NR 508 Week 5 Discussions 1 (Part Two) Recent
NR 508 Week 5 Discussions 1 (Part Two) Recent
discussion part two
the patient is diagnosed with a severe urinary tract infection (pyelonephritis), and you decide to prescribe him sulfamethoxazole/trimethoprim (smx/tmp) beginning with 2 g initially as a loading dose, followed by 1 g as a maintenance dose bid. over the next couple of weeks, the symptoms associated with his uti diminish, and his mental status improves. however, ms. webb brings him back to your clinic with symptoms, which scare her yet again, and she explains that she thinks he may have a relapse of his uti. these symptoms include a high fever (103.6°f) and tachypnea, and upon pulmonary examination at your clinic, you hear crackles, and find classic findings of lung consolidation.
what laboratory tests should you order, and what is your primary diagnosis at this point and subsequent steps in his treatment and management?
once explained, please indicate and describe your chosen pharmacological treatment with inclusion of dose and mechanism of action of your chosen prescription. NR 508 Week 5 Discussions 1 (Part Two) Recent
discussion part one
elliot is a 74 year-old male who presents to your clinic with complaints of frequent nosebleeds (4 in the past week) and several severe bruises scattered variously throughout his anatomy. the patient is also complaining of a runny nose, cough, and head/chest congestion. he has a history of chronic atrial fibrillation and is currently prescribed and taking warfarin. approximately 3 weeks previously, he started taking over-the-counter cimetidine for heartburn he was experiencing. below is a list of the patient’s medications, his physical examination, and his laboratory findings:
medications
digoxin 0.25 mg qd cimetidine otc bid
pseudoephedrine sr 120 bid warfarin 7 mg qd
allergies: nkda NR 508 Week 5 Discussions 1 (Part Two) Recent
physical examination
vs: bp: 180/95, hr 75, irregularly irregular, rr 17
weight: 95 kg
heent: wnl NR 508 Week 5 Discussions 1 (Part Two) Recent
abd: + bowel sounds ext: bruising on arms and legs
neuro: alert & oriented x 3 gen: well developed, well-nourished male
ecg: atrial fibrillation
laboratory
na 143 meq/l k 4.5 meq/l
cl 99 mmol/l co2 25 meq/l
bun 18 mg/dl scr 0.9 mg/dl
inr 4.8 hct 42% NR 508 Week 5 Discussions 1 (Part Two) Recent
hbg 15 mg/dl digoxin 3.8 ng/ml
what problems should be identified in this patient? NR 508 Week 5 Discussions 1 (Part Two) Recent
what are the precise mechanisms of action of each drug?
what do you think is contributing to the patient’s hypertension?
are there any drug interactions that you can identify as associated with this current drug regimen, and if so how, mechanistically, are they occurring?
what is the clinical significance of these interactions? NR 508 Week 5 Discussions 1 (Part Two) Recent
Description
Feedback Questions for Peer Presentation Reviews
Consider the following points when composing your review of a classmate’s presentation:
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- How effective was the presentation?
- What did the classmate do well? NR 508 Week 5 Discussions 1 (Part Two) Recent
- What elements of the presentation could be improved for future work?
- Is the material presented in a clear and concise manner?
- If there is one thing that you could learn from this person’s presentation and apply to your own future work, what would it be? Why did you pick that element?
- Does the color scheme really work for the presentation or against it? Why?
- How strong is the audio recording that accompanies the presentation? Is there anything you would suggest to improve next time?
- Does the presentation make a strong first impression? Why or why not? NR 508 Week 5 Discussions 1 (Part Two) Recent
- Does the presentation leave a solid lasting impression? Why or why not?
- Summarize your general thoughts on the presentation and applaud the best parts of the work.
Description
Answer the following BOLD questions. Answer does not need to exceed more than a couple of paragraphs.
What do you think of Chinua Achebe’s claim that the racism of works like Heart of Darkness precludes us from considering them great works of literary art? NR 508 Week 5 Discussions 1 (Part Two) Recent
Note that there are several ways of addressing Achebe’s claim. One might agree with it, and then explore its implications for our evaluation of other works in the traditional canon. One might agree with it, and then explore its implications for other “isms,” like sexism, heterocentrism, etc. Or one might contest Achebe’s claim, for example by arguing that the artistic merit of a work’s “technical” qualities can outweigh any moral/ethical problems with its plot/characters (as, for example, is sometimes argued on behalf of Nabokov’s novel Lolita), or even that our literary judgement should not depend on moral/ethical considerations at all.
Whichever way you choose to answer, your essay should at least mention the arguments of Edgar Allan Poe in “The Poetic Principle” and Walter Pater in Studies in the History of the Renaissance.