John Smith, A 52-year-old male patient with a history of hyp…

John Smith, A 52-year-old male patient with a history of hypertension and hyperlipidemia and recently diagnosed with a brain tumor is brought to the emergency department by their spouse with complaints of excessive thirst and urination. Nurses’ Notes   0900: Patient John Smith, accompanied by spouse presents with excessive thirst and urination. Wife states patient was up to bathroom urinating every hour last night.  Patient’s current medications are Lisinopril 10 mg po daily and rosuvastatin 10 mg po at bedtime. He has an appointment with oncologist next week for his newly diagnosed brain tumor.   Vital Signs     Time 0900     Temp 98.2 F     HR 98     RR 23     B/P 118/76     Pulse oximeter 97% on RA     Pain 0     Laboratory Report   Lab Results Reference range Cholesterol 299  mg/dL 240 mg/dL high BUN 20 mg/dL 10-20 mg/dL Creatinine (Serum)        1.3 mg/dL 0.9 to 1.4 mg/dL Glucose        120 mg/dL 70-110 mg/dL Potassium(serum) 3.9 mEq/L 3.5 to 5 mEq/L Sodium (serum) 150 mEq/L 135 to 145 mEq/L Chloride (serum) 98 mEq/L 96 to 106 mEq/L Serum Osmolality 310 mOsm/kg 275-295 mOsm/kg Urine specific gravity 1.001 usg 1.005-1.030 usg After reviewing Mr. Smith’s lab results and clinical presentation, which diagnosis would be appropriate?

A 63 year old male has presented to the ER with complaints o…

A 63 year old male has presented to the ER with complaints of mid-sternal chest pressure that has been ongoing for the last 2 hours.  Nurses’ Notes     1300 63-year-old male patient is being seen treatment area with sternal pain chest pain radiating down left arm that is worse with walking. Pain began 2 hours ago while walking outside. Patient also reports shortness of breath with activity. Reports taking a regular aspirin on the way to the hospital. Vital signs: T- 99 F(37.2C); HR- 110; RR- 28 bpm; B/P- 160/90; Pulse oximeter- 90% on room air; chest pain 8/10. Weight reported at 280lbs/127kg (BMI 35). Started on unit chest pain protocol. Oxygen applied, and nitroglycerin given. A peripheral intravenous line has been placed in the patient’s left arm. Morphine given. Labs drawn.   Laboratory Report     Lab Results Reference range Cholesterol (Total) 250 mg/dl 240 high WBC 10 x 103 cells/mm3 4.5 – 10.5 x 103 cells/mm3 Platelets 400,000/ mm3 140,000 to 450,000/ mm3 Potassium(serum) 3.9 mEq/L 3.5 to 5 mEq/L Sodium (serum) 140 mEq/L 135 to 145 mEq/L Magnesium (serum) 1.5 mEq/L 1.5 to 2.1 mEq/L Troponin T 0.5 ng/ml 0 to 0.04 ng/ml Creatine Kinase MB (CKMB) 170 IU/L 5 to 25 IU/L When the patient was connected to the cardiac monitor the below rhythm was observed.  The heart rate is noted to be 110 beats per minute with the above tracing. What is the nurse’s interpretation of the rhythm observed?