Demographic Narrative
Anna Stork is a 72-year-old white female who was diagnosed with congestive heart failure 2 years ago. She has periodic exacerbations of CHF requiring numerous hospital admissions in the last six months. She has been followed by the Medical Center of Trinity Hospital cardiologist, Dr. D. Patel since the diagnosis. Anna’s past medical history is significant for anterior MI approx. 5 years ago, stent implanted, atrial fibrillation, arthritis, IAD and pacemaker implanted, and CHF. Her surgical history includes; stent, IAD, and pacemaker implanted. She denies any allergy history.
Anna stroke lives with her husband Steve Stork in a three-bedroom apartment in Newport Richey, Florida. Her both parents are deceased. Her father died at 68 due to myocardial infarction and mother died at 92 due to old age problems. She has a total of 4 siblings. One sister with hypertension which is controlled by medications and diet, one brother with hypertension and cardiomyopathy, and the other 2 siblings (boy and girl) are in good health with no current illnesses. Her husband has mild dementia, diabetes, and hypertension. She has 2 children (son & daughter); both are healthy with no significant medical history. Anna Stork is happily married for 40 years. She denies alcohol, tobacco, and illicit drug use. She was a former smoker and quit smoking few months ago. One of her sister own few day care centers and she work 8 hour shift 3 days a week in one of her
Nearly 5.1 million people in the United States have been diagnosed with heart failure. Yet so many people don’t have a clue what it is until they have been diagnosed with it. Congestive Heart Failure, or CHF, is a disease that has many symptoms, can be tested and treated, has several causes, and can be avoided.
Jonathan is a 63-year-old man, born on August 23rd, 1956 and lives with his eldest son. He was married two times and has three children, two children from his first marriage and one from his second. He lives in northern Ontario but originally was from southern Ontario, he moved here shortly following his second divorce. He is of Italian decent and is a practicing Catholic. The patient’s weight is 95 kilograms; he is 178 centimeters tall and has a body mass index (BMI) of 28.3. Jonathan says he smokes around one pack of cigarettes a day, does not exercise enough and eats fast food a few times a week. The patient now has congestive heart failure as a consequence of his myocardial infarction (MI) or heart attack. He was transferred from another hospital in the beginning of November and was waiting for more tests to be completed before he could be discharged. Jonathan has some known comorbidities that can exacerbate his CHF, this includes smoking, obesity, and noncompliance with medications.
A is an 87 year old women, with a long history of health troubles including chronic kidney disease, congestive heart failure, coronary artery disease, a pacemaker insertion for her atrial fibrillation, type 2 diabetes, dyslipidemia, colon cancer, breast cancer, mild cognitive impairment and most recently paranoid psychosis.
Mildred D, a 78 year old women, has a history of heart disease , diabetes, two heart attacks and most recently she has had a stroke. Due to her having the stroke it has left her in a semicomatosed and paralyzed state, where she has to be fed through a feeding tube.
Norma James is a 65 years old widow who lives alone. Mrs. James has a medical history of Type 2 diabetes mellitus and hypertension and has also been diagnosed with atrial fibrillation. Mrs. James has been a smoker since her 20s and smokes about a ½ pack of cigarettes per day. She has two adult sons who lives far and has minimum contact with them. She does not work and has a very limited savings. She relies on Old Age Security Benefits for income. She has been living in the same neighbourhood for years but has only few individuals who she considers friends. She prefers to spend her time alone at home watching television, reading or watching over her six cats.
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).
The article is published in a peer-reviewed, scholarly and evidence-based journal. The sources are valid and five of the seven references are current within five years of the date of the article. The fact that the article is looking for EBP, also lends to validity, in that the authors were seeking best practice and what is appropriate care available to the CHF patient.
