Question

A.

• George is a 75 year-old patient with urosepsis being treated in the Intensive care unit (ICU). The nurse assesses George and finds that he has blood in his urine and stool, and is oozing blood from his central line site and his gums.

• 1. What does the nurse suspect maybe occurring with George?
  2. What medications should the nurse avoid administering to George?
  3. The nurse is monitoring George’s vital signs every 15 minutes. What other monitoring is essential to include along with the vital signs?
  4. What medication does the nurse anticipate infusing?

B.

• Fred, a 43 year-old construction worker, has a history of hypertension. He smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. His current concern is calf pain during minimal exercise, which decrease with rest.

  1. What does the nurse is the hallmark symptom of peripheral arterial occlusion disease?
  2. The patient is having ankle-brachial index (ABI) determined. The right posterior tibial reading is 75 mm Hg, and the brachial systolic pressure is 150mm Hg. What would the ABI be for this patient?
  3. The nurse is educating Fred about managing his condition. What methods can the nurse suggest to increase arterial blood supply?
  4. What is the best method for the nurse to assess Fred’s peripheral pulses to obtain consistent results with other health care practitioners?

C.

• Georgia, a 30 year-old woman, is diagnosed as having secondary hypertension when serial blood pressure recordings 170/100 mm Hg. Her hypertension is the result of renal dysfunction.

  1. How will Georgia’s kidney help maintain her hypertensive state?
  2. The nurse informs Georgia that she should see her ophthalmologist. Why is it important that Georgia adhere to follow up with an ophthalmologist?
  3. Georgia is prescribed with Furosemide (Lasix) 20mg once every day. What does the nurse understand about the action of Lasix?
  4. What health education can the nurse suggest to Georgia to reduce complications and improve disease outcomes?

Answer 1

1. The bleeding will be occurs only sepsis patient mainly internal bleeding.here patient having urosepsis it caused for infection .patient have sepsis mean bleeding will happen.

You have to avoid antibiotics first because for identify the which infection is growth for in urine.first send to the urine sample for culture so it will be identify the which organism growing in urine. Accordingly you should be take the treatment for asper doctor order.

Patient having bleeding so you have to check the vital signs every 15 minitues.vital signs monitoring patient with severe condition are not.

Normally urosepsis patient treatments are,

* levofloxacin

* aztreonam

* ampicillin

* peperacillin- tazobactum

* meropenam.

2. The nurse assess Fred's symptoms ad being associated with peripheral arterial occlusive disease.the nursing diagnosis is probably: Alteration in tissue perfusion related to compromised circulation

The nurse knows that the hallmark symptom of peripheral arterial occlusion disease is : intermittent claudication

Additional symptoms to support the nurse's diagnosis include:

Blanched skin appearance when the limb is dependent Diminished distal pulsations Reddish- blue discoloration of the limb when it is elevated

The pain associated with this condition commonly occurs in muscle groups.

One joint level below the stenosis or occlusion

The pain is due to the irritation of the nerve endings by the buildup of muscle metabolites and lactic acid

Pain is experienced when the arterial lumen narrows to about 50%

The nurse notice that several minutes after jack's leg is dependent the vessels remain dilated.thus is evidenced by the coloring of the skin which the nurse describes as Rub or

The nurse is asked to determine ABI.the right posterior tibial reading is 75 mmHg and the brachial systolic pressure is150 mmHg.the ABI would be 0.50

In health teaching the nurse should suggest methods to increase arterial blood supply which include,

* A planned program involving systematic lowering of the extremity below heart level

* Buerger - Allen exercises

* graded extremity exercise.

3. Renal dysfunction patient should be follow salt restricted diet as per doctor order.

Why the follow up with opthalmologist for renal dysfunction patient because for eye problems can happen.high blood pressure and diabetes can also increase your risk for eye disease and blurred vision also.

Furosemide is given to help treat fliud retention (edema) and swelling that is caused by renal dysfunction.it works by acting on the kidneys to increase the flow of urine.

* Educate the patient daily routine, and regarding exercises to improve the kidney function also

* concern to the dietician what type of diet should be follow and ask needed to loss of weight.

* monitor medication asper doctor order

* personal hygiene

* salt restricted diet should be follow

* Do exercise correctly

* take rest maximum

* should be don't go crowded areas.