06Jan 2022 by
give a simple 200 words paragraph reply to the writing below. You can use same resources.
The patient is taking nifedipine for his history of hypertension. It is a calcium-channel blocker that functions in relaxing blood vessels to prevent strain of the heart, causing blood pressure to lower (MedlinePlus.gov, 2021).
The patient is taking lisinopril as an additional regimen to control blood pressure. Unlike nifedipine, it is classified as an angiotensin-converting enzyme (ACE) inhibitor and lowers blood pressure by dilating the blood vessels to allow more blood to pump through (MedlinePlus.gov,2021).
Paroxetine is a drug under the serotonin reuptake inhibitor (SSRI) classification (WedMD.com,2021). This medication is used to treat mood disorders, OCD, or PTSD. In the patients case study, it is used to treat their generalized anxiety disorder.
Tenting of the skin refers to a method of checking the skins elasticity, or skin turgor, and can determine if an individual is dehydrated (MedlinePlus.gov, 2021). The skin that Is tested is grasped between two fingers to tent it up, then released to allow the skin to return to its normal form. The patients skin remaining tented longer than usual indicates that the patient may be dehydrated.
The Grey-Turner sign is manifestation in the subcutaneous tissue on the lateral aspects of the patients flank that, if present, will display ecchymosis. This can be indicative of necrotizing pancreatitis (Guldner & Magee, 2021). Another indication would by Cullens sign, which is the similar ecchymosis or discoloration but present around the individuals umbilicus. The patient being negative for Grey Turner sign and Cullen sign is a good prognosis.
Three risk factors of pancreatitis that are relevant to this patient includes the alcohol abuse that he faces. According to the Mayo Clinic (2021), excessive alcohol consumption is considered drinking 4-5 alcohol beverages a day, which is minimal compared to Mr. F.C.s 10-12 cans in a day. Another risk factor is high serum triglyceride levels, the normal level being 150 mg/dL or less. The patients triglyceride level of 971 mg/dL is a serious factor contributing to the acute pancreatitis. Lastly, according to the Mayo Clinic (2021), infection or surgeries can be a risk factor for pancreatitis. The patients history of hepatitis C or past abdominal surgeries can be contributing factors.
Two laboratory levels indicative of acute renal failure would be the blood urea nitrogen (BUN) and creatinine. According to the Cleveland Heart Lab (2019), a normal BUN level for a male individual over 19 years old is 8-23 mg/dL and normal creatinine is 0.70-1.25 mg/dL. This patients BUN of 34 mg/dL and creatinine of 1.5 mg/dL shows there is an ongoing kidney injury.
According to the Mayo Clinic (2021), a high hemoglobin and hematocrit level can be caused by dehydration. According to the patient, he has experienced poor appetite and several episodes of nausea and vomiting. These factors contribute to the dehydration and will further alter these blood levels.
Based on the Ranson criteria, there are factors considered including: patient age, WBC level, blood glucose levels, LDH, AST, hematocrit, BUN and creatinine, serum calcium, PaO2, base deficit, and fluid sequestration (Tang, 2019). According to the Ransons criteria calculator, there is a cumulative is 6 points from this patients labs, indicating a 40% predicted morality (MDCalc, 2019).
According to the Cleveland Clinic (2020), the key electrolytes and their normal levels that are analyzed are sodium (136-144 mEq/L), magnesium (1.4-1.9 mEq/L), potassium (3.5-5 mEq/L), calcium (8.5-10.2 mg/dL), chloride (97-105 mEq/L), phosphate (0.87-1.55 mEq/L), and bicarbonate (22-30 mEq/L). The patient does not have a significant electrolyte imbalance.
Arterial blood gases are key to analyze the acid-base balance in a patient and provides information regarding oxygenation and the effectiveness of ventilation (Knott, 2020). Indications include illnesses regarding the heart, liver, kidneys, diabetes mellitus, sepsis, burns, toxins, or ventilated patients. Despite appearing restless and in pain, there was no reporting changes in his respiratory status, indicating no necessity of an ABG.
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