Aortic Valvuloplasty Case Studies

Scenario: An elderly woman showed symptoms of near syncope and was admitted via ambulance to a small community hospital. She experienced an inability to move on her own and almost lost consciousness while watching her grandson play basketball. Her symptoms occurred during a visit to her daughter’s home, which is approximately 150 miles from Liza’s home. When Liza was admitted to the hospital, her daughter explained the numerous types and dosages of medications her mother was taking. She also mentioned that Liza had not been taking her Coumadin as directed by her physician for the past week or so. Liza was admitted to the intensive care unit for evaluation. Over the course of hospitalization, Liza’s condition worsened.

Susan is a 78 year old widowed lady who was admitted to a medical ward following an episode of coffee brown vomiting and breathlessness. Susan has a past medical history of chronic

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to

The patient was a female on her 80s who was admitted to the hospital because of the COPD exacerbation. She had a history of stroke with minor residual effects, smoking, hypertension, and schizoaffective disorder - a chronic mental condition that is manifested mainly by the symptoms of schizophrenia, such as hallucinations or delusions, and mood disorder symptoms like manic or depressive episodes (NAMI, 2017). Patient length of stay was more than 300 days. She had two daughters who visited her everyday.

Patient 1: monitor B/P, pulse, respirations, skin appearance and touch, notable changes in neurologic function, ECG, lab

The patient is an 85-year-old female who is brought to the ED by her family because of increasing confusion and supposedly she had a degree of altered mental status of two hours previous to presentation. In the ED she is completely worked up. CT shows advanced atrophy with microvascular changes and several lacunar infarcts nothing acute. Specific gravity in the urine reveals her to be markedly dehydrated. She culture completely, started on IV antibiotics, IV fluids and B12. On the day after admission she still presents as persistently confused. She is evaluated by PT. The patient who was formerly ambulating with a walker and allegedly driving a car is unable to be ambulated. Before the history indicates that she has a slow downward

At today’s visit she is accompanied by her husband and private aide. Her husband reports that she is doing much better. He states that her pain has improved and she has not taken her pain medication since last visit. He states that her anxiety had improved extremely with the recent change in her Xanax. He states that he has hired 24 help for the patient and since she has not fallen. She reports that she is feeling well. The caregiver reports that the patient continue to suffers from hypotension and hypertension with variation in blood pressure. The patient also continues to suffer from chronic tremors as a result of her Parkinson.

The following case scenario is based on a fictitious patient, and it would be use on this paper as a guidance to develop a patient and family teaching plan. The situation: Mrs. Marquez, a 39-year-old Caucasian female was admitted into the Emergency Department due to complains of shortness of breath and anxiety. Patient cannot take deep breaths, appears overweight and denies Allergies to medication. The background: Patient has medical history for panic attacks, atrial fibrillation, and Grand Mal seizures; however, patient is not constantly taking her seizure medication. Patient previously had a cholecystectomy, and smokes 1 pack of cigarettes per day for 12 years. The Assessment: Patient vital signs 98.8° F oral, 109 heart rate, 26 respiratory rate, 150/86 blood pressure, SaO2 97% on room air. Denies pain. Neurological; Patient is 65 inches tall, weighing 246 lbs. She is able to move all extremities with strong pushes and pulls. States her “last seizure was two months ago.” Respiratory; Respirations are even, deep, and rapid. Lungs are clear on auscultation. Cardiac; EKG reveals atrial fibrillation; patient states, “It feels like my heart is racing at times.” Pulses are palpable +3 all extremities; capillary refill is instant. GI; Abdomen soft, no distended, and no tender with bowel sounds present in all four quadrants; skin is intact and warm. Current medications: Dilantin 400mg PO BID, Lexapro 20mg PO daily, Metoprolol 25

Patient Y stated that prior to her referral to the Accident and Emergency department she had become

Setting the Stage: Patient 1 is an 87 year old retired man who arrived by ambulance. His last admittance to the hospital (from the nursing home that he lived at) was 2 months ago. According to his medical records, he had a history of peripheral arterial occlusive disease and deep vein thrombosis, and came in due to leg pain and a urinary tract infection. While the patient did not have a diagnosed neurocognitive disorder, the patient appeared delusional, and told the occupational therapist that he (the patient) was a retired occupational therapist, but had told the physical therapist the previous day that he was a carpenter. The patient was being treated for depression and anxiety with medications.

Your mother was brought in by the ambulance on January 19. She was having difficulty speaking, swallowing and was showing signs of paralysis on her right side. Your mother has a history of high blood pressure and high cholesterol. Your father said that she is taking medication daily. Your father said that your mother has been fine until her face started drooping and she complained of having a headache. Your father stated that she was unable to drink her coffee without it spilling down her face and she was reaching in the cupboard when her arm started to fall. She was getting up from the kitchen table when she collapsed and was not able to get up without help. Your mother then was not able to move and could not swallow or talk.

The patient is an 81-year-old female who was brought to the ER there this morning while trying to make her bed she felt a little bit dizzy. She felt like the room was spinning and she knew she was going to go down. The next day she remembers is that she saw some blood on the right side of her eye she was on the floor she activated her alarm and the EMS actually had to climb thru a window to get her. The patient denies any palpitations prior the episode or any prior episodes of passing out the past. In the ER she was having a glucose level of 47. She has is quite significant history, she had a laminectomy done in February 2015, was discharged to rehabilitation where she had some problems with difficulty breathing and ended up in Saint Barnabas

Mrs X is an 81 year old lady who suffered from an ischemic stroke. She first started noticing the symptoms when she was visiting a friend. Mrs X started experiencing sudden trouble speaking and seeing, weaknesses, sudden confusion and severe headache. As her symptoms worsened her friend thought it was necessary to call the emergency services and after explaining Mrs X 's symptoms an ambulance arrived within 15minutes.

Joanna is an experienced nurse taking care of Mrs. Kelly, who was Joanna’s patient many times in the past for her primary problem which is COPD. This time Mrs. Kelly was admitted with complaints of abdominal pain what was different from her primary diagnoses. Her vital signs were with normal limits and no significant changes from privies results, but for the nurse she looks sick, and Joanna know that something is wrong. She calls the resident doctor, but he tell her to watches and calls back with series changes. Joanna multiple attempts to report that something needs to be done to evaluate the cause of Mrs. Kelly pain was ask to calm down. However nobody took patient symptoms series and the next day patient died.