Mr. Grassley is a 65 year old retired teacher from Ithaca, NY. 10 years ago, he presented with a suspicious digital rectal examination and an elevated PSA level of 9 ng/ml. A biopsy of the prostate revealed no abnormalities. The year, he presented again with a PSA level of 12 ng/ml. Again, a biopsy was negative. Why is the prostate-specific antigen (PSA) not considered an ideal tumor cell marker? Is there a level at which cancer would be indicated?

Mr smith a 52 year old patient, is admitted to the coronary care unit with the diagnosis of acute inferior myocardial infarction. the patient has a history of smoking two packs of cigarettes for 35 years, and he drinks a six pack of beer on weekend nights, but does not drink the rest of the week. he is the sole financial support for his family. he is a consultant for a company and is out of town during the week days. mr smith has gained 20 pounds. he is 5 foot, 6 inches, weighing 200 pounds. his diet consists mostly of fast foods. he rarely exercise. his wife care for their three teenage children. the eldest son, 17 years of age, totaled the family car when drinking and driving 2 days ago and he is in the local children’s hospital in the intensive care unit in critical condition. mr smith developed chest pains and slumped over in his chair during an argument with his wife about their teenage daughter, who is 15 years of age and wanted to get birth control pills. the wife is in the waiting room while the nurses settle mr smith into his room. the youngest son, 13 years of age, is at a friends house. the teenage daughter is staying at the bedside of the criticall i’ll eldest son. the wife blames her eldest son for her husband’s heart attack and told the emergency department nurse that she does not care to see her son i’ll. a. what maladaptive response to stress may have contributed to mr smith’s development of an illness b. based on the case study, what family assessment data may be used to determine coping strategies being currently used by the family. c. what nursing interventions should be used to promote effective coping for the patient and his family?