Patient: M.C Date of Birth: 3/06/1996 Date of Exam: June 9, 2015 Chief complaint: “I am stuffed up and my eyes are watering and itchy.” Subjective History of Present Illness: M.C is a 19 year old male that presents to the office complaining of sneezing, nasal congestion, watery, itchy eyes, and rhinorrhea that have progressed over the last eleven days. His symptoms tend to be worse in the mornings when he wakes up and he has had a sore throat upon awakening that improves as the day progresses. He has also been getting mild sinus pressure 2/10 pain located around the eyes, that are relieved with OTC Tylenol. He has recently moved to Tampa from New York and has not had symptoms similar to this before. He does mention, however, that in the past smoke has caused him to get itchy …show more content…
Conjunctivitis - Patient has conjunctival injection with clear watery discharge. The patient does not, however, present with typical eye crusting. Plan Flonase 50 mcg spray OTC - instruct patient to use to use one spray per nostril daily and increase to two sprays per nostril daily if no improvement. Instructed patient on proper use of the nasal spray and to avoid spraying medication directly into nostril. Allegra 180 mg OTA - this medication should not make the patient drowsy and since he is a student it is helpful so that he does not get tired during class and can study. If the patient feels like the Mucinex is helping he can continue to take it, if not, he may discontinue it. The patient was also instructed to try and avoid triggers of his allergies. If running through the park worse his symptoms he might try running on Bayshore instead. If smoke produced symptoms, as he stated they have in the past, he should avoid it. It might be helpful for the patient to keep a journal of triggers as
R.S. has been using the recommended treatment for his condition, which inlcude inhaled short-acting Beta-2 agonist and Theophylline, a bronchodilator, to control his respiratory disease.
Medications used to treat hypothyroidism consist of armour, proloid, synthroid, cytomel and euthroid (Dellipizzi-Citardi, 2011, p.59). Armour is a thyroid tablet consisting of extracts of the thyroid gland. Proloid is also known as thyroglobulin, which consists of purified extracts of a pig’s thyroid. Another name for synthroid is levothyroxine sodium. Cytomel is also referred to as liothyronine sodium. Lastly, euthroid is called liotrex. (Dellipizzi-Citardi, 2011, p.59). Some side effects of these medications are angina and arrhythmias. One nursing implication for these medications is administering a single dose before breakfast with a full glass of water, initial doses are low and gradually increase based on a thyroid function test. (“Thyroid, levothyroxine & liothyronine”, n.d.) Another nursing implication is if a patient has difficulty swallowing the tablet, crush it and put it in five to ten milliliters of water and administer it immediately by either spoon or dropper. (“Thyroid, levothyroxine & liothyronine ”, n.d.)
Concerning his ongoing symptoms, it is likely that he has some mild asthma in association with low-grade rhinosinusitis and intermittent reflux. I have advised him to continue with Nexium, but he will commence Alvesco 160mvg daily and intranasal saline and steroid sprays.
Most patients may begin with symptoms of a runny nose, cold or sinusitis that continue to persist longer than normal upper respiratory infections and fail to respond to therapeutic measures. Even though, not all patients experience all of the symptoms, the severity of the disease is different for each patient. Other symptoms can include: arthritic joint pain, blood in urine, cough (with or without presence of blood), fever, inflammation of the ear with hearing problems, inflammation of the eye with vision problems, lack of energy, loss of appetite, nasal membrane ulcerations and crusting, night sweats, numbness of limbs, pleuritis (inflammation of the lining of the lung), rash and/or skin sores, saddle-nose deformity, weakness, fatigue, and weight
Smith brings his 4-year-old to your office with chief complaints of right ear pain, sneezing, mild cough, and low-grade fever of 100 degrees for the last 72 hours. Today, the child is alert, cooperative, and well hydrated. You note a mildly erythemic throat with no exudate, both ears mild pink tympanic membrane with good movement, lungs clear. You diagnose an acute upper respiratory infection, probably viral in nature. Mr. Smith is states that the family is planning a trip out of town starting tomorrow and would like an antibiotic just in case.
Mom reports that [Name] has had itchy eyes and has been sneezing for about 1-month. Mom plans to take him to [Place] for a visit because she thinks he has allergies.
Dose: 300 mg daily in 1 or 2 doses initially, then after 2 weeks the dose increase as indicated to 450–600 mg daily in 1 or 2 doses. The maximum daily dose is 600 mg.
Discuss the possible drug and excipient-related constrains of the formulation (no identity of the drug was given to you at this
Pulmonary complications of smoked substance abuse. West Med 152: 524-530.
The case study presents a middle-aged male of 57 years old with complaints of a cough for the past couple of months and shortness of breath when climbing stairs. His history that consists of smoking ½ to 1 pack per day for 30 years. He also has
65year old male Bill Mc Donald a current smoker, presents from home with a chronic productive cough, increase shortness of breath at rest, wheezing and increase in lethargy. Bill has a past medical history of chronic obstructed airway disease, recurrent bronchial infections and current pack a day smoker.
Bacterial Conjunctivitis, commonly known as “pink eye”, is one of the most well-known and treatable eye infections for both children and adults. The name was chosen because it is an inflammation of the conjunctiva. The conjunctiva is the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. It is commonly called “pink eye” because of the red color of the eye from irritation and was described as such.