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This is a 57-year-old female who required inpatient hospitalization due to: brought by ambulance to the Emergency Department via gurney from home presented with alteration in her mental status, lethargic and decreased responsiveness due to intentional overdose- polydrug ingestion. Her medical history was significant for bipolar disorder, chronic pain syndrome, hypertension, alcoholism, obesity, CVA, status post abdominal surgery for gunshot wound. In the Emergency Department, her vital signs included a blood pressure of 155/97 mmhg. She had glucose of 104 (noted as high). Her physical apperarance revealed obtunded but with some verbalization, midposition and reactive pupils, Oral mucosa moist, Obese. After some time, she became more unresponsive
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.
On 02/10/16, Mr. Newsome submitted to a random drug screen. The test was returned positive for Ethyl Glucuronide (ETG). On 02/17/16, Mr. Newsome reported for case management with Crest Aftercare and Probation. Mr. Newsome admitted to drinking 3 beers on 02/08/16. Mr. Newsome was placed on contract with Crest Aftercare. On 06/29/16, Mr. Newsome submitted to a random drug screen. The test was returned positive for Amphetamines. Mr. Newsome did not have any known medication prescribed to him by his primary care physician at the time of the drug screen.
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.
The patient has been facing symptoms including increased thirst, frequent urination, unexplained weight loss, and fatigue. Having these symptoms causes his body to not be able to start cellular respiration, Electron Transport Chain, and the Krebs cycle. The patient's blood glucose level, intracellular glucose levels, and interstitial levels are out of range. The blood glucose levels normal range is between 78-108 mg/dL, but the patients is 130 mg/dL. High blood glucose levels makes your blood mucky. This slows down circulation which causes the cells to not get oxygen and the nutrients that they need. This also causes people to be fatigue. Since he is fatigue he is unable to do cellular respiration. As the cells run out of oxygen they change
Jane had not slept for 72 hours and had poor diet and was observed not to be drinking fluids. Jane has a diagnosis of Bipolar
Coolen, P., Best, S., Lima, A., Sabel, J., & Paulozzi, L. (2009). Overdose deaths involving prescription
An intensive outpatient program is often recommended for treating drug and alcohol abuse. People in an intensive outpatient addiction treatment program will typically get individual and group services 10 to 12 hours per week. Studies have shown that intensive outpatient drug rehab is effective for treating addiction.
There are many differences in emergency services and critical care services. Below is a comparison:
Client self-reported as a 25-year-old, Caucasian, single, employed male referred to clinic by self-due to substance use. Client has a diagnostic impression of 304.00 Severe Heroin Related Use Disorder/Dependence, 304.10 Sedative, Hypnotic, or Anxiolytic Use Disorder/Severe/Sustained Full Remission and 304.40 Amphetamine-type Substance Use Disorder, Severe/Sustained Full Remission. Client appears clinically appropriate for Level 1 OTP with medication assistance due to the following ASAM: Dimension 1: (Medium) Client self-reported moderate withdrawals hot flashes, runny nose, restless legs and achy. Client denies history of seizures, hallucinations or delusions. Client self-reported last use of Heroin was four days ago where he consumed $60 worth
In 1974, the Substance Abuse and Mental Health Services Administration (SAMHSA) created the Drug Abuse Warning Network (DAWN) in order to gather data on drug-related medical emergencies in major metropolitan hospitals in the U.S. There are two basic types of information that are reported. The first is the number of times that someone has been to an emergency department for ANY reason that relates to recent drug use. This can include purposeful or accidental overdoses, the use of illegal drugs, adverse reactions to medication, and recreational use of prescription or over-the-counter drugs. The second is the number of drug-related deaths, as determined by a professional. These are seven major circumstances that are the most addressed when it
Working in an acute care facility and in home health care is different in many aspects. Acute Care is provided to individuals who are admitted to a hospital for a short period of time. They can be treated for surgery, illness, accident, or be recovering from trauma. The main objective in acute care is to discharge the person as soon as they are medically stable. The other health
One of the bigger issues that come up when dealing with medically ill inmates is the cost. When the inmates get older, they start having more illnesses that cause them to need more treatment outside of the prison. They start needing to go to hospitals and having surgeries instead of the medical facility in the prison. If they have to stay in the hospital for a few days, then they need guards to stay with them which costs more money.
form of treatment. There is nothing in her history that hinted at any biological problems.
. She presented to UH clinic for examination after many attempts without examination was possible.
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her