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A 13-year-old girl is admitted to the psychiatric unit for anorexia. Her body weight is 89 lbs. and height is 64 inches. She admits to frequent self-induced vomiting and abuse of laxatives. She was treated on the medical unit with intravenous fluids. Now that she is on the psychiatric unit she is experiencing fluid retention as evidenced by mild puffiness and bloating. Explain these symptoms
Anorexic patients can retain fluids due to increased production of aldosterone, causing the kidneys to retain water.
A 17-year-old black male is admitted to the hospital in sickle-cell crisis. Pain management is a top priority for patients in sickle-cell crisis. Explain why.
Patient's with sickle cell anemia can experience sickle-cell crisis, which is caused when the sickled cells become backed up in the capillaries, causing blood to become thicker and impairing circulation. This impaired circulation leads oxygen-deprived tissues to produce lactic acid, causing pain for the patient.
A 19-year-old, single, sexually active college student, who has not used birth control on a regular basis, is in her first trimester of pregnancy. She is at the OB/GYN clinic for her first prenatal visit. In assessing her nutrition, the doctor discovers that the patient drinks heavily on a regular basis. She also states she does not like milk. What information will the doctor give the patient regarding nutrition?
The doctor would tell the patient to immediately stop drinking and start her on prenatal vitamins. Drinking while pregnant can cause serious damage to the fetus, as substances in alcohol can cross the placental barrier. The doctor will also ensure the patient is eating enough food and maintaining appropriate calorie intake.
A 28-year-old woman has been in the first stage of labor for several hours. Her uterine contractions are weak, and her labor is not progressing normally. Because the woman insists upon a vaginal delivery, the physician orders that pitocin (a synthetic oxytocin) be infused. What will be the effect of pitocin? What is the normal mechanism by which oxytocin acts to promote birth?
Pitocin causes the placenta to produce and release prostaglandins, a stimulant that causes the contractions of the uterine wall. More contractions initiate a positive feedback loop, which causes the release of more oxytocin, causing more contractions.
A 30-year-old woman is admitted to the emergency room. Her husband, who rode in the ambulance with her, said that she had suddenly complained of severe pain in the right iliac region of her abdomen and then had collapsed. Upon examination, she was shown to have signs of internal hemorrhage and her abdominal muscles were rigid. Her menstrual history revealed that she had missed her last menstrual period. A diagnosis of ruptured tubal, or ectopic, pregnancy was made and surgery scheduled. What is an ectopic pregnancy, and why is it problematic?
Ectopic pregnancy is when the embryo implants at any site other than the uterus. It is problematic because as the embryo grows, the space where it is implanted wont be able to facilitate its growth, causing rupture and internal bleeding.
A 38-year-old male is upset about his low sperm count and visits a "practitioner" who commonly advertises his miracle cures of sterility. The practitioner is a quack who treats conditions of low sperm count with megadoses of testosterone. Although his patients experience a huge surge in libido, their sperm count is even lower after hormone treatment. Explain why.
Increasing testosterone inhibited the release of GnRH, inhibiting FSH. Without FSH, spermatogenesis is inhibited.
A 40-year-old pregnant woman is concerned about possible genetic defects in her unborn fetus. Her physician recommends prenatal testing and advises her of two methods. Compare and contrast amniocentesis with chorionic villus sampling relative to the time each can be performed, and the relative advantages and disadvantages of each.
Aminocentesis is generally not done before the 14th week of pregnancy. It's risks include injuring the patient. Chorionic villus sampling can be done at 8 weeks of pregnancy. It is faster than aminocentesis but risky for the fetus.
A 45-year-old patient was admitted to the hospital with a diagnosis of cirrhosis of the liver. He is thin and malnourished. His abdomen is very large due to an accumulation of fluid in the abdominal cavity. His lower extremities are very swollen. Explain why these changes have occurred.
Cirrhosis is the scaring of the liver, often due to chronic excessive alcohol consumption. Edema of the abdomen and lower extremities occurs because blood cant flow through the damaged tissues properly, leading to backup and filtration loss of fluid.
A 52-year-old woman was diagnosed with leukemia and has been receiving chemotherapy as an outpatient. She tells the RN that she hasn't been feeling well. The patient's skin is warm to the touch and she has a low-grade fever of 100.2°F. The neutrophil blood count is less than 1000/μl. The nurse is concerned about the possibility of infection because of the neutropenia and low-grade fever. Explain why.
