The following case study has three questions that are highli…

The following case study has three questions that are highlighted in yellow to address.  Please address each one separately and thoroughly.   A 4-month-old previously healthy boy with a cough is brought in by his mom. The cough has been present for 5 days and occurs both day and night, worsening over the past day. He has been working harder to breathe and wheezing over the past 24 hours. She became worried during the night his chest “sucking in” with each breath.  She has not noticed his skin become pale or bluish-tinged nor has she witnessed him stop breathing at any point. He has never felt warm to her. She does think his oral intake is slightly decreased but he is still making the same number of wet diapers as usual. ROS: Mom reports the baby has had a dry hacking cough.  No one else sick. Past Medical: No hospitalizations or surgeries. Up to date on immunizations Mom has asthma Lives at home with mom and dad.  No smoking or pets. NKDA No current meds Assessment: Temp: 100.4 HR: 122 RR: 40 O2 sat: 95% ra 60% height, weight, and head circumference General: no acute distress HEENT: anterior fontanelle flat, mucus membranes moist, with clear stringy discharge from bilateral nares. right tympanic membrane red and bulging.  Left TM gray Heart: rate regular with no murmur Lungs: expiratory wheeze noted anteriorly and posteriorly in all lobes. no retractions at present, no nasal flaring. Abdomen: round, soft, nontender Skin: warm, dry, with no rashes   What is differential diagnosis? What is the most likely diagnosis? What is your treatment plan and anticipatory guidance about the diagnosis?  If treating with antibiotic, what is the recommended dosage?

Bess had the following lab studies resulted: Hgb A1C 9.2…

Bess had the following lab studies resulted: Hgb A1C 9.2% Finger Stick Blood Sugar 232 Creatinine 1.2 What would be the target Blood pressure and Hgb A1C? How would you manage this patient: What would be your choice of anti-hypertensive agents and why? What would be your choice of anti-diabetic agents and why?

Case study:  Moira Moira is a 54-year-old female with a two-…

Case study:  Moira Moira is a 54-year-old female with a two-day history of a pulsating/throbbing headache which is worse with movement and physical activity.  She describes photophobia and phonophobia.  She is nauseated but has not vomited.  Moira describes the pain as 6-7/10, with 10 being the worst pain imaginable.  The pain began while at work 2 days ago.  It started with her seeing what she describes as halos around lights.  Moira has a history of migraine headaches.  She has been given naproxen sodium 500 mg. tablet, to take at onset of headache and then every 12 hours as needed for pain.  She has taken it as prescribed, but the headache has not resolved.  Moira is very frustrated.  She has these types of headaches approximately 5 days out of the month and often misses 1-2 days of work each month due to these migraines.  Moira reports no change in the frequency or intensity of these headaches, but no longer feels the current treatment plan is effective.  She has not been to work since this headache began 2 days ago.  Based on what you know, what is your diagnosis? Are there any diagnostic tests you would order? What is your treatment plan for Moira going forward?  Include any changes you would make to the current treatment plan. Please include patient teaching.

The following case study has three questions that are highli…

The following case study has three questions that are highlighted in yellow to address.  Please address each one separately and thoroughly.   History: A 21 year old female presents to the clinic with complaints of vaginal discharge that started about 3 weeks ago.  She states that she is approximately 9 weeks pregnant.  She describes the discharge as creamy in color and states that it has a strong odor.  She states that there is no itching, bleeding, or abdominal pain.  She has had 2-3 previous episodes that were similar to this one prior to pregnancy.   She has been with her sexual partner for the past 3 years and neither of them have had any other sexual partners.  Until 3 months ago, they always used a condom.  She has never had a cervical Pap smear. Examination: The external genitalia appear normal.  On speculum examination there is a small amount of smooth grey discharge along the walls of the vagina.  There is no bleeding.  What is the diagnosis and differential diagnosis for this patient? How would you manage this patient? Are there any implications for the pregnancy?

The medication ranitidine 30 mg/kg/day PO in four divided do…

The medication ranitidine 30 mg/kg/day PO in four divided doses for gastrointestinal ulcers is prescribed. The drug is supplied as ranitidine 300 mg/5mL. The client weighs 80 lbs. How many mL’s per dose will the nurse give? Give answer to the hundredths place and do not round.

The following case study has three questions that are highli…

The following case study has three questions that are highlighted in yellow to address.  Please address each one separately and thoroughly.     A 6 year old previously healthy boy is brought in by his grandma with reports of cough, fever, and chills for 4 days.  Past Medical History: no previous hospitalizations, did have RSV at 3 months old.  No sick visits for 1 month ago when he had an ear infection. Allergy: NKDA ROS: General: Grandma reports fever up to 102.2 last night, fever reducer last given 2 hours ago.   Does watch TV when fever down but very irritable. Several kids in his class at school with URI. HEENT: nose with slight clear discharge, sometimes complains of a headache. Lungs: Started out as a dry cough but has progressed to a rattly cough and all day long. Like he needs to cough something up. One time grandma noted some streaks of blood when he spit out sputum. Abdomen: child reports his “tummy hurts,” no diarrhea or constipation, last BM yesterday, no vomiting, does have decrease appetite Musculoskeletal: plays well normally   Assessment: HR: normal RR: 55 O2 sat: 94%ra Wt: 30lb Temp: 100.6   General: no acute distress but does look sick. HEENT: mucus membranes moist, scant amount of discharge from bilateral nares. Heart: rate regular with no murmur Lungs: diminished breath sounds and crackles in left middle and lower lobe. No retractions or nasal flaring. Abdomen: round, bowel sounds active, soft, nontender Skin: warm, dry, with no rashes What are the differential Diagnosis?   Diagnostic Tests: Flu- negative   What is your diagnosis? What is the plan of care/treatment?  If ordering a medication, what is the recommended dose?  

White light consisting of wavelengths ranging from 400nm to…

White light consisting of wavelengths ranging from 400nm to 700 nm fall incident upon a diffraction grating having 600 lines/mm. The first order spectrum extends over a range of angles on a screen. Next, the grating is removed and replaced with one having 900 lines/mm. Which of the following statements are correct about the range of angles comprising the first order spectrum?