{"content":{"sharePage":{"page":0,"digests":[{"id":"41469711","dateCreated":"1313632081","smartDate":"Aug 17, 2011","userCreated":{"username":"fielder.cl","url":"https:\/\/www.wikispaces.com\/user\/view\/fielder.cl","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41469711"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"answers","description":"#1 Weight loss, chest pain, shortness of breath
\n#2 Could be tumor compression of cervical sympathetic nerve plexus.
\n#3 Infiltrates in bases and tumor in lower airway
\n#4 Start oxygen and bronchodilator, biopsy of tumor","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41464903","dateCreated":"1313621236","smartDate":"Aug 17, 2011","userCreated":{"username":"swank.re","url":"https:\/\/www.wikispaces.com\/user\/view\/swank.re","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41464903"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"Answers to questions","description":"Answers to questions for group 5
\n1. What symptoms in the history suggest possible Lung Cancer?
\n The presence of blood in the sputum
\n
\n2. What is the importance of the ptosis? (drooping eye lid)
\n A drooping eyelid can signify the tumor is pressing against the cervical nerves.
\n
\n3 What is a possible cause of the patients hypoxemia?
\n The xray stated infiltrates in the bases along with a mass in the RML
\n
\n4 What would be the first thing you would do for this patient?
\n Put patient on oxygen and bronchodilator then have additional testing done to verify if the mass is malignant or benign.","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41463443","dateCreated":"1313616457","smartDate":"Aug 17, 2011","userCreated":{"username":"hcoppus","url":"https:\/\/www.wikispaces.com\/user\/view\/hcoppus","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41463443"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"answers","description":"1.bloody sputum,hard to swallow, SOB weight loss
\n2.perssing against the cervical nerves
\n3.infiltrates in bases
\n4. bronchoscopy for sample","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41445875","dateCreated":"1313553086","smartDate":"Aug 16, 2011","userCreated":{"username":"griffith.nl","url":"https:\/\/www.wikispaces.com\/user\/view\/griffith.nl","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41445875"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"answers","description":"1. productive cough, weight loss, dysnea, diffinculty swallowing, drooping eye lip
\n2. tumor blocking cervical sympathetic nerve plexus.
\n3. infiltrates in bases with mass in airway.
\n4. Put patient on O2 to help with o2 saturation problems, and perform a bronchoscopy to get a biopsy of tumor shown in xray","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41437089","dateCreated":"1313526188","smartDate":"Aug 16, 2011","userCreated":{"username":"dunnigan.el","url":"https:\/\/www.wikispaces.com\/user\/view\/dunnigan.el","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41437089"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"answers","description":"1)Blood in sputum, weight loss, clubbing of nailbeds, dull percussion over RML
\n2)It is a clinical sign that the tumor is compressing the cervical nerves
\n3)Lung infiltrates in the bases with a mass in lower tracheobronchial AW
\n4)Do a sputum culture and MRI to role out or verify lung Ca, also put pt on oxygen and a breathing treatment to open up his AW","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41434183","dateCreated":"1313518943","smartDate":"Aug 16, 2011","userCreated":{"username":"hatfieldt","url":"https:\/\/www.wikispaces.com\/user\/view\/hatfieldt","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41434183"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"Final Posting","description":"Great job! I like the way you listed your "assessment". The only suggestion I would have would be to check for tracheal deviation and list that in your "observation" since patient is having difficulty swallowing.","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41191247","dateCreated":"1312396769","smartDate":"Aug 3, 2011","userCreated":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41191247"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"changed some stuff","description":"hey i changed the ABG values a little the PO2 of 70 didn't make sense with the SpO2 of 89% because 60 is 90 and I made a more vague CXR assesment so then I could make a possible diagnosis in the SOAP. Let me know what u think or if it needs changed.
