The emergency department provider contacts the AGACNP to adm…
The emergency department provider contacts the AGACNP to admit an 89 year old male with non-small cell lung cancer who now has a right lower and upper lobe pneumonia. Vital signs: Pulse 105, BP 89/51, RR 22, O2 89% on 4L NC, Temp 101.4F Which of the following would be most appropriate to ask about when interviewing this patient?
Read DetailsA 35 year old male with known anxiety, depression, and poly-…
A 35 year old male with known anxiety, depression, and poly-substance abuse presents to the emergency department after a friend found him on his cough and could barely wake him up. He reports he found vomit down the side of the couch. Vitals: Pulse 75, BP 98/52, RR 35, O2 94% on 2L NC, Temp 99.9F Labs: WBC 11K, H&H 17.9 & 41.2, Plt 179K. Na+ 132, K+ 2.9, glucose 71, anion gap 22, BUN 23, Cr 1.2, Mg+ 1.2. Serum drug screen: + THC and tricyclic antidepressants acetaminophen:
Read DetailsA 29 year old male presents to the emergency department with…
A 29 year old male presents to the emergency department with his significant other who complains that the patient “isn’t acting right”. On triage exam, the registered nurse notes rapid deep breathing, mild lethargy, and reports the patient appears inebriated. Vital signs: Pulse 135, BP 101/54, RR 38, O2 95% on room air, Temp 99.1F The triage nurse categorizes the patient as a level 2 and moves the patient to an exam room. The AGACNP interviews and examines the patient. The patient and significant other deny any major medical problems. He reports he smokes cigarettes though he denies alcohol consumption or drug use. He works as a mechanic at an auto body shop. Chest x-ray: no acute findings Labs: WBC 6K, H&H 17.6 & 42.3, Plt 456K. Na+ 136, K+ 3.9, glucose 87, BUN 29, Cr 2.5, Mg+ 1.7. Lactic acid 5.5. Procalcitonin 0.5. ABG: pH 7.22, CO2 18, O2 80, HCO3 8 Drug screen: negative except for THC The AGACNP then interviews the patient and significant other again and asks more about psychiatric history. The significant other states they have “an on-and-off relationship” and recently broke up again. The significant other had gone to the patient’s home to retrieve some belongings when the patient was not acting normally. What substance or substances should the AGACNP ask, and possibly assume, if the patient consumed?
Read DetailsA 23 year old male with known schizophrenia is brought to th…
A 23 year old male with known schizophrenia is brought to the crisis stabilization unit by his parents who complain “he is having one of his episodes again”. Vitals signs and lab work is stable. The patient is admitted to the unit. It is 2am and the AGACNP is covering the needs of the crisis stabilization unit until the psychiatric team returns at 7am. What is the most appropriate regimen to stabilize this patient?
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