Reference no: EM133595755
Case Study: Mr. Taft is a 74-year-old man who was admitted to the Emergency Department (ED) for fatigue and fever of 3-week duration. The patient had a history of chronic obstructive pulmonary disease, ischemic cardiomyopathy, hemorrhagic stroke, which had caused cognitive impairment and difficulties in mobilization, HCV-related hepatopathy, obesity, diverticula, and an aortic abdominal aneurysm treated with an endoprosthesis one year earlier.
Two days before admission, he went to the ED for confusion and was discharged within a few hours with a diagnosis of progressive cognitive impairment.
At the ED, the patient had mild confusion, but the physical examination was otherwise normal. Temperature 102.0° F, HR 103, Resp 28, Blood Pressure 154/88.
A chest X-ray study was negative for acute lesions. On admission to the medical unit, blood tests were ordered & showed signs of inflammation and an elevation of procalcitonin. The physical examination showed abdominal tenderness, but there was only mild abdominal pain with no signs of peritonitis.
Questions:
1. Explain the purpose of each of the following tests:
- Complete blood cell count (CBC) with differential
- Basic chemistry profile
- Liver function test (LFT), measurement of lactate dehydrogenase level
- Erythrocyte sedimentation rate (ESR)
- Antinuclear antibody (ANA) rheumatoid factor (RF), c-reactive protein (CRP) level
- Procalcitonin
- Tuberculosis skin test (PPD skin test)
- Two to three sets of blood cultures, urinalysis, urine culture
- Chest x-ray
2. What do you think is going on with Mr. Taft? What are your thoughts?
3. What additional information do you want and why?
4. Why is procalcitonin considered a promising diagnostic marker for sepsis and antibiotic therapy?
5. Should this patient be started on oseltamivir?
6. Would it be appropriate to start Mr. Taft on linezolid? Why or why not?
7. Based on the case study:
- Write two to three nursing diagnoses
- Identify three nursing interventions for each diagnosis