3/25/2020 0 Comments Pathophysiology Case Study EssayPatient Case Question 1: For which condition is this patient likely taking nifedipine? Nifedipine is a calcium channel blocker used to treat high blood pressure and chest pain. Patient’s past medical history indicates that he has had hypertension “for years,†the patient is most likely taking Nifedipine to manage this condition. May also be taking nifedipine so as to prevent chest pain from his past condition of Coronary Artery Disease (CAD). Patient Case Question 2: For which condition is this patient likely taking lisinopril? Lisinopril is an ACE inhibitor that treats high blood pressure and heart failure. Patient could be taking lisinopril in tandem with nifedipine to manage his hypertension and Coronary Artery Disease. Patient Case Question 3: For which Condition is this patient likely taking paroxetine? Paroxetine is used to treat various mood disorders. It is most likely that the patient is taking paroxetine to treat his generalized anxiety disorder, which he has been experiencing for the past 18 months (according to his past medical history). Patient Case Question 4: What is meant by “tenting of the skin†and what does this clinical sign suggest? “Tenting of the skin†involves a skin turgor test. By pulling a fold of skin from the back of the hand, lower arm, or abdomen with two fingers one can assess the ability of the patient’s skin to change shape and return to normal (elasticity). “Tenting of the skin,†indicates that the skin is not returning to normal quickly, which means the person has severe dehydration, a fluid loss of 10% body weight. The result of his skin turgor test indicates late signs of dehydration (patient had skin with poor turgor), and the presence of tenting in the skin indicates the severity of his dehydration. Patient Case Question 5: Are the negative Grey Turner and Cullen signs evidence of a good or poor prognosis? A positive test for Cullen sign occurs when a patient has superficial bruising in the subcutaneous fat around the umbilicus. A positive Grey Turner test occurs when a patient has bruising of flanks (last rib to top of hip), which indicates a retroperitoneal hemorrhage. Both Cullen and Grey Turner signs are used to indicate/predict acute pancreatitis, when these signs are present one has a high rate of mortality (37%). The patient tested negative for both Grey Turner and Cullen signs, so his prognosis is good. Patient Case Question 6: Identify THREE major risk factors for acute pancreatitis in this patient. Patient has sinus tachycardia, paired with the patient’s severe dehydration the patient is showing signs of having acute pancreatitis. Patient also has a history of alcohol abuse and is regularly taking ACE inhibitors, which puts him at a high risk of developing acute pancreatitis. Patient also has diminished bowel sounds that indicate possible acute pancreatitis. Patient Case Question 7: Identify TWO abnormal laboratory tests that suggest that acute renal failure has developed in this patient. Patient’s Blood Urea Nitrogren (BUN) level is 34 mg/dL; which indicates decreased kidney function. Patient has a potassium level of 3.5 meq/L which is below normal range (3.7- 5.2 meq/L), this indicates possible renal artery stenosis. Both of these lab results suggest that the patient has developed acute renal failure. Patient Case Question 8: Why are hemoglobin and hematocrit abnormal? Patient’s hemoglobin level is 18.3 g/dL, normal hemoglobin levels for men are between 14 and 18 g/dL. Patient’s hematocrit level is 53%, normal hematocrit levels are 40-50%. This abnormally high lab results indicate early stages of kidney disease and anemia. Patient has developed acute renal failure, so these test results are as expected for a patient under such conditions. Patient Case Question 9: How many Ranson criteria does this patient have and what is the probability that the patient will die from this attack of acute pancreatitis? Patient has seven points of Ranson criteria. Patient’s WBC count was over 16K, patient is over age 55, patient’s blood glucose level was higher than 200 mg/dL, patient’s LDH level was over 350, patient had high BUN level, and Patient had high fluid needs due to his dehydration. Patient’s predicted mortalitiy is 100% based upon the Ranson criteria, so it is very likely that the patient will die from this attack of acute pancreatitis. Patient Case Question 10: Does the patient have a significant electrolyte imbalance? Patient has a sodium level that is 1 meq/L below normal range, and a potassium level 0.2 meq/L below normal range. This indicates that the patient is having renal complications that are interfering with electrolyte balance. Patient Case Question 11: Why was no blood drawn for an ABG determination? No blood was drawn for an ABG determination because patient’s lungs were clear to no auscultation, so no test was needed to test patient’s blood PH. Also patient had urine with a PH within normal range, so an ABG test was not really needed.
