Past Medical History: – Hypertension  – Hyperlipidemia  Social History: – Non-smoker  – Occasional alcohol use  Medications: – Lisinopril 10 mg daily  – Atorvastatin 20 mg daily  Allergies:  – Aspirin – Vancomycin – Penicillin – Mushrooms   Laboratory:   – Complete blood count: Leukocytosis (WBC 15,000/mm³) with left shift    – Erythrocyte sedimentation rate (ESR): Elevated    – Blood cultures x 2 sets: Pending    – Urinalysis: Normal  Imaging:   – Chest X-ray: Bilateral infiltrates consistent with pulmonary edema    – Echocardiography: Large vegetation attached to the mitral valve  Physical Examination:  – General: Appears unwell, diaphoretic  – Cardiovascular: Regular rhythm, no murmurs – Respiratory: Coarse crackles, bilaterally at lung bases  – Abdomen: Soft, non-tender  – Extremities: No edema  – Weight: 195 pounds Vital Signs:    – Temperature: 39.2°C (102.5°F)    – Blood pressure: 140/90 mmHg    – Heart rate: 110 bpm    – Respiratory rate: 24/min    – Oxygen saturation: 92% on room air  Diagnosis: Infective endocarditis (IE), likely secondary to bacteremia following dental extraction  Orders: Vancomycin 500 mg IV Q 12 hours Omnipen 1 gram IV Q 6 hours   NS @ 100 ml/hr O2 @ 2L/NC Continue home medications Soft diet Cardiology & Infectious Diseases Consult Pharmacy Supplies: Vancomycin (vancomycin hydrochloride) 500 mg / 100 ml – Infuse over 1 hour Omnipen (ampicillin) 1 gram / 100 ml – Infuse over 30 minutes.   At what rate (ml/hr) should the nurse prepare to administer Vancomycin? Round answers to whole numbers.    

The nurse is assigned to park in a newly created parking lot that is far from the hospital building. Some of the lights in the new parking lot have not been installed. As the nurse is about to leave, she notices several young men loitering near the walkway she must take. The nurse should

Annual visit: Diagnostic Results Hct 38% Hgb 13 g/dL Platelet count 350,000/mm3  Physical Examination Client is here today for annual check-up; client’s BMI is 19 Client reports they started following a strict vegan diet 1 month ago. Hand grasps strong and equal bilaterally. Breath sounds clear and present throughout. Apical heart rate is regular and strong.  Abdomen is flat and soft. Bowel sounds are present. Skin warm and dry; buccal mucosa pink; skin color is consistent with the client’s genetic background 6 months after annual visit: Hct 26%  Hgb 8 g/dL Platelet count 275,000/mm3 Client made appointment today due to experiencing paresthesia of fingers and toes, muscle weakness, and fatigue. BMI is 18 Breath sounds clear and present throughout. Apical heart rate is strong, regular, and slightly tachycardic. No murmurs are auscultated.  Skin cool; buccal mucosa pale; nailbeds are pale for the client’s genetic background; tongue appears red and smooth.   The nurse should recognize that which of the following findings from the visit 6 months after the annual check-up require immediate follow-up? (Select all that apply.)

A nurse in a clinic is collecting data from a client who is 13 weeks gestation and has hyperemesis gravidarum. Which of the following should the nurse identify as the priority?

Neurophysiology studies are usually required for the diagnosis of GBS.

About 50% of patients with only ocular myasthenia gravis are seropositive. What does seropositive mean?  

What are the TWO important clinical cues that should prompt an RT to consider a diagnosis of Amyotrophic Lateral Sclerosis (ALS)?

Guillain-Barré is divided into subtypes. Which subtype is a severe variant of GBS that is more prevalent in Asia, Central America, and South America? This subtype causes severe, rapid destruction to nerves throughout the body.

What lung disorders have decreased in DIFFUSION CAPACITY (DLCO)? (Select all that apply.)

What is the most sensitive diagnostic test for myasthenia gravis and most difficult?