What is MODS? Multiple organ dysfunction syndrome. Progressive failure of two or more organ systems, resulting from acute, severe illnesses or injuries (sepsis, systemic inflammatory response, trauma, burns) and mediated by the body 's inability to sufficiently activate its defense mechanisms (Saunders, 2007).
After reviewing W.A.’s presentation, what organ systems do you suspect are involved and why? Heart, kidneys, bladder
Heart: The BNP level in W.A.’s blood was above normal. A high value of BNP in the blood may show early heart failure in people on kidney dialysis. She also has +2 pitting edema and Crackles in bilateral lower lobes and shortness of breath. As heart failure gets worse, fluid starts to build up in your lungs and other
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Urinalysis: Dark yellow and cloudy, protein 28 mg/dL, positive for casts, positive for red blood cells and white blood cells, positive for glucose and ketones.
What do you think is the origin of W.A.’s septicemia?
Septicemia is an infection of the blood, also known as bacteremia or blood poisoning. The most common infections that lead to septicemia are: urinary tract infections, lung infections, such as pneumonia, kidney infections, and infections in the abdominal area. I believe the origin of W.A.’s septicemia is her kidneys.
What additional tests would you anticipate for W.A.?
Ultrasound/CT Scan- To get a picture of the kidneys and urinary system. This will show the size of the kidneys whether or not there is kidney stones, tumors or cysts present.
Biopsy- To remove a tiny piece of kidney for evaluation. What kind of kidney damage is happening?
Urine output measurements- The amount of urine you excrete in a day may help your doctor determine the cause of your kidney failure
Chest XRAY- This will show the size of the heart and whether there is fluid build-up around the heart and lungs.
Echocardiogram- This will show a graphic outline of the hearts movement.
Doppler Ultrasound- To evaluate blood flow across the hearts
I would also perform a urine test to test for any high levels of proteins lost from the kidney. Part 5 A V/Q scan would show blood flow obstruction (embolism) and the use of the radioactive material would be used to examine the airflow in images. The airflow will be normal but the blood flow will be blocked, this is the V/Q mismatch.
Reason for Visit: Puncture Wound to the Right FA S: TM works in GA Chassis when he injured his right FA. According to TM he was putting in nuts on the exhaust muffler and a piece of metal was sticking out of the muffler and stuck him in his right FA. TM denies previous injury to right arm. TM rates his pain at 2/10. O:
It was noted that the claimant presented to the ER with complaints of a headache and fever. Urinalysis showed urine pH of 8.0 with squamous epithelial cells of 31-50/LPF. She had elevated glucose at 126 with low levels of BUN at 6, potassium at 3.3, sodium at 135, and chloride at 95. She was diagnosed with a viral syndrome. Zofran and a follow-up visit were recommended.
No JVD. No cyanosis, clubbing, or edema. 2+ pulses bilaterally at the carotid artery. 1+ pulses bilaterally at radial, DP, and PT arteries. No murmur or change in cardiac status with 1 min of vigorous activity in the office.
Although, sonography technology is used to diagnosis many other medical conditions such as conditions in the heart, breast, abdomen, blood vessels and musculoskeletal problems. This technology works along with x-ray, MRI and CAT scans. (Diagnostic, 2016) Diagnostic medical sonographers are
5. Approach to the diagnosis. 5.1. Is it cardiac or not? 5.2.
The sonographer will then go into the patient's room then look. If anything is wrong or something doesn’t look right, the sonographer will take it to the cardiac doctor or the OB/GYN fro closer look at what might be the problem ("Summary.",
Some signs that a patient may have right sided heart failure are: shortness of breath, swelling of feet and ankles, JVD. This is often diagnosed by a EKG, or a chest xray. There are a few ways to determine if a patient has carpal tunnel. The Phalen 's sign is a common test used to do this the provider will have the patient hold your elbows at shoulder level and place the backs of your hands together with your wrists bent at 90 degrees. Hold this position for 60 seconds.
The patient was irritated and not complained, body movement were voluntary, his skin was warm and capillary refill < 3 seconds which indicated good circulation. The patient lungs were clear posteriorly and anteriorly in upper and lower part of the lungs. His O2 sat. was 98% . Patient bowel sounds were present and last BM was 1 day
Assessment and Diagnosis Ms. F is a 66-year-old African American female. She was most recently hospitalized complaining of nausea, vomiting, abdominal pain and decreased appetite; it was found that
If their results indicate that you do have pleural mesothelioma they will then be able to suggest the best treatments for your
Review of Symptoms General: denies fever, night sweats, significant weight gain or loss, exercise intolerance, depression, sleep disturbances, or fatigue HEENT: denies dry eyes, irritation, vision changes, difficulty hearing, ear pain, sore throat, runny nose, or sinus pressure Neck: denies swollen glands or stiff neck Pulmonary: denies cough, wheezing, or shortness of breath Cardiovascular: denies chest pain or palpitations Gastrointestinal: denies abdominal pain, nausea, vomiting, diarrhea, constipation, acid reflux, or melena Genitourinary: reports dysuria and vaginal itching, denies incontinence, hematuria, increased frequency, abnormal bleeding, or vaginal odor Musculoskeletal: denies muscle aches, weakness, joint pain, back pain, or edema Integumentary: denies any rashes, lesions, or change in hair Neurological: denies numbness, headache, seizures, tingling or sensation changes Endocrine: denies bruising, excessive sweating, thirst, hunger, heat or cold intolerance Objective Data Physical Exam Vitals: blood pressure - 130/77, heart rate - 97, respiratory rate - 17, temperature – 97.9 , oxygen saturation –97% on room air, weight – 183 pounds, height – 5 feet 4 inches, body mass index –
She ordered a CT scan of Mrs. Adae 's chest to rule out the possibility of an aneurism, a CT scan of her abdomen to evaluate her liver, additional lab work, and thyroid testing, possibly to be performed on an outpatient basis. Mrs. Adae 's DischargeSummary, signed by Dr. Pesante, states, in part, "it just seems like [Mrs. Adae 's] problem may have moreso been either some kind of infectious process or possibly a thyroid abnormality." Also on July 1, three days after her discharge from CMH, the CMH laboratory reported to the resident on duty that Mrs. Adae 's blood cultures were showing "gram positive cocci in clusters. " The following day, the laboratory reported to Dr. Pesante that Mrs. Adae 's blood cultures were positive for staphylococcus aureus, a type of bacterial infection. Neither the resident on duty on July 1 nor Dr. Pesante contacted Dr. Bain or the attending physician on-call about Mrs. Adae 's blood culture results.
Caitlin Little 2.15.18 ANP II Case Study 1. Mr. Tripson’s physician is clearly taking very seriously the symptoms he is exhibiting on his second day of hospitalization after suffering a severe head trauma that resulted in a coma. Polyuria and frequent urination are symptoms of diabetes, though given his head trauma the diagnosis could be even more serious, even potentially life threatening. The physician will order blood and urine tests to rule out different types of diabetes and gain a better conclusion about what’s going on internally with Mr. Tripson.
(Morgan) RN 0948 ABCDE complete. Patient exhibits 5 clinical review criterions. Nurse in charge notified. Clinical review called 0950.