You graduated 3 months ago and are working with a home care agency. Included in your caseload is J.S., a 60-year-old man suffering from chronic obstructive pulmonary disease (COPD) related to cigarette smoking. He has been on home oxygen, 2 L oxygen by nasal cannula (O 2 /NC), for several years. Approximately 10 months ago, he was on chronic oral steroid therapy. His current medications include an ipratropium/albuterol
(Combivent) inhaler, beclomethasone (Beclovent) inhaler, dexamethasone (Decadron), digoxin (Lanoxin),
and furosemide (Lasix).
1. On the way to J.S.'s home, you make a mental note to check him for signs and symptoms of
Cushing syndrome. Why?
2. Differentiate between Cushing syndrome and Cushing disease.
3. Your assessment includes the following findings. Determine whether the findings are
attributable to J.S.'s COPD or possible Cushing syndrome. Place an L beside the symptoms
consistent with COPD and a C next to those consistent with Cushing syndrome.
_____ 1. Barrel chest
_____ 2. Full-looking face (moon face)
_____ 3. BP 180/94mm Hg
_____ 4. Pursed-lip breathing, especially when patient is stressed
_____ 5. Striae over trunk and thighs
_____ 6. Bruising on both arms
_____ 7. Acne
_____ 8. Diminished breath sounds throughout lungs
_____ 9. Truncal obesity with thin extremities
_____10. Supraclavicular and posterior upper back fat
4. You inform the physician of J.S.'s assessment. The physician believes J.S. has developed
Cushing syndrome and decides to change his prescription from dexamethasone (Decadron)
daily to prednisone (Deltasone) given on alternate days. Explain the rationale for this change.
5. Identify possible consequences of suddenly stopping dexamethasone (Decadron) therapy.
6. You advise J.S. to take the prednisone (Deltasone) at breakfast. Why?
7. Cushing syndrome can affect memory. Patients can easily forget what medications have been
taken, especially when there are several different medications and some are taken on
alternating days. List at least three ways you can help J.S. remember to take his medications
as prescribed.
8. J.S. states that his appetite has increased but he is losing weight. He reports trying to eat, but
he gets short of breath and cannot eat any more. How would you address this problem?
9. You ask him questions related to the presence gastric discomfort, vision, and joint pain. Why?
10. Differentiate between the glucocorticoid and mineralocorticoid effects of prednisone
(Deltasone).
11. How would your assessment change if J.S. were taking a glucocorticoid that had significant
mineralocorticoid activity?
12. Review J.S.'s list of medications. Based on what you know about the side effects of loop
diuretics and steroids, discuss the potential problem of administering these in combination
with digoxin.
13. You need to assess J.S. for signs and symptoms of an infection. Why?
14. What signs and symptoms of infection do you assess for in J.S.? Select all that apply.
a. Pain
b. Fever
c. Loss of function
d. Palpitations
e. Unusual drainage
f. Localized edema
15. Realizing J.S. is susceptible to infection, you review with him ways to reduce the risk of
infection. Identify four major points to include.
16. In addition to measures to reduce the risk of infection, what other information would you
want to stress to J.S. at your visit? Select all that apply.
a. Drink at least 4000mL of fluids daily.
b. Increase intake of foods high in sodium.
c. Weigh yourself first thing in the morning.
d. Take vitamin and electrolyte supplements as prescribed.
e. Notify the physician if your pulse is lower than 60 beats/min.
f. Call the doctor if your weight increases more than 2-3 pounds in 1 day.
g. Take the furosemide (Lasix) first thing in the morning and again at bedtime.
Glucocortocoids Medications
Fludrocortisone
Dexamethasone
Aminpglutethimide
Metyrapone
Mitotane
Etomidate
The Nursing Process
What nursing assessment will you perform regarding each medication?
What planning and implementation do you need to do for each medication?
How would you evalute the effectiveness of each medication?

Answers

Answer 1

Answer: 1. On the way to J.S.'s home, you make a mental note to check him for signs and symptoms of

Cushing syndrome. Why?

Explanation:

Answer 2

On the way to J.S.'s home, you make a mental note to check him for signs and symptoms of Cushing syndrome.

What is cushing syndrome?

Cushing syndrome is defined as a tumor which is developed by unwanted and unusual growth of cell and this tumor is present in pituitary gland which is situated in the basal part of the brain this also produce a heavy amount of ACTH which produce stimuli to the adrenal glands.

Taking high dose of glucocorticoids for long time can cause cushing's syndrome and the main function of glucocorticoids is to remove pain and it is injected in the joints.The non-hodgkin's lymphoma is the cancer of lymphatic system and condition occurs when a large number of abnormal lymphosides produces in the body and the lymphosides are a type of white blood cells.

