minemine

Thanks! for you help Esme12.

Thanks Esme12, i was thinking that the patient has COPD or what do you think?

thanks mattnurse for taking your time to elaborate the case study. i was thinking if the case study is asking for only one medical diagnose. i was thinking of copd seen they are the main reason why patient are tripod. tripod breathing: patients with advanced lung disease (in this case copd) will often assume a tripod position (leaning forward, hands on knees) when breathing difficulties occur. this provides a position that optimizes respiratory mechanics. 4. how do smoking and diabetes contribute to the patient’s underlying medical diagnosis you identified? smoking is the number cause of copd, it damage the lung. patient with copd, have an increase risk of developing diabetes, the risk appear to exist regardless of severity of copd. elevate level of blood glucose are associate with abnormal lung function.

thank you siri for the info. thanks esmel2 for making me think as a nurse. thanks mattnurse for seeing where the mistake come from, i just started my nursing program this year, so i was taught that as a nurse you can't do medical diagnose, you can only do nursing diagnose. i'm not really sure if this medical diagnose kind of make it a little bit hard to just go straight to the point without thinking otherwise, because the sign and symptoms are also related to other diagnose. like you guys said i need to give my own opinion about the case study before you can correct me if am on the right track. i try my best, please kindly correct me if am wrong. the following are the answers to the case study: [table=class: table2, width: 100%, align: center] [tr] [td=class: formtext2, width: 95%, colspan: 2] answers below are subject for review/correction...comments and corrections are welcome... thanks! 1. asessment: chronic kidney disease secondary to dm nephropathy, hypertensive cardiovascular disease, coronary artery disease, in congestive heart failure iiic, pneumonia(cap). 2. smoker, diabetic x 20 years, hypertensive, with signs of heart failure/renal failure. signs of infection. 3. sepsis, respiratory failure. 4. effects of smoking to cardio(so many to identify). 5. aside from echo (12-l-ecg, abg, electrolytes, dont forget bun/crea, kub ultrasound to confirm if the cause of renal failure is really secondary to dm(usually normal in size, if hypertensive-small size). 6. restrict diet that will futher damage the kidney & cardio... 7. diuretics, statins, insulin, antihypertensive probably central sympatholytics. [/td] [td=width: 2%] [/td] [/tr] [tr] [/tr] [/table]

I'm new to this sites. please can someone help me with the following case study questions. I will rely much appreciate it. Thanks! A 75 year old female is admitted with complications of shortness of breath, increasing with exertion and at night, feeling fatigue, and difficulty sleeping. Upon your assessment you note she has 2+ pitting edema and brownish discoloration of lower extremities, crackles and wheezing in lungs and is in a tripod position to breathe with a dry hacking cough and overweight. Vital signs are blood pressure of 168/102, temperature is 101.4, pulse 102, respirations 20 and labored, pulse oximeter reads oxygen saturation is 88%. She is cyanotic and cool to touch. She reports a 20 year history of Type 2 diabetes, smokes approximately 3 packs a week for 50 years. A chest ex-ray reports left lower lobe pneumonia and enlarged heart. IV antibiotics are initiated, an echocardiogram is ordered and she is put on oxygen 2 liters. Based on the information you obtained and your assessment what do you suspect is the underlying medical diagnosis? What information given led you to the diagnosis? What are two complications the patient could be at risk for secondary to her pneumonia? How do smoking and diabetes contribute to the patient’s underlying medical diagnosis you identified? What laboratory tests would suspect be ordered and why? What dietary restrictions would be indicated for the patient? What class of medications do you expect the patient to be taking for this underlying medical diagnosis you identified?