Please review the case presentation below and provide answers to the following;
1. Three differential diagnoses: Pulmonary Embolism, Cellulitis, Muscle Strain / Tear
2. Definitive diagnosis: Pulmonary Embolism
3. Management plan (include appropriate treatment/diagnostic tests) D-Dimer,CBC, creatinine, aPTT ,PT, ABG, if d-dimer is elevated do a CXR, ECG, CT,V/Q scan,Pulmonary angiogram, Echo, MRI, CUS, CT Venography
4. Indications for referral and/or consultations (if needed)
5. Health education/lifespan considerations
6. Schedule a F/U appointment
Case Study: Case IV:
G. E., a 52-year-old social worker, has been treated for a deep vein thrombosis for 2 days. He calls the nurse to come to his room right away. When the nurse arrives, she sees that he is apprehensive, restless, diaphoretic, and extremely anxious. His pulse oximetry reading is 82% (previously had been 97% on room air), heart rate is 116 beats per minute and blood pressure is 100/56 mm Hg. He is complaining of a sharp chest pain that gets worse when he breathes in and has shortness of breath.
Pulse Ox check– 82%
General: Alert & apprehensive
SKIN: Cool & diaphoretic
HEENT: Normocephalic; PERRL, sclera clear, Bil.TMs pearly gray. Pink, moist nasal turbinates. O/P without erythema, masses, or lesions. Pink, moist mucous membranes.
NECK: Supple without LAD
HEART: Tachycardia with S4
RESP: Tachypnea with rales throughout lung fields
ABD: Soft, round, NT with positive BS
APA formatting , references must be no older then 5 yrs old.
Consider a patient receiving combination therapy, perhaps R-CHOP or AC-TH, that includes BOTH a monoclonal antibody or other targeted therapy along with cytotoxic chemotherapy. Demonstrate your understanding of concepts related to combination therapy that includes a monoclonal antibody or targeted therapy by posting how you would explain the following to the patient at a level (e.g., 5th grade) they would understand.
For this discussion, address EACH of the four following points in your discussion post – REMEMBER you are explaining these points to a patient! To earn credit, your post must be at a level the patient can understand (e.g. 5th grade level).
1.What combination therapy regimen are you posting about? (Regimen must include BOTH a monoclonal antibody/targeted therapy plus cytotoxic chemotherapy)
2.How would you explain to your patient the rationale for why they are receiving combination therapy (cytotoxic chemotherapy plus monoclonal antibody/targeted therapy) at a level the patient would understand?
3.How do monoclonal antibodies differ from chemotherapy?
4.What are some important points to discuss with the patient regarding this therapy? Be sure to list 2 key teaching points for EACH agent in the regimen.