The non-hodgkin's lymphoma is treatable disease and it can be treated by medical professionals. The main symptoms of non-hodgkin's lymphoma are fever, stomach, night sweats, swollen lymphnodes and loss of appetite.

Therefore, On the way to J.S.'s home, you make a mental note to check him for signs and symptoms of Cushing syndrome.

Learn more about cushing syndrome here:

https://brainly.com/question/28268078

#SPJ2


Related Questions

HELPPPPP PLZ




Which of the following materials can not be recycled?


paper


aluminum cans


glass


Styrofoam

Answers

Answer:

Styrofoam

Explanation:

because Styrofoam is not recycled

Answer:

styrofoam can not be recycled   Explanation:

What is the main way viruses cause disease in the body

Answers

Answer:

Viruses make us sick by killing cells or disrupting cell function. Our bodies often respond with fever (heat inactivates many viruses), the secretion of a chemical called interferon (which blocks viruses from reproducing), or by marshaling the immune system's antibodies and other cells to target the invaders

Answer:

Viruses make us sick by killing cells or disrupting cell function. Viruses are like hijackers. They invade living, normal cells and use those cells to multiply and produce other viruses like themselves. This can kill, damage, or change the cells and make you sick. Different viruses attack certain cells in your body such as your liver, respiratory system, or blood.

Anyone Please help ?!!!

Answers

1 is 60 BPM as a resting heart rate
I think that’s right I looked it up thanks for the points and god bless

Match the concept to its best description. The act of managing your emotions after you've assessed them. Recognizing, understanding, and choosing how we think, feel, and act. It shapes our interactions with others and our understanding of ourselves. Using all factors that make up emotional intelligence to allow for positive relationship-building and maintenance while working through conflict. The ability to understand your emotions as they happen. Removing the focus from yourself and focusing on others to understand their emotions. A. Emotional Intelligence, B. Self-Awareness, C. Self-Management, D. Social Awarenesss, E. Relationship Management

Answers

Answer:

1. Self management.

2. Emotional intelligence.

3. Relationship management.

4. Self-Awareness.

5. Social awareness.

Explanation:

1. Self management: the act of managing your emotions after you've assessed them.

2. Emotional intelligence: recognizing, understanding, and choosing how we think, feel, and act. It shapes our interactions with others and our understanding of ourselves.

3. Relationship management: using all factors that make up emotional intelligence to allow for positive relationship-building and maintenance while working through conflict.

4. Self-Awareness: the ability to understand your emotions as they happen.

5. Social awareness: removing the focus from yourself and focusing on others to understand their emotions.

Emotional intelligence can be defined as the cognitive ability of an individual or person to be able to recognize his or her emotions, have an understanding of the message being conveyed and knowing how these emotions affect the people around him or her.

Basically, there are five (5) main characteristics or features of emotional intelligence and these are;

I. Motivation (self management).

II. Self-awareness.

III. Empathy (relationship management).

IV. Self-regulation (self management).

V. Social skills (social awareness).

ACTIVITY 1: Identify the following:
1. Causing it to bend or fold.
2. Occurs due to fluid accumulation at the site of the injury
3. Complete tear
4. Causing it to twist.
5. Causing a pull or stretch.​

Answers

Answer:

1. Compressive Forces.

2. Swelling

3. Anterior cruciate ligament (ACL)

4. Shear Forces.

5. Tensile Forces.​

Explanation:

1. Compressive Forces are those that impact the center making it bend or fold.

2. Swelling appears when fluid accumulates due to increased blood flow and blood vessel permeability.

3. The most common anterior cruciate ligament injury is a complete tear.

4. Shear Forces oppose forces toward the different ends of the structure, making it twist.

5. Tensile Forces are the ones that act away from the center of the structure, creating a pull or stretch.​

Approximately how many accidents occurred between 1965 and 1970 inclusive?

Answers

Answer:

about 1800 accidents

what procedure involves implanting a piece of vein on the heart

Answers

Angioplasty is also called percutaneous coronary intervention (PCI). For angioplasty, a long, thin tube (catheter) is put into a blood vessel and guided to the blocked coronary artery. The catheter has a tiny balloon at its tip.

consider chronological age, biological age, psychological age, and social age. When you are 70 years of age, in what order would you want these characteristics arranged, beginning with strength and progressing to weakness?

Answers

chronological, biological, social, and psychological

Use the drop-down menus to select the best answers.
developed cell theory.
studied slices of wood and coined the term "cell."
was the first researcher to isolate and identify specific types of cells.

Answers

Answer: Cell is the basic structural and functional unit of the body of the organism.

Explanation:

The cell theory is related to the discovery of the cells proposed individually by Schleiden and Schwann who studied the plant and animal cells individually. They proposed that all organisms are made up of cells and the cells are the building blocks of the cells. The cell for the first time was discovered by Robert Hook in 1665 under the self constructed microscope in the thin slice of the wood.

