Case Study : Clinical Background

In general he is a not acutely ill appearing male. His neck veins were elevated to the angle of the jaw. He had no thyromegaly or lymphadenopathy. His lungs were clear to auscultation. His heart was regular rate and rhythm with an S3 and an S4. His PMI was laterally displaced by 1 cm. His abdomen was (full), slightly distended and had a positive fluid wave. He had no pitting edema in the abdominal exterior wall. His rectal exam was heme-negative. His extremities showed 4+ pitting edema up to his knees and in his feet

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,

Discuss a clinical experience in which you had to incorporate one or more learning styles such as visual, kinesthetic, and auditory. Explain the outcomes and how you created an effective learning experience.

Chweyah, dated 08/11/2017, indicated that the claimant presented for a follow-up visit after his discharge from the hospital on 08/08/2017. He was admitted on 08/04/2017 due to normocytic anemia, pain in both knees, starvation ketoacidosis, hypertension, gout with tophus, and duodenitis. The esophagogastroduodenoscopy revealed erythematous duodenopathy, erythematous mucosa in the antrum, and small hiatal hernia. He had a colonoscopy which revealed internal hemorrhoids. Objective findings showed blood pressure of 112/86 with a pulse of 105. He was diagnosed with quadriceps weakness, pain in both knees, normocytic anemia, type 2 diabetes mellitus, hypertension, stable chronic kidney disease stage III, and bilateral impacted cerumen. It was noted that he can return to work on 08/16/2017 with limitations of not standing for more than 10 minutes at a time for 1

A visit note from Renu Mehta, MD (Family Medicine), dated 08/02/2017, indicated that the claimant presented with complaints of lower extremity pain and stomach pain. She continued to have abdominal discomfort. She had a history of hematuria and continued to have a 1+ blood. Objective findings showed a BMI of 31.89 with a blood pressure of 105/72. She was diagnosed with an abdominal pain and hematuria. A series of laboratory tests were recommended.

On 7/27/2015, HOH and client attended to ILP meeting with their daughter Emily. Child was observed well dressed for the weather. Client explaining to cm that her floating hospital was cancel and she doesn’t know the reason.

Gadsden is located in the northeastern corner of Alabama and is the county seat of Etowah County. It is 60 miles

As seen in this case study, TM was listed as a full code and no GOC conversation was had between the physicians and the patient until the day of his discharge to home. This led to an unnecessary swallowing study in which the patient needed to be uncomfortably scoped. Due to the lack of GOC conversation the patient also chose to go home with general nursing services instead of end-of-life (EOL) hospice support. In the inpatient medical oncology floors of a large teaching hospital like this one, most patients are covered by rotating interns and residents that are not comfortable having GOC conversations with patients and leave it up to the primary physician to come and discuss.

JG, a 34-year old Caucasian female presented to the primary care physician office with complaints of losing weight and feelings that "her heart is beating out of her chest". On assessment it was noted that JG had lost twenty pounds in 3 months. JG exhibited tremors in hands, bulging eyes, and pretibial edema. On physical examination there was a goiter, or enlarged thyroid gland noted.

In early 2013, an employee of UnityPoint Health-Trinity Wellness departmnet developed a program titled HEART- Helping Everyone Access heaRt Treatment in an effort to combat the above average mortality rates from cardiovascular disease in Rock Island County in Illinois. Deaths from cardiovascular disease were 21% higher in this county compared to the national average at that point in time. After the Trinity employee developed the program, Trinity applied for funding from the AstraZeneca Healthcare Foundation (AZHF) to support the implementation of this program. In October of 2013, AZHF announced that they were awarding Trinity a one year grant for $187,270 to support the implementation of HEART. After Trinity received the grant, the

On the same date an abdominal x-ray was also completed which revealed no small bowel dilation, no free gas, with a few small pelvis phleboliths (venous calcifications) noted. My involvement and care of the patient occurred Feb 22nd. On this date her lab work was: BUN 6.3, Cr 64, Na 138, K+ 3.5, Cl 107, C02 22, WBC 8.2 (15.4 Feb 15, 4.1 Feb 17), Hgb 93 (106 Feb 15, 80 Feb 16, 73 Feb 17), Hct .291, Plts 305. On assessment the client was still on contact plus isolation, but both a stool C+S and C-Diff tests were negative. Vitals: T 35.8, P 68 reg, RR 18, BP 94/52, Spo2 98% room air, Pain 0/10 (did receive 650mg acetaminophen @ 0630 for chronic Lt arm/hand pain).

Then plaintiff realized that on January 03 2017, she suffered a minor stroke due to exposure to CO poisoning and as of result lack of oxygen to her brain, stroke is a disease when the brain is robbed of oxygen. It was approximately 700 over-flights from January 01, 2017 through the early morning of January 03, 2017 and at that time plaintiff’s heart and breathing condition were in a very bad shape.

After a few days the headache had returned along with a few new symptoms. She was experiencing neck pain with the headache and feeling unbalanced. She made an appointment with her PCP. Her PCP ordered a battery of test, compiled a patient history, and treated her symptoms until further information was obtained. Tests ordered were as follows: CBC, Chem 16, and UA. All tests were within normal range. However, the symptoms were still present and the patient was not improving.

The amount of glucose detected in the urine was 500 mg/d, measuring above the norm of 130-180 mg/d. A high glucose concentration could be associated with calcium oxalate and calcium phosphate. High levels of glucose may occur with diabetes, renal glycosuria, and pregnancy. A follow-up test for diabetes may be given for these reasons. There was a small indication of bilirubin in the urine sample which should normally pass into the liver. Presence of bilirubin cold indicate live damage or diseases such as hepatitis. No ketones were found in the urine we sampled which is normal. The specific gravity of the urine reflects the patient’s hydration status and the sample measured a normal 1.030. In the urine sample there was a trace amount of blood found. This could require additional resting for a sign of kidney damage or infection, kidney or bladder stones or cancer, and blood disorders. Blood also creates a change in the color of urine, perhaps this had something to do with the abnormal coloring of the urine sample. The PH and urobilinogen were both identified as normal by the test. A trace amount leukocytes were identified in the urine. A small amount of leukocytes are normal and expelled in the urine when they are damaged or killed when fighting an infection. A high number of leukocytes may show signs of infection in the urinary system and create cloudy and foul smelling urine. A positive

Dr. Kevin Aminzadeh is a rare gem among the dental guild. He is not only an outstandingly knowledgeable in his field but his approach towards his customers is very professional and informative. I have been one of his patients for an entire year because of the complexity of my case. It took a long time and many procedures to achieve the brilliant result I dreamt of and which I can proudly show now through my smile. I will be forever thankful to Dr. Aminzadeh for the warmth, patience and nurture he welcomed me with since day