Thank you for referring Ransley Mascurine, a 55 year-old gentleman who currently works as a counsellor and is also an avid body builder. Ransley is a non-smoker and of late, has been consuming alcohol two to three standard drinks each evening. The only regular medication is Lipitor.
Concerning his sleep, Ransley generally retires to bed between 10.30 and 11.00pm with short sleep onset latency. There is a history of snoring and witnessed aponeas. He describes fragmented sleep, but significant sleep maintenance insomnia. There is infrequent nocturia and no significant restless legs symptoms. When he wakes at around 4.30am, he often feels initially refreshed, but within a couple of hours will start to become somnolent and will often nap for half an hour between 1.00 and 3.00pm.
Ransley reports frequent nasal congestion that has been more problematic in the last couple of weeks and I note you have commenced him on some oral antibiotics and prednisolone which seems to be helping.
For the last couple of years his weight has been stable around 82kg.
Examination revealed an oxygen saturation of 98% and blood pressure of 145/90. Oropharyngeal inspection revealed significant crowding (Mallampati class 3) with macroglossia. Chest auscultation was clear and two heart sounds were audible with nil else.
Assessment:
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I have outlined to him the pathophysiology of the disorder and treatment options that are available. He will now proceed to a diagnostic sleep study. He has previously had microsleeps when driving a couple of years ago, but has put in place precautions since and has not had any issues of late. It is imperative that he continues to take very strict precautions when driving. He will also need to look at trying to increase his sleep hour
Chronic sleep loss is becoming more common in modern culture and less restricted to sleep-deprived diseases such as insomnia. Suggested to be the result of a number car, industrial, medical, and other occupational accidents, sleep deprivation is beginning to be recognized as a public concern. As a result, the Centers for Disease Control
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis, which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the most common reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and respiratory crackles in chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010).
As patients grow older, and develop conditions that require prescription and over the counter medications, opportunities for dangerous alcohol/drug interactions increase.
THESIS STATEMENT: Narcolepsy is a sleep disorder that has a specific medical definition, life-changing symptoms, and there are ways in how people treat it.
“Transient insomnia can be caused by temporary situations like arguments, medical illness and jet lag. On the other hand chronic insomnia has many causes. Sleep apnea, over use of caffeine, anxiety disorders, stress and several other factors. The symptoms of insomnia can be noticed right in the morning. When you wake up and are not feeling refreshed from a nights sleep. A person may have difficulty sleeping, toss and turn for hours or fall asleep easily but are awakened very early in the morning. To diagnose a person with insomnia, a patient may keep a record for two weeks of their sleeping patterns, food intake, exercise, etc., and then a physician can base their diagnosis by the reported signs and symptoms. If an insomnia patient does not respond to treatments then they may have a sleeping disorder that requires a specialist” (“Insomnia Encyclopedia“).
In this scenario Mr. Abdul is at high risk of chronic alcoholism mainly causing danger to his liver due to alcohol abuse in which healthy liver cells are replaced by scar tissue. Evidence showed by the Australian Bureau of Statistics [ABS] (2010) that alcoholic liver disease accounted fourteen percent of all deaths due to diseases of the digestive system and of alcoholic liver disease, more males than females died and seventy five percent majority of people aged betw...
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
Drowsy driving is something I have seen and experienced first hand. It is incredibly dangerous, putting others and the driver at a higher risk of harm if one drives while tired. To avoid the chance of getting into an accident due to drowsy driving one needs to pay attention to their condition before they get in the driver’s seat. Warning signs are easy to spot if a person is paying attention to their own physical condition and others are also paying attention before a person departs from a location. Warning signs would include someone looking exhausted or beginning to nod off before even getting in the car. People should avoid driving at very late hours if they haven’t slept since the previous night. Even if one feels fine when first getting
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.
Drowsy drivers who feel like they’re able to drive should re-consider their judgment. Sometimes people feel like they’re able to drive under sleepy conditions but honestly they’re putting themselves and others on the road around them in serious danger. Drivers can prevent drowsiness by taking naps or drinking some kind of caffeine drinks. This can help promote awareness and can improve the safety of the driver driving and also other drivers on the road surrounding the driver.
We experience two phases of sleep which repeat themselves every ninety to one hundred and ten minutes, achieving approximately five complete cycles per night. The phases are non- rapi...
"TEENS, SLEEP DEPRIVATION AND AUTOMOBILE CRASHES . N.p., n.d. Web. 26 Feb. 2014 (Farm Bureau News)
"Sleep Problems". Online Posting care of Keep Kids Healty.com. 20 Apr 2000. 12 Sept 2001. http://www.keepkidshealty.com/schoolageproblems/sleep.html
Sleep is important and necessary for quality mental and physical health as well as quality of life and safety (NHLBI, 2012). People with sleep deficiency are at an increased risk of motor vehicle accidents, are prone to reduced work productivity, and have decreased levels of concentration (Hedges, 2012). Continued sleep deficiency can raise one’s risk for chronic health problems (NHLBI, 2012). Therefore, a consistent sleep pattern is necessary to achieve and maintain quality of life. The nurse can assist the patient suffering from sleeping difficulty in achieving a