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A 45-year-old patient was admitted to the hospital with a diagnosis of cirrhosis of the liver. The nurse is observing him closely for the possibility of gastrointestinal bleeding. Why is this considered a possible complication? It obstructs blood flow throughout hepatic portal system causing portal hypertension. The veins are also small enough that they tend to burst when force to cary large volumes of blood. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
23. The patient is 52 years old and has a history of hypertension. His cholesterol level is 245. He states his job is very stressful and he is recently going through a divorce. He admits to being overweight and has an inactive lifestyle. His father died of a stroke at age 60. He is worried about having a heart attack and/or stroke and wishes to change his lifestyle. The nurse encourages the patient to eat more fish. Explain why eating more fish would be of benefit for this patient Omega 3 fatty acids have powerful anti-arrhythmic effects on the heart making blood platelets less sticky preventing clotting and lowering BP. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
The patient is 45 years old and is obese. He states he has been on the Atkins diet and has lost 20 pounds. What are the dangers inherent in following fad diets for quick weight loss? Many fad diets limit certain groups of nutrients, some of which contain poor quality protein and are dangerous. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
The patient is a 28-year-old female with insulin-dependent diabetes. She developed viral gastroenteritis with nausea and vomiting. She did not take her insulin and she became increasingly nonresponsive. Her husband called 911 and she was taken to the emergency room. Her pulse rate was 128 and her respiratory rate was 28, deep, and smelled fruity (Kussmaul breathing). Her urinary glucose and ketone levels were both 4+. Her pH was dangerously low. Explain how the body attempted to compensate for the low serum pH. Deep, rapid respirations are the body's attempt to compensate for extreme low pH. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A young athlete is admitted to the hospital with diarrhea, vomiting, bone and joint pain, hyperglycemia, and tingling sensations. What is the problem? overdosing of vitamins A, D, E, C, B6, and niacin can be toxic. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
Harry is hospitalized with bacterial pneumonia. When you visit him, his teeth are chattering, his skin is cool and clammy to the touch, and he complains of feeling cold, even though the room is quite warm. Explain his symptoms. White cells battling pneumonia release pyrogens that act directly on the hypothalamus. causing neurons to release prostagladins.
Prostagladins reset thermostat initiating heat promoting mech.
Vasoconstrictions cause decline in heat loss from body surface hence clammy skin.
0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
After chopping wood for about 2 hours, on a hot but breezy afternoon, John stumbled into the house and immediately fainted. His T-shirt was wringing wet with perspiration, and his pulse was faint and rapid. Was he suffering from heat stroke or heat exhaustion? Explain your reasoning and note what you should do to help John's recovery suffering from heat exhaustion due to to excessive loss of fluids and low blood pressure, & clammy skin. Man needs electrolyte replacement therapy and should be cooled down. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A 45-year-old patient was admitted to the hospital with a diagnosis of cirrhosis of the liver. He is thin and malnourished. His abdomen is very large due to an accumulation of fluid in the abdominal cavity. His lower extremities are very swollen. Explain why these changes have occurred. Cirrhosis is characterized by extensive degeneration and destruction of liver parenchymal cells. Edema and ascites (accumulate of fluid) in peritoneum cavity are clinical manifestations of the portal hypertension. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A patient has esophageal cancer and must have a feeding tube inserted. The nurse tells the patient that the tube will be inserted surgically into the duodenum. The patient's wife asks why the tube will not be inserted into the stomach. What should the nurse say? Duodenum is part of the small intestine i.e., most digestive organ where absorption is best. also less risk of vomiting which would cause complications. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A patient was admitted to the hospital because of severe epigastric pain. He has noted that his stools were darker than the usual brown color. He appears pale and very anxious. The history reports that he drinks 2-3 beers per day and smokes 2 packs of cigarettes a day. Based on the assessment data, what condition might the nurse determine this patient has? Explain why. Patient has a gastric ulcer.

most distressing symptom of gastric ulcers is gnawing epigastric pain.
Dark stools and pale skin would cause one to suspect a bleeding ulcer.
0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A patient is 67 years old and has had a hiatal hernia for three years. In the last year, she has complained of worsening heartburn, especially at night. What are the characteristic symptoms of a hiatal hernia and which of these symptoms did the patient have? heartburn, regurgitation from gastroesophageal reflux.

Woman complained of heartburn.
0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A woman is brought to an emergency room complaining of severe pain in her left iliac region. She claims previous episodes and says that the condition is worse when she is constipated, and is relieved by defecation. A large, tender mass is palpated in the left iliac fossa and a barium study reveals a large number of diverticula in her descending and sigmoid colon. What are diverticula, and what is believed to promote their formation? Does this woman have diverticulitis or diverticulosis? Explain. diverticula are small herniations of the mucosa in the colon walls.

