Past Medical History: – Hypertension – Hyperlipidemia So…
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.
Read DetailsThe nurse is assigned to park in a newly created parking lot…
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
Read DetailsAnnual visit: Diagnostic Results Hct 38% Hgb 13 g/dL Platele…
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.)
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