NR 507 Week 3 Discussion (Parts 1, 2, 3) + Quiz Answers 2025

NR 507 Week 3 Discussion PART No. 1: A 17-year-old African American from the inner city complains of severe chest and abdominal pain. Upon examination the attending physician performs and EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming, she is drug seeking he sends her home. She comes back to the ER four hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings. · What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least three (3) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why. · Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your differential? · How do you treat this patient now? Are they any preventative actions that could have been taken? PART No. 2: Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia (GERD) with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back (Orthopnea). This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 F, R = 20. · Write three (3) differential diagnoses in this case and explain how each item in your differential fits and how it might not fit. · What tests would you order? What immediate treatment would you consider giving this patient and what treatment when he went home? Assume your first differential is definitive. · Now, he comes back to your clinic 3 months later and both his ankles are slightly swollen. What possible explanations are there for this observation? CHF now involving right side Must order Echo with EKG and Nuc stress test, labs Pro BNP. PART No. 3: A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm bells are set off. The vitals are: P = 116, R = 22, T = 98.6 F, BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64). Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus. · Explain the murmur from a mechanistic view of the hearts physiological functioning? · What is the epidemiology of a patent ductus arteriosus? · How is a patent ductus arteriosus treated? NR 507 Week 3 Quiz Answers: 1. The underlying disorder of _____ anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B12.(Points : 2) 2. What is the pathophysiologic process of aplastic anemia? (Points : 2) 3. The body compensates for anemia by (Points : 2) 4. A woman complains of chronic gastritis, fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit levels, and a high mean corpuscular volume. These findings are consistent with _____ anemia. (Points : 2) 5. In hemolytic anemia, jaundice occurs only when (Points : 2) 6. Symptoms of polycythemia vera are mainly the result of (Points : 2) 7. Which proinflammatory cytokines are responsible for the development and maintenance of DIC? (Points : 2) 8. Which of the following is a description consistent with acute lymphocytic leukemia (ALL)? (Points : 2) 9. Heparin-induced thrombocytopenia (HIT) is described as a(n) (Points : 2) 10. Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)? (Points : 2) 11. Hemolytic disease of the newborn can occur if the mother is (Points : 2) 12. Polycythemia occurs in a fetus because (Points : 2) 13. The type of anemia that occurs as a result of thalassemia is (Points : 2) 14. The sickle cell trait differs from sickle cell disease in that the child with sickle cell trait (Points : 2) 15. Hemophilia B is caused by clotting factor _____ deficiency. (Points : 2) 16. What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?(Points : 2) 17. An individual who is demonstrating elevated levels of troponin, creatine kinase (CK), and lactic dehydrogenase (LDH) is exhibiting indicators associated with: (Points : 2) 18. What alteration occurs in injured endothelial cells that contributes to atherosclerosis? (Points : 2) 19. Which of the following is manufactured by the liver and primarily contains cholesterol and protein? (Points : 2) 20. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes? (Points : 2) 21. When does systemic vascular resistance in infants begin to rise? (Points : 2) 22. An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect? (Points : 2) 23. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? (Points : 2) 24. The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.(Points : 2) 25. Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click? (Points : 2)

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Discussion: Diagnosis and Management of Skin Disorders 2025

Dermatologic disorders can present due to an actual skin problem or as the result of a systemic problem that manifests in the skin. Depending on the type of disorder, the presentation might be unique, making a quick diagnosis possible. However, some disorders have similar presentations in terms of symptoms and appearance, making diagnosis more difficult. Skin color and tone can also contribute to difficulty in diagnosis, making it important to consider cultural variations during assessments. In this Discussion, you examine the following case studies of skin disorders. Case Study 1 An adolescent presents to your office with a complaint of an itchy, red rash that first appeared on his lower legs 1 week ago after he returned from a camping trip. The rash has since spread to the upper legs, trunk, and groin. He denies fever or other systemic symptoms. Case Study 2 An 8-month-old presents to your office with a rash on both cheeks that has progressively worsened over the last week. Mom first noticed the rash after his 6-month checkup. He has generalized dry skin and rubs at his cheeks often. Case Study 3 A 24-month-old presents with a red rash that began on his trunk yesterday and has now spread to the face and upper extremities. His grandmother reports that earlier in the week, the toddler had intermittent fevers up to 101.5°F without other symptoms. The fever broke approximately 48 hours ago and the rash began a few hours later. Case Study 4: You see a 9-year-old male who presents with a white, scaly patch on the back of his head. There is some alopecia in the area with hair breakage noted at the scalp. To prepare: Review the DermNet NZ and Dermnet Skin Disease Atlas websites in this week’s Learning Resources. Select one of the four case studies of skin disorders. Analyze the skin disorder in the case you selected including lesion type, lesion distribution, color, and any ancillary findings. Consider a differential diagnosis for the skin disorder in the case study you selected. Determine the most likely diagnosis for the patient. Think about a treatment and management plan for this disorder. Consider appropriate dosages for any recommended treatments. By Day 3 Post an explanation of the skin disorder in the case study you selected. Include in your explanation the lesion type, lesion distribution, color, and any ancillary findings. Then, present a differential diagnosis and explain which is the most likely diagnosis for the patient and why. Finally, explain a treatment and management plan for the patient’s skin disorder, including appropriate dosages for any recommended treatments.

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