Circulation, Disability, Exposure (ABCDE) Approach

As I did the physical exam I explained to the patient that I would listen to the arteries with a stethoscope for an abnormal sound which will let me know if there is poor circulation due to plaque? I also explained to the patient that by checking the pulse in the ankle and legs it would also indicate if

The purpose of this paper is to discuss the results of a comprehensive health assessment on a patient of my choosing. This comprehensive assessment included the patient 's complete health history and a head-to-toe physical examination. The complete health history information was obtained by interviewing the patient, who was considered to be a reliable source. Other sources of data, such as medical records, were not available at the time of the interview. Physical examination data was obtained

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

Analyzing Mr. Edward blood pressure (140/85) during his last visit to the doctor, plus the constipation and the GERD, and also the level of his cholesterol, it show that he has all the condition to develop myocardial

BP 166/73 | Pulse 69 | Temp 96.9 °F (oral) | Resp 14 | SpO2 99% on room air

Chest pain is posed as life threatening-has many definitions ranging from either stabbing, dull, crushing or burning. In certain cases, pain travels up the neck, the jaw, can radiate to the back or down one or both arms. Many different problems can cause chest pain and it can be difficult to determine the exact cause of chest pain (Burman et al’, 2011). Patients’ experiencing chest pain is symptoms consistent with, myocardial ischemia and is a common reason for presenting to ED (Pub Med Central, 2010).

Lungs: Clear to auscultation bilaterally. No wheezes, rales, or rhonchi. Symmetric chest expansion. Breathing nonlabored. Diminished breath sounds in all lung fields. Resonant to percussion.

Denies cardiac surgery or hospitalization for cardiac evaluation or disorder, congenital heart defect, or vascular procedures

Vital signs assessment: Assess as per post-op protocol or more often if unstable to assess treatment effects, identify signs of clinical deterioration in an early stage and to detect any procedural complications. Mrs. M’s RR (respiratory rate) is 22bpm which is slightly elevated and could due to her pain, SaO2 (Oxygen saturations) is 95% which is a normal figure, she has an elevated BP of 145/90 that could result from her pain, a psychological problem such as anxiety about transferring or ambulating post-op or can even due to her cardiovascular history. Her T (Temperature) is 36.8° and P (Pulse) is 98bpm which are normal ranges. RR and SaO2 needs to be checked precisely because her PCA Morphine can cause potentially fatal opioid-related respiratory depression. This problem can lead to a possible need for critical care

which the patient’s health will be significantly affected by the lack of proper blood flow,

Disability – Assessment of disability involves evaluating the patient’s central nervous system function. Assess the patient’s level of consciousness using the AVPU scale. Talk to the patient if they are alert and talking they are classified as A. If the patient is not fully awake establish whether they respond to the sound of your voice (opening their eyes, making any sounds) if they do they are classified as V. If the patient does not respond to voice administer a painful stimulus (gently rubbing the sternum bone). If they respond they are a P on the AVPU scale. And finally if they do not respond to any of the above they are a U, you should then move onto the more detailed Glasgow Coma Scale (GCS). You will assess the patient’s pupils (eyes) and motor responses (arms and legs) among other things to give the patient a score out of 15 (15 being the highest). A GCS of fewer than 8 is a medical emergency and you would then have to go back to assessing the patient’s airway.

Mrs. Baker’s immediate assessment would include ensuring a patent airway, adequate breathing and circulation, and a brief neurological status. Once the immediate assessment is complete then a secondary assessment is conducted that includes a full set of vital signs with focused adjuncts, pain control, a full head-to-toe assessment with a patient history.

We should inspect the whole extremity for deformities, edema, lesions of the skin, ecchymosis, swelling of the joints, neurovascular status, scars, range of motion and gait. During inspection the patient should be walking, sitting or lying.

Nowadays primary care physicians often have access to many diagnostical tools. It spans from blood and urine tests for specific substances to ECG. But until the middle of the previous century, the GP’s examination methods were few. The most significant are still important: interview, inspection, palpation, percussion, auscultation, and smell. A primary diagnosis could only be done by sensing the illness by using those traditional methods. In other words, the physician got a feeling or intuition of what was wrong. In order to exactly define different conditions, it has been important to standardize the use and terminology of the traditional examination methods. E.g. “dorsal crepitations in the basal parts of the right lung” is a subjective

Based on the laboratory test, electrocardiogram, and the patient’s presentation would lead the health care provider to believe that the patient is having a myocardial infarction or heart attack. A myocardial infarction is when suffienct blood flow to the coronary arteries is decreased or stopped which in turn leads to partial or complete failure of the cardiac muscles in that area of the heart (Abreu de Vargas, Riegel, de Oliverira Junior, Silveira Siqueira, & Oliveira Crossetti, 2017, p. 2804). When the cardiac muscle is not getting the blood flow and the oxygen that it needs the tissues start to become necrotic and release a chemical called troponin. A laboratory test that is performed on patient that complains of chest pain is a troponin,