J.B. is a 58-year-old retired postal worker who has been on your floor for several days receiving plasma
pheresis every other day for myasthenia gravis (MG). About a year ago, J.B.
started experiencing difficulty
chewing and swallowing, diplopia, and slurring of speech, at which time he was placed on pyridostigmine
(Mestinon). Before this admission he had been relatively stable. His medical history includes hyperten
sion controlled with metoprolol (Lopressor) and glaucoma treated with timolol (ophthalmic preparation).
Recently J.B. was diagnosed with a sinus infection and treated with ciprofloxacin (Cipro). On admission,
J.B. was unable to bear any weight or take fluids through a straw. There have been periods of exacerbation
and remission since admission.
You note that the nursing assistive personnel (NAP) has just entered these vital signs into
J.B.'s record. What is your immediate concern and why?
You suspect that myasthenic crisis, an exacerbation of myasthenic symptoms, associated with his
infection and probable under medication, is occurring. Clinical manifestations of a myasthenic crisis
are a sudden marked rise in blood pressure, increased heart rate, and elevated respiratory rate with
signs of distress. Immediate intervention is required to avert respiratory failure.
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A group of community members are diagnosed with a chronic illness affecting the same body system. What should the nurse consider as social determinants of health that contributed to the development of the disease process in these individuals?
(Select all that apply.) 1. Age 2. Housing 3. Gender at birth 4. Community violence 5. Office location of employment
An adult client with paranoid schizophrenia lives in a homeless shelter with her 13-year
old-daughter. The mother is fragile but not psychotic most of the time. The nurse establishes a relationship with the daughter and determines that the child has adapted to shelter life, having formed a relationship with one of the shelter volunteers who encourages her to attend school. The teen relates that she has a friendship with a classmate. When she describes this relationship, the nurse determines that the teen is able to exercise both social skills and problem-solving skills. The mobile treatment team asks the nurse to make a recommendation regarding what should be done to assist the teenage daughter. The best recommendation would be to a. suggest foster home placement. b. seek assistance from the domestic violence program. c. make referrals for existing and emerging developmental problems. d. foster healthy characteristics and existing environmental supports.
For many terminally ill children and their families, being at home or in a special facility may be the preferred choice for meeting their complex needs during the dying process. This is commonly known as ____________
Fill in the blank(s) with correct word
Which statement or condition best demonstrates the concept of "multifactorial inheritance"?
A. A mutation in a single gene results in the expression of problems in a variety of tissues and organs. B. The susceptibility to a problem is inherited as a single gene trait but development of the problem is related to environmental conditions. C. A mutated gene is inherited but the results of expression of that gene are not evident until middle or late adulthood. D. Several genes are responsible for the mechanism of hearing and a mutation in any one of them results in hearing impairment.