to help him complete the project. The job required them to stake at least 7 lengths each day in order to be completed on time. However, the whole team has became very tense and agitated, especially Tom Parker, as the deadline was just around the corner and there’s still many to be finished within the limited time. The problem became worse with the way Tom managed and treated his team. The only motivation to the team was the $300 bonuses promised by the company when the job is done on time, otherwise, they might wished to give up already. This happened because working as a field assistant and in long-working hours only giving them low wages, which is considered unreasonable compared to what they have to do. During the eight hard days, everything had actually proved the strengths and weaknesses of each of the team members, including Tom. Case analysis symptoms 1) What symptom(s) exist in this case to suggest that something has gone wrong? The symptom(s) to suggest...
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