\nRayann","replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"40861997","dateCreated":"1310761406","smartDate":"Jul 15, 2011","userCreated":{"username":"Schaffner1","url":"https:\/\/www.wikispaces.com\/user\/view\/Schaffner1","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/40861997"},"dateDigested":1531982630,"startDate":null,"sharedType":"discussion","title":"Physical Exam","description":"Patient is in moderate respiratory distress, seems to be very anxious and agitated. Patient has a harsh productive cough. HR is 115 regular, RR 24bpm, and BP of 160\/92. Body temp. is normal, slight peripheral cyanosis. Auscultation discovers fine crackles in the bases on inspiration and slight expiratory wheezing in the right lung. Pulse ox showed a saturation of 89% on room air. CXR shows atelectasis of the RLL with a mass in the lower tracheobronchial airways. His ABG\u2019s are pH 7.37, PaCO2 45 mmHg, PaO2 70 mmHg and HCO3 23 mEq\/L.","replyPages":[{"page":0,"digests":[],"more":0}]}],"more":false},"comments":[{"id":"41086729","dateCreated":"1311869037","smartDate":"Jul 28, 2011","userCreated":{"username":"hatfieldt","url":"https:\/\/www.wikispaces.com\/user\/view\/hatfieldt","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41086729"},"dateDigested":1531982630,"commentId":"482666","orphaned":false,"startDate":null,"sharedType":"comment","title":"Comment: What would you find on inspection (es...","description":"What would you find on inspection (especially nailbeds), palpation and percussion on this patient?
\n
\nGood start!","rangeActions":[{"name":"Comment added","rangeText":"Physical Exam**__==
","dateCreated":"1311869037","user":{"username":"hatfieldt","url":"https:\/\/www.wikispaces.com\/user\/view\/hatfieldt","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/243252731?mode=code"},{"name":"Comment region changed","rangeText":"\u200dPhysical Exam**__==
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","dateCreated":"1312396571","user":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/244149637?mode=code"}],"replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41086725","dateCreated":"1311869037","smartDate":"Jul 28, 2011","userCreated":{"username":"hatfieldt","url":"https:\/\/www.wikispaces.com\/user\/view\/hatfieldt","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41086725"},"dateDigested":1531982630,"commentId":"515240","orphaned":false,"startDate":null,"sharedType":"comment","title":"Comment: May want to make this more recent","description":"May want to make this more recent","rangeActions":[{"name":"Comment added","rangeText":"stress test a year ago that was normal","dateCreated":"1311869037","user":{"username":"hatfieldt","url":"https:\/\/www.wikispaces.com\/user\/view\/hatfieldt","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/243252731?mode=code"},{"name":"Comment region changed","rangeText":"\u200dstress test a year ago that was normal","dateCreated":"1312394420","user":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/244143973?mode=code"},{"name":"Comment region changed","rangeText":"\u200d\u200dstress test a year ago that was normal","dateCreated":"1312395907","user":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/244147953?mode=code"},{"name":"Comment region changed","rangeText":"\u200d\u200d\u200dstress test a year ago that was normal","dateCreated":"1312396571","user":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/244149637?mode=code"}],"replyPages":[{"page":0,"digests":[],"more":0}]},{"id":"41086727","dateCreated":"1311869037","smartDate":"Jul 28, 2011","userCreated":{"username":"hatfieldt","url":"https:\/\/www.wikispaces.com\/user\/view\/hatfieldt","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/res223summer2010.wikispaces.com\/share\/view\/41086727"},"dateDigested":1531982630,"commentId":"954441","orphaned":false,"startDate":null,"sharedType":"comment","title":"Comment: Make sure you include the color of th...","description":"Make sure you include the color of the sputum. What do cancer patients frequently have in their sputum?","rangeActions":[{"name":"Comment added","rangeText":"sputum a day","dateCreated":"1311869037","user":{"username":"hatfieldt","url":"https:\/\/www.wikispaces.com\/user\/view\/hatfieldt","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/243252731?mode=code"},{"name":"Comment region changed","rangeText":"\u200d sputum a day","dateCreated":"1312394420","user":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/244143973?mode=code"},{"name":"Comment region changed","rangeText":"\u200d\u200d sputum a day","dateCreated":"1312395907","user":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/244147953?mode=code"},{"name":"Comment region changed","rangeText":"\u200d\u200d\u200d sputum a day","dateCreated":"1312396571","user":{"username":"osborne.rn","url":"https:\/\/www.wikispaces.com\/user\/view\/osborne.rn","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"diffUrl":"\/page\/diff\/Group+05\/244149637?mode=code"}],"replyPages":[{"page":0,"digests":[],"more":0}]}]},"http":{"code":200,"status":"OK"},"redirectUrl":null,"javascript":null,"notices":{"warning":[],"error":[],"info":[],"success":[]}}