The nurse is concerned because a low-grade fever is a sign of an infectious process occurring in the patient. This is dangerous for a patient with neutropenia, because she has a decreased ability to fight off infection.
A 55-year-old male was admitted to the hospital with heart failure. He complains of increasing shortness of breath on exertion and needing to sleep on three pillows at night. On physical assessment, the nurse determines that his ankles and feet are very swollen. Which of these symptoms reflect left-sided heart failure and which reflect right-sided heart failure?
Shortness of breath on exertion and difficulty sleeping prone is likely caused by left sided heart failure as the body fails to deliver oxygenated blood throughout the body. Right sided heart failure is likely causing peripheral edema as blood waste fails to return to the body.
A 58-year-old woman complains of loss of urine when coughing and sneezing, and during exercise. She has had three children. Describe the possible causes of urinary incontinence in this patient.
Her urinary incontinence is likely due to her relaxed pelvic muscles lacking estrogen. This is likely due to her age and multiple pregnancies
A 68-year-old male is admitted to the hospital for emphysema. He is hypoxic and his lab tests reveal low oxygen levels. His hematocrit is 65%. The physician has told him that he has a type of polycythemia in which he has an increased number of erythrocytes circulating in his bloodstream. The patient tells the nurse that he does not understand what that means. How would the nurse explain this in terms the patient could understand?
"Because of your low oxygen levels, your body is producing more red blood cells, which is called polycythemia."
A Doppler ultrasound was performed on an infant who had symptoms of breathlessness and it was found that he had a patent ductus arteriosus. Discuss the location and function of the ductus arteriosus in the fetus and relate it to the reason for the infant's breathlessness.
The ductus arteriosus is a shunt on the heart between the pulmonary trunk and the aorta that usually closes at birth. His breathlessness is likely caused by unoxygenated blood mixing with oxygenated blood due to the shunt being open.
A family has four offspring belonging respectively to ABO blood groups A, B, O, and AB. Give the genotypes and phenotypes of the parents.
The genotypes of the parents are IAi with type A blood and the other is IBi with Type B blood.
A man enters the hospital complaining of chest pain. His history includes smoking, a stressful job, a diet heavy in saturated fats, lack of exercise, and high blood pressure. Although he is not suffering from a heart attack, his doctor explains to him that a heart attack is quite possible. What did the chest pain indicate? Why is this man a prime candidate for a heart attack?
His chest pain indicated stress of the cardiac tissues. He is a prime candidate for a heart attack due to his risk factors: smoking, a stressful job, poor diet, hypertension, and lack of exercise.
A man involved in a traffic accident is rushed to the emergency room of a hospital with severe internal bleeding. Examination reveals a ruptured spleen. What is the treatment of choice and what is the likely long-term outcome (prognosis)?
His prognosis is good, the patient will likely live. Splenectomy's were commonly performed to treat ruptured spleens, but this is no longer done. A general surgeon will likely repair the spleen.
A man of Mediterranean ancestry goes to his doctor with the following symptoms. He is very tired all of the time. He has difficulty catching his breath after even mild exercise. His doctor orders the following tests: CBC, hematocrit, differential WBC count, and hemoglobin electrophoresis. The tests show immature erythrocytes, fragile erythrocytes, and less than 2 million RBCs per cubic millimeter. What would be a tentative diagnosis and suggested treatment?
The tentative diagnosis is thalassemia. The patient will need a blood transfusion.
A nurse palpated enlarged lymph nodes. Describe signs and symptoms that help to distinguish cancerous lymph nodes from infected lymph nodes.
Cancerous lymph nodes are often harder than infected lymph nodes.
A patient has an 80% blockage of his left anterior descending coronary artery. Describe what occurs in terms of myocardial oxygen supply and demand if his sympathetic nervous system is stimulated.
Infarction of the myocardial tissue can occur as the coronary arteries are not able to supply enough blood to the cardiac tissue.
A patient has esophageal cancer and must have a feeding tube inserted. The doctor tells the patient that the tube will be inserted surgically into the duodenum. The patient's wife asks why the tube will not be inserted into the stomach. What would the doctor say?
"The duodenum is a part of the small intestine, which is where digestion is completed and nutrient absorption occurs.
