Question

In: Nursing

Mrs. Sullivan is a 54 year old female patient that is being admitted to your medical floor from the emergency room. Mrs. Sullivan has a history of Crohn’s disease and is having a major flare up of this disease.

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.

1. Mrs. Sullivan is a 54 year old female patient that is being admitted to your medical floor from the emergency room. Mrs. Sullivan has a history of Crohn’s disease and is having a major flare up of this disease. She reports that she is having approximately 20 loose bloody stool per day. She came to the emergency room with dizziness and the sudden confusion. She was brought in by her adult son. She is having moderate abdominal pain that is intermittent. She has been incontinent of a small amount of tea colored urine that is foul smelling.

Labwork:

WBC: 20.1

RBC: 10.2

Hb: 6.5

Pt: 214

BUN: 34

Cr: 2.5

Vital signs:

BP: 78/40

P: 220

R:16

T:101.5

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.

2. Mr. Jones is a 65 year old overweight male that is complaining of signs of fatigue and thirst. A non healing wound persists on his left ankle. His bloodwork reveals the following results:

FBS 404

WBC 12.2

Expert Solution

Crohn's disease is a type of inflammatory bowel disease that may affect any part of the gastrointestinal tract from mouth to anus. With symptoms of abdominal pain diarrhea( bloody in case of severe), fever, skin rashes, tiredness.

The causes of this disease is unknown, some suspect that the cause is due to certain bacteria.

Disease can cause ulsers in small intestine, colon. Associated sign of this include reddish, tender nodules, Inflammation in joints and liver.

The diagnosis is made by baroum enema, colonoscopy.

When she admitted to hospital nurse should supply intravenous nutrition or total parenteral nutrition ( TPN).

She should advice patient liquid diet and low fiber diet.

Supplementation of calcium, folate and vit B12 is helpful when malabsorption of these nutrients is apparent.

The use of anti -diarrheal agents(diphenoxylate and atropine, loperamide) and antispasmodic also can help to relieve symptoms of cramps and diarrhea.

Treatment: Should fallow some vaccination schedules. They should receive a single dose of Tdap,then Td boosterevery 10 years. Influenza vaccine annually, 2 doses of hepatitis A and 3 doses of hepatitis B.

Since there is no cure for disease, the goals of treatment is to minimize side effects.

Anti- inflammatory agents such as 5-ASA compounds and corticosteroids, topical antibiotics, immunomodulators are medications used to treat Crohn's disease.

Nightingale answered 2 years ago

Mrs. Sullivan, an 82-year-old female with a frequent history of Alzheimer Disease, UTI, fall and combativeness...

Mrs. Sullivan, an 82-year-old female with a frequent history of Alzheimer Disease, UTI, fall and combativeness brought by her son and presents to the medical-surgical unit came from E.D. She previously worked as a full-time local administrator at a real estate office for over 50 yrs. Her worsening of her condition in the last 10 months. Various progressive cognitive symptoms such as memory deficits and confusion have rendered her unfit to continue to work. Mrs. Sullivan sought for physical therapy...

Ricky Waltz, a 50-year-old American-Asian patient, is admitted to the medical-surgical floor from the emergency department...

Ricky Waltz, a 50-year-old American-Asian patient, is admitted to the medical-surgical floor from the emergency department with severe abdominal pain thought to be from acute pancreatitis. He has a history of drinking at least a case of beer a day. He also smokes and appears cachectic. His old chart indicates a history of COPD, but he does not take drugs for this. He does have a new productive cough. At change of shift, the nurse finds the patient dyspneic and...

. The patient was a 77-year-old female admitted with Congestive Heart Failure, and past medical history...

. The patient was a 77-year-old female admitted with Congestive Heart Failure, and past medical history of an Acute MI, four to six months before admission date. She had been taking Lasix 40mg PO BID and Cardizem 30 mg TID. In a report, I heard that her last O2 saturation was 77% on 3 liters via nasal cannula. Vital signs- afebrile, HR 108, RR 22, BP 148/88. She had an IV of D5W at KVO, the EKG was done, and...

Brief Patient History Mrs. G is a 54-year-old African American woman who has been having intermittent...

Brief Patient History Mrs. G is a 54-year-old African American woman who has been having intermittent indigestion for the past month. She has a history of hypertension and hyperlipidemia. She was admitted as an inpatient on a medical floor for management of her blood pressure and is scheduled to undergo endoscopy tomorrow. Mrs. G suddenly becomes diaphoretic and complains of nausea and epigastric pain. Clinical Assessment The rapid response team is called to evaluate Mrs. G. When the team arrives...

A 62 year old, 183 lb female is admitted to the emergency room and diagnosed with...

A 62 year old, 183 lb female is admitted to the emergency room and diagnosed with DVT. The ER physician orders a bolus dose of heparin at 70 units/kg, to be administered in the ER. Calculate how many mLs the nurse will draw up into a syringe for the bolus dose given that the heparin concentration in the vial is 1,000 units/mL. Show your work. A dopamine drip is ordered for a 74 kg male who was admitted to the...

P.R., a 66-year-old woman who has no history of respiratory disease, is being admitted to your...

P.R., a 66-year-old woman who has no history of respiratory disease, is being admitted to your intensive care unit (ICU) from the emergency department (ED) with a diagnosis of pneumonia and acute respiratory failure (ARF). The ED nurse tells you that P.R. was stuporous and cyanotic on her arrival to the ED. Her initial vital signs were 90/68, 134, 38, 101° F (38.3° C) with an Spo2 of 53%. She was endotracheally intubated orally and placed on mechanical ventilation and...

Mr. Tan is a 69-year-old patient who is admitted from the Emergency Room with a diagnosis...

Mr. Tan is a 69-year-old patient who is admitted from the Emergency Room with a diagnosis of hypokalemia after 48 hours of vomiting, and diarrhea. The patient's potassium level is 2.9 upon admission. The patient's creatinine level is 0.9 mg/dL and the BUN is 10 mg/dL. As the primary nurse, use the SBAR mnemonic to contact the attending physician for desired orders to care for Mr. Tan. The admitting resident asks you if the ER physician checked a magnesium level....

D.V., a 32-year-old man, is being admitted to the medical floor from the neurology clinic for...

D.V., a 32-year-old man, is being admitted to the medical floor from the neurology clinic for evaluation of his symptoms. D.V. has experienced increasing urinary frequency and urgency over the past 2 months. Because his female partner was treated for a sexually transmitted infection, D.V. underwent treatment, but the symptoms did not resolve. D.V. has also recently had two brief episodes of eye “fuzziness” associated with diplopia and flashes of brightness. He has noticed ascending numbness and weakness of the...

your patient is a 78-year-old female admitted to the neurology unit via the emergency department for...

your patient is a 78-year-old female admitted to the neurology unit via the emergency department for observation and pain Management of worsening headache related to a fall 4 days ago what are your primary concerns for this patient and what assessments and interventions would be associated with your concerns and why

Mr. Jones is a 75 year old male patient that presented in emergency room with a history of cardiovascular disease (CAD).

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and in details of what a nurse would do.1. Mr. Jones is a 75 year old male patient that presented in emergency room with a history of cardiovascular disease (CAD). He came to emergency room with complaints of crushing chest pain, dizziness and nausea. The patient is able to communicate but his wife is also present. Abnormal ECG readings reveal...