A 22 year old African American female presents to the emergency department with severe generalized pain, fatigue, shortness of breath, nausea, and vomiting. She reports she has sickle cell anemia. Pertinent Labs: WBC 14K, H&H 7.8 & 20, Plt 150K, Na+ 132, K+ 3.2, BUN 24, Cr 1.2. Vitals: Temp 98.6F, Pulse 105, BP 110/60, O2 92% on room air. All of the following include management of acute sickle cell crisis except:
Read DetailsA 24 year old type I diabetic presents to the emergency department with complaints of nausea and vomiting. Kussmaul breathing is noted on exam. He is lethargic though oriented. Vital signs: Temp 97.6F, Pulse 120, BP 110/65, RR 35, O2 98% on room air. BMP: Na+ 125, K+5.0, BUN 25, Cr 1.2, Ca+ 9.0, Glucose 653. ABG: pH 7.19, PaCO2 35, PaO2 82, HCO3 9 What condition does this indicate?
Read DetailsThe AG-ACNP is seeing a patient in the local Good Samaritan clinic (free clinic), who reports that he just found out one of his recent sexual partners is HIV positive. A Calypte EIA test is performed on site and the results are negative. When should the nurse practitioner recommend for the patient to be screened again?
Read DetailsYou are caring for a 42 year old female who is status post thyroidectomy secondary to thyroid cancer. On physical exam you tap on the patient’s check and note ipsilateral facial twitching. Which electrolyte abnormality correlates with this physical finding?
Read DetailsA 52 y/o female presents to the emergency department with complaints of vomiting and diarrhea for 3 days and has been unable to tolerate PO fluids. The patient also reports nausea, muscle cramps, and weakness since symptoms began. Vitals: Temp 98.5F, Pulse 120bpm, BP 98/54, RR 24, O2 96% on room air. Chemistry panel: Na+ 133, K+ 2.8, Ca+ 8.0, glucose 98, Mg+ 1.5. What is the most appropriate treatment for this patient?
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