NR 603 Week 5 iHuman Virtual Patient Encounter and Reflection Attempt 3810225 - Frank Russo.

History Notecard by Maria Szafranski on case Frank Russo - Chamberlain Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = Sx = Sx = Sx = Sx = Sx = Onset Location Duration Characteristics Aggravating Relieving Timing / Treatments Severity Attempt: 3810225 Report generated on 2/7/2026, 8:42:03 PM America/Denver Management Plan by Maria Szafranski on case Frank Russo - Chamberlain 1. Diagnostic tests Chest X-ray showed diffuse bilateral interstitial infiltrates. CBC showed multiple low normal levels indicating bone marrow suppression and slight neutropenia. CMP within normal limits. These findings indicate pneumonia, and combined with his HIV positive status, it is likely Pneumocystis Jiroveci pneumonia. 2. Medications: Sulfamethoxazole/trimethoprim - TMP15-20 mg/kg/day and SMX 75 to 100 mg/kg/day, by mouth 3 times per day for 21 days. Take 400mg/ 80mg tab by mouth every 8 hours for 21 days, dispense 63 tabs, no refills (Truong & Ashurst, 2023) Tylenol 1000mg - take 2 500 mg tablets every 8 hours by mouth as needed for fever. Oxygen - 2L per minute via nasal canula, titrate to maintain oxygen saturations >92%. 3. Suggested consults/referrals Referral to ED for evaluation, and admission to hospital for treatment of hypoxia and pneumonia. Consults - Infectious disease - to manage underlying cause Pulmonology - to manage any respiratory complications Critical care/hospitalist for admission to hospital for treatment of hypoxemia 4. Client education Pneumocystis Jiroveci pneumonia is a serious fungal lung infection that can occur in people who are HIV positive. It is very important to complete the full dose of antibiotics. Do not stop taking early, even if you feel better. Take the Sulfamethoxazole/trimethoprim as ordered 3 times a day with plenty of water. Take with food if you experience an upset stomach. Avoid prolonged sun exposure, as well as alcohol while taking the antibiotic. You should go to the emergency room for further evaluation and treatment, and hospitalization if necessary. Get plenty of rest, and drink at least 6 - 8 - 8 oz glasses of water per day. Avoid smoking, as this can further damage your already fragile lungs. Sit upright to make breathing easier. Try and take deep breaths, even if they trigger coughing several times per day. This helps maintain lung function and prevent atelectasis, or lung collapse. Use a humidifier to help add moisture to the air, this can help reduce coughing. Monitor your temperature, and treat any fevers with Tylenol per package instructions. Monitor your breathing and oxygen saturation. If your