A patient is prescribed a calcium channel blocker to prevent angina (chest pain), by decreasing the demand for oxygen. Explain why.
A calcium channel blocker works be preventing calcium ions into the myocardial muscle cells. This decreases the force of myocardial contractility, decreasing the oxygen demand. This reduces the the work load on the heart.
A patient lost a lot of blood during surgery and his blood pressure dropped from 120/80 to 90/50. Describe how the kidneys respond to this change in blood pressure.
When blood pressure drops, cells in the kidneys release renin into the blood, which triggers for the release of angiotensin II, a vasoconstrictor. This increases blood pressure and increases blood delivery into the kidney.
A patient takes a nitroglycerin tablet sublingually for chest pain. Nitroglycerin acts directly on smooth muscle, producing relaxation and vessel dilation. How would this relieve chest pain?
Nitroglycerin sublingual is used to treat chest pain because it is a vasodilator, increasing blood flow and promoting oxygen delivery to the cells.
A patient was admitted to the hospital with chest pains. On admission, his pulse was 110 and blood pressure was 96/64. According to his history, his normal pulse rate is usually between 80 and 88 and his blood pressure runs from 120/70 to 130/80. Explain why these changes in BP and HR occur.
An increased heart rate with decreased blood pressure suggests that he has reduced stroke volume. With his chest pain, he probably has suffered heart damage.
A patient was admitted to the hospital with chronic obstructive pulmonary disease. His P O2 was 55 and P CO2 was 65. A new resident orders 54% oxygen via the venturi mask. One hour later, after the oxygen was placed, the nurse finds the patient with no respiration or pulse. She calls for a Code Blue and begins cardiopulmonary resuscitation (CPR). Explain why the patient stopped breathing.
In people who retain carbon dioxide because of pulmonary disease, arterial PCO2 is chronically elevated and
chemoreceptors become unresponsive to this chemical stimulus. In such cases, declining PO2 levels act on the
oxygen-sensitive peripheral chemoreceptors and provide the principle respiratory stimulus, or the so-called
hypoxic drive. Pure oxygen will stop a person's breathing, because his respiratory stimulus (low PO2 levels) would
A patient with tuberculosis is often noncompliant with treatment. Explain why this may happen.
The patient is likely non-compliant due to their prolonged antibiotic course treatment of 12 months.
A patient's anxiety caused her to develop respiratory alkalosis. The nurse instructs the patient to take some slow deep breaths. Explain why this would be effective.
Deep slow breaths reduces the elimination of CO2
A physician orders Tylenol for a temperature greater than 101°F. The patient's temperature is 100.4°F. Explain the rationale for not medicating a fever of 100.4°F.
You don't want to medicate a low-grade fever because you can possibly disturb the inflammation process and prevent your body from fighting off an infection.
A pregnant woman complains to her doctor that her ankles and feet stay swollen all of the time. She is very worried about this. As her doctor, what would you tell her?
I would tell her that this is common for some women while pregnant due to an increase in blood volume from her pregnancy. Her blood pressure would need to be monitored for possible pre-eclampsia.
A woman comes into the hospital emergency room complaining that she is having problems swallowing and her neck is swelling. She has a history of radiation treatment to her neck as a child for acne. What could be the problem?
It is possible that her immune system is recognizing her thyroid as foreign and attacking it due to her history of radiation treatment. This is called Hashimoto's thyroiditis.
A woman had a mastectomy that included the removal of axillary lymph nodes on her left side. What does she risk regarding her left arm and why?
Removal of the axillary lymph nodes can cause edema due to the loss of the lymphatic vessels and that drainage system. She can have edema of that arm.
A woman, whose family history contains severe osteoporosis, asked her doctor to prescribe estrogen after she reached menopause to reduce her risk of osteoporosis. The doctor refused to provide long-term estrogen replacement therapy. Why?
Exposing her to estrogen replacement therapy long-term can increase her risk for breast cancer.
A young girl requires a liver transplant due to failure of her liver to function. What is required for her to have a good prognosis and why?
For a good prognosis, she must have the same ABO blood group as the donor. Her liver tissue should also be similar to that of the donor so that her body does not recognize it as foreign and reject it.
After a long scuba diving session on a Caribbean reef, Carl boards a plane to Dallas. He begins to feel pain in his elbow on the flight back to Dallas. What is happening to him?