My client is Margie M, a 69-year-old widower with chronic venous stasis ulcers. PMH: Asthma, Cataracts, Arthritis, Tremors, Narcolepsy, Congestive Heart Failure, Diabetes Mellitus, Peripheral Vascular Disease, Hyperlipidemia, Hypothyroidism, Gastric Ulcers, Irritable Bowel Syndrome, Micro colitis, Restless Leg Syndrome, Hypertension, Atrial Fibrillation, Anxiety, Depression, Cardiac Stents, and Cerebral Aneurysm. She lives in a two bed, one bathroom house with her daughter Becky, Becky’s husband Jim, and her twenty-five year old grandson Jason. Margie’s daughter, Terri, Jason’s mother is deceased. Jason has mild developmental delays. Margie has one son, Buster, who is not involved in her care. We met for lunch at McDonald’s
Patient Sallie Mae Fisher was released from the hospital last Saturday. This patient is eighty two years old and lives alone as her daughter lives too far away to be helpful. Her medical history includes chronic congestive heart failure (CHF), atrial fibrillation (AF), and hypertension (HTN). She has been hospitalized four times for CHF exacerbation in the last six months. She was discharged from the hospital after being there three day to treat increased dyspnea, an eight pound weight gain, and chest pain. This paper will identify, prioritize, and describe at least four problems with evidence for each problem and identify at least four medical or nursing interventions with rationale for the interventions included.
Patient A.S. is 87-year-old female with a diagnosis of Acute onset chronic systolic heart failure, Afib, CHF, and hypothyroidism. She has a past medical history of Hypertension, diabetes mellitus, CAD (Stent 2001). The patient was admitted to Lutheran Augustana Center on January 4, 2016 and was evaluated for therapy on January 5, 2016. Her current medications include Albuterol and Ipratropium via nebulizer to address shortness of breath. A combination of drugs to treat the symptoms of congestive heart failure and other comorbid diagnosis include: Eliquis, Furosemide, hydralazine, and metoprolol. Other medications include Synthroid to treat hypothyroidism, Tradjenta for hyperglycemia, and Zocor for hyperlipidemia. The patient also presented with skin problems. She has bilateral ecchymosis in her lower extremities and abdomen. Lotrisone lotion was prescribed for atopic dermatitis. Edema was also present in her lower extremities.
Mary Martinez is a 72 year-old female that is here in Prep and Holding for a scheduled elective right knee replacement surgery. I am performing a final pre-op exam at 6am. The patient is awake, alert, and oriented to name, place, and date. Patient has no known allergies. Patient stated her past medical history included: atrial fibrillation, hypertension, coronary artery disease, Type II diabetes mellitus, hyperlipidemia, and osteoporosis. Medications were reviewed with patient. Patient stated taking Coumadin, aspirin, metformin, metoprolol, calcium, and simvastatin. The last time, she has taken her medications were last night at 2000, including her warfarin and aspirin. She has been NPO since midnight. Physical assessment was performed. Patient complains of chronic pain in the right knee. Pupils are equal and reactive. Lung sounds are clear with auscultation on all lobes without any respiratory distress noted. Respiratory rate is 18 breaths per minute. Patient is on room air with oxygen saturation of 97%. Heart sounds are irregular with no murmur noted. Heart rate ranges from 92 to 120 beats per minute (bpm). Blood pressure is 140/67. Labs were reviewed. Abnormal values were International normalized ratio (INR)
In May of 2012, my mother had suffered her third sever stroke and was hospitalized with pneumonia for a month but could not remain in the hospital die to my father's inability to pay for her hospitalization. As a result of her stroke, she also developed Parkinson's disease. My mother was seriously suffering from Type II Diabetes, abnormal heart murmurs, high blood pressure
"CHF (congestive heart failure)" is captured with an associated ICD-9-CM code (428.0) or ICD-10-CM code (I50.9) and SNOMED CT code (42343007), the ICD code is routed to the financial system for review and claims generation, while the SNOMED CT code is available for other reporting. (Bronnert, Masarie,
Mr. Heart, a 72-year-old male admitted for an elective open heart procedure has the following medical and surgical history: coronary heart disease; arthritis; hypothyroidism; diet controlled diabetes; underwent appendectomy; arthroscopic right knee surgery; and two cardiac stents. No history of smoking and weights 160 lbs. at 5’ 11”.
Robert is a ninety-year-old man, who has been experiencing progressive and worsening heart failure. He has a long cardiac history and has been under the care of a cardiologist for the past 30 years. His medical history includes, hypertension, osteoarthritis, dyslipidemia and heart disease. Robert lives in a senior condominium community with his wife Janet.