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12/26/2019 0 Comments societhf Adventures Of Huckleberry Finn And Society :: Adventures Huckleberry Huck Finn Essays Adventures Of Huckleberry Finn And Society "All modern American literature comes from one book by Mark Twain called Huckleberry Finn," according to Ernest Hemingway. Along with Ernest, many others believe that Huckleberry Finn is a great book, but is the novel subversive? Since this question is frequently asked, people have begun to look deeper into the question to see if this novel is acceptable for students in schools to read. First off subversive means something is trying to overthrow or destroy something established or to corrupt (as in morals). According to Lionel Trilling, " No one who reads thoughtfully the dialectic of Huck's great moral crisis will ever again be wholly able to accept without some question and some irony the assumptions of the respectable morality by which he lives, or will ever again be certain that what he considers the clear dictates of moral reason are not merely the engrained customary beliefs of his time and place." Trilling feels that Huck Finn is such a subversive character that this will not make people believe in something totally again, because they will fear being wrong like the society in Huckleberry Finn was. I believe this and I think the subversion in the novel is established when Mark Twain begins to question the acceptable morality of society. Twain uses humor and effective writing to make Huckleberry Finn a subversive novel about society in the 19th century. Huck Finn, a boy referred to as "white trash," is a boy that has grown up believing totally what society as taught him. This passage shows an example of how society teaches him. "...And keep them till they're ransomed." "Ransomed? What's that?" "I don't know. But that's what they do. I've seen it in the books, and so of course that's what we've got to do." "Well how can we do it if we don't know what it is?" "Why, blame it all, we've got to do it. Don't I tell you it's in the books? Do you want to go to doing different from what's in the books, and get things all muddled up?" (8-9) This is a conversation between Tom Sawyer and his gang of robbers. This shows how the boys are influenced by society and believe they most follow exactly what is in the books, because that is the right way to do things.
12/23/2019 0 Comments Stochiometry labImmediately turned too navy blue color Same musty looking cloud that floated and did not mix well, brought out the blue lour Immediately changed color to a musty yellow color, not very see through anymore either No Change Caused creamy white substance that did not mix well, not immediate reaction Enhanced light blue color with creamy substance not mixing into the middle Turned to a dark blue color with a hint of brown looking Musty cream cloud that did not mix.Brought out the yellow Made the yellow color a shade darker, not much change Cream specks, mixed better than others, faster reaction as well Darkened the yellow tint and mixed well with original Darker the yellow color, as well as making It seem a hint of orangeMusty cream that mixed a little and faded with a clear looking substance Minimal Change, blended into clear substance Created a dark white color, very hard to see through, thick looking substance No Change Muggy cream that took over the clear color substance, immediate reaction Must cream color, almost looks like a cloud, very enhanced over the black paper More grey colored and more visible to see the bottom Musty cloud, that did not mix but brought the light green out in the dye No change, blended to clear with small hint of green No ChangeGreenish Cream Substance, mixed decently but still see through Teal color created with the musty cream color still around Same teal tint created as solution before Conclusion: Throughout this experiment, I learned that mixing Ionic compounds can cause a different reaction for each. All compounds included sodium, which made it interesting to see the different reactions occur Just by changing one chemical in the compound. The reactions that took place were all physical reactions, mostly being a color change or the addition of the creamy color look. Dark paper makes all colors ore easily spotted, whether a change took place or not.My personal favorite was adding the Nappy simply because it brought out all of the original colors of the solutions. This helped me understand the changes that were taking place as I went throughout the rest of the experiment. For many of the additions, as time passed they became more defined. Ionic compounds typically carry two charges, one positive and one negative. This is why the white participate is formed in all of the equations. Sodium Sulfate and Sodium Chloride both had little to no change to the substance in al reactions, this lead Error could occur in this experiment, but it was very difficult.
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