The following case study has three questions that are highli…
The following case study has three questions that are highlighted in yellow to address. Please address each one separately and thoroughly. A 4-month-old previously healthy boy with a cough is brought in by his mom. The cough has been present for 5 days and occurs both day and night, worsening over the past day. He has been working harder to breathe and wheezing over the past 24 hours. She became worried during the night his chest “sucking in” with each breath. She has not noticed his skin become pale or bluish-tinged nor has she witnessed him stop breathing at any point. He has never felt warm to her. She does think his oral intake is slightly decreased but he is still making the same number of wet diapers as usual. ROS: Mom reports the baby has had a dry hacking cough. No one else sick. Past Medical: No hospitalizations or surgeries. Up to date on immunizations Mom has asthma Lives at home with mom and dad. No smoking or pets. NKDA No current meds Assessment: Temp: 100.4 HR: 122 RR: 40 O2 sat: 95% ra 60% height, weight, and head circumference General: no acute distress HEENT: anterior fontanelle flat, mucus membranes moist, with clear stringy discharge from bilateral nares. right tympanic membrane red and bulging. Left TM gray Heart: rate regular with no murmur Lungs: expiratory wheeze noted anteriorly and posteriorly in all lobes. no retractions at present, no nasal flaring. Abdomen: round, soft, nontender Skin: warm, dry, with no rashes What is differential diagnosis? What is the most likely diagnosis? What is your treatment plan and anticipatory guidance about the diagnosis? If treating with antibiotic, what is the recommended dosage?
Read DetailsBess had the following lab studies resulted: Hgb A1C 9.2…
Bess had the following lab studies resulted: Hgb A1C 9.2% Finger Stick Blood Sugar 232 Creatinine 1.2 What would be the target Blood pressure and Hgb A1C? How would you manage this patient: What would be your choice of anti-hypertensive agents and why? What would be your choice of anti-diabetic agents and why?
Read DetailsCase study: Moira Moira is a 54-year-old female with a two-…
Case study: Moira Moira is a 54-year-old female with a two-day history of a pulsating/throbbing headache which is worse with movement and physical activity. She describes photophobia and phonophobia. She is nauseated but has not vomited. Moira describes the pain as 6-7/10, with 10 being the worst pain imaginable. The pain began while at work 2 days ago. It started with her seeing what she describes as halos around lights. Moira has a history of migraine headaches. She has been given naproxen sodium 500 mg. tablet, to take at onset of headache and then every 12 hours as needed for pain. She has taken it as prescribed, but the headache has not resolved. Moira is very frustrated. She has these types of headaches approximately 5 days out of the month and often misses 1-2 days of work each month due to these migraines. Moira reports no change in the frequency or intensity of these headaches, but no longer feels the current treatment plan is effective. She has not been to work since this headache began 2 days ago. Based on what you know, what is your diagnosis? Are there any diagnostic tests you would order? What is your treatment plan for Moira going forward? Include any changes you would make to the current treatment plan. Please include patient teaching.
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