Mrs. ramirez was admitted to the hospital for wrist surgery secondary to rheumatoid arthritis. postoperatively, she is stabilize
d and transferred to the general surgery unit. mrs. ramirez's medications include digoxin, lasix, captopril, synthroid, aspirin, protonix, and prednisone. when administering morning medications, mrs. ramirez refuses her aspirin and prednisone, and the nurse holds the medications. over the next 3 days, mrs. ramirez continues to refuse the prednisone, and the medication is not administered. on the third postoperative day, mrs. ramirez becomes hypotensive, tachycardic, and has a decrease in level of consciousness. stat labs are sent for a complete blood cell count and chemistry panel, and the physician is notified of the change in patient status. on review of the patient's record, the physician notes that mrs. ramirez has not received her prednisone for 4 days. mrs. ramirez has been on prednisone for the past 5 years for her rheumatoid arthritis, and the physician begins to treat the patient for acute adrenal insufficiency. a. what other clinical manifestations should the nurse monitor for with suspected adrenal insufficiency?
b. the physician orders a stat dose of iv hydrocortisone. what is the rationale for this medication in this situation?
(a) This is a case of iatrogenic cause of acute adrenal insufficiency and can present will signs and symptoms related to glucocorticoid insufficiency. Other clinical manifestations to be monitored are fatigue, weight loss, myalgia, fever, anemia, lymphocytosis, hypotension, and hyponatremia.
(b) The first step in managing a case of acute adrenal insufficiency is immediate rehydration therapy with PNSS. The doctor gave a stat dose of IV hydrocortisone for replacing the lack of glucocorticoids to achieve physiologic levels of glucocorticoids in the body.
petroleum is formed when large quantities of dead organisms, mostly zooplankton and algae, are buried underneath sedimentary rock and subjected to both intense heat and pressure.
By providing the numbers in which methane is more powerful than carbon dioxide the author is appealing to the scientific facts to convince people that the greenhouse effect is destroying our planet, and that global warming is a reality that we must counter attack and treat as a priority.
Explanation:
For anyone with this question as a multiple choice question, itś D.
Heredity can be defined as a biological process that involves the passing on of characters or traits from parents to their offsprings genetically. These traits can be physical for example, height, colour of eyes or mental for example, intelligence.
