CHIEF COMPLAINT: Dyspnea. For details on his present illness, past medical history please see dictation from (___). Physical exam on admission please see dictation (___). Laboratory please see dictation (___). On ___ [DATE] WBC 13.9, hemoglobin 10.9, platelets 113, INR was 1.4. On ___ [DATE] sodium 130, potassium 3.5, chloride 91, CO2 27, BUN 22, creatinine 0.7, glucose 225. HOSPITAL COURSE: The patient was admitted. He was treated with IV steroids and antibiotics. He gradually improved. He is still having trouble with oxygenation however and, arrangements are being made for a higher flow oxygen at home. In addition he will use an oxymizer. Consideration was given to having him go to the ___ [PLACE] for physical therapy, but he has
an appointment today at ___ [PLACE] in the pulmonary fibrosis clinic. I have been encouraging the family to try to get there as soon as possible, and several previous appointments have apparently been canceled. I feel that he is doing relatively poorly on his current regimen, and of he does not go there today, he may perhaps, never get there. Family understands that his prognosis is poor, probably regardless of any input from (atrophy) care center. FINAL DIAGNOSES 1. Idiopathic pulmonary fibrosis with usual interstitial pneumonitis on biopsy. 2. Chronic obstructive pulmonary disease. 3. Diabetes mellitus. 4. Hypertension. 5. Status post pancytopenia, probably secondary to Azathioprine. 6. History of Gastrointestinal bleeding secondary to gastritis. He will be discharged on his usual medicines, but take prednisone 60 mg daily instead of 40. He will resume Azathioprine and oral (acetylcysteine). He will see me in the office next week. As noted above, prognosis is poor, especially given his poor response to therapeutic attempts to treat his UIP. Diet and activity are as before
The presented case is of a patient named R.S. who has a smoking history of many years, which can be directly tied to his development of chronic bronchitis, a chronic obstructive pulmonary disease (COPD) specified as Type B. It is estimated that in 90% of chronic bronchitis or “blue bloaters”, cigarette smoking is the major cause. Chronic bronchitis involves persistent and irreversible airway obstruction, due to the constant inflammation of the bronchial mucosa, leading to hypertrophy and hyperplasia of bronchial glands. The latter exposes the individual to higher risks of bacterial infections; often colonization of organisms such as Streptococcus or Staphyloccocus pneumoniae can be exhibited. This is due to the lost or impaired function of mucociliary clearance action which results from the replacement of certain sections of ciliated columnar epithelium by squamous cells in the bronchi. (Copstead &Banasik, 546-547)
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
Which K, S, and A pertain to the care you provided to the patient you have chosen? Why?
These have help development an intensive rehabilitation program for the patient. It will take an active involvement by the patient to assure optimum recovery.
If you suffer with sleep apnea and are overweight, you are not alone. You’ve probably been told by one or more of your doctors that you’d be healthier if you lost weight. But, have any of them ever told you about a diet for sleep apnea patients, or better yet, about the 6 best diets for sleep apnea? No? Well, I will.
...to communicate with your patient in order for them to be updated with their family’s sickness. And also have compassion towards them. You are likely to see a lot of injuries and scenarios play out among patients that have been admitted to the hospital. There are many achievements in this field that you may accomplish. And priorities that you have to deal with. For instants your time you have to adjust your schedule.
I will recommend to the nurses to use these effective listening strategies while encouraging the patient to explain their interpretations of their medical condition and their plan of care. I will also introduce the new unit based questionnaires given to patients at discharge prior to leaving the unit.
He was an outpatient, who arrived at 8 am to get ready for his surgery. Feeling I was ecstatic and enthusiastic to get back into the field of work to do my clinical rotations. Although I was ready to have a new experience at the recovery unit, I was also extremely scared, because this unit was a specialized unit, where the patient needs vital care while recovering from anesthesia.
Develop plan of care that meets the needs of the patient in this particular situation.
... basic information of the patient. Professional and precise language should be used when documenting. For the care plan, I have learned to correctly write a nursing diagnosis and writing interventions that are within nurses’ capability and suits the patient’s personal status. From now on, I will remember to distinguish medical diagnosis from nursing diagnosis. For each diagnosis, I will write about the patient’s (potential) response to the health problem and state why this might be the concern.
Sleep apnea is a sleep disorder which causes frequent pauses in the breathing process during the sleep.
D- The patient arrived on time for her session as she was seen outside. The patient reports, she has to see her cardiologist for 35 days at noon to monitor her blood flow sometime next month. She is also scheduled on 05/23/2016, at night to conduct her sleep apena and also, scheduled on a Tuesday for a ultrasounds, referring to her pulse to her legs to ensure there is no blockage in her legs.
Chronic obstructive pulmonary disease, also known as COPD, is a lung disease that block airflow and makes breathing difficult. There are two common condition, emphysema and chronic bronchitis that help make up COPD. There are also about four gold stages; mild, moderate, severe, and very severe. COPD is the fourth leading cause of death in the U.S, the disease typically occurs after age 35.
Red blood cell indices:(mean corpuscular volume [MCV], mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration [MCHC]
Sleep Apnea (cessation of air flow at the mouth for greater than 10 seconds) can