Prescriptive Case Study One Liam Wilson is a healthy, vaccinated, 19-month-old boy with a prior history of acute otitis media (AOM) at 11 months. Liam’s treatment with amoxicillin HD for his first AOM was successful, but after the eighth dose, a rash appeared on his trunk and extremities, but had no evidence of anaphylaxis. At his visit today, Liam’s mother reports crying and tugging of the right ear for two days, along with decreased appetite, decreased playfulness, and difficulty sleeping for three days. She also noticed that Liam felt very warm to the touch, but she does not have a thermometer at home for monitoring. Liam’s mother stays at home, taking care of Liam and his healthy older sister. Liam continues to use pacifiers to fall asleep during afternoon naptime and at bedtime. Both parents are smokers. Currently, Liam has an elevated, un-medicated temperature of 103.6 F. His physical exam reveals bilateral erythematous tympanic membranes (TM), with the right ear being worse. The right TM is bulging with copious cerumen and questionable purulent fluid behind the TM, but the TM landmarks appear normal bilaterally. His throat is erythematous and the nares are draining thick, yellow mucus. Liam’s diagnosis is a right AOM, and the following paragraphs …show more content…
If the diagnosis is uncertain, the text recommends antibacterial therapy if illness is severe, meaning AOM presents with moderate to severe otalgia or fever of 39°C (102.2°F) or higher. A high-dose amoxicillin at 40–45 mg/kg twice daily is the first treatment of choice due to its cost, taste, safety, and effectiveness. The duration of treatment depends on the patients’ age and the severity of illness and can range from 5 to 10 days. For patients with a penicillin allergy, drug selection process depends on the severity of the reaction (Burchum & Rosenthal,
I am writing this letter on behalf of the case regarding Shaun Ewing. Court date is sceduled for February 10, 2017 in court room 7. I was the complainant and victim in the matter and would like to respectfully request dismissal of the charges against him in this matter. The reason for my request is that at the time I was upset and emotional and I was not thinking rationally about the situation. Since the time of the incident I have had the opportunity to reflect upon the matter and I now realize that people make mistakes and say and do things they wouldn't normally do when they are upset.
Jabez Wilson is upset because he has just received notice that the Red-Headed League has been disbanded. He was being employed there because his exceptionally brilliant red hair supposedly made him the ideal candidate for membership in what was represented as a sort of fraternal organization founded by a wealthy man for the purpose of benefiting red-headed men. Wilson was getting generously paid for simply copying articles from the Encyclopedia Britannica. He is apparently hoping that Sherlock Holmes could find out why the League had been disbanded without advance notice and whether it might reopen again, or whether it has moved to a different location.
Matthew Dunn is a 23-year-old male who has been sentenced to 7 years in federal prison for an armed robbery of a downtown convenience store. His charge was decided with knowledge of his extensive juvenile and adult record. School Life Dunn was an honour roll student until grade 10. He loved math and did well in arts too. He loved going to school to see his friends, of which he had many.
12. Candidate Wilson briefed a five paragraph order that contained the majority of information his subordinates required to understand their mission, how it was going to be accomplished, and what role they would play in its accomplishment. Although there were frequent pauses, Candidate Wilson demonstrated confidence while briefing his subordinates and this level of confidence would persist throughout the execution of this scenario. Due to safety considerations, this evaluator would not allow Candidate Wilson to attempt his first two courses of action. His aggressive approach towards mission accomplishment had to be restrained for safety's sake.
Cough syrup had not helped and so the nurse practitioner and myself decided to treat her. She was subsequently put on Augmentin, has just a few days left. She is feeling much, much better.
According to Ron Dagan, acute otitis media (middle ear infection) are most common in kids 3 months old to 3 years old. (Dagan p. 1). In Clinical Bacteriology of Recurrent Otitis Media with Effusion, it states, “antibiotic resistance has increased due to indiscriminate overuse and misuse of antibiotics.” The overuse of an antibiotic and/or using the wrong antibiotic to treat the sickness has made bacteria more resistant to the antibiotics. Later on in the passage, Dagan adds, “we collected nine hundred middle ear fluid samples for six hundred fifty four pediatric patients who underwent ventilation tube insertion due to OME…”
We are beginning a legacy and we want you to be a part of it! In memory of James Wilson, Sr., our family has elected to start an endowment at Texas Southern University. This comes at a great time because the matriarch of our family, Mrs. Mary Wilson will be turning 90 this year. This gives us the opportunity to honor them both by beginning a legacy that will continue for years to come.
William Wells Brown Clotel; Harriet. Wilson Our Nig Journal Essay 1 Topic: Compare and contrast the two slave narratives. In the book of Wilson Our Nig it is about a lady by the name of Mag Smith who was seduced and left with a child.
John Wilson is an outsider and also referred as a stranger who comes to the new world, Canada, and struggles to live by himself. When Wilson arrived in Canada, it was lucky and easy for him to find a job because there was a sign about “English Need not Apply” (p.12) and he is a Scottish. However, the jobs he could acquire were such as construction of bridge and gardener with low wage and lots of painstaking. The surplus could barely feed him after he sent the money back to his family. Although life was harsh in an unknown area, “he felt disconnected from the old world [Scotland] and everyone [his family, his friends and the scandal] in it” (p.18).
Reighn receive medication management services from the MUSC Clinic. The youth’s overall physical health is well. She has seasonal allergies to food and the environment. There were no reports of illness within the past 30 days. Reighn does not have a history of sickness.
Two years ago my cousin Joshua was diagnosed with Henoch-Schonlein Purpura (HSP). HSP is a disease involving inflammation of small blood vessels and is most commonly seen in children (Trnka, 2013). HSP is the most common childhood vasculitis with a reported annual incidence that varies between ten and thirty cases per one hundred thousand children, based on hospital and overall population estimates for children under seventeen years of age. Children can form a respiratory infection, purpura, arthritis or arthralgia, abdominal pain, and possibly renal disease as symptoms of HSP (Trnka, 2013).
14. Tomlin, Charles • Date of Conviction: 1979 • Date of Exoneration: 1994 • Summary of the Case: On the night of 12/7/1978, Daniel Stewart, a 25-year-old drug dealer was fatally shot and robbed of nine pounds of marijuana worth $5,000 in an alley in Bakersfield, California. Stewart’s girlfriend, Leticia Mendez, 24, was sitting next to Stewart when he was shot in the face. Mendez told Bakersfield police that the gunman was a stocky black man, about 5 feet, 6 inches to 5 feet, 8 inches tall with a mustache and a medium Afro hairdo. At first she said the gunman was a hitchhiker.
It is best for the kid to be brought to the medical professional to receive antibiotic and treatment with erythromycin. Additionally, the health care provider may suggest for members of the family to
You look around and all you see is darkness. Silhouettes surround you in an organized manner. All of a sudden lights come on and hundreds of silhouettes join you in a deathly silence. You see a man walking towards the center holding a thin stick. As he raises his stick you raise yours, which in your hands is a 73 centimeters of elegant horse hair and fine brazil wood.
The usual presentation is a large amount of vomiting that eventually becomes projectile. If not identified soon the child will soon become dehydrated and less likely to attempt feeding. Weight loss can also occur. The diagnosis is usually made by clinical history, palpation of an olive like mass in the upper right quadrant, usually backed up with ultrasound. The patient’s arterial blood gas can also sometimes show a hyperchloremic acidosis due to the evacuation of stomach contents.