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BIO407
Case Studies Exam 2
You must complete all 3 case studies. They are due the day of our second exam. Please be sure to include
any sources of information you used to help you answer each question.
Case Study – Aortic Stenosis
Isaiah was a 54 year-old male who started developing chest pains and trouble breathing when
he exercised. He told his physician that he had noticed the angina and dyspnea some time ago. At
first they were only when he exercised vigorously, but they had steadily worsened until he
sometimes experienced them even at rest. When the patient’s chest was auscultated, several
abnormalities were observed. His heart was making a harsh systolic murmur that was heard at
the upper right sternum, and there were indications of fluid in his lungs. An ECG showed signs
of left ventricular hypertrophy. Blood analysis revealed elevated levels of epinephrine,
aldosterone and angiotensin. An oral history revealed that he had suffered from a severe case of
strep throat that had developed into rheumatic fever about 15 years ago. He was diagnosed with
aortic stenosis secondary to his episode of rheumatic fever. The chronically increased afterload
on the left ventricle had eventually led to left heart failure (congestive heart failure). The doctor
told him that the treatment for heart failure includes trying to increase contractility, decrease
preload and decrease afterload, so he was given prescription for a phosphodiesterase inhibitor, an
ACE inhibitor and a diuretic.
1.
How does strep throat lead to congestive heart failure?
2. What is the source of the systolic murmur?
3. Why was Isaiah experiencing dyspnea and fluid in his lungs?
4.
Why is the angina and dyspnea exacerbated by exercise?
5.
Why does he have elevated levels of epinephrine, aldosterone and
angiotensin?
6. How do the drugs he was given improve cardiac function?
Case Study –Fibrothorax
Lori was 43 years old when her pulmonary problems started. She got extremely ill and was
forced to take a week off of work. During this time her body temperature was 41
o
C and she
experienced severe
dyspnea
(had to stop for breath after walking for 100 yards). She was
coughing and producing large amounts of rust colored sputum. She was diagnosed with
lobar
pneumonia
with
pleural empyema
. She was treated with antibiotic and the infection was
controlled. After she returned to work she was still experiencing moderate dyspnea. To determine
the reason for the lingering symptoms she underwent several pulmonary function tests. Blood
gas measurements and ventilatory function measurements yielded the following:
PaO
2
75 mmHg
PaCO
2
50 mmHg
Residual Volume (RV)
2250 ml
Forced Vital Capacity (FVC)
2680 ml
Force Expiratory Volume (FEV
1
)
2420 ml
It was determined that the pleural exudates had organized into
fibrothorax
. Her doctor
suggested that a
decortication
surgery might be indicated. She is consulting with her family to
decide if she wants to undergo this procedure.
1. What is dyspnea? Why is Lori experiencing this symptom?
2. What is lobar pneumonia? How does it compare to lobular or interstitial
pneumonia?
3. What is pleural empyema? How does it relate to the infection she
suffered from?
4. Do these blood gas results tell you anything about Loris pulmonary
function?
5. Do these ventilatory function measurements tell you anything about her
disease? Is she suffering from a restrictive or an obstructive disorder?
6. Do you think she should have the surgery? Why?
Case Study – Venous Insufficiency
Marvin, a 42 year old factory worker, comes to his physician complaining of an open sore on
his left shin that does not seem to be healing. As the doctor unwrapped the bandage the patient
had applied, a strong odor was detected. She identified the wound as an infected venous stasis
ulcer. She noticed that the lower leg was edematous and the skin of the foot and ankle was
somewhat discolored. Portions of the saphenous vein were visibly distended and tortuous. An
oral history revealed that the patient stood at a workbench all day on the job. She explained to
the patient that his varicose veins were caused by valvular incompetence in his veins. This had
progressed to the chronic venous insufficiency he was now suffering from.
After the infection was controlled with antibiotics, the patient was advised to wear elastic
stockings, sit down at work whenever possible and to perform toe raises every 5 minutes if he
did have to stand up for extended periods.
1. What is the likely cause of the patient’s valvular incompetence?
2. Why does valvular incompetence lead to varicose veins and chronic
venous insufficiency?