Ernest McCulloch and James Till they conduct the experiment to obtain the special type of cells called stem cells from the bone marrow of the mice. These cells have the ability to divide and differentiate at a faster pace.

Answer:

✔ Schwann, Schleiden, and Virchow

developed cell theory.

✔ Hooke

studied slices of wood and coined the term “cell.”

✔ Leeuwenhoek

was the first researcher to isolate and identify specific types of cells.

Explanation:

A 54-year-old male patient arrives in the emergency department complaining of severe chest pain that radiates to his mid-back along with dyspnea. He is morbidly obese, has smoked two packs of cigarettes a day for the past 20 years, and has two immediate family members who have died of heart disease.



1. What does the ED physician suspect is causing the patient’s symptoms?



2. What tests should the ED physician order?



3. Will surgical intervention be necessary, and if so, what procedure?



4. What procedure is typically attempted before surgery, where is that procedure performed, and by what type of physician specialist?

Answers

Answer:

Explanation:

1) The ED physician would most likely suspect that the patient is having a Myocardial infarction.

2) With all of the details provided the physician should order the following tests to be done on the patient in order to locate affected areas, abnormalities, blood type, clots, etc.

EKG , Cardiac catheterization, Blood Type and cross match, Coagulation studies, CBC, and a Full chemistry profile

3) Surgical intervention depends on whether or not the EKG scans come back clean or not if they do not then surgical intervention may be necessary in order to save the patients life. This would be accomplished with a procedure known as Percutaneous coronary intervention

4) Sometimes before attempting surgery an Interventional cardiologists may decide to perform a balloon angioplasty procedure. This basically involves the physician passing a tube through your clotted blood vessel in order to open it and maintain it open.

Mieko and James had unprotected sex for an entire year. What is the celihood that Mieko became pregnant?

Answers

Answer:

90%

(Use if needed: https://quizlet.com/293123367/psyc-106-ch-10-14-flash-cards/)

In reaching an agreement regarding a patient issue concerning negligent care, the patient agrees to reduce the amount of money sought if the healthcare agency agrees to pay for the cost of a new treatment. This scenario is an example of which aspect of meditation?

a. clarifying the problem

B.

negotiating concessions

C.

mirroring or reflecting

D.

constructive controversy

Answers

Answer: B.  negotiating concessions

Explanation:

The negotiating concessions aspect of mediation which falls under the negotiation stage, is where the parties negotiate a settlement that will end the  ongoing conflict. Both parties will have to make concessions with one of the parities making more than the other if they are in the wrong.

This is the case here because the patient has made the concession not to ask for more money if the other party - healthcare agency - pays for the new treatment. The healthcare company also makes the concession of paying for the new treatment. This is therefore the negotiating concessions aspect.

Josie is a freshman student who wants to be popular and attractive to everyone. She is
not happy with her weight, so she tries to diet. However hard she tries, she fails. Angry
at herself, she eats everything she sees. After eating she goes to the bathroom to induce
vomiting.​

Answers

Answer:

?

Explanation:

confused on what you want us to do

maths :How much time will a 500 m long train take to cross a tree if it is moving at a speed of 72
(Hint: Take the length of the train as the distance.)​

Answers

distance=500m=1/2 hours.

speed=72km/hr

speed=distance/time

time=distance/speed

time=1/(72×2)

time=1/154 hour

Explanation:pla mark brainlist

Complete question:

How much time will a 500 m long train take to cross a tree if it is moving at a speed of 72 km/h

(Hint: Take the length of the train as the distance.)​

Answer:

The time taken for the train to cross a tree is 25 s.

Explanation:

Given;

length of the train, L = distance between the train and a tree, d = 500 m

speed of the train, v = 72 km/h

Convert the speed to m/s, since the unit of the distance is in meters;

[tex]v = 72\frac{km}{h} \ \times \ \frac{1 000 \ m}{1 \ km} \ \times \ \frac{1 \ h}{60 \ \min} \ \times \ \frac{1 \ \min}{60 \ s} = \frac{(72 \times 1000) \ m}{(60\times 60) \ s} = 20 \ m/s[/tex]

The time of the motion is calculated as;

[tex]time = \frac{distance}{speed} \\\\time =\frac{500 \ m}{20 \ m/s} \\\\time = 25 \ s[/tex]

Therefore, the time taken for the train to cross a tree is 25 s.

If one parent seal is pure long-whiskered and the other is short-whiskered, what percent of offspring would have short whiskers? (W-long, w- short)

a. 0%
b. 100%

Answers

Answer: a) 0%
Explanation: if one has none and the other has short whiskers, there is not enough off spring to make long whiskers

Describe the significance of carbohydrates, fats, and proteins on health and performance? What are general recommendations for each macronutrient intake? How does body type, health status, and performance goals influence these recommendations?

