In the laboratory, this type of enzyme is used to cut DNA in…
Questions
In the lаbоrаtоry, this type оf enzyme is used to cut DNA into smаller pieces that can be inserted into plasmids.
Extrа Credit: This questiоn will be grаded аfter the exam and wоrth 5 extra credit pоints. Questions must be answered in full to receive credit. Patient Profile: Mr. Arthur Jenkins is a 72-year-old male with a medical history of NYHA Class III chronic heart failure, long-standing hypertension, and permanent atrial fibrillation. He has been relatively stable on his medication regimen for the past six months. However, during a routine follow-up visit at the cardiology clinic, he reports several new concerns. Current Medications: Lisinopril (ACE Inhibitor) 20 mg daily Metoprolol Succinate (Beta-Blocker) 50 mg daily Digoxin (Cardiac Glycoside) 0.125 mg daily Warfarin (Anticoagulant) 5 mg daily Furosemide (Loop Diuretic) 40 mg daily, which was added two weeks ago by his primary care physician to manage increased peripheral edema. Clinical Presentation: Mr. Jenkins complains of a persistent, non-productive dry cough that keeps him awake at night. He also reports feeling unusually fatigued and "faint" when he stands up quickly from his recliner. Most concerning to him is a recent change in his vision; he describes seeing yellowish-green halos around the lights in his home. Assessment Data: Blood Pressure: 102/64 mmHg (Baseline: 130/82 mmHg) Heart Rate: 54 beats per minute, irregular Potassium Level: 3.2 mEq/L (Normal: 3.5–5.0 mEq/L) INR: 2.5 (Target range for AFib: 2.0–3.0) 1. Based on the sources, which medication is most likely responsible for Mr. Jenkins’s persistent dry cough, and what is the underlying physiological reason for this side effect? 2. Mr. Jenkins is reporting visual disturbances (yellow-green halos) and extreme fatigue. Which medication in his regimen is associated with these specific signs of toxicity, and what is the therapeutic serum range for this drug? 3. The patient's potassium level is 3.2 mEq/L. Explain the relationship between this laboratory finding and the risk of digoxin toxicity. Which recently added medication likely contributed to this electrolyte imbalance? 4. The patient reports feeling "faint" when standing up quickly. Identify three medications in his current regimen that can cause orthostatic hypotension and list one nursing intervention to help prevent falls related to this condition. 5. The nurse notes the patient's heart rate is 54 bpm. According to the sources, what should be the nurse's immediate action regarding the administration of Digoxin and Metoprolol?