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A Vomiting and Dyspneic Teenager
Janet Han, DO and Shireen Khan, MD
History of Present Illness
CHIEF COMPLAINT: Shortness of Breath
15 y/o female with no pertinent PMHx presents to the emergency department with shortness of breath onset 3 days ago. Patient is also reporting cough, congestion, sore throat, subjective fever and chills, myalgias, as well as nausea and vomiting. Today, she states she is so nauseous she has tried to force herself to throw up several times. Since then, she has been experiencing neck pain with movement. Patient is UTD with all her vaccines. Denies alcohol and drug use. Initially denies vaping/smoking; later states she has vaped daily until her symptoms’ onset.
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A Rare Case of Pulmonary Nocardiosis with Pseudomonas Aeruginosa Superinfection in an Immunocompromised Patient
Kevin Liu, MD; Samuel Shulimson, DO; and Herbert Patrick, MD
Introduction
Nocardiosis is an uncommon opportunistic infection with over two thirds occurring in those who are immunocompromised [1] or who have undergone solid organ transplants [2]. Here, we present a unique case of pulmonary Nocardiosis complicated by superimposed Pseudomonas infection.
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Sudden Hearing Loss: WRS Importance and Timing of Medical Intervention
Irina Linkov Middleton, Alexandra Costlow, Molly Wolfson, Midori Wakabayashi, and TingTing Zhan
Objective: The aim of this study was to evaluate recovery in hearing acuity of idiopathic sudden sensorineural hearing loss (ISSNHL) based on timing of onset to determine how late is too late to medically intervene.
Study Design: A retrospective chart review was conducted in patients previously treated for primary complaint of sudden hearing loss (HL). Participants meeting inclusion criteria were analyzed based on timing of onset to service date, age, gender, associated ear, associated symptoms as well as recovery in pure tone average (PTA) and recovery in word recognition scores (WRS).
Setting: All patients seeking treatment for SSNHL were seen in a hospital/medical setting by otolaryngologists/otologists.
Methods: Utilizing the hospital’s medical record system, an initial sample of 696 participants treated for ISSNHL from 2016-2019 was collected. Of the 696 participants, 161 met the inclusion criteria and were analyzed.
Results: Timing of symptoms onset to treatment initiation as well as recovery detail were statistically significant in recovery anticipation.
Conclusion: Pure tone average (PTA) and word recognition score (WRS) recovery two variables analyzed as part of hearing recovery based on symptom onset to treatment initiation. Of the recovered participants, 14.9% and 42.2% experienced with BothRecovery or EitherReocvery respectively. Recovery detail, especially WRS recovery, is a key variable which should be analyzed when anticipating recovery of symptoms. WRS recovery was also identified in participants who sought treatment after 42 days of onset, suggesting recovery is possible beyond clinical guidelines set by the American Academy of Otolaryngology-Head and Neck Surgery (AAO).
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Generational Differences in Nursing Influencing Job Satisfaction
Sarah Carter, RN, CAPA; MaryJo Marino Hertzog, RN, BSN, CAPA; Demetrius Trihoulis, RN; and Viktor Hum, RN
Purpose
A generation is defined as a group of individuals who are roughly the same age, and who experience and are influenced by the same set of significant historical events during key developmental periods in their lives.
With multiple Nursing generations working together in the heath care setting identifying and understanding generational differences that influence job satisfaction will help to promote a healthy work environment and a sustainable work force.
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Does having a nurse navigator vs. not having a nurse navigator decrease the cost of healthcare in patients with a sepsis diagnosis?
Marybeth Forward, RN; Amanda Kuzewycz, BSN, RN-BC; Sandra Little, MSN, RN; Anne Lyons, BSN, RN-BC; Kelly Panei, BSN, RN, PCCN; and Diane Yaple, MS, LPC
Purpose
The nurse navigator facilitates the care of a patient with the diagnosis of sepsis across the healthcare continuum. This includes:
- Promoting optimal outcomes
- Preventing readmissions
- Patient education
- Decreasing length of stay in skilled nursing facilities
The coordination of transition of care starts from the time of admission through the 90 day post acute period.
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