Carl likely is experiencing "the Bends". This is happening because Carl did not give his body enough time to adjust to the changes in pressure from below sea level to sea level before getting on the plane.
After receiving penicillin intravenously, a 32-year-old male patient has an anaphylactic reaction. The nurse understands that therapeutic management includes what critical items?
For a patient in anaphylactic shock, the most important thing to do is protect their airway. Anaphylaxis causes the bronchioles to constrict, making air exchange difficult. The patient may need to be placed on oxygen or intubated.
An 18-year-old patient has a complaint of painful urination, fever, chills, and back pain. This is her second urinary tract infection (UTI) within 5 months. How can the doctor instruct the patient on prevention of another UTI?
The doctor can to tell the patient to ensure that she is always wiping properly after using the restroom and to try and drink more cranberry juice.
An older man sees his doctor for severe pain in his lower abdominal or flank area, elevated temperature, and nausea. Exhaustive tests rule out abdominal obstructions and infections. Plain X-rays indicate a radiopaque (whitish) spot in the area of his right ureter. Diagnose his problem. Give suggested treatment and prognosis.
The patient likely has kidney stones. Surgery would be suggested to remove the stone, or to increase IV fluids to flush the stone out. The prognosis is good.
Assume that the allele controlling brown eyes ( B) is dominant over that controlling blue eyes ( b) in human beings. (In actuality, eye color in humans is an example of polygene inheritance, which is much more complex than this.) A blue-eyed man marries a brown-eyed woman, and they have six children, all brown-eyed. What is the most likely genotype of the father? What is the most likely genotype of the mother? If a seventh child had blue eyes, what can you conclude about the parents' genotypes?
The Father is likely bb and the mother is likely Bb if the 7th child has blue eyes. If all the children have brown eyes, then the mother could be BB.
At the battle of Shiloh in the American Civil War, Confederate General A. S. Johnston was killed when he was shot in the thigh. Witnesses reported that he bled to death almost before he realized that he was wounded. Which blood vessel was most likely to have been injured? Why is a tourniquet usually ineffective in stopping the bleeding from this wound?
It is likely that his femoral artery was injured. A tourniquet is usually ineffective in stopping the bleeding from this wound because the pressure of blood loss is too great here, the artery is too big, and the tourniquet cant apply enough pressure.
Atherosclerosis is a progressive disease of blood vessels that is responsible for millions of deaths each year. Describe the disease process, noting the involvement of specific cell/tissue types and molecules.
This disease affects the aorta and coronary arteries. Atheroscleriotic plaques are formed from fatty streaks, collagen, and elastin fibers. The fatty streaks are caused by macrophages oxidizing surplussed fats from injured endothelial cells
Colorblindness is a recessive sex-linked trait. Suppose a colorblind female marries a man with normal vision. (a) What is their probability of producing a color-blind son? (b) What is their probability of producing a color-blind daughter? (c) What is their probability of producing a daughter who is a carrier for the color-blind gene?
All of their sons will be color-blind, but none of their daughters will be color blind. The daughters will all be carriers for color-blindness.
Debbye has been having pelvic pain, especially during her monthly period, for many months. She has been to several doctors and they all tell her that she is just experiencing extra-heavy monthly flows. The tests all turn up negative. She has been trying to conceive but nothing works. What could the problem be?
Debbye probably has endometriosis. It can cause sterility by cycles of endometrial cell growth and death. This cycle leads to inflammation and scarring of the uterine tubes, preventing sperm from reaching the egg.
Describe why the prognosis of cancer is best when there is no detectable spread from the region of the primary tumor to the lymph nodes.
The prognosis of cancer is best when there is no detectable spread from the region of the primary tumor to the lymph nodes because it means the cancer can be removed. Once it spreads to a lymph, it can become system and not treated with surgical removal.
Based on your knowledge of how the prostate encircles part of the urethra, what are two clinical manifestations of an enlarged prostate?
Enlarged prostate can cause urinary retention and urinary frequency, or the feeling of constantly needing to urinate.