Formed when diet lacks bulk and the volume of the colon is small.
Woman has diverticulitis due to inflammation of her diverticula.
0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
Sami has been hospitalized with acute gastritis. Her symptoms were epigastric pressure (just above the stomach), headache, nausea, and vomiting. She revealed that she had been suffering back pain and drank four shots of gin and took three aspirin to "kill the pain." What led the physician to make this diagnosis, and what may have caused the sudden attack? Gastritis inflammation in the mucosal lining of the stomach, abrupt onset is due to rapid ingestion of alcohol and aspirin. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
Jose is brought to the emergency room complaining of a burning sensation in his chest, increased salivation, and difficulty in swallowing. He is having difficulty breathing and feels the presence of a "lump in his throat." The diagnosis is gastroesophageal reflux disease. Explain. gastroesophageal reflux disease, a disorder in which rate of reflux is greater than normal individuals. Reflux and regurgitation may result in aspiration of gastric contents into air passages, causing respiratory distress hoarseness, asthma, pneumonia. The lump may be due to esophageal sphincter pressure. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
Mrs. Wong goes to the emergency room with the following symptoms: severe pain in the umbilical region, loss of appetite, nausea, and vomiting. While she was waiting to see a doctor, the pain moved to the lower right abdominal quadrant. What is the diagnosis and treatment? Mrs. Wong has appendicitis, the accepted treatment is the immediate removal of her appendix. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
John has undergone surgery and has developed pneumonia. He also has a history of emphysema. Which assessment parameters would the nurse expect to find? 1. dyspnea
2.hypoxemia, b/c increase secretion in lungs.
3. accessory muscles to assist in breathing.
4. Productive cough
5. breathing sounds may crackle
0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A patient with tuberculosis is often noncompliant with treatment. Explain why this may happen. b/c of length of treatment once a patients begin to feel better and clinical symptoms dissipate the patient may stop taking the medication. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
While dining out in a restaurant a man suddenly chokes on a piece of meat. The waitress is also a student nurse and comes to the man's aid. She asks him if he can talk. The man responds by shaking his head no and grabbing at his neck. What is the significance of the man's inability to talk? Speech involves the intermittent release of expired air. The man is unable to speak b/c the piece of food has closed the man's glottis in the pharynx. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A patient was admitted to the hospital with chronic obstructive pulmonary disease. His O2 was 55 and CO2 was 65. A new resident orders 54% oxygen via the venturi mask. One hour later, after the oxygen was placed, the nurse finds the patient with no respiration or pulse. She calls for a Code Blue and begins cardiopulmonary resuscitation (CPR). Explain why the patient stopped breathing. Pure oxygen will stop a persons breathing, because his respiratory stimulus (PO2 levels) would be removed. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
After a long scuba diving session on a Caribbean reef, Carl boards a plane to Dallas. He begins to feel pain in his elbow on the flight back to Dallas. What is happening to him? Carl is experiencing the bends due to
(1) Boyles law: not giving himself enough time to allow the gas that was force in his blood to decompress.
(2) (Henry's Law) the plane is not pressurized reducing the atmospheric pressure holding the gas
0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
A smoker sees his doctor because he has a persistent cough and is short of breath after very little exertion. What diagnosis will the doctor make and what can the person expect if he does not quit smoking? The patient is suffering from chronic bronchitis. The patient can expect all the symptoms of obstructive pulmonary disease, as well as, developing hypoxemia, CO2 retention, respiratory acidosis, emphysema, or lung cancer. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
While having a physical examination, a young male informed his doctor that at age 8 he had lobar pneumonia and pleurisy in his left lung. The physician decided to measure his VC. Describe the apparatus and method used for taking this measurement. Define the following terms used in the description of lung volumes: TV, IRV, ERV, RV, and VC. The doctor use a spirometer, which is a hollow bell inverted or water which gives a graphic recording of the rotating drum.
(TV) is normal breathing of air into and out of the lungs.
(IRV) is the amount of air forcibly inhaled beyond the tidal volume.
(ERV) is the amount of air forcibly expelled beyond the tidal expiration.
(RV) is is the amount of air that remains after strenuous expiration.
(VC) is the total amount of exchangeable air.
0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history
Timothy has been having difficulty breathing since he had pneumonia last month. Recently he had severe pain in his chest and back, and his breathing was extremely irregular. The doctor at the emergency room told him that one of the lobes of his lung had collapsed. How could this happen? Timothy suffered from atelectasis, most like cause by air entering the pleural cavity rupturing the visceral pleura. Could have occurred when he cough during his pneumonia. 0 sevi000 Wed, 04 Apr 2012 19:28:56 GMT view revision history

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