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Tutor profile: Marissa H.

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Marissa H.
ER/Trauma Nurse for three years and Educator
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Questions

Subject: Health and Medicine

TutorMe
Question:

Discuss the management of a CHF patient in terms of medications, testing, and assessment.

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Marissa H.
Answer:

CHF patients experience a backflow of blood from the heart back into the periphery or the lungs. As a result, many of these patients experience lower extremity edema and shortness of breath, respectively. These patients many have pitting edema, dyspnea, chest pain, jugular venous distention, and other signs of fluid overload. Testing includes serum brain natriuretic peptide (BNP), echo-cardiogram, electrocardiogram (ECG), chest xray, and troponin test. BNP will be elevated due to the increased vascular demand for expansion, echo-cardiogram will yield decreased ejection fraction, ECG may show T wave inversions or other ECG changes, chest xray may show cardiomyopathy, and serum troponin may be elevated during acute distress as well. These findings are indicative of the need for diuresis. In order to accomplish this, diuretics such as furosemide are administered. These act on the nephrons to increase urine output and decrease fluid overload. Medications to control any dysrhythmia or hypertension that occur with these patients.

Subject: Nursing

TutorMe
Question:

Discuss the prioritization of the following tasks: 1) Drawing blood from an anemic patient to repeat the blood count following blood transfusion. 2) Providing an aerosol treatment to a COPD patient complaining of shortness of breath. 3) Administering 2mg IV push ativan to a seizing patient. 4) Completing a head to toe assessment on a new admission to the unit, you just witnessed this patient come onto the unit using her cell phone to order takeout.

Inactive
Marissa H.
Answer:

The top priority is determined based on assessment of airway, breathing, then circulation (ABCs). The top priority among these tasks is to administer ativan to the seizing patient because this is an imminent emergency that can lead to altered airway patency. The short of breath COPD patient may also experience airway compromise, however, this patient is not the priority due to the fact that he has a patent airway and his difficulties are related to breathing. The blood draw would be the third priority because low hemoglobin is a circulatory concern that follows A and B. Finally, the patient who is able to operate her cell phone and desires to order food is likely in stable condition and should be able to wait for assessment until the prior patients are attended to.

Subject: Biology

TutorMe
Question:

Compare and contrast the endoplasmic reticulum and the mitochondria in terms of their structure and function within the eukaryotic cell.

Inactive
Marissa H.
Answer:

The endoplasmic reticulum (ER) and the mitochondria are both organelles within the eukaryotic cytoplasm. The ER and mitochondria both are constructed of membranous folds. Both are responsible for production of essential cellular products. The rough ER is responsible for production of proteins that are either used within the cytoplasm or transported out of the cell for usage in other parts of the body. The mitochondria is responsible for oxidative phosphorylation, the process of ATP production. ATP is then used within the cell in order to provide the energy needed for cellular processes. In this sense, the products of the two organelles are different. Another difference between the two is that the ER is an extension of the nucleus, whereas the mitochondria is its own entity within the cytoplasm.

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