Eleven-year-old Harry is complaining of a severe sore throat and gets to stay home from school. His pediatrician prescribes a course of broad-spectrum antibiotics, and Harry feels much better within a few days. However, some two weeks later, Harry has a dull, bilateral pain in his lower back and his urine is a smoky brown color. On the basis of Harry's signs and symptoms, diagnose his condition and indicate the relationship (if any) between his present condition and his earlier sore throat.
Harry is likely experiencing nephritis. His kidneys are inflamed due to his previous sore throat infection. Anti-streptococcal antibodies were likely produced from his infection, entering the glomerus and causing inflammation.
Ellen, a 47-year-old woman who has suffered kidney disease for several years, has been diagnosed with proteinuria. Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What is proteinuria, and could this condition be playing a role in her swollen limbs?
Proteinuria occurs when the glomerular capillary permeability is increased to the point that large plasma proteins are able to pass into the glomerular filtrate and excreted in urine. Her swelling is likely due to the loss of plasma proteins decreasing osmotic pressure.
Explain how an angiotensin converting enzyme inhibitor (ACE inhibitor) such as captopril would be effective as an antihypertensive.
Angiotensin is a vasoconstrictor that reduces blood pressure by interrupting the renin-angiotensin-aldosterone system
Explain the action of drugs like sildenafil (Viagra) on the male reproductive system.
It enhances the effect of nitric oxide on reproductive tissues, relaxing the smooth muscle in the blood vessels of the penis, dilating them and allowing erectile tissues to fill with blood.
For each of the following situations, describe the anticipated effect on blood pressure and the physiological basis of the response: (1) a high-salt diet, (2) a blow on the head that damages (disables) the vasomotor center, (3) an attack by a mugger, and (4) a hypothalamic tumor resulting in excess ADH production.
1. The blood pressure will be increased as high sodium diet increases extracellular volume.
2. The blood pressure will decrease because the vasomotor center is necessary for blood pressure control.
3. Blood pressure would increase due to fight-or-flight response
4. Excess ADH production would increase blood pressure by increasing water retention
Hank, a 17-year-old high school student, suffered a heart attack during a recreational swim. An autopsy revealed that he had had atherosclerosis and that his death had been caused by coronary artery disease. What might have been the cause of this disease that usually strikes a person much older than Hank?
Hank suffered from familial hypercholesterolemia. It is a disease where the LDL receptors are absent, affecting the uptake of cholesterol by tissue cells, causing coronary artery disease.
Harry is hospitalized with bacterial pneumonia. When you visit him, his teeth are chattering, his skin is cool and clammy to the touch, and he complains of feeling cold, even though the room is quite warm. Explain his symptoms.
Harry's symptoms are consistent with a fever secondary to his bacterial pneumonia.
Helen is a 62-year-old smoker. Her physician has diagnosed her as having emphysema that has caused her to hypoventilate. Surprisingly, when her blood pH is checked, it is 7.40. Why?
Helen is suffering from respiratory acidosis due to retaining too much CO2. Her shallow breathing, due to damage to her lungs from the disease, is causing this.
In humans, farsightedness is inherited by possession of a dominant gene. If a man who is homozygous for normal vision ( aa) marries a woman who is heterozygous for farsightedness, what proportion of their children would be expected to be farsighted?
Half of their children will be expected to be farsighted.
Jane and Allen have just discovered that their son is a hemophiliac. Neither of them has hemophilia, and Allen claims that no such condition was ever expressed in his family. Jane was told that her father was a hemophiliac and that problems resulting from this condition caused his death. Allen has also been told that hemophilia can only be passed on to an offspring by parents and not by grandparents; he believes that Jane was unfaithful and that the child is not his. If you were a genetic counselor, what would you tell Allen?
Allen is an idiot for jumping to conclusions and not being able to understand basic genetics. The grandfather passed on hemophilia through his X chromosome to Jane, who passed it on to her son. She didn't express it because she is XX, like all women.
Jane had been suffering through a severe cold and was complaining of a frontal headache and a dull, aching pain at the side of her face. What regions are likely to become sites of secondary infection following nasal infection? What would be the treatment?
The parasinuses are likely to become the secondary site of infection for a nasal infection.
Jose is brought to the emergency room complaining of a burning sensation in his chest, increased salivation, and difficulty in swallowing. He is having difficulty breathing and feels the presence of a "lump in his throat." The diagnosis is gastroesophageal reflux disease. Explain.
