Gastrointestinal Disorders.

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T.H., a 57-year-old stockbroker, has come to the gastroenterologist for treatment of recurrent mild to severe cramping in his abdomen and blood-streaked stool. You are the registered nurse doing his initial workup. Your findings include a mildly obese man who demonstrates moderate guarding of his abdomen with both direct and rebound tenderness, especially in the left lower quadrant (LLQ). His vital signs are 168/98, 110, 24, 100.4° F (38° C); he is slightly diaphoretic. T.H. reports that he has periodic constipation. He has had previous episodes of abdominal cramping, but this time the pain is getting worse. Past medical history reveals that T.H. has a “sedentary job with lots of emotional moments,” he has smoked a pack of cigarettes a day for 30 years, and he had “two or three mixed drinks in the evening” until 2 months ago. He states, “I haven’t had anything to drink in 2 months.” He denies having regular exercise: “just no time.” His diet consists mostly of “white bread, meat, potatoes, and ice cream with fruit and nuts over it.” He denies having a history of cardiac or pulmonary problems and has no personal history of cancer, although his father and older brother died of colon cancer. He takes no medications and denies the use of any other drugs or herbal products.

Identify four general health risk problems that T.H. exhibits.
Identify a key factor in his family history that might have profound implications for his health and present state of mind.

3.The physician ordered a KUB (x-ray study of the kidneys, ureters, and bladder), complete blood count (CBC), and complete metabolic profile. Based on x-ray and laboratory findings, physical examination findings, and history, the physician diagnoses T.H. as having acute diverticulitis and discusses an outpatient treatment plan with him.What is diverticulitis? What are the consequences of untreated diverticulitis?

4.While the patient is experiencing the severe crampy pain of acute diverticulitis, what interventions would you perform to help him feel more comfortable?

5. What is the rationale for ordering bed rest?

T.H. is being sent home with prescriptions for metronidazole (Flagyl) 500mg PO q6h, ciprofloxacin (Cipro) 500mg PO q12h, and dicyclomine (Bentyl) 20mg 4 tomes per day for 5 days.
6.For each medication, state the drug class and the purpose for T.H.
7.Given his history, what questions must you ask T.H. before he takes the initial dose of metronidazole? State your rationale

8.What is a disulfiram reaction?

9. What are the signs and symptoms of an allergic reaction

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Longfellow’s Unique American Hero in Evangeline

A one of a kind American saint unique in long individual in Evangeline: The clarification of Adam’s long individual in the United States is something else. Through the portrayal of the story sonnet Evangelin, the idea of American Adam can be seen in different manners. R. W. B. Lewis investigated the journey for American Renaissance journalists and made a one of a kind American writing in the 1955 content “American Adam in the Nineteenth Century: Innocence, Tragedy and Tradition”.

In 1847, the American writer Henry Wadsworth Long Fellow distributed a long story sonnet about the ejection of the Acadians called Evangeline, delineating an imaginary individual Ivagne. Phosphorus’ quandary. This sonnet got in vogue and got acclaimed. Evangeline oak is a vacation destination in Louisiana. The melody “Acadian Driftwood” recorded by The Band in 1975 speaks to the development and Acadian development. Antonine Maillet composed a novel called Pélagie-la-Charrette because of huge wreck. It was granted to Prix Goncourt in 1979. Fantastic PréPark is Canadian National Historic Site of Grand-Pére, Nova Scotia State and is protected as a landmark to the outcast. It incorporates the commemoration church and the sculpture of Evangeline, the subject of long individual verse. In 2018, Canadian history specialist and writer A.J.B. Johnston distributed YA’s epic called The Hat, propelled by the occasion in the Grand Prix of 1755.

On the off chance that the understudies meet a long individual before attending a university, at that point the writer they know isn’t in this assortment: Evangeline, “Ha Faasha’s melody”, “Million’s romance”. This long individual’s assortment is our “revisionist” long individual in the second 50% of the twentieth century and nearly perceives renowned journalists who may have thought of them, aside from sonnets like “Hymns of life” can not. On the off chance that verse understudies don’t really peruse Long Fellows, he just tuned in to him (in an ordinary case) and they need to know why he is so celebrated.

These are a ton of extraordinary writers. Long Fellow is one of only a handful barely any writers who joined new works. He made a few best sonnets ever. Sonnets of the Evangeline, Haihuasha tunes, and long individual stories, for example, Miles Stendish’s tribute give a sentimental perspective on the early American history and vote based goals. Evangelin is perhaps the longest sonnet at any point composed by an essayist. It is mainstream through the differentiation everything being equal. It is perused, cherished and thought in an unassuming bungalow (Wagonknecht P.85). Evangelin is difficult to misrepresent his style at home and abroad, which is the principal long verse that rose above his own time in American writing (Wagonknecht P.85)

 

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