3. Why does venous insufficiency result in edema and venous stasis ulcer
formation?
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Related Questions
K
EINTRAVENOUS X
Your answer
mm ABC - NCM 118 X
9:00 PM the next day.
10:00 PM the next day
A 58-year-old male patient was diagnosed with pneumonia and was brought
under your care. The patient complains of difficulty of breathing, chest pain of
5/10, and coughing with phlegm. Your initial assessment reveals a respiratory
rate of 33 bpm, temperature of 38.1°C, heart rate of 90 bpm, and blood pressure
of 110/80. His physician ordered an infusion of 1,000 mL of normal saline to be
administered over the next eight (8) hours using a macroset with a drop factor of
10 drops per mL. You initiated the IV at 1:00 PM during your shift. With the current
rate, at what time would you hang the next bag?
9:00 PM of the same day.
10:00 PM of the same day.
Th Course: ABC - X
Your answer
docs.google.com
in Course: ABC - X
At the change of shift, you notice 200 ml left to count in your patient's IV bag. The *
IV is infusing at 80 ml/hr. How much longer in hours will the IV run? Fill in the
blank and…
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Question:
1. Develop a Preventive Program based on the scenario.
Background
Brad is 32 year old male. He was cooking methamphetamine in his kitchen when the substance caught on fire at 2300. The entire house was engulfed in flames when the fire department arrived on scene. The neighbor called 911 when he smelt smoke. Brad was found unconscious by the firefighters and was pulled out. He was stabilized on scene and was rushed to West Hills ED via ambulance. While enroute, the paramedics started an 18 gauge IV in the right C and had Brad on 100% O2 non-rebreather. Paramedics alerted ED of an estimated ETA of 5 minutes. Upon arrival at the ED, Brad was found to have stage 3 burn wounds on his anterior and posterior torso and entire left arm with stage 2 burns on his anterior neck. Brad was at risk for smoke inhalation and a compromised airway, so RT intubated him and fluid resuscitation was initiated.
En Route to Emergency Department
Paramedics alerted the emergency department of…
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Mr. Jackson was hospitalized today for heart failure. The physician orders a loading dose of digoxin 0.75 mg to be given intravenously. The digoxin is available in a solution of 0.5 mg/mL. (Learning Objectives 2, 4, 6)
1. How many milliliters should the nurse prepare?
2. What should the nurse do before administering the IV dose?
3. If digoxin toxicity develops, what signs or symptoms might Mr. Jackson have?
4. How often should Mr. Jackson be monitored for signs of digoxin toxicity?
5. What conditions might increase Mr. Jackson’s likelihood of exhibiting digoxin toxicity?
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Must post first.
Bob, a 65-year-old man with atrial fibrillation, has been using warfarin for the past 12 months after he presented to the local emergency department with signs of a TIA. A head CT scan and trans-esophageal echocardiogram done at the time were normal. He has been well since.
Bob has came it the clinical today as the INR taken this morning was 4.6. Up until now, his INR results (which have been measured every 2 weeks) have been stable and in the range of 2.0√3.0. He has not started any new prescribed medications recently.
Bob also has hypertension and osteoarthritis (for which he had a left total hip replacement 6 months ago). Current medications: Atenolol 50 mg once daily, Lisinopril 10 mg once daily and warfarin 6 mg at night.
On examination: BP 140/80 mmHg; pulse rate 65, irregular. The remainder of the physical examination is normal with no evidence of bruising, epistaxis, or gastrointestinal bleeding.
List potential drug interaction(s) with warfarin, which…
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Question: To the following Given Drugs How to explain the drug's Indication, Side effects, and Health Teaching to the patient that is easier to understand to them?
Given Drug:
Ampicillin 1gm IVTT q6 2
Paracetamol 300 mg IVTT q4
Miconazole 200mg (Monistat) ovule, 1 supp, PV @ HS x 3 days
Title: Care of clients with Human Immunodeficiency Virus
Focus Area: Obstetric Nurse Station
Margerie Ramos, a 32-year-old female, who, on her 34th week of pregnancy was transferred to the hospital after coming from a prenatal clinic and reported to be experiencing continuous regular contractions for almost 2 days. This is her third pregnancy. The labor and delivery team were planning to admit her to observe and monitor her baby through a fetal Non-Stress Test and to exclude complications associated with preterm labor. The patient previously agreed to a scheduled repeat C-section since she already had two prior ones.
