LM is a 53-year-old patient diagnosed with relapsing remitti…
LM is a 53-year-old patient diagnosed with relapsing remitting multiple sclerosis (RRMS). She experienced a MS exacerbation while taking dimethyl fumarate (Tecfidera®) and is requesting to switch medication. She prefers an oral medication for convenience and is reluctant to use an injectable or infusion. Her past medical history includes a heart attack 4 months ago. She has no history of depression and is up to date on cancer screenings. Which disease-modifying therapy (DMT) would be the MOST appropriate for LM to switch to?
Read DetailsA nurse is caring for a client with immune thrombocytopenic…
A nurse is caring for a client with immune thrombocytopenic purpura (ITP) who reports new onset of severe headache and visual changes. The client’s platelet count is 15,000/mm³. Which action should the nurse take first? Reference Range: Platelet: 150,000-400,000/mm³
Read DetailsCase 2 (use this case to answer the 5 questions that follow)…
Case 2 (use this case to answer the 5 questions that follow) Name: Fiona Y. Age: 42 Gender: Female Medical history: epilepsy, major depressive disorder, anorexia (restrictive eating disorder) Chief Complaint: Fiona has had a recurrence of depressive symptoms. Presenting Concerns: Fiona has a history of depression. She was managing depression effectively by taking citalopram (at the maximum recommended dose) until a few months ago when she experienced recurrence of symptoms. Today she reports a persistent down mood, lack of enjoyment, difficulty sleeping, fatigue, low motivation, and a noticeable loss of appetite. She is planning to stop citalopram and would like to explore alternative antidepressant options to address her current depressive symptoms. Fiona was diagnosed with epilepsy four years ago and has been consistently taking lamotrigine. In the last year she’s experienced 1 seizure. During a visit to her primary care provider, Fiona requested contraception and the decision was made to prescribe an oral contraceptive which she plans on filling and starting later today. Current medications: Lamotrigine 300 mg daily (started taking 4 years ago) Citalopram 40 mg daily (started taking 2 years ago) Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg daily (combined oral contraceptive pill prescribed today) Social History: Fiona does not use over-the-counter medications. She works in a demanding job but reports no significant psychosocial stressors contributing to her current depressive symptoms.
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