WEEK 14: CASE STUDY ASSIGNMENT CHAPTER 42

minimum of 2 references used for each case study. References must be reputable and within 5 years. Provide a reference page for each case study. Chapter 42 in the textbook must be used for each case study as a reference. Use apa in text citation and reference page.

WEEK 14: CASE STUDY ASSIGNMENT CHAPTER 42

The patient is a 55-year-old alcoholic who scheduled an appointment to see his family nurse practitioner. He tells the nurse practitioner that he has been experiencing a persistent cough and has been experiencing pronounced fatigue and nausea. In addition, he shares that he has been very irritable and is experiencing more memory lapses. His stomach is distended, but on palpation, his liver is small in size and firm, indicating cirrhosis. Lab tests indicate a decrease in hemoglobin, albumin, and prothrombin levels with elevated serum bilirubin and ammonia levels.

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Describe the various stages through which the patient’s liver has progressed and the implications of the current stage.

Provide a specific rationale for each of the patient’s manifestations and blood values.

Is it possible to reverse the damage to the liver at this stage? What is the prognosis by nurse practitioner? Choose four significant complications that likely to occur and discuss the predisposing factors and effects on the liver.

WEEK 14: CASE STUDY ASSIGNMENT CHAPTER 42

The patient is 48 years old and has been admitted to the hospital with severe abdominal pain. Earlier that day she had generalized abdominal pain, followed by a severe pain in the lower right quadrant of her abdomen, accompanied by nausea and vomiting. That evening she was feeling slightly improved and the pain seemed to subside somewhat. Later that night she experienced severe, steady abdominal pain with vomiting. A friend took her to the hospital, where examination demonstrated lower right quadrant tenderness and mild abdominal rigidity. Fever and leukocytosis indicated infection. A diagnosis of acute appendicitis, with possible perforation, was indicated, with immediate surgery.

1. Why is the sequence of pain (location and type of pain) significant in the diagnosis of acute appendicitis? Describe the rational for each type of pain. Does this sequence confirm the diagnosis?

2. Using the pathophysiology, describe the reason for:
The pain subsiding and then recurring

Leukocytosis and fever

Abdominal rigidity

3. Discuss the complications that might arise from rupture of the appendix.