Case study 2 – disorders of haemopoietic system

Louise is a 57-year-old lady that has presented to her GP with •fatigue, weight loss, sweating, easy bruising, discrete ecchymosis, feeling of abdominal fullness’ and re recurrent mild upper respiratory tract infections (URTI) On examination she was found to have an enlarged spleen and small diffuse petechiae.

Lab test show the following results

• Haemoglobin 90 g/L (115 – 165 g/L)

• Platelet count 58 x 109/L (150 – 450 109/L)

• White blood cell count 1.4 x 109/L ( 4.5 – 11 x 109/L)

• Hct 0.61mL/L (61%) L ( 37 -47mL/dL)

• Peripheral Blood smear WBC 76% are blasts

2a. Explain the possible causes of the abnormalities.                3 marks (1 mark for each abnormality)

• Haemoglobin

• Platelets

• Peripheral blood smear

2b.     What history or clinical presentation can be linked to the abnormal haematological findings, support with rationale / explanation.                                                                                            3 marks (0.5 per CM 0.5 for explanation)

2c.       Describe and discuss the differentiation between Acute Myeloid Leukaemia and Acute Lymphocytic Leukaemia

Tiffany, 36-year-old woman who has been experiencing of pain and swelling in her hands and feet. On examination by her General Practitioner (GP) her hands and feet display evidence of inflammation; rubra, heat and swelling and decreased function. On palpation and movement, they cause considerable pain which she rates as 5 - 7 on pain scale of 0 -10. When questioned on when this pain and inflammation first started, she is unable to say, but it has gradually worsened over the past 4 weeks. She states she has been taking Ibuprofen which initially provided relief but is no longer as effective. It is worse in the morning and she is now unable to carry out her many aspects of her normal routine. Her GP suspect’s Rheumatoid Arthritis (RA).

Questions:

3a.       Discuss the pathogenesis of Rheumatoid arthritis and link it to the clinical manifestations that Tiffany is experiencing.                                                        4 marks

3b.       Discuss the diagnostic tests that may be used in the diagnosis of RA

3 marks

3c.       Disease Modifying Anti Rheumatic Drugs (DMARD) are often the first line of pharmacological therapy despite the significant side effects. Name two non-biological DMARD’s, describe how they work and why they are prescribed despite the significant adverse drug reactions (ADR’s)                                                                                                 3 marks ( 1 mark for drug names, 2 marks for discussion)

1. How might an organisation benefit from network relationships in terms of information that can be gathered and trends that can be identified? 100-120 words CHCPRP001

• Case Study

Read the following case study and answer the questions that follow:

Grace Speak is a fourth-year student at Best University. She and her fellow classmates are working hard in their final courses and preparing for exams. Inspired by the teamwork that the healthcare profession espouses, Grace gets an idea for a study group. She thinks it will really help to share case experiences, course notes, and study tips. Unfortunately, several members of her peer group live out of town, which makes it difficult for them to participate fully. Grace is torn, as she does not want to exclude them from the study group. When she voices her concerns to a classmate, her friend suggests using social media tools as the primary medium for sharing information.

Questions

1. Two required elements that a single social media site must have to meet the needs of her study group are the ability to share ideas and experiences (chat), and share information (store documents). Research several social media sites that meet both of the required elements for Grace’s group. Select one social media tool, include its website, and explain your rationale for selecting that tool.

Selected Social Media Tool (and website)

[Write your response here.]

Rationale

[Write your response here.]

2. Grace discovers that not all of the members of the group use the social media tool she selected. In your own words, create a set of simple instructions that other members of the group could follow to ensure full group participation.

[Write your response here.]

3. Grace decides to establish a set of “ground rules” from the outset when she forms the study group. Create a set of “ground rules” that will help to create a group with full participation by all members and that will not place members of the group at risk, for either privacy or academic (plagiarism) concerns. Provide your reasoning for the “ground rules” you established.

Ground Rules

[Write your response here.]

Rationale

[Write your response here.]

4. In a specific week, the assignment is particularly challenging. One of the students in the study group offers to post the “answers” he received from a student who completed this same assignment last year from the same instructor. Grace knows that one of her close friends in the study group is at risk of failing if she does not do well on this assignment. Describe how Grace might handle this situation to reduce the academic risk of plagiarism for herself, her friend, and other members of the study group.

[Write your response here.]

Subject Hypertension patient: Please make to have it as a actual scernio of a patient going into to the hopstial and for section B give rationales. A.Health History – age, gender, ethnicity, past and current medical history, chief complaint, and history of present illness on admission.B.Laboratory/Diagnostic Testing – describe the diagnostic tests ordered/completed, pertinent results (including normal and abnormal ranges), and rationales for the use of each diagnostic test.

The Federal government has classified controlled substances into different schedules. What are the variables the government considered to establish the scheduling method (e.g. how are the schedules determined?) and some major differences between each schedule?

Also what is Forensic Toxicology and the roles and responsibilities of the Forensic Toxicologist?

provide a care plan for elderly patient that has been admitted with a medical diagnosis of fractured hip and second day post op for hip arthroplasty

-Provide a care plan for patient with first ten days post op after amputation

-provide a care plan for an inpatient who is on traction

-Provide a care plan for a patient in a cast ; Day 1-28

A 17-year-old boy arrived to the ED after going into cardiac arrest during a football practice. Diagnostic testing reveals cardiomyopathy. Which type of cardiomyopathy commonly presents this way?

a. Hypertrophic cardiomyopathy (HCM)

b. Restrictive or constrictive cardiomyopathy (RCM)

c. Arrhythmogenic right ventricular cardiomyopathy (ARVC)

d. Dilated cardiomyopathy (DCM).

She is nervous about the procedure. What is the nurse's best response?

a. “The whole team will be monitoring you very closely for the entire procedure.”

b. “This is basically a risk-free procedure.”

c. “Remember that this is a step that will bring you closer to enjoying good health.”

d. “Thousands of patients undergo EP every year.”

What spiritual considerations surrounding a disaster can arise for individuals, communities, and health care providers? Explain your answer in the context of a natural or manmade disaster. How can a community health nurse assist in the spiritual care of the individual, community, self, and colleagues?

Complete drug card-

Generic /brand name

Category class

expected Pharmacological Action

Complications

Contraindications/Precautions

Interactions

Medication Administration

Evaluation of Medication Effectiveness

Therapeutic Use

Nursing Interventions

Client Education

Complete medication form for the following medications

1. Cyclopentolate hydrochloride

2. Timolol

3. Pilocarpine

1. Describe the difference between cold sores and canker sores.

2. Describe the causes and symptoms of plaque formation, halitosis, and xerostomia and review ways to prevent or control these conditions.

3. Describe the best treatment option a patient can use to combat halitosis.

4. What are treatment goals for mouth disorders such as providing comfort, allowing healing, and preventing the spread of the disease?