Jose is experiencing GERD, which causes those symptoms. GERD is a disorder where the rate of reflux is greater than normal, which may result in aspiration of gastric contents into the air passages.
Max is bitten by a rattlesnake while on a camping trip. His friends immediately apply ice packs to the bitten area to slow the spread of the protein-based toxin; they then rush him to an emergency facility. What treatment would be given and why?
Max would be given an immunoserum that will slow the progression of the snake poison, allowing his body to develop the necessary antibodies to fight the infection.
Mrs. Gray, a 50-year-old mother of seven children, is complaining of dull, aching pains in her legs. She reports that they have been getting progressively worse since the birth of her last child. During her physical examination, numerous varicosities are seen in both legs. How are varicosities recognized? What veins are most likely involved? What pathologic changes have occurred in these veins, and what is the most likely cause in this patient's case?
Varicosities are recognized by enlargement of the veins. Superficial veins are most likely involved. This is likely due to her multiple pregnancies.
Mrs. Phang, eight months pregnant with her first child, makes an appointment with her obstetrician to investigate the cause of vaginal bleeding. Because it is actually more "spotting" than frank bleeding, and painless, she is becoming worried. Ultrasound visualization of her abdomen shows that the placenta is formed across the internal os of the cervix, and she is ordered to her bed for the remainder of the pregnancy. What name is given to Mrs. Phang's condition? Why is it an extremely serious condition? Why was she ordered to have complete bed rest for the remainder of her pregnancy?
Mrs. Phang's condition is called placenta previa. It is serious because, as the cervix and the uterus stretch, the placenta can be torn. Because of the placenta's location, vaginal birth is not possible.
Mrs. Wong goes to the emergency room with the following symptoms: severe pain in the umbilical region, loss of appetite, nausea, and vomiting. While she was waiting to see a doctor, the pain moved to the lower right abdominal quadrant. What is the likely diagnosis and treatment?
She could possibly have appendicitis but a diagnosis is not made from just symptoms alone. Several tests and imaging would need to be done to properly come to a diagnosis. If appendicitis, she would have the appendix removed.
Nursing care of a patient with acquired immune deficiency syndrome (AIDS) includes monitoring of counts. Explain why.
The nursing care for an AIDS patient includes monitoring T lymphocyte counts because AIDS patients have lowered T lymphocyte counts, meaning they are more susceptible to opportunistic infections.
Rachael has been complaining of frequent and burning urination. She also reported seeing some blood in her urine. Her physician suspects cystitis. What is cystitis, and how can it cause these symptoms?
Cystitis is a condition where the mucous membrane of the bladder because swollen and bleeding occurs. Dysuria is likely caused by inflammation of the urethra.
Sami has been hospitalized with acute gastritis. Her symptoms were epigastric pressure (just above the stomach), headache, nausea, and vomiting with traces of old dark blood. She revealed that she had been suffering back pain and drank four shots of gin and took three aspirin to "kill the pain." What led the physician to make this diagnosis, and what may have caused the sudden attack?
Gastritis is an inflammation of the mucosal lining of the stomach. Her sudden symptoms were likely caused by combining aspirin with alcohol, destroying the mucosal lining.
Teresa has been complaining of severe abdominal pain, vaginal discharge, and a low-grade fever. What might be the doctor's diagnosis, and how should the condition be treated?
Teresa could have PID, pelvic inflammatory disease, which is an extensive bacterial infection of the pelvic organs. She should be treated with antibiotics.
The folk singer, Woody Guthrie, died of Huntington's chorea. One of his parents also died of this disease affecting the nervous system. The disease usually affects carriers between 25 and 45 years of age and is inherited as a Mendelian autosomal dominant trait. Using Punnett squares, determine the probability that any of the three Guthrie offspring will have this devastating disease.
The probability of his children having it is 50%
The lactation nurse visits a first-time mother six hours after her delivery of a healthy 8-pound boy. The patient is giving the baby boy a bottle of sugar water. She tells the lactation nurse that she does not seem to be producing milk. What should the nurse say to the patient?
The nurse should explain to the patient that she wont be producing milk for another 3 days. She should advise the mother to massage her breasts and roll the nipples to start stimulatory effects for milk production.
The patient is 45 years old and is obese. He states he has been on the Atkins diet (low carbohydrate and high protein and fat) and has lost 20 pounds. What are the dangers inherent in following fad diets for quick weight loss?
