Mr. Reynolds, age 65, is slowly recovering from a recent heart attack. He has a history of emphysema but is having more difficulty breathing. He dislikes medications and any form of therapy.

Question 1

Using normal anatomy and physiology, discuss how impaired ventilation can interfere with cardiac recovery and function.

Answers may vary.

Question 2

Based on the patient’s medical history and his feelings about recovery programs, in conjunction with the patient’s need for medications and other therapies, discuss the need for medication and participation in recovery programs and possible strategies and the roles of other professionals in support of his recovery from the heart attack and to manage his respiratory condition.

JL, a 50-year-old woman, fell and broke the left tibia at the ankle. She is in the emergency department, waiting for the fracture to be immobilized. The leg hurts and she notes that the ankle is swelling. A diagnosis of a simple fracture and sprain (damage to ligaments) is made.

Question 1

What is the cause of pain and swelling? What can JL expect in the days to come as inflammation resolves and healing begins?

Answers may vary.

Question 2

What is the rationale for immobilizing the fractured bone?

Answers may vary.

Question 3

She is told to come back to the fracture clinic in 24 hours to have her cast checked. What could happen to the inflamed tissue if the edema increases in the casted area?

Answers may vary.

Question 4

She reports feeling fatigued and anorexic, and has a low-grade temperature. What is the cause of these symptoms?

Ms. W. is a 55-year-old patient who consulted her physician because of recurrent epigastric pain and nausea and two recent episodes of vomiting, in which the emesis was dark-colored and granular in appearance. Her history includes heavy alcohol use, cigarette smoking, and persistent headaches. She has not followed all her physician’s previous recommendations but has been controlling her headaches by taking two aspirins every few hours. Following tests, a bleeding gastric ulcer was diagnosed.

Question 1

Discuss the factors contributing to Ms. W.’s condition.

Answers may vary.

Question 2

Discuss synergism, antagonism and potentiation as they apply to this case.

Answers may vary.

Question 3

Discuss the potential effects of increased bleeding from the ulcer.

Answers may vary.

Question 4

Discuss issues related to patient compliance.