A 24-year-old male college student was presented at the ESU health clinic. He looked tired and pale. He presented because of a high fever and chest pain. He was afraid he was having a heart attack (a bad week of exams). He was examined immediately by the PA and an EKG strip was run. He had no evidence of acute heart problems. The attending physician visited the patient. He obtained the following history from the past 36 hours. The patient had a tight cough. He had significant muscle aches and pains. He had a bad headache and a fever of 101-103F.

The physician ordered a chest x-ray. It did not show any significant consolidated inflammation suggestive of pneumonia. The patient showed significant nasal drainage and a moderately tight, but productive cough on physical exam. He had a fever of 101F and generally inflamed mucous membranes. A rapid Strep test showed no evidence of Streptococcal infection and his tonsils and adenoids had been removed.

1. What type of infection do you believe he has? what microorganism is causing this disease?

2.  From the complaint and physical examination, which of the symptoms lead you to your choice of agent? how did you come to that conclusion?

3. From the history, which of the information confirmed your choice? What is the treatment for this illness/disease?

4. Which of the following is most likely to follow this infection? How did you come to that solution of the treatment? In other words, why is it that treatment?

Please reference and cite and also keep both studies separated and numbered! And keep the answered questions and explanation together, about a paragraph for each question. thank you!

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Case study 6

A 70-year-old patient with Alzheimer’s disease was brought to the emergency room by the staff of a local nursing home. He presented as lethargic with a sallow complexity. He had an admission temperature of 102.4F and a respiratory rate

of 33/minute. During respiration, the right side of his chest moved better than the left. He showed dense consolidation of the lower lobe of the left lung on physical exam. A sputum sample revealed blood and a greenish color.

A chest x-ray showed tight consolidation of the left lung with evidence of formation of cavities in the lung tissue from cytotoxic damage. The patient complained of chills in the exam room, combined with his fever. A smear of his

sputum demonstrated no acid-fast bacteria.

1. What type of infection do you believe he has? what microorganism is causing this disease?

2.  From complaint and physical examination, which of the symptoms lead you to your choice of agent? how did you come to that conclusion?

3. From the history, which of the information confirmed your choice? What is the treatment for this illness/disease?

4. Which of the following is most likely to follow this infection? How did you come to that solution of the treatment? In other words, why is it that treatment?
Please reference and cite and also keep both studies separated and numbered! And keep the answered questions and explanation together, about a paragraph for each question. thank you!

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.
2. Create a problem statement.
3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.
4. Discuss the impact on the health care delivery system.

As health care costs continue to rise dramatically in the United States, one major issue that must be addressed is access to health care for the uninsured and underinsured. Which plan’s expanded health care coverage to uninsured Americans is aimed at controlling costs and improving the quality of health care?

Medicaid

Medicare

Diagnosis-related groups (DRGs)

The RN is caring for a woman who experienced interpersonal violence from her spouse of 15 years. Which nursing intervention would assist with empowering this patient?

-Identify a family member to help solve family problems.

-Teach her how to avoid conflicts with her spouse.

-Help her recognize ways she is dependent on her abuser.

A client with Alzheimer’s disease has had recent episodes of confabulation. The client is most likely in which stage of Alzheimer’s?

Stage 5

Stage 4

Stage 3

A 38-year-old Filipino patient, G3P2+0 presented to the emergency department on the 18th of October 2019 complaining of acute onset of lower abdominal pain associated with a history of amenorrhea for three months. She was unsure of the date of her last menstrual period and had no previous antenatal follow-up. She was medically free and her past obstetric history included a normal uncomplicated vaginal delivery, followed by a cesarean section which was performed four years back. She had no allergies and was not taking any medication or contraception. Upon presentation, she complained of generalized lower abdominal pain which was of sudden onset, continuous, not radiating, and not relieved by oral analgesia. The pain was associated with nausea and symptoms of anemia such as dizziness and shortness of breath, but there was no history of loss of consciousness or gastrointestinal or urinary tract symptoms. There was no history of fever or symptoms suggestive of pelvic inflammatory disease.

Upon clinical examination, the patient looked pale and distressed. Her blood pressure was 90/42 mmHg, with a pulse rate of 110 beats per minute. Her abdomen was generally distended and tender on both superficial and deep palpation, with signs suggestive of peritonitis. The digital vaginal examination was positive for cervical motion tenderness and her BhCG Level measured 113000 IU/ml. The examination was complemented by a bedside pelvic ultrasound, which showed an empty uterine cavity as well as a live fetus floating in a moderate amount of free fluid in its pouch of Douglas ​(Figur. Her hemoglobin count measured 3.2 g/L, and her total white cell count was 7.5 g/L. Blood grouping and cross-matching of four blood units were immediately sent.

The possibility of a ruptured ectopic pregnancy was explained to the patient, and she consented to an emergency laparotomy with possible salpingectomy. During the laparotomy, a total of 4 liters of intra-abdominal blood was suctioned while blood transfusion was ongoing. A live 13-week fetus was found and removed from the pelvic cavity, and the remains of the ectopic pregnancy (gestational sac and placenta) were found along a ruptured right fallopian tube. The right tube was successfully resected, and the specimen was sent to histopathology. Both the right and left ovaries looked normal. Peritoneal lavage was completed, and a large pelvic drain was inserted. The histopathology report revealed chorionic villi within the lumen of the right tube, which was consistent with tubal ectopic pregnancy.

Intra-operatively, the patient received a total of five units of packed red blood cells plus three units of fresh frozen plasma. She was transferred to the Surgical Intensive Care Unit where she was observed for two days. During her ICU stay, she remained hemodynamically stable. Her oxygen saturation was maintained with a 6L O2 face mask. Her chest was clear with bilateral equal air entry. Her abdomen was soft and lax, and the surgical wound was covered with a dressing. The pelvic drain contained hemoserous fluid measuring around 450cc and urine output was adequate. Repeated hemoglobin level post-transfusion was 10 g/L, and her white blood cell count was 15 g/L. Electrolytes were balanced and double antibiotic coverage was initiated along with and anti-stress medications. On post-op day 3, the patient was transferred back to the Gynecology ward. She was discharged home in a stable condition five days after surgery.

Please include:

Assessment

Diagnosis

Planning

Implementation

Evaluation