Case Study 6:

Brenda Zalewski, a 45-year-old woman, had a goiter as a child and a thyroidectomy at age 12. She has been taking a synthetic thyroid preparation since that time. Ms. Zalewski takes a maintenance dose of levothyroxine (Synthroid) 0.1 mg orally daily. She is 5 feet 8 inches tall and weighs 215 pounds.

While Ms. Zalewski is in the hospital, the nurse is administering her medications. Hospital routine is to administer all once-daily medications at 9:00 AM. When reviewing the medication administration orders, the nurse notes that Ms. Zalewski is to receive levothyroxine at 9:00 AM. Patients usually receive their breakfast trays between 8:00 and 8:30 AM.

1. What action should the nurse take with regard to the administration of Levothyroxine?

Ms. Zalewski has been discharged from the hospital and is being seen by the home care nurse. During the visit, the nurse reviews all of Ms. Zalewski’s medications. Ms. Zalewski states she is taking aluminum hydroxide gel (Amphojel) every morning when she arises to prevent gastric distress after breakfast.

1. How will the administration of Amphojel affect her levothyroxine?
2. What patient teaching should the home care nurse provide to Ms. Zalewski?

Rubric

Find 3 different Mission Statements from Health Care Facilities you would like to work for in the future. What values and other aspects would attract you to work at each specific site?

The 5 General Topics of Disease Summary Skin Disorders: Dermatitis and Skin malignancies

1. Etiology & risk factors

2. Pathogenesis: The molecular mechanism of the disease process (How the disease process evolves)

3. Clinical Picture: Signs& Symptoms, Sequelae, and Complications

4. Diagnosis: Labs & tests (as well as screening tests and follow up tests whenever applicable)

5. Pathophysiologic rationale of treatment

 

This summary should cover two topics: 1. Different types of Dermatitis.         2. Skin malignancies

 

Dermatitis

Types: Atopic dermatitis

Allergic contact dermatitis

Irritant contact dermatitis

Stasis dermatitis

Seborrhoeic dermatitis

Etiology& pathogenesis of each type:

Clinical Picture of each type: Use pictures of the lesions seen in each type with their description

Diagnosis: by the C/P

 

Skin malignancy

Types: Basal cell carcinoma.       Squamous cell carcinoma.          Melanoma

Clinical picture of each type: Use pictures

As for Melanoma focus on the criteria of malignant transformation of a benign nevus to a malignant one.

Diagnosis: Skin biopsy

 

 

 

Please see the instructions attached. This is the textbook information McCance, K.L., Huether, S. E. (2018) Pathophysiology: The Biological Basis for Disease in Adults and Children. (8th Ed) St. Louis, MO. Elsevier Mosby ISBN-13: 978-0323583473 ISBN-10: 9780323583473

Obstructive Uropathy & APSGN

 

The 5 General Topics of Disease Summary

1. Etiology & risk factors

2. Pathogenesis: The molecular mechanism of the disease process (How the disease process evolves)

3. Clinical Picture: Signs& Symptoms, Sequelae, and Complications

4. Diagnosis: Labs & tests (as well as screening tests and follow-up tests whenever applicable)

5. Pathophysiologic rationale of treatment

 

This summary should cover TWO TOPICS: Acute Post-Streptococcal Glomerulonephritis (APSGN)& Obstructive Uropathy.

 

Acute Post-Streptococcal Glomerulonephritis (APSGN):  IN PEDIATRIC PATIENTS

1. Etiology:

Group A beta-hemolytic streptococcal infection followed by an autoimmune reaction.

2. Pathogenesis:

The molecular mechanisms of the steps that follow the strept. Infection and leads to the development of glomerulonephritis as an autoimmune disorder.

3. Clinical Picture:

Signs and symptoms of the condition and possible complications.

4. Diagnosis:

Lab and other tests used to diagnose the condition.

 

Obstructive Uropathy:

1. Etiology:

Talk about all the different causes that obstruct the urinary tract (stones, strictures, tumors, BPH)

Then focus on STONES & BPH

2. Pathogenesis:

Talk about types of stones and the risk factors of developing these different types of stones.

Talk about BPH and the cellular/molecular mechanisms involved in the development of this condition

3. Clinical Picture:

Signs & symptoms of urinary tract stones and BPH as well as their complications

4. Diagnosis:

Labs & other tests to diagnose these two obstructive uropathy disorders

5. The pathophysiologic rationale of treatment:

Especially for meds used for BPH

Please see the instructions attached. This is the textbook information McCance, K.L., Huether, S. E. (2018) Pathophysiology: The Biological Basis for Disease in Adults and Children. (8th Ed) St. Louis, MO. Elsevier Mosby ISBN-13: 978-0323583473 ISBN-10: 9780323583473

Describe the purpose of and the assessment steps to the primary assessment. Discuss the purpose of the secondary assessment and what is included with this procedure