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CASE STUDY 002: PROFILE OF THE CLIENT Mr. Aponi has had dementia in the past. Mr. Aponi’s dementia makes it difficult for him to react

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CASE STUDY 002: PROFILE OF THE CLIENT Mr. Aponi has had dementia in the past. Mr. Aponi’s dementia makes it difficult for him to react adequately to questions, and he might get agitated and resistant to nursing care. He spits out his meds, grabbing the bedside rail when the nurse tries to turn him, and shouting for his wife to come to his rescue. Study of a Case Mr. Aponi is an 85-year-old man who has had dementia in the past. He lives in a long-term care facility. Mr. Aponi’s frequent incontinence needs the creation of therapeutic communication in order to facilitate ADL care and frequent skin hygiene. When the nurse is first caring for Mr. Aponi, she quickly discovers that talking slowly and gently is the most effective way of focusing the client’s attention and persuading him to follow basic directions like turning side to side. In some ways, the nurse seems uncomfortable speaking to Mr. Aponi as if he were a child. The nurse, on the other hand, notices that Mr. Aponi is calmer when he speaks in this manner, that he responds well to praise and compliments, and that he is quite ful to the nurse in assisting with his own care. On the second day of his care, the nurse notices that Mr. Aponi is becoming more agitated and requires frequent reorientation. Because Mr. Aponi keeps jerking his arm away and screams “no,” the nurse will need the of another person to hold his arm firmly while taking his blood pressure. Mr. Aponi tells the nurse at one point during the day, “A minute ago, there was a small boy in the room. What happened to him?” The nurse realizes there was no small boy in the room, but she is at a loss for words. Mr. Aponi’s remark is ignored by the nurse, who turns her attention to the television. Mr. Aponi does not seem to recognize the nurse or recall that the nurse has been caring for him for the past two days when the nurse says good-bye to him at the conclusion of the second day. After two days of responding to his frequent shifts in behavior, the nurse is pained to see him so confused and emotionally weary. Question 70 What are the signs and symptoms of a pulsatile liver, and what is their clinical significance? Question 71: Can a patient with a prosthetic valve take warfarin during pregnancy or menstruation? Is anticoagulation required in patients who have a repaired ventricular septal defect (VSD) or aortic coarctation? I have a question concerning the Duke criteria for diagnosing infective endocarditis. Is Staphylococcus aureus the most common cause of acute bacterial endocarditis? Question 73 Is Staphylococcus aureus the most common cause of acute bacterial endocarditis? Is this a common symptom of bacterial endocarditis? 74th question describe how a mycotic aneurysm develops in infective endocarditis. 75th question Why are the right valves more typically impacted in infective endocarditis when bacteria enter via the IV route, such as in IV drug users? Question 76 You mentioned that microorganisms in IV drug users move straight to the right ventricle, causing right-heart endocarditis. But, if bacteria also travel through the veins to the right heart in dental 13 Cardiovascular disease 128 operations, why are the left heart valves more typically affected? Question 77: In infective endocarditis, what causes splenomegaly? Question 78 We know that Janeway lesions are caused by infective endocarditis, but is there another condition that can cause them? Question 79 Duct-dependent circulation is another name for patent ductus arteriosus (PDA). What does this statement indicate, and are there any other conditions that are similar to this one? What effect does this condition have on the human body? Question 80: How should a youngster with both congenital and valvular heart disease be treated?

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