A PNP is completing a history and physical on a 6-week-old m…

A PNP is completing a history and physical on a 6-week-old male infant with a 4-day history of cough and nasal congestion. He occasionally has a bluish tint around his lips while sleeping. No history of fever. Older siblings have upper respiratory infections. Appetite has been decreased due to the copious nasal secretions, but he has a normal urine output. He was delivered at 34 weeks. He had mild respiratory distress syndrome—2 days on a ventilator in the NICU. He went home in 10 days and has done well since. No immunizations. Physical exam reveals mild respiratory distress, respirations 52/min, with slight intercostal retractions. Temperature is 100.2°F, and the PNP knows this a a result of [answer3] such as interleukins and prostaglandins. Other vital signs included: HR 130/min. Perioral duskiness is seen. Oxygen saturation at room air is 83%. HEENT exam otherwise normal. Chest exam shows coarse rhonchi, expiratory wheezes. Heart rate and rhythm regular. No murmurs appreciated. Abdomen is soft and non-tender. Neurological is intact. Chest X-ray shows mild hyperexpansion, no consolidation. The next step would be to perform a nasal swab for [answer1]. The PNP suspects the infant will need [answer2] as part of the supportive care treatment plan.

A NNP is admitting a newborn infant to the unit; he was deli…

A NNP is admitting a newborn infant to the unit; he was delivered at 30-weeks gestation. At birth, the infant weighs 1500 gm (low), but otherwise appeared normal. Soon after birth, the infant becomes cyanotic and breathes with a grunting noise. Chest X-rays reveal dense lungs with significant atelectasis but no cardiovascular abnormalities. This is most suggestive of [answer2], which is due in part to inadequate [answer3] production and secretion. As the weeks progress, the neonate had significant complications, including intraventricular hemorrhage, which has left the baby with neurological deficits. The NNP believes the condition resulted in significant areas of brain cell death, which involves [answer1] necrosis.   

A 39-year-old woman of Japenese descent comes to clinic for…

A 39-year-old woman of Japenese descent comes to clinic for a check-up. She has no chronic disease history. She recalls being told that she had a “touch of sugar” during her last pregnancy. She has two children. Her last child weighed 9 lb 7 oz (4.28 kg) at birth.  Her lipid profile (last check three years ago) was notable for elevated total and LDL cholesterol and elevated triglycerides. She has had some nocturia (about twice a night) but denies any weight loss, polydipsia, increased thirst, or polyuria during the day.  On physical exam, her BMI is 24.3 kg/m2; her blood pressure is 124/74 mm Hg; and she does not have acanthosis nigricans. Her exam is otherwise normal. You prioritize testing for [answer1], which is related to [answer2].