severe cellulitis with diabetes mellitus‚ glaucoma and hypertension. Mrs. Collins was admitted to the hospital for 6 days and received IV antibiotics. During her stay it was discovered that Mrs. Collins has atrial fibrillation and began treatment of Digoxin. It was also suspected that Mrs. Collins contracted MRSA and the physician would like to continue IV antibiotics for an additional 5 days. It is in this setting that case management was contacted to explore home care services in lieu of an additional
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implemented when administering a diuretic? 2. Carl Edwards is a 75-year-old man with congestive heart failure. Having sustained three myocardial infarctions in the last 10 years‚ he has decreased left ventricular function. Mr. Edwards takes Digoxin‚ Capoten‚ Coreg‚ and Lasix for management of this disease. Today he presents to the emergency department with fatigue‚ generalized weakness‚ and feelings of “skipping” heartbeats. Upon arrival‚ he is placed on the cardiac monitor‚ his vital signs
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Digitalis lanata plant 3) TASTE Bitter 4) ODOUR Slight 5) SHAPE Leaves are sessile‚ linear-lanceolate to oblong-lanceolate. CHEMICAL EVALUATION CHEMICAL CONSTITUENTS It contains lanatosides A‚ B‚ C‚ D and E‚ acetyldigitoxin‚ digitoxin‚digoxin‚ glucoverodoxin etc. Some flavones derivatives e.g; scutellarein‚ luteolin and dinatin have also been reported. CHEMICAL TESTS KELLER-KILIANI TEST FOR DIGITOXOSE The test consists of boiling about 1 g finely powdered digitalis with 10 ml 70 % alcohol
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Congested Heart Failure (adapted from McGraw Hill Case Studies) Chief Complaint: 74-year-old woman with shortness of breath and swelling. History: Martha Wilmington‚ a 74-year-old woman with a history of rheumatic fever while in her twenties‚ presented to her physician with complaints of increasing shortness of breath ("dyspnea") upon exertion. She also noted that the typical swelling she’s had in her ankles for years has started to get worse over the past two months‚ making it especially
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Care Plan: TURB and Kyphoplasty Recovery Situation and Background E.P. is an 88-year-old Caucasian male. He was admitted on 02/18/13. His code status is full code‚ and he declines to bring in his advanced directive. He reports that he is 68.5” tall‚ and his actual weight is 165 pounds. He and his wife are the sources of information‚ and they are reliable. His blood pressure is 124/62‚ taken on his right arm in a lying position‚ his oral temperature is 99.8‚ his right radial pulse is 74 beats per
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1. RADIOLOGY REPORT LOCATION: Hospital‚ Outpatient PATIENT: Dan Diel ORDERING PHYSICIAN: Daniel G. Olanka‚ MD ATTENDING/ADMIT PHYSICIAN: Daniel G. Olanka‚ MD RADIOLOGIST: Morton Monson‚ MD PERSONAL PHYSICIAN: Ronald Green‚ MD EXAMINATION: Gallbladder ultrasound. CLINICAL SYMPTOMS: Increased bilirubin. GALLBLADDER ULTRASOUND: Examination was technically difficult with some limitations due to overlying leads. Large right pleural effusion identified. Gallbladder is visualized. No obvious
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The choice of anticoagulants depends on CHA2DS2-VASc score as follow‚ CHA2DS2-VASc risk Score Congestive heart failure (any history) 1 Hypertension (prior history) 1 Age ≥75 years 2 Diabetes mellitus 1 Stroke/transient transient ischemic attack/thromboembolism history 2 Vascular disease (e.g.‚ myocardial infarction‚ peripheral vascular disease or aortic plaque) 1 Age 65-74 years 1 Sex (female gender) 1 CHA2DS2-VASc of the patient in the question stem would be 1 (for congestive heart failure)
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2. What is an objective from each of the learning domains for a 75-year old female who is two weeks post hospitalization for cardiac bypass surgery? 1) Cognitive: dealing with intellectual abilities She will participate in problem-solving to develop a plan of care for her rehabilitation and post CABG lifestyle changes. I will present information the patient will need to control her condition in words the patient understands. If the patient understands why she had surgery in the first
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rest of the liver 3. Nuclear changes in centrilobular hepatocytes and single cell necrosis with pycnotic cells by 3 hours 4. Gross necrosis of the entire centrilobular areas by 6 hours 5. Hepatic congestion . Metabolism in Acetaminophen Toxicity 1. Drug metabolizing enzymes convert acetaminophen to a reactive metabolite that bound to proteins covalently 2. Glutathione detoxify the metabolite and form acetaminophen-glutathione conjugate at nontoxic dose. However‚ the metabolite depleted
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readily to compounds with low toxicity. Example: Straight carbon chain compounds like linear alcohol ethoxylates or betaine esters. * Key Characteristics of Concern: Toxicity to aquatic organisms‚ like fish (vertebrates)‚ daphnids (invertebrates) and algae; persistence in the environment; toxicity of biodegradation byproducts. * Example: Alkylphenol ethoxylates--biodegrade under anaerobic conditions to alkylphenols‚ which persist in the environment‚ have high toxicity to aquatic organisms‚ and may
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