Get Answer: Drugs Affecting Hematological Question Guide

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Original Question

I. Drugs Affecting the Hematological System Complaint 9 month well child examination History Josiah is a 9-month-old who presents to clinic for a well-child examination. He appears healthy with no parental concerns. His height is 28.5 inches (60th percentile), weight is 9.8 kg (70th percentile), and head circumference is 18 inches (60th percentile). His growth is consistent along the growth curve. The infant’s diet is as follows: breastfed, some solids, mostly family diet pureed for baby, and no meats yet. He does not like iron-fortified baby cereals but likes crackers and teething biscuits. His mother gives him vitamin D drops daily and no other supplements. Assessment Josiah is alert, pulls to a stand, babbles, and is interactive. The anterior fontanelle is flat. His skin is pale and conjunctiva is slightly pale. His skin is pink and warm, with no bruising. The rest of the examination is within normal limits. Finger stick hemoglobin (Hgb) is 10.2. 1. What would be the initial management plan for an infant with anemia? List 4 interventions. 2. What would be the management of an infant with anemia at the four-week follow-up examination? Provide 3 interventions for management. II. Drugs Affecting the Immune System Complaint Sports physical History A 13-year-old female is playing lacrosse and volleyball and presents to clinic today for her sports physical and immunizations. She is healthy and has no prior injuries or illnesses other than an occasional upper respiratory tract infection. Case Study 3 Immunization History She has had all her vaccines through the “kindergarten” shots: Three Hepatitis 3 Five DTaP, Four Hib, Four Polio , Two MMR, Two Hepatitis A, Varicella disease at age 4 years Assessment Physical examination is within normal limits. 1. What immunizations are due to be given at this visit? What precautions are taken after the immunizations are provided? 2. What education should the parent and patient receive? 3. When are the next immunizations due? What immunizations will be provided at that time? III. Drugs Affecting the Gastrointestinal System Complaint “My heartburn has been waking me up at night.” History A 47-year-old male patient presents to the clinic with complaints of intermittent nocturnal gastroesophageal reflux. History reveals that he awakens experiencing burning pain substernally and in the back of his throat. This results in “my larynx closing down” and his being “almost unable to breathe.” As soon as he can breathe effectively, he swallows “a lot” of antacid and flushes it down with water. The entire episode is very frightening, and he is often afraid to go back to sleep. Because he already has a problem with mild sleep apnea, he is becoming increasingly tired and unable to function at work due to lack of sleep. He now sleeps only in his recliner. He is also concerned about the substernal pain because his father had a myocardial infarction at age 49 and required coronary artery bypass surgery. He is 5 feet 9 inches tall and weighs 220 pounds (body mass index [BMI] is 32.5), with much of his excess weight carried in his abdomen. He is not a smoker, “occasionally” has three or four beers with friends, and “often” has pizza or submarine sandwiches for lunch with a “diet cola.” He takes no drugs other than the antacid after a reflux episode. Assessment A chest x-ray and electrocardiogram are negative for cardiopulmonary disease, and Greg is diagnosed by history with gastroesophageal reflux disease (GERD). 1. What would be the initial management plan for GERD? Provide 5 interventions for the management plan. 2. What education does the patient need? Provide 3 teaching points.

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