need help with four different case studys

Case study #1

Penelope Richards is a 62-year-old white female with osteoarthritis, hypertension, and type 1 diabetes for the past 15 years. She now has diabetic retinopathy and primary open-angle glaucoma. On her last examination, it was noted that she had a micro aneurysm of the retina.    She is scheduled to have argon laser trabeculoplasty to seal the leaking microaneurysms from macular edema. Labs before the procedure:


  • ☐Potassium (K+) 4.0
  • ☐ Sodium (NA+) 140
  • ☐ Glucose 152
  • ☐ BUN 18
  • ☐ Creatinine 1.1
  • ☐ RBC 3.8
  • ☐ Hgb 11.0
  • ☐ Hct 32
  • ☐ WBC 5,000
  • ☐ Platelets 140,000


  1. Click OR Highlight the labs listed above that are abnormal, either high or low.


2. Ms. Richards will be NPO 8 hours before the procedure. The surgeon orders intravenous (IV) therapy 1000 mL Dextrose 5% in Water (D5W) to infuse over 12 hours by gravity. The drop factor is 15 gtt/ mL.  What is the IV rate gtt/ min for this infusion? Show your work.




3. Since Ms. Richards has a history of hypertension, it is advisable to take her prescribed antihypertension medication before the surgery. The medication is Enalapril 5 mg tablet twice a day. The pharmacist distributes a 10 mg tablet. 


 How much should Ms. Richards take for one dose?    ________tablets. Show your work.



Case study #2

Sally “Lee Lee” Johnson, an 18-year-old female, admitted for weakness, fatigue, and heart palpitations. The assessment reveals dyspnea with a respiratory rate of 30. Lee Lee admits she usually eats one meal a day and has painful and heavy menstrual periods. Lab listed below

  1. ☐ RBC 3.0,
  2. ☐ Hemoglobin 6.5
  3. ☐ Hematocrit 23%,
  4. ☐ WBC 10,000,
  5. ☐ Platelets 190,000
  6. ☐ Blood type AB+


4. Which lab will determine if Ms. Johnson requires a blood transfusion? Select all that apply. Click or highlight the answer.


5. Which Blood type (s) is/are compatible with Ms. Johnson’s blood type? (maybe more than one response) Click or highlight the answer below.


O- ☐   O+ ☐  A- ☐  A+ ☐  B- ☐ B+ ☐ AB- ☐  AB + ☐



Case study #3

Due to religious reasons, Ms. Johnson refuses the blood transfusion. The physician orders the following medications: Epoetin alfa (Epogen) 20,000 units subcutaneous injection daily. Ferrous Sulfate 325 mg by mouth daily, vitamin B12 1000mcg subcutaneous injection daily for seven days. The pharmacist sends a vial of Epoetin alfa 10000 units/ mL. 


6. How many mLs of Epoetin alfa (Epogen) will the nurse administer? Show your work. 


Case study #4

Joseph “Bop” Jones is a frail 80-year-old man with a draining wound on his right heel. He has a history of Type 1 diabetes requiring insulin. He is complaining of nausea and vomiting. A central line catheter was inserted for Total parenteral nutrition. 

7. The intravenous nurse is planning to flush each port of the central line. What size syringe should the nurse use to flush the central line?

  1. ☐   3 milliliter (mL)
  2. ☐   5 milliliter (mL)
  3. ☐   10 milliter (mL)
  4. ☐   20 milliter (mL)


8. Mr. Jones is scheduled to receive his insulin AC. What time of day is AC?