Discussion (1) A client with systemic lupus erythematosus (SLE) begins to bleed excessively from her nose and mouth. The nurse suspects antiphospholipid syndrome. What actions should the nurse take? What physicians orders should the nurse expect? discussion (2) Mary, 82 years old, lives in a nursing home. Her family has noticed the following gradually occurring over the past week: agitation, irritability, and confusion; muscle twitching of extremities; and complaints of being thirsty all the time, even after drinking. They have noticed that her urinary catheter bag doest have as much fluid in it, and she looks flushed at times. Mary has had frequent episodes of diarrhea. The nursing staff drew blood for complete blood count (CBC), serum osmolarity, and electrolytes and has been monitoring her BP and heart rate every 4 hr. Her BP has ranged from 86/60 to 88/66, and her pulse range is 105 to 118 and regular. The staff also reviewed her medication profile and discovered that Mary received two extra doses of lactulose that were not ordered. A. Based on Marys presenting symptoms and the nurses knowledge of fluid volume and balance, what does the nurse suspect is happening? B. What treatment options for Mary will need to be discussed with the family?
Discussion (3): Philip, age 60, has been having difficulty catching his breath for about 2 months. He finds he gets short of breath even when resting. He has also been spitting up blood, has a wet cough, and is hoarse. He states that he has had chest pain off and on but now it has become worse. He describes it as central chest pain. Philip was treated for a basal cell carcinoma of his upper lip 12 months ago, and he has been a heavy smoker for 40 years. A. As the nurse caring for Philip, what things would you consider in this case?
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