Upon admission, the patient verbalized, “I'm cold, I feel so hot.” Temperature…
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nurse intervention for Mr. Reddy is a 62 yo presenting to ED at 1500hrs. He was preparing the gas cylinder for a Sunday BBQ when it suddenly exploded while he was trying to connect the hose. Family standing by tried to extinguish the fire with their hands and tried to remove his clothing. Burns 30% TBSA – Face, hands, bilateral lower limbs. Complaints of severe pain and burning 10/10. Past Medical History: Hypertension, Type II DM Regular medications – Candesartan 8mg, Glimepiride 4mg, Metformin 500mg and Pravastatin 20mg. Fully vaccinated against COVID.
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87-89. Case Study 1: A palliative patient has been subjected for blood extraction
requesting the following tests (CBC, Creatinine, Sodium, Potassium, and lonized
Calcium). The phlebotomist first used a 5mL syringe, 21 gauge, however, fails to
extract blood on the first attempt
87. What could be the reason behind the failed blood extraction? *
A. Fragile vein
B. Gauge too low
C. Both A and B
D. Neither A nor B
88. What should be the best gauge number to be used, in order to correct
this case?
A. 25
B. 23
C. 21
D. 18
89. Which of the following-colored top tubes should be used as indicated
by the tests requested?
A. EDTA tube
B. SST
C. Heparinized tube
D. All of the above.
arrow_forward
HPV Case Study
Read the case study and, using your knowledge of human biology and other resources indicated, answer the questions that follow. Save and submit to the drop box.
Bob is healthy 44-year old and father of 2 who recently completed his first marathon. Life was good; he was in the best shape of his life, gainfully employed and happily supporting and raising his family at home. However, Bob has been sporadically dealing with a sore throat for the better part of the past year. The symptoms would come and go but for the most part consistently there. Eventually, he went to see his doctor who examined his throat and saw an inflamed red area in the back of his throat and prescribed a course of antibiotics presuming the sore throat was caused by a bacterial infection. Bob adhered to the course of antibiotic therapy but the sore throat still persisted. At this point, the doctor felt as if perhaps Bob had post-nasal drip perhaps caused by a viral infection or allergies and…
arrow_forward
0
View Share Window Help
106%
View
Add Page
Activity Report:
CBC
16
Zoom
O
ACTIVITY 19
EB
E
Insert Table Chart Text Shape Media
VALUE
INTERPRETATION
all
*
Copy the CBC Component and Values from the given CBC Above
.
Interpret results a high, low or within normal limits
Write possible conditions if results are high or low
REVIEW QUESTIONS
1. What is the importance of complete blood count?
140 words
✪
© stv
MacBook Air
0
Comment
POSSIBLE
CONDITION
Aa
Collabora
arrow_forward
Question
CASE STUDY SCENARIO
Mr. Zane is a 65 –year-old African Canadian male from Brampton, Ontario, Canada. He came to the Emergency Department with his wife of 30 years. Mr. Zane was sent to the Emergency Department by his primary healthcare provider because “he has not been feeling well” for the past few days. He describes a fullness in his head and chest without any associated symptoms. His medical history is pertinent only for primary hypertension, and he states that he ran out of his medication two weeks before he started experiencing symptoms.
Physical examination reveals an anxious man with a BP of 230/130 mm Hg and a heart rate of 108 beats per minute. Respirations are elevated at 22 breaths per minute. No papilledema is seen on funduscopic examination. Lungs have bilateral crackles, one quarter up from the bases. Cardiac examination reveals a regular tachycardic rhythm with normal S1 and S2. Jugular venous pressure is normal but demonstrates sustained fullness with…
arrow_forward
Question: 1. Unstable angina
For this disease pathology, please provide the following information:
What causes this disorder (pathology)? Are there any threats to life risks associated with this disease that you should watch out for, and why? (Not all terms will have life-threatening conditions associated with them)
What types of lab work or diagnostic testing (ECG, X-ray, ultrasound, MRI, etc.) would you typically see ordered with this disease?
