[Solved]: PATIENT DESCRIPTIONVivian Armand is a 45-year-old…

PATIENT DESCRIPTIONVivian Armand is a 45-year-old woman who is a practicing registered nurse. She recently traveled to the Caribbean islands with her church as part of a medical mission trip with other doctors and nurses. Since returning she had been having fatigue, cough, fever, night sweats, and has lost 22 lbs. She saw her physician a couple of days ago and he began testing her for tuberculosis. She is now admitted to the hospital under respiratory isolation for hydration and further testing. Upon admission Vivian was tested for HIV and the Rapid Test came back positive. With further questioning about her work and travel history to determine the exact date and exposure to TB and HIV, Vivian revealed that about 10 years ago she was stuck by a needle at work. The physician has ordered further testing for HIV and will begin a TB and HIV treatment regimen. ALLERGY- Pollen Adverse Reaction/AllergyFull Code Advance DirectiveRespiratory Isolation Clinical warningOVERVIEW:Dehydration AcuteTuberculosis AcuteFever AcuteCough, productive AcuteWeight loss AcuteLab TEST:Temp -102.1F, Pulse-86, Respiration-20, BP-118/66, Pulse Oximetry-94%PaO2-86mmHg, PaCO2-45mmHg, ABGs pH-7.36, SaO2-94%, HCO3-27mEq/LCOMPLETE METABOLIC PANEL:Glucose,Serum-82mg/dL, Bun-35mg/dL(High), Creatinine,Serum-0.8mg/dL, Sodium,Serum-145mmol/L, Potassium,Serum-3.4mmol/L (Low), Chloride, Serum-102mmol/L, Carbon Dioxide, Total-32mmol/L, Calcium,Serum-8.8mg/dL, Albumin,Serum-5.0g/dL, Protein, Total, Serum-4.5g/dL(Low),CBC with Differential:Hemoglobin-12.2g/dl, Hematocrit-36.9%, RBCs-4.5cells/mcl, MCV-80fL(Low), MCH-30pg, MCHC-33%, Platelet count-125,000LIPID PROFILE:Cholesterol,total-240mg/dl(High), HDL cholesterol-36mg/dl, LDL cholesterol-72mg/dl, Triglycerides-192mg/dL(High)LIVER PANEL (LIVER FUNCTION TEST):ALT-42U/L, AST-41U/LURINALYSIS:Color-Amber, Clarity/turbidity-Clear, Urinalysis pH-6.8, Specific gravity-1.024, Urinalysis glucose-negative, Ketones-negative, Crystals-abnormal, Bacteria-abnormalALERTS:Admitted on 03/03/2016 @13:05-Temp(103.8),BP-120/86, , @14:00-Temp(102.9), BP-120/70, @15:00-Temp(102.1), BP-118/66MEDICATION:APAP 500mg Oral tab(Tylenol). Dose-1000mg PRN Q4H Active- For mild discomfort and temperature greater than 101 F.Sodium Chloride 0.9% (Normal Saline) (NaCl). Dose 1L (125ml/hour) IV – Continuous ActiveOndansetron 2mg/mL Injectable Solution (Zofran) Dose 4mg PRN Q4H Every 4-8hours PRN for nausea and vomiting.Pyrazinamide 500mg Oral tab. Dose-2g daily Non-VerifiedPyroxin (Pyridoxine Hcl) 25mg tab. Dose-25mg daily Non-VerifiedEthamutol Hydrochloride 400mg Oral tab. Dose 1.6g daily- Non-VerifiedINH 150mg/Rifampin 300mg Oral Capsule (Rifamate), Dose 300mg/600mg daily – Non-VerifiedCompleteba thorough education of ordered TB and HIV medications before starting with 1st dose once. Instructions:Please complete the following-Working up the above patient-Verify 4 orders-Write a 5mins verbal presentation for this patientKeeping in mind insurance coverage of medications when the patient is discharged, Make sure DC Medicaid formulary covers these drugs at discharge, know what is on DC Medicaid formulary.