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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
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.
Reporting Party (RP) stated that resident Richard Soto (age 63, DOB: 08/29/53) was admitted to St. Mary's Medical Center for overdsing on lithium and was discharged on 1/1/17. It was reported that 12 hours later, the resident was admitted agin to the hospital for overdosing on pain medication. RP is concerned that resident's medication is not being monitored. RP stated that the resident's medication should be locked and inaccessable to the resident. Staff denied resident having any access to pain medications. RP stated that the resident was "lucky with these last two overdoses and there is concern that the client may not be lucky a third time."
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
Mrs. Who dresses appropriately, well groomed, and appears to be well-developed and nourished: height is 170 cm, weight 74.3 kg, with BMI of 25.7; temperature 37.1, pulse 72 regular, respiratory 16 at ease, blood pressure 128/66, O2sat 99% RA. On examination, her head, eyes, ears, nose and throat are normal; auscultation of the heart with normal S1 and S2 without murmurs, extra sounds, or carotid bruits; JVP without extension; peripheral vascular exam are normal; extremities warm without edema; auscultation of lungs with good air entry bilaterally without adventitious sounds, vesicular throughout; abdominal and urinary exam are negative for pain, mass, and function. Neurologically, she is alert and oriented to time, place and person; mentation
form of treatment. There is nothing in her history that hinted at any biological problems.
Coolen, P., Best, S., Lima, A., Sabel, J., & Paulozzi, L. (2009). Overdose deaths involving prescription
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
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
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.
The patient is an 86-year-old female who was found on the floor by her son. He left the home for approximately an hour and when he came back he found his mother on the floor. She was confused the day prior to admission. She relates that she had insomnia for the past 2 days she was to refill her Ambien came back and took her Ambien she was actually going down the stairs she felt dizzy and fell down. She has a history of vertigo and has been on Meclizine for that and there is also questionable history of loss of consciousness. She has a long-standing medical history of hypertension and dyslipidemia, as well as dementia. Initially on presentation her BP was 132/72, pulse of 60, respirations of 14, she is afebrile and oxygenating well on
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
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.
. She presented to UH clinic for examination after many attempts without examination was possible.