A 61-year-old gentleman was admitted on 25/1/2016 to Letterkenny General Hospital with central chest pain after history of a fall. He also had drastic weight loss and loss of motor and sensory function. He walks with the aid of a walking stick as he has problems walking due to his lower limb weakness. The patient was a heavy smoker of 90 pack years (3 packs/day for 30 years) and stopped nine years ago. He stopped drinking seven years ago. He is married and lives at home with his wife. He works as a plasterer. He has a strong family history of ischaemic heart disease and type 2 diabetes mellitus. Two of his brothers had coronary bypasses and stents. His father died of a myocardial infarction. Two of his brothers are also type 2 diabetics. During
his 41 days of admission, the patient underwent a series of investigations and tests such as X-rays, CT contrast scans, MRIs, respiratory function tests, blood tests, nerve conduction studies and septic screens. His diagnosis of Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) was established after his nerve conduction studies were done. He acquired a chest infection during his hospital stay on the 22/2/2016 and was commenced on intravenous piperacillin/tazobactam (Tazocin) TDS and vancomycin. The patient also began experiencing postural hypotension on standing and diagnosed with steroid induced hyperglycaemia on 7/3/2016. He was advised to come off his oral hypoglycaemic agent once his steroid was stopped and to monitor his glucose levels daily. He was set to be reviewed in diabetic outpatients in two to three months’ time. The patient was discharged the following day. This reflective diary discusses the ethical issues that arose from his 41 day long admission.
759. Mr. Miller is likely presenting with an acute myocardial infarction. Based on his past medical history of hypertension, hyperlipidemia, obesity, and diabetes, along with his current symptoms of chest pain, shortness of breath, pale skin with beads of sweat on the forehead, as well as elevated lab 's Troponin, CK, and CK-MB, he is most likely presenting with an acute myocardial infarction.
Darien is a patient who possibly displays comorbidity. His symptoms lead me to believe that he could possibly be diagnosed with obsessive-compulsive disorder and generalized anxiety disorder. Darien’s symptoms that point to OCD are that he has rituals he must complete and if he does not he becomes anxious and is unable to continue with his day. He is however aware that these rituals are not actually helping him but he cannot stop doing them. He also reports feeling anxious most of the day, especially if he cannot perform his rituals, and that he is becoming increasingly more anxious. He is also unable to keep himself from worrying and feeling anxious.
Many programs develop a preliminary or initial treatment plan upon the client's admission to a program before a comprehensive assessment has been completed.The preliminary treatment plan starts the treatment process and is derived from the initial interview, intake assessment,ad other psycho social evaluations.The preliminary treatment plan defines the clients areas of concern and determines the severity of each problem to identify the clients immediate needs.it may involve drafting an abstinence contract and a schedule of treatment activities,such as establishing a time frame for the completion of a comprehensive assessment.Preliminary treatment plans outline an initial recovery strategy to support the client during initial treatment. They also achieve the
Surgery is the most common treatment for all stages of colon cancer. Cancer cells may be removed by one of the below procedures:
Client Profile: Lane Bronson is a 55 year old male with a history of angina, hypertension, Type 2 diabetes, COPD, and sleep apnea. He comes to the physican’s office complaining of worsening shortness of breath. His skin tone is grey, and his angina is worsening. Previously stable, he now does not get relief from rest or nitroglycerin. The physician called 911 and had Mr. Bronson directly admitted to the hospital.
“Elaine” is a 34-year-old white female patient with an extensive medical history. She has a history of seizures, uncontrolled diabetes since the age of fourteen, neuropathy, fibromyalgia, COPD, Sleep Apnea, and is currently suffering from two venous ulcers on her feet. She came to the ER one week ago with nausea and vomiting and was found to be in Diabetic Ketoacidosis and her wounds had become infected. She spent three days in the ICU and for one day was ventilated. She was then sent out to the Medical/ Surgical for further management 3 days ago.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
Recognition, response and treatment of deteriorating patients are essential elements of improving patient outcomes and reducing unanticipated inpatient hospital deaths (Fuhrmann et al 2009; Mitchell et al 2010) appropriate management of the deteriorating patient is often insufficient when not managed in a timely fashion (Fuhrmann et al 2009; Naeem et al 2005; Goldhill 2001). Detection of these clinical changes, coupled with early accurate intervention may avoid adverse outcomes, including cardiac arrest and deaths (Subbe et al. 2003).
The patient that stimulated the interest in this subject was a 57-year-old male admitted with an acute exacerbation of COPD. The patient also had a history of hypertension, pulmonary embolism, and deep vein thrombosis. The patient is a smoker as well as his family. He has had many problems with trying smoking cessation for years. The patient also has a history of depression and anxiety. The patient has been on many medications to control his hypertension, but it is still out of the normal range. This man was in great need of nonpharmacological intervention and education.
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
Social worker that practice in the rural environment should understand the importance of their client’s community. People who live in rural areas are viewed as “country”, unfortunate, and illiterate people not living the “normal” standards. In other words, these characteristics of the rural lifestyle are people who are comfortable living in the low populated environment are restricted to different resources compared to the urban communities. Furthermore, to understand the rural lifestyle I conducted interviews of three elderly African American women who lived their entire lives in the rural part of Alabama: Ms. Orange, 85 of Millry, Ms. Molly, 83 of Camden, and Ms. Washington, 77 of Fruitdale.
Most everyone has seen one of those population clocks. They display the growing numbers of deaths and births in the current day, as well as the year in total. It's always quite interesting to check out the other countries, watching the numbers climbing, seeming impossibly fast.
his father is dead while mother still alive. his mother had diabetes, hypertension and hyperlipidemia. he has three daughters and one son. All of his daughters and son does not complain of any chronic diseases. And also his brothers and sisters does not complain of any chronic diseases. one of his cousin is complain of heart attack and died after a couple of years.
My first patient that I started as student nurse on one of the long Rehab Center was a seventy two year old man who had Clostridium difficile (C.diff), Dementia, Hip replacement, and Obesity. Due to the above sickness he had many complications. I can still remember his face suffering from pain. Because of his lack of ambulation and incontinence, he had developed a very serious pressure ulcer under his sacral area. I went through to the room with my instructor and the instructor introduces me for the patient as his student nurse from Towson University and will taking care of him. However the patient was not happy and he becomes a challenging patient in my first experience day. But I may learned more from that challenging patient for my future experience.
The purpose of this paper is to analyze, diagnose, and to determine a proper treatment plan to work toward the beneficial prognosis for the individual indicated within the case study.