What would you expect to see in the lab or diagnostic results?
What are the most common treatments?
Which treatments would be the most important or take priority?
arrow_forward
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Related Questions
- K EINTRAVENOUS X Your answer mm ABC - NCM 118 X 9:00 PM the next day. 10:00 PM the next day A 58-year-old male patient was diagnosed with pneumonia and was brought under your care. The patient complains of difficulty of breathing, chest pain of 5/10, and coughing with phlegm. Your initial assessment reveals a respiratory rate of 33 bpm, temperature of 38.1°C, heart rate of 90 bpm, and blood pressure of 110/80. His physician ordered an infusion of 1,000 mL of normal saline to be administered over the next eight (8) hours using a macroset with a drop factor of 10 drops per mL. You initiated the IV at 1:00 PM during your shift. With the current rate, at what time would you hang the next bag? 9:00 PM of the same day. 10:00 PM of the same day. Th Course: ABC - X Your answer docs.google.com in Course: ABC - X At the change of shift, you notice 200 ml left to count in your patient's IV bag. The * IV is infusing at 80 ml/hr. How much longer in hours will the IV run? Fill in the blank and…arrow_forwardQuestion: 1. Develop a Preventive Program based on the scenario. Background Brad is 32 year old male. He was cooking methamphetamine in his kitchen when the substance caught on fire at 2300. The entire house was engulfed in flames when the fire department arrived on scene. The neighbor called 911 when he smelt smoke. Brad was found unconscious by the firefighters and was pulled out. He was stabilized on scene and was rushed to West Hills ED via ambulance. While enroute, the paramedics started an 18 gauge IV in the right C and had Brad on 100% O2 non-rebreather. Paramedics alerted ED of an estimated ETA of 5 minutes. Upon arrival at the ED, Brad was found to have stage 3 burn wounds on his anterior and posterior torso and entire left arm with stage 2 burns on his anterior neck. Brad was at risk for smoke inhalation and a compromised airway, so RT intubated him and fluid resuscitation was initiated. En Route to Emergency Department Paramedics alerted the emergency department of…arrow_forwardMr. Jackson was hospitalized today for heart failure. The physician orders a loading dose of digoxin 0.75 mg to be given intravenously. The digoxin is available in a solution of 0.5 mg/mL. (Learning Objectives 2, 4, 6) 1. How many milliliters should the nurse prepare? 2. What should the nurse do before administering the IV dose? 3. If digoxin toxicity develops, what signs or symptoms might Mr. Jackson have? 4. How often should Mr. Jackson be monitored for signs of digoxin toxicity? 5. What conditions might increase Mr. Jackson’s likelihood of exhibiting digoxin toxicity?arrow_forward
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- Question CASE STUDY SCENARIO Mr. Zane is a 65 –year-old African Canadian male from Brampton, Ontario, Canada. He came to the Emergency Department with his wife of 30 years. Mr. Zane was sent to the Emergency Department by his primary healthcare provider because “he has not been feeling well” for the past few days. He describes a fullness in his head and chest without any associated symptoms. His medical history is pertinent only for primary hypertension, and he states that he ran out of his medication two weeks before he started experiencing symptoms. Physical examination reveals an anxious man with a BP of 230/130 mm Hg and a heart rate of 108 beats per minute. Respirations are elevated at 22 breaths per minute. No papilledema is seen on funduscopic examination. Lungs have bilateral crackles, one quarter up from the bases. Cardiac examination reveals a regular tachycardic rhythm with normal S1 and S2. Jugular venous pressure is normal but demonstrates sustained fullness with…arrow_forwardQuestion: 1. Unstable angina For this disease pathology, please provide the following information: What causes this disorder (pathology)? Are there any threats to life risks associated with this disease that you should watch out for, and why? (Not all terms will have life-threatening conditions associated with them) What types of lab work or diagnostic testing (ECG, X-ray, ultrasound, MRI, etc.) would you typically see ordered with this disease? What would you expect to see in the lab or diagnostic results? What are the most common treatments? Which treatments would be the most important or take priority?arrow_forward
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