Problem 2. A 40-year-old patient Z. suffers from tuberculosis. He has come to see his physician...

Problem 2. A 40-year-old patient Z. suffers from tuberculosis. He has come to see his physician with complaints of dyspnea, pains in the right upper quadrant, and subfebrile fever. These symptoms emerged 4 weeks ago and were progressing. On examination: the face is pale and rounded, orthopnea is evident (the patient is sitting upright with his hands resting upon chair; this posture is necessary to ease breathing); the area of cardiac dullness is increased to the left and to the right by 2 cm, heart rate is 100 per min, blood pressure is 90/60 mm Hg. On auscultation: muffled heart sounds, crackles at the base of the lungs. Breathing rate is 26 per min. The neck veins are distended; the liver is tender on palpation, and extends 3 cm below the costal margin; there is trace pretibial and feet edema. X-ray examination of the chest shows the globular shadow of the heart.Does the patient have signs of cardiac insufficiency? Substantiate your answer. What additional tests are required to specify the form of the heart pathology in this case? Make a conclusion about the form of cardiac insufficiency in this patient.

Expert Solution

please provide your feedback

Nightingale answered 2 years ago

Carmen is a 40-year- old woman who suffers from severe depression. Her physician has tried several...

Carmen is a 40-year- old woman who suffers from severe depression. Her physician has tried several different antidepressants that have been unsuccessful in treating her condition. The physician is now considering placing Carmen on a tricyclic antidepressant or a monoamine oxidase inhibitor. What type of client education would you want to provide to a client who is prescribed a tricyclic antidepressant? What type of client education would you want to provide to a client who is prescribed a monoamine oxidase...

Fred, a 40 year old man, goes to see his doctor. He tells her he is...

Fred, a 40 year old man, goes to see his doctor. He tells her he is experiencing weight loss, polyuria, polydipsia, and extreme fatigue. The doctor notes he has a fruity smell to his breath so she orders a fasting glucose for the next day. The fasting glucose was 150 mg/dL (normal range 70-99 mg/dL). Choose the treatment option(s) that best fit this patient's condition. a. a calculated diet and exercise b. metformin HCl (Glucophage) c. vasopressin d. a and...

J.J., a 55-year-old white male, has come in for his annual physical. He has hypertension and...

J.J., a 55-year-old white male, has come in for his annual physical. He has hypertension and type 2 diabetes mellitus. His blood pressure is controlled with lisinopril 20 mg daily and amlodipine 5 mg daily (BP 132/82 mm Hg). His most recent HbA1c was 7.2% while taking metformin. His father died at age 55 of a myocardial infarction, and his brother, age 57, just underwent angioplasty. J.J. eats fast food at least five times a week because of his work...

Case : A 64-year old man who was recently told by his physician that he needed...

Case : A 64-year old man who was recently told by his physician that he needed to begin taking insulin for his diabetes is afraid of needles. He has had diabetes for 20 years and doesn’t think this new plan is necessary. He is very concerned about administering his own injections. The provider responds by instructing the patient on the physiology, because she believes the foundation for diabetes education is to understand how the illness works. Question1: Think back to...

A 52-year-old man went to his physician for a physi- cal examination. The patient had been...

A 52-year-old man went to his physician for a physi- cal examination. The patient had been a district manager for an automobile insurance company for the past 10 years and was 24 pounds overweight. He had missed his last two appointments with the phy- sician because of business. The urinalysis dipstick finding was not remarkable. His blood pressure was elevated. The blood chemistry results are listed Analyte Patient Value Reference Range Na 151 135–143 mmol/l K 4.5 3.0–5.0 mmol/l Cl...

A 50 year-old male patient presented to his physician with a resting blood pressure of 160/100....

A 50 year-old male patient presented to his physician with a resting blood pressure of 160/100. He had no other medical concerns. He was prescribed Losartan, 50mg per day. This medication is an angiotensin II receptor antagonist. Discuss how a drop in renal blood flow will result in the formation of angiotensin II, and why Losartan will prevent a blood pressure increase.

CASE 1 A 64-year old man who was recently told by his physician that he needed...

CASE 1 A 64-year old man who was recently told by his physician that he needed to begin taking insulin for his diabetes is afraid of needles. He has had diabetes for 20 years and doesn’t think this new plan is necessary. He is very concerned about administering his own injections. The provider responds by instructing the patient on the physiology, because she believes the foundation for diabetes education is to understand how the illness works. Question1: What is your...

You are a student nurse assigned to a 57 year old male patient has come to...

You are a student nurse assigned to a 57 year old male patient has come to medical ward to have treatment due to mild to severe cramping in his abdomen and bloody stool. Your initial findings include a mildly obese man who demonstrate guarding of his abdomen especially the left lower quadrant. His vital signs are 168/98, 119,24, 38 degree Celsius and is slightly diaphoretic. He reported periodic constipation. He has had previous episodes of abdominal cramping, but this time...

Your 36-year-old patient has just tested positive for HIV. He asks that you not inform his...

Your 36-year-old patient has just tested positive for HIV. He asks that you not inform his wife of the results and claims he is not ready to tell her yet. You also are aware that your sister has been seeing this man. What is your role legally? What would you say to your patient? Would you tell your sister?

A 33-year-old male patient visits his primary care physician complaining of right buttock and right leg...

A 33-year-old male patient visits his primary care physician complaining of right buttock and right leg pain with no known injury. He is employed as a long-haul truck driver and is healthy. Upon examination by a neurosurgeon, the patient exhibits normal range of motion except when raising his right leg that causes sharp pain. The surgeon orders an MRI that shows an L4-L5 herniated disc. The patient is scheduled for a lumbar discectomy. 1. Discuss the differences between a laminectomy...

Question