Arguments To Tennova Healthcare Lebanon

Mr BW was a 74-year-old man who had a fall due to a new onset of seizures, which resulted, to a direct impact of his head on the ground while at home. While at the hospital, MR BW underwent a CT and MRI brain scan and showed a haematoma, which resulted to commencing of the patient on Keppra and Bezodiapenes. Moreover, Mr BW also developed a sudden onset of pleuretic chest pain, which was confirmed by CTPA as a small pleural effusion on the left lungs; while there was also pulmonary embolism on both upper and lower lobes of the left lung. Due to the development of a provoked pulmonary embolism, patient commenced on Clexane injection. In September 2015, an elective open abdominoperineal resection was performed on Mr BW, which resulted to prolonged stay in the hospital due to delayed wound healing.

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

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

This is a 50 years old male with no significant past medical history presented initially with shortness of breath and hypoxia and was transferred to the ICU. He was treated for bilateral pneumonia that required prolonged mechanical ventilation via a tracheostomy. He has necrotizing pneumonia and he has been in the hospital for 6 weeks due to the development of multi-organ failure. He was weaned from mechanical ventilation to the point he was tolerating a CPAP/PS mode. Later on, it was noticed that he

The assessment of Mrs. Baker should include vital signs including pulse oximetry. Given her difficulty in breathing, lung sounds should be auscultated. Because she is on two different medications that could affect blood pressure, lisinopril and hydrochlorothiazide (HCTZ), hypotension could be one cause of her collapsing. In addition to vital signs, decreased peripheral pulses and capillary refill can also be indicators of hypotension. Also, because HCTZ is a diuretic, dehydration should be considered. Since she was in her backyard when she collapsed, it could be that

Fifteen minutes into my shift, I walked into this client’s room to administer his pre-operative intravenous antibiotic. When suddenly, the client held his hands to his head and started to complain, “My head is splitting into two!” I did not even have a chance to ask any prudent questions about his pain, nor even had a chance to get his vital signs. The client had a sudden onset of right upper extremity paresis and left sided visual loss. The client’s vital signs at change of shift were B/P 143/79, AP 83, RR 18, Temp. 98.5 F.

The patient is a 21 year old female who presented to the ED with suicidal thoughts and multiple superficial laceration to her left arm. The patient reports a altercation with her boyfriend, which he was physically and verbally abuse. The patient denies homicidal ideations and symptoms of psychosis. The patient reports substance abuse of opiates and benzo's.

On scene vitals were check in office, P/t BP was in normal range 124/88, but pulse was 112 (strong and rapid). P/t said she does not partake in any forms of illegal substances or alcohol products. P/t was told five times that it would be in her best interest if she go to the hospital to get checked out. P/t said she will scheldule an appointment with a doctor's office in the morning

Mr. S, a 69-year-old patient was admitted into the hospital, after he presented at home a sudden severe headache, vomits and neck stiffness. In A/E this patient presented a Glasgow Coma Scale (GCS) of 15/15 (E-4, V-5, M-6), both pupils, equal and reactive to light (3mm) and normal motor power. Also he complained about severe pain in his head, which was measured at 7/10, using the numeric pain scale (which 0 means “no pain” and 10 means “extreme pain”) (British Pain Society, 2006).

The patient’s chart said that he stated upon admission that he was employed and working for one of the local television stations; however, he did not state his current position at his job. He also stated that he did not have a history of smoking or alcohol use. His OTC and recreation drug use history was listed as unknown. None of these statements could be confirmed due to the patient being sedation and intubation with no family

The patient is an 85-year-old female who is brought to the emergency room by her family because of weakness over the past 2 weeks and not acting herself. The niece reports the patient has a history of dementia in the last 6 months to one year. She evidently stopped her medication about a month and a half ago because she felt that they were not helping her. She had been experiencing generalized weakness, difficulty with ambulation, decreased po intake and decreased appetite for the past few weeks. Her medical history is significant for hypothyroidism. She has had a thyroidectomy, hypertension, hypercholesterolemia, and lung lung cancer. The patient presents with a degree of acute kidney injury. Initial creatinine is 2.62 and with some

ML had neurological involvement before admission. This included a history of stroke which contributed to the anoxic encephalopathy. This loss of oxygen and blood flow to areas of the brain was evident on his results from a CT of the head. The CT showed that patient ML had mild to moderate ischemia and low attenuation in multiple parts of the brain. The CT scan also made evident that this patient had suffered from cerebral volume loss. These results were not surprising considering the patient was unresponsive except for pain stimuli and was also nonverbal due to having a trach and being on mechanical ventilation. Due to him being unresponsive it was difficult to assess if his current infection had any effect on his neurological state.

This patient is an 80 year old female who required inpatient hospitalization due to: She was brought by the ambulance to the Emergency Department with complaint of chest pain for the past week, worsening over the past 2 days. She also had non-productive cough, nausea, diaphoresis, shortness of breath, and bilateral inspiratory crackles with mild expiratory wheezing in her lungs, as well as one plus pitting edema on the lower extremities. Her medical histories were significant for diabetes mellitus type 2, hypertension, hyponatremia, status post for PCI or coronary artery bypass graft with pacemaker, and a recent hip fracture status post left hip replacement. In the Emergency Department, her vital signs included a blood pressure of 150/78mmhg, and a respiratory rate of 24 breaths per minute, with an oxygen saturation of 95 % on 3 Liters of oxygen per minute. She had a troponin I of 227 and BNP level of 1539 (noted as elevated). At that time, she was given aspirin to chew, sublingual nitroglycerin , 40 mg of IV Lasix, morphine, was placed on oxygen which helped with her breathing , telemetry monitoring, and EKG was done.

Orientation:  Time (present/absent):  Place (present/absent):  Person( present/absent): ii. MMSE score (Appendix 5): • Glasgow Coma Scale: • Auditory impairment: • Vision impairment: • Coordination:  Finger-Nose-Finger Test:  Rapid alternating movement: • Gait (normal/abnormal): • RASS (Appendix 4): • CAM-ICU score (Appendix 3): • DRS-98 Score (Appendix 6): Patient’s status: Patient’s Laboratory investigation profile: Hematological: • Hemoglobin (gm/dl): • Total Leukocyte Count (per mm3): • Platelet (x 103/mm3): • Hematocrit (%): Value: Biochemical: • Sodium (mmol/L): • Potassium (mmol/L): • Urea (mg/dl): • Creatinine (mg/dl): • BUN : Creatinine ratio: • Bilirubin (Total) (mg/dl): • AST (U/L): • ALT (U/L): • ALP (U/L): • Protein (Total) (gm/dl):

History of present illness: This patient has a history of hypoxic-ischemic encephalopathy due to non-accidental trauma (child abuse), cerebral palsy, scoliosis, obstructive sleep apnea on home CPAP, gastrostromy tube (GT) dependence, recent fundoplication, and was admitted for respiratory failure likely due to pneumonia vs. viral infection. Patient presented with fever and increased work of breathing for a week. Temperature at home was at 104 F and he desaturated into low 70s on home pulse oximeter. The emergency medical services put him on non-rebreather and escalated to BiPAP and still there was significant work of breathing despite increasing pressures, so he was intubated in the emergency room. He was started on vancomycin and ceftriaxone after blood cultures were obtained as well. Currently the patient is diagnosed with respiratory failure, neuromuscular disorder (neuromuscular scoliosis), and anoxic brain injury. Patient has been hospitalized in the past for pneumonias.