Reference no: EM133578112

Assignment:

A) Chris Matthews is a 7-year-old male patient whose mother states he has had diarrhea for 3 days. He kept her up all night last night going to the bathroom at least three times. He says his stomach hurts but has not vomited, although he is eating very little. While you are preparing to weigh the patient, he initially does not want to get on the scale and begins to cry. After his mother has persuaded him to get on the scale and you have obtained all the measurements and vital signs, you check his immunization record. While doing so, you see a note on Chris's chart indicating he is home-schooled and his parents are against immunizations. Answer The following question

1) Considering Chris Matthews's age, what special aspects of care should you be aware of while caring for him?

2) What information (chief complaint) should you chart regarding Chris?

3) What screening and diagnostic tests would you perform or assist the licensed practitioner in performing?

B) Peter Smith, a 73-year-old male with mild Type 2 diabetes, calls to schedule an appointment. He states that he is feeling very anxious and fatigued and is having difficulty eating and sleeping since his wife passed away a few months ago. You notice in his medical record that his sleep issues are ongoing and were present before his wife's death. A sleep study was ordered several months ago, revealing mild nocturnal apnea. At that time, Mr. Smith was given a brochure and was educated on behavior modifications to help prevent apnea. When you ask if these seemed to help, Mr. Smith states that he lost the brochure and does not remember what it said. Answer the following question.

1) Considering Mr. Smith's age, what special aspects of care should you be aware of while caring for him?

2) Why would Mr. Smith be prone to falls, and what can you do to help prevent them?

3) You need to collect a urine specimen from Mr. Smith. What special considerations should you take?

4) What symptoms does Mr. Smith have, and why is it important for you to recognize them?

C) John Miller, a 65-year-old male, arrives at the clinic complaining of his shoes not fitting and feeling like he cannot take a deep breath. During the patient interview, he also stated that he is having intermittent pain in his chest. He is taking glyburide 2.5 mg daily, captopril 25 mg twice a day, and HCTZ 25 mg daily. He has not taken the HCTZ for 2 weeks and is hoping to get this medication refilled. The physician wants to evaluate his congestive heart failure. He ordered an ECG and a stress echocardiogram. The patient has not previously had a stress echocardiogram and you need to explain it to him before the test begins.

1) Explain to John the difference between an ECG and an echocardiogram.

2) John expresses concern about having a heart attack during the procedure. How can you alleviate his fear?

3) You must perform an ECG on this patient. Describe the steps in the procedure.

D) Andrea Hochradel arrives to have her Holter monitor removed. She sits down in the exam room, takes the monitor and all the electrodes and wires out of her purse, and plops them on the table. What should you do?