Isaiah is a 73-year-old who presents with complaints of left…

Isaiah is a 73-year-old who presents with complaints of left flank pain for the last week.  The pain is gradually worsening and radiates from the lower thoracic area around to the abdomen.  He describes the pain as burning, “almost like little electrical shocks” and now has a deep ache and throb accompanying the electric shocks.  He states he has been able to sleep at night, but did have to take 400 mg of ibuprofen last night to do so.  He denies pain with urination, frequency, urgency.  No change in bowel movements and he is eating and drinking normally.  Upon entering exam room he is sitting quietly on the exam table and repositions self easily for exam.  Urinalysis is negative for blood, leukocytes, nitrites.  What is the best plan of care? 

Ted Smith is a 48-year-old who presents with complaints of s…

Ted Smith is a 48-year-old who presents with complaints of sharp chest pain in his mid-sternum for 2 days duration. The pain has been steady and radiates to his left arm, worsened by swallowing and deep breathing; relieved by sitting up or leaning forward. He notes occasional tightness in his chest but denies shortness of breath, cough, or diaphoresis. This is his first episode of chest pain, but he worries that he may be having a heart attack because his father died of an MI at age 51. Based on his history, your top 4 differential diagnoses would include:

Anna, a 38-year-old, presents to clinic with a recent sinus…

Anna, a 38-year-old, presents to clinic with a recent sinus infection, left lid swelling, conjunctival chemosis and injection, and pain with eye movement. The patient tells the NP she is having a hard time seeing. Upon physical examination, the patient also has proptosis and diplopia and is febrile. What is the APRN’s best plan of care for Anna?