Answers

Answer:

In this article, we take a closer look at these important macronutrients – what they ... Just tell your clients to eat these three things and they'll fill all the needs their body ... MUFAs support cell health and can help keep your low-density lipoprotein ... no fat intake recommendations other than limiting saturated fat to 10% of total ...

Explanation:

you have to study

The _______ system is responsible for body functions such as growth and reproductive development


Endocrine

Answers

Answer:

Endocrine System

Explanation:

The endocrine system, made up of all the body's different hormones, regulates all biological processes in the body from conception through adulthood and into old age, including the development of the brain and nervous system, the growth and function of the reproductive system, as well as the metabolism and blood sugar

Answer:

Endocrine

Explanation:

solve the riddle
what is as big as you but does not weigh anything?

Answers

Answer:

depresssion

Explanation:

Answer:

your shadow?

Explanation:

Yellow body color is dominant to blue. Which letter should we use in this problem?
a. Y
b. B

Answers

Answer:

You should use Y.

Explanation:

Uppercase letters are used for dominant genes, and Y stands for yellow.

Answer:

A. Y

Explanation:

Because yellow is the dominant color and that is the one you normally use :)

How does sensory memory work?

Answers

Answer:

sensory memory

Explanation:

Sensory memory is one of several memory types that make up your ability to process and recall what you see. Sensory memory is a brief precursor to short-term memory that allows you to process and recall the sensations you take in.

Answer:

I'm in middle ........ sorryyz

What are the advantages and disadvantages of women having children in their mid-to-late
40s?

Answers

Answer:

advantage: people in their 40's are more likely to be more finacially stable than people in their 20's or 30's

disadvantage: the baby is more likely to come out with disablilities

Explanation:

science bwo

Advantage: older people are so financially stable unlike younger adults
Disadvantage: the baby may not be healthy and may have disability’s.

what starts with a p and ends with and n

Answers

Answer:

pen

popcorn

Explanation:

do you need more word lol? like advanced words?

^^

Pain during sports is completely normal and should not be a concern.
Please select the best answer from the choices provided
ОТ
OF

Answers

Pain during sports is completely normal and should not be a concern-

False.

Pain during sports could be the result of an injury, and should be a concern.

False......................... dont ask why

........... is a scalar quantity Distance
A Velocity B. Distance​

Answers

Answer:

distance is the answer..

Answer:

B. Distance is a scalar quantity

When you eat salt, which organ helps eliminate the salt after digestion?​

Answers

Answer:

the kidney lol, it regulates our amount of sodium in the body

Explanation:

The kidney, it tells us the amount of sodium. And it regulates

Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help Help

Answers

Answer:

12. Stomach

14. Nerves

16. Stomach

18. The heart

20. Muscle

22. Lungs

Explanation:

That's my best guess.


Which of the following disorders, conditions, or events is a serious health consequence of poorly-controlled gestational diabetes?

Answers

Answer:

1) Women with gestational diabetes can and do have healthy pregnancies and healthy babies.

2)Most pregnant women get a test for gestational diabetes at 24 to 28 weeks of pregnancy.

3)If untreated, gestational diabetes can cause problems for your baby, like premature birth and stillbirth.

4)Gestational diabetes usually goes away after you have your baby; but if you have it, you’re more likely to develop diabetes later in life.  

5)Talk to your health care provider about what you can do to reduce your risk for gestational diabetes and help prevent diabetes in the future.  

The game officials' role in team sports includes all the following EXCEPT:
A.
enforcing the rules of the competition
B.
starting and ending the competition
C.
choosing which players should be substituted
D.
approving each team's score

Answers

Answer:

C

Explanation:

C

thats the coach's job, not the official's

who uses social media women or man. Is this quantitative or qualitative?

Answers

Answer:

Social media research is the process of analyzing social media data to conduct quantitative (and at times qualitative) research in order to understand how audiences relate to topics, by using tools and data extraction techniques.

Hi, does anyone play baseball. See In my PE class we are learning about baseball and I don't really understand it because I don't play baseball. I know someone here knows baseball or at least play baseball. Please help me.

1. What happens when the ball is foul tipped into the catcher's glove and he hangs on to it? IN BASEBALL

2. I just put another K on the board. What feat did I just accomplish? IN BASEBALL

PLEASE HELP ME :) I WILL MARK YOU BRAINIIEST

Answers

Answer:

1. If a foul tip first strikes the catcher's glove and then goes on through and is caught by both hands against his body or protector, before the ball touches the ground, it is a strike, and if third strike, batter is out.

2. you got another strike out

Explanation:

If it is caught by both hands and his body, before the ball touches the ground it is a strike if third strike batter becomes out.it is according to rule 5.09(a)
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