SOLVED15

Group 1 Subjective data Charlie comes to the neighborhood wellness clinic where you are doing a clinical rotation. He states he has a history of seasonal allergies and asthma. He is complaining of itchy watery eyes, runny nose, and cough. Objective data Eyes https://emory.instructure.com/courses/128605/files/10840425/preview?verifier=S18hh3Fl7Vi6A7RepNpaifIcgKP1RcCDgZvvv7l3 Allergic Conjuctivitis.jpeg Nose allergic salute.jpeg Lung Sounds 1. What history and physical data cues are you noticing that indicate allergy symptoms? 2. In the periphery, the two types of cells in which histamine is synthesized and stored are: and . 3. Histamine causes of arterioles and the capillary permeability of venules. In the lungs, histamine causes . 4. Charlie says he takes diphenhydramine/Benadryl for an allergy, but that he does not like how they make him feel. He explains, “These pills make me sleepy during the day, and I always have a dry mouth. Is the normal?” How would you respond? 5. Charlie states “I feel like I am taking too many of these pills. What would happen to me if I took too many?” 6. Because of the side effects from diphenhydramine, Charlie was prescribed loratadine/Claritin. He asks “Will this medicine make me sleepy too?” How would you respond? 7. The resident prescribed the second generation antihistamine nasal spray azelastine/Astelin for Charlie. The nursing student asks you how azelastine/Astelin is different from other second generation drugs. How would you respond? Patient Progression: 2 months later, Charlie presents with c/o SOB 20 minutes after being stung by a bee. His BP is 82/60 and he is feeling dizzy and SOB. 8. What life-threatening disorder to you suspect Charlie is having? 9. What is the treatment of choice for what Charlie is experiencing? 10. The resident prescribed diphenhydramine/Benadryl. Why is diphenhydramine/Benadryl not the first-line medication for what Charlie is experiencing? 11. Match the inflammation terminology to the description: 1. Histamine a. The enzyme for synthesis of leukotrienes 2. Lipooxygenase b. The primary mediator released in mild allergic reactions 3. Cyclooxygenase c. The enzyme for synthesis of prostaglandins 12. Anaphylactic shock occurs when the allergic reactions continues inappropriately long. The primary substances responsible for continuing the process are: Group 2 Jermaine is a 45-year-old male with a history of multiple sclerosis. He was prescribed prednisone 10 mg QD. 1. The nursing student asks “how do glucocorticoids interrupt the inflammatory process compared to NSAID’s?”. Choose the correct mechanism of action. Each row may have more than one correct answer. NSAIDs Glucocorticoids Inhibits prostaglandin synthesis Suppresses infiltration of neutrophils Suppresses the proliferation of lymphocytes Inhibits leukotriene synthesis 2. What long-term effects do glucocorticoids have on the pituitary and adrenal glands? 3. Jermaine asks “Are there any side effects of prednisone if I take it for a long time?” Identify if the sign/symptom below is True or False as a possible adverse effect of long-term glucocorticoid therapy. a. Osteoporosis b. Growth spurt c. Cataracts d. Peptic ulcer disease e. Infections f. Hypoglycemia g. Cachexia h. Depression i. Peptic ulcer disease 4. Jermaine states “The doctor said that prednisone is a steroid. Will it build up my muscles?” How would you respond? 5. Jermaine asks if he should take the prednisone with food. How would you respond? 6. Jermaine asks if the prednisone should be taken in the morning or night? 7. Jermaine asked if he can take ibuprofen, an NSAID, for minor aches and pains? Explain your answer. 8. Describe the effects of glucocorticoids on metabolism. 9. Identify if the following fluid and electrolyte abnormalities below are related to use of glucocorticoids or as a result of adrenal crisis. Glucocorticoids Adrenal Crisis 1. Dehydration 2. Hyponatremia 3. Hypokalemia 4. Hyperglycemia 5. Hypocalcemia 6. Hypotension 10. Treatment for adrenal crisis includes: 11. Jermaine has been on Prednisone for 4 weeks. He states “I am feeling so much better. Can I stop the Prednisone?” How would you respond? 12. To avoid adrenal crisis patients should be taught to: a. You can skip taking the medication on days you are feeling well. b. When traveling, be sure to pack your medication in your luggage. c. Seek treatment quickly for illness, trauma, and stress. d. If fatigued, take the glucocorticoid at night. a. Take glucocorticoids on an empty stomach to improve absorption. a. Avoid taking NSAIDs while on glucocorticoid because taking both may increase risk of PUD.

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HEALTH SCIENCE
NURSING
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