A Case Study Of A 67 Year Old Male Patient

The patient is a 65-year-old gentleman who presents to the ED on the 28th complaining of fever and chills. He has a long complicated medical history. The patient had a left total hip revision done on 8/19/2016 for presumptive infection of a continued seroma collection. He is known to have continues seroma collections on a recent CT in the outpatient setting. He presents now because of chills and fever. It is to be noted he is already been scheduled for surgery on the 29th. In view of the chills and fever he was sent in the evening prior the surgery. His temperatures were recorded when seen in the ED as 99. He is awake, alert and oriented. He does have an elevated C-reactive protein. His medical history is also significant for hypertension,

The WBC and platelets are high because the Pt.’s body is trying to fight an infection.

Mr. Howard, a 57-year-old man, had a 3-month history of progressive typical anginal chest pain. He reported that the symptoms first occurred with heavy exertion and involved what he described as“heaviness” in his chest. The symptoms were promptly relieved with rest. Over the past weeks, he had been experiencing increasingly frequent episodes of chest pain and diaphoresis. The episodes had become more prolonged, and he had experienced one episode of pain occurring at rest after a heavy meal. Mr. Howard was moderately obese and had a 20-year history of hypertension, which was being treated. Other risk factors in Mr. Howard’s history include hypercholesterolemia (350 mg/dL), which he was attempting to treat with dietary modifications, and a 30-year two-pack-a-day smoking history which continued up to the present time. Mr. Howard previously had surgery for a bilateral inguinal hernia repair, cholecystectomy, and arthroscopic surgery on his left knew. He also gave a history of problems with gastric reflux and was currently taking cimetidine (Tagamet).

low platelet count and low white blood cell count. In reference to Mr. J.’s symptoms and CBC results additional diagnostic labs were ordered.

“The patient is Adam Rudd, a 78 y/o white male with a history of hypertension. He has been diagnosed with hypertension past 15 years and is on anti-hypertensive medications and aspirin. He is very weak and short of breath. He is accompanied with his longtime friend Jennifer, who reports that Rudd was looking very weak and was complaining of severe headache and blurred vision before coming to the hospital. He is 5’9” and weighs 270 lb. Vital signs recorded were: oral temperature 98.20 F, BP 224/120 mm Hg with a heart rate of 102 beats/minute and respiration of 24 breaths per minute. The pulse oximetry reading was 94% on room air. He is complaining of severe headache and blurred vision. Rudd said that he did not take his antihypertensive medication or aspirin since he ran out of pills. He has not been taking his medication for past 15 days. He reports no known allergies to any medications or other substances.”

SW is a 65 year old white female who is 5’8” tall and who weighs 155 lbs. Her IBW is 140 lbs. and she has an IBW % of 110.71. She went to emergency department on February 1, 2015 complaining of shortness of breath and coughing since November, 2014. Her medical diagnosis includes multi-drug resistant organism, diabetes, COPD, and lung cancer. Her laboratory result shows that she has an elevated WBC of 17.4 on February 2nd and it increased to a critical level of 32.2 the next day. An elevated WBC usually means an infection is happening in the body. Her RBC is elevated at 6.19 which could mean hemoconcentration or it could be due to her COPD. Her decreased MCH of 25.0 & 24.8, her Neutrophils of 13.8 and her elevated RDW of 18.2 & 18.4 could mean that she’s having some iron deficiency anemia. Her laboratory also shows that her albumin is low which can be from prolonged immobilization, decreased nutritional status or worse it could be due to her lung cancer. Her low Sodium of 132 and Chloride at 93 may be due to her diet or medication side effects. Her serum glucose at 118 is elevated which can be from her diabetes or from stress of being in the hospital. Her Platelet count of 405 is normal and her BUN of 5 is also within range. Her arterial blood gas is showing compensated imbalances. Her pH is 7.35 which is normal on the low side. Her PaCo2 is 65.2 which is very elevated, her PaO2 is 66.4 which is very low, her HCO3 is also very elevated at 35.3.

Patient S is a seventy-eight-year-old male who presented to the ED in Rushville on October 25th with signs and symptoms of a stroke. These symptoms were leaning to the left side, a left facial droop, weakness in the left arm, and ataxia. The patient has no history of stroke. Patient S was admitted to 4-G in Memorial for a right-sided ischemic stroke. The patient has a history of atrial fibrillation (A-Fib), hyperlipidemia, bleeding problems, hypertension, sleep apnea, and a pacemaker. Patient S lives at home with his wife. Patient S was independent before the stroke. On October 13th, the patient had surgery of lumbar stenosis on L3, L4, and L5. The patient and wife reported increased serosanguinous drainage that soaked the dressing. Patient denied fever or pain at incision site. The doctor decreased Warfarin from 5 milligrams (mg) to 2.5 mg and prescribed a full dose of aspirin.

