What information would be important to gather from this patient?

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Homer is a 58 year old male Caucasian who farms in the community. He seeks treatment in the clinic today for complaints of weakness. Homer states that for the past two weeks he has not had any �pep� and that he feels �too tired to finish chores�. His past history includes COPD and hypertension. He admits to a forty-year history of smoking cigarettes, and continues to smoke � ppd. Homer denies chest pain or shortness of breath. Homer has brought his current medications with him, which include: ASA 81 mg daily, Hydrochlorothiazide 50 mg daily, and Aloe Latex (oral herbal). He states to take �a swig� of Aloe daily �for my stomach�. Homer denies any allergies to medications.

? Share your thoughts on possible reasons for Homer�s weakness.
? What information would be important to gather from this patient?
? What tests or procedures would be important to perform?

A physical assessment reveals Homer�s vital signs: T-37.1, P-120, R-24, and BP-108/76. His heart rate is irregular and an EKG demonstrates atrial fibrillation with a rate of 140 bpm. The provider admits Homer to the hospital medical telemetry unit. Standard orders are written for blood tests and cardiac monitoring. His current medications are to continue while he is hospitalized, along with: Digoxin 0.5 mg IV every 6 hours times four, then 0.25 mg by mouth daily.

? Share any concerns you may have regarding these orders.
? What steps would you take in carrying out Homer�s plan of care?

Homer�s lab values are: Hemoglobin 14 (13.5-17.5), Hematocrit 40 (38.8-50), Na 140 (135-145), K 4.6 (3.6-4.8), BUN 18 (7-18), Creatinine 1.3 (0.8-1.3)

? Share any concerns you may have regarding these values.

After the fourth dose of digoxin intravenously, Homer�s heart rate drops to 45 bpm, sinus bradycardia with occasional PVCs. He is complaining of nausea and states to feel �sicker than when I came in.�

? Share your thoughts regarding this condition change.
? What tests, actions, or procedures if any should be performed?
? Outline the mechanism of action of the drugs indicated in this patient.
? List potential drug interactions.

An ethical dilemma is when someone struggles with deciding between two or more alternatives. Follow the step instructions below: Step 1: Review “How to Analyze a Case Study”

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Case Study: April and Jordan worked in a small ad agency in Providence, Rhode Island The firm started five years ago and was making a profit, but barely. The ad agency needed some larger clients and put in a bid for a city government contract. The firm was one of two agencies up for a large government contract to do the ad work for the Providence’s government day campaign. April being preoccupied with a sick child left much of the work for Jordan to do. Having pulled the entire presentation together Jordan went over everything the day before the final client meeting with April. Since April had better speaking skills, they decided that April would present the majority of the work and Jordan would supplement information in a few areas. The presentation was a huge hit. The contract was awarded to the agency garnering April many accolades. So grateful were the owners of the business, they approached April with a bonus check in the amount of $10,000. April was torn because this money would help with the medical bills for her son but at the same time knew that Jordan did all the work and deserved the bonus money. Instructions: This assignment is the first of two assignments. Students will read a case study related to business ethics. In completing the assignment, students will analyze a case study scenario and apply the concepts learned in week 3 by answering a series of question. In completing the assignment, students will answer the questions in paragraph and sentence format. NOTE: 1) There are four classifications of ethical dilemmas: 1)conflict of interest; 2) conflict of loyalty; 3) issues of honesty and integrity; 4) bribes; and 5) whistleblowing. 2) An ethical dilemma is when someone struggles with deciding between two or more alternatives. Follow the step instructions below: Step 1: Review “How to Analyze a Case Study”

Compare the roles of outpatient services and hospitals related to their place within the health care delivery system. How are they similar? How are they different?

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In this this assignment you will be comparing outpatient services to those offered by hospitals. As medical professionals we need to understand the roles of each and how they differ.

Create a PowerPoint presentation that addresses the following:

  1. Compare the roles of outpatient services and hospitals related to their place within the health care delivery system. How are they similar? How are they different?
  2. How have the roles of outpatient services and hospitals evolved from historical times to the present?
  3. Identify three functions shared by both outpatient services and hospitals. How do outpatient services and hospitals differ in their approach to these functions? How are they similar?
  4. Which type of health provider (outpatient services or hospitals) has been most effective in caring for underserved populations? Explain your reasoning.
  5. Are the financial challenges faced by hospitals different from those of outpatient services? How are they similar?

Discuss your final diagnosis and the pathophysiology behind the diagnosis. Calculate the fluids required for fluid resuscitation.

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Case
You are called to a 30 year old male who has been burned in a factory blast. His factory colleagues have rescued him and have continually poured water over him for the last 10 minutes.

Assessment
Alert and oriented but in significant pain, he is speaking in full sentences but his voice is husky.
He has partial thickness circumferential burns to his arms, partial thickness burns to the front of his legs, full thickness to his chest and partial thickness to his abdomen and although he was wearing a helmet at the time he is displaying a singed mustache and eyebrows.
Vital signs, RR 26, SaO2 – not obtained, PR 128 palpable at the radial pulse, BP not obtained,

PMHx
Nil known allergies
No significant past medical history
No significant family history

What do you know about the patient? What is the key information? What do you still need to find out?

Outline 3 provisional diagnoses.

Discuss your final diagnosis and the pathophysiology behind the diagnosis. Calculate the fluids required for fluid resuscitation.

Discuss the implications for paramedic practice.