Increasing fat intake has the chance of disrupting the natural gut micro biota as oxidized fats produce gases that kill microbes.
The patient is 52 years old and has a history of hypertension. His cholesterol level is 245. He states his job is very stressful and he is recently going through a divorce. He admits to being overweight and has an inactive lifestyle. His father died of a stroke at age 60. He is worried about having a heart attack and/or stroke and wishes to change his lifestyle. Among other advice, the nurse encourages the patient to eat more cold-water fish such as salmon. Explain why eating more fish would be of benefit for this patient.
Fish contains omega-3 fatty acids that lower the proportions of both saturated fats and cholesterol, making blood less sticky and preventing clotting from happening.
The patient is a 28-year-old female with type-1 diabetes mellitus. She developed viral gastroenteritis with nausea and vomiting. She did not take her insulin and she became increasingly nonresponsive. Her husband called 911 and she was taken to the emergency room. Her pulse rate was 128 and her respiratory rate was 28, deep, and smelled fruity (Kussmaul breathing). Her urinary glucose and ketone levels were both 4+. Her pH was dangerously low. Explain how the body attempted to compensate for the low serum pH.
She is likely in ketoacidosis. Her rapid respirations are an attempt to compensate for low pH by blowing off CO2.
The patient is in her first trimester of pregnancy. She complains of feeling nauseated and has vomited on occasion. She tells the nurse that she did not have this with her first pregnancy. She asks the nurse, "What is causing this and when will it end?" How should the nurse respond?
The nurse would explain to the patient that nausea is common during the first trimester due to elevated hCG levels. This usually resolves after the body adjusts to the increased hormone levels.
Timothy has been having difficulty breathing since he had pneumonia last month. Recently he had severe pain in his chest and back, and his breathing was extremely irregular. The doctor at the emergency room told him that one of the lobes of his lung had collapsed. How this condition called and how it could happen?
Timothy has a condition called atelectis, a collapsed lung. This happens when air enters the pleural cavity. This likely happened from Timothy's productive cough and pneumonia.
What are some possible complications a patient may have after a radical mastectomy?
The entire breast is removed along with underlying muscle, tissue, and lymph nodes. The patient may experience lymphedema related to edema on the side of the mastectomy.
What clinical effects would low blood pressure have on the kidneys of a burn patient?
This patient would have lower glomerular hydrostatic pressure due to water loss from the burnt skin. This can lead to an acute kidney injury.
While dining out in a restaurant a man suddenly chokes on a piece of meat. The waitress is also a student nurse and comes to the man's aid. She asks him if he can talk. The man responds by shaking his head no and grabbing at his neck. What is the significance of the man's inability to talk?
The man being unable to talk means that the piece of meat is blocking the glottis and he is unable to move air. Air is needed to speak, the meat is likely preventing this from happening.
While having a physical examination, a young male informed his doctor that at age 8 he had lobar pneumonia and pleurisy in his left lung. The physician decided to measure his VC. Describe the apparatus and method used for taking this measurement. Define the following terms used in the description of lung volumes: TV, IRV, ERV, RV, and VC.
His vital capacity (VC) was measured using a spirometer. As he breathed into a handheld device, the speed and volume of air flow was calculated from the output of a pressure transducer. Tidal volume (TV) is the amount of air that moves into and out of the lungs with normal breathing. Inspiratory reserve volume (IRV) is the amount of air that can be forcibly inhaled beyond a tidal inspiration. The expiratory reserve volume (ERV) is the amount of air that can be evacuated from the lungs over and above a tidal expiration. Residual volume (RV) is the amount of air that remains in the lungs even after the most strenuous expiration. Vital capacity (VC) is the total amount of exchangeable air.
While passing through a village on safari you notice a man with one enormous leg and one normal-sized leg. What could have caused the increased size of the swollen leg?
That man likely has Filariasis, or elephantiasis, which is caused by parasitic worms that get in the lymph system and reproduce to portions that block vessels, causing edema.
Why would there be cause for concern if a young pregnant mother is Rh -, her husband is Rh +, and this is their second child? If there is a cause for concern, is anything could be done?
There is a concern that the child will develop erythroblastosis fetalis and die before birth. She will need to be given RhoGAM to prevent her from becoming sensitized against the fetus.
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