His vital signs are as follows: BP 172/100, heart rate 92 beats per minute, and a temperature of 102.2 F. There have been some labs done. His red blood count is 3.1 million cells, white blood count is 22,000 cells, potassium is 5.4 mEq/L, calcium is 6.8 mg/dL, phosphate is 4.3 mEq/L, urea is 37 mg/dL, creatinine 2.0 mg/dL, albumin is 2.9 mg/dL, and pH is 7.29. With labs like these, more testing was done. A chemistry panel which showed protein 1.7

This type of lab usually shows the general health of the patient and the current state of blood cells. One of the segments of this lab is white blood cell (WBC) count. In ES’s lab work it was shown that his WBCs were at 16,700, which is high on the scale (normal values are 5,000-10,000). Upon further assessment it was found out that patient was not in current infection state (which is one of primary reasons of high WBCs) but it was due to corticosteroid therapy that he was on. Additionally to WBCs count is included red blood cell (RBC) count, and RBCs in their turn include hemoglobin and hematocrit levels. Hemoglobin is a protein that binds to oxygen and helps it to transport it to cells. Hematocrit level is a way to measure the space that is being taken by red blood cells in the blood. In ES’s lab chart it was noted that RBCs were on low side of 4.5 million but are still within normal limits (normal values are 4.5-5 million). On other hand the hemoglobin levels were low, measured at 11.6 (normal levels are 14-18 in males). This puts ES on mild case of anemia. One medical journal state that “mechanisms of anemia in COPD are probably multifactorial. They may be anemia of chronic disease related to inflammation, iron and vitamin deficiency, comorbidities, hypogonadism or treatment related.” (Sarkar, M., Rajta, P. N., & Khatana, 2015). Another test that came up to

An interesting case I attended to involved an elderly man in his 80s who is a non-smoker and non-alcoholic. He looked grayish, pale and sweaty, which is the typical appearance of a cardiac patient. He presented with chest pain that he gave a pain score of 8/10, and which worsened upon inspiration. He also presented with vomiting and shortness of breath. Electrocardiogram (ECG) indicated a ST Elevation Myocardial Infarction (STEMI). Paramedic believes it was an anterior infarct with elevation in V2, V3, V4 leads and reciprocal depression in Leads II, III and aVF. The patient had several risk factors for heart disease such as high blood pressure, being overweight and living a sedentary lifestyle. He has had chest pain previously, but it was

My patient is a 68-year-old Indian male. His health issues include hypertension, Type 2 diabetes, hyperlipidemia, cellulitis, and insomnia. He has been in the facility for 3 years. My patient’s weight is 156 lbs. and there were no major weight changes for the time he has been in the facility. My patient needs assistance with either wheelchair or a walker, is able to ambulate with or without a device. He is not allergic to anything, therefore, no modification to the medication is needed. The primary the patient is in the facility is because of a foot ulcer. The foot ulcer is unable to heal at a normal pace because he has diabetes. My patient did not take any medication prior to admission to the facility.

also had a complete blood count, a blood test, as a baseline to assess his overall health. The complete blood count is “To evaluate numerous conditions involving red blood cells, white blood cells, and platelets. This test is also used to indicate inflammation, infection, and response to chemotherapy (Bladh et al., 2013).” T.A.’s abnormal blood results were as follows: RBC 3.3 10^6 cells/microL (low), hemoglobin 11.0 g/dL (low), hematocrit 33.2% (low), and mean corpuscular volume 99.7 fL (high). The normal range for RBC should be 3.8-5.81 10^6 cells/microL. Hemoglobin and hematocrit levels should be 12.6-17.4 g/dL and 36-52%. Normal mean corpuscular volume should be 79-103 fL. T.A.’s abnormal lab values indicate anemia. A decrease in red blood cell is related to nutrient deficiency such as a deficiency in iron or vitamins that are needed for red blood cell production and maturation. The decrease production or maturation of red blood cells lead to anemia in the patient. A low hemoglobin is associated with an overall decrease of red blood cell count and anemia caused by nutritional deficit of iron, vitamins, and folate. It can also be low due to a decrease level of erythropoietin caused by the AKI. Like hemoglobin, a low hematocrit is associated with an overall decrease of red blood cell count due to anemia, nutrition deficiency, and AKI. T.A.’s increased mean corpuscular volume is related to anemia caused by vitamin B12 or folate deficiency (Bladh et al.,

Clinician facilitated a family therapeutic session between UC and his Father who is sponsoring UC. Clinician reviewed the Safety Plan and sponsor agreed to utilize the resources provided should the UC need such care. Sponsor indicates he was aware UC would travel to the USA and agreed to provide support and sponsor him. Sponsor indicated he wanted the UC to come live with him so that the UC can have a better education and economic opportunities. Sponsor states he and UC have been separated for many years, however, he has maintained ongoing contact with UC during this years. Sponsor expressed understanding of the responsibility of UC’s overall care and feels he can provide proper care for the UC. Sponsor indicates he will follow conditions

Patient WS is a 52 years old male his complained of crushing chest pain, shortness of breathe with exertion and diaphoretic. His has history of present illness of angina. The patient has a history of hypertension, high cholesterol, and cholecystectomy. He is a full-time carpenter, no known allergies, smokes one pack per day, and no active exercise. The patient takes one heavy meal per day and mostly skips breakfast and eats fast foods for lunch.

G. J. is a 28 year-old male patient with no past medical history. On September 13, 2015, he was admitted at Kendall Regional Medical Center with a chief complaint of worsening back pain lasting for over a month. He denies any recent trauma or falls, numbness, tingling, or paresthesia. No urinary symptoms or fever. The patient has been trying multiple medical management options in the outpatient setting, but they have all failed to relieve the pain. G. J. was sent to the hospital for consideration of surgical management given that patient’s medical management was unsuccessful. Patient is admitted to internal medicine for further evaluation and investigation. With the analysis of several MRIs, the patient is diagnosed with