A review of her medical record indicates medical history of CKD stage 3 that is stable, NIDDM-stable. She also suffers from Afib, muscle weakness, hypothyroid, major depression, UTI, Bipolar, GERD, HTN, anemia and Anxiety.
At today’s visit she is seen at Tiffany hall SNF. She is found in her room. She is awake and alert and oriented. She c/o of pain in her hips and knees, that she describe as achy with a severity of 5/10, the pain does not radiate but does affect her ability to ambulate, she is using a wheelchair. Her pain regimen is Lortab 7.5 mg p.o every 4 hours. She reports that she has increased hip pain when she sleeps on her mattress because she sinks in her mattress. She is schedule to follow up with her orthopedic doctor Dr. Shute.
PHYSICAL EXAM: Temperature 98.6, Blood pressure 140/90. Pulse 110. Respirations 26. Her lungs are clear, showing mild signs of distress. Heart sounds are normal, irregular rhythm and bradycardia noted. No edema noted in extremities. Patient skin is cool to touch, slightly clammy. EEG shows prolonged QRS wave, with ischemic ST changes and PVCs. Chest radiograph clear.
At today’s visit she is found in her room at Tiffany hall SNF. She is awake, alert and confuse. The facility staff reports that the patient often refused care. She is wheelchair dependent. She is assist with most ADLS. She has chronic edema in lower extremities and refuses to elevate legs. She also refused
At today's visit, she is accompanied by her husband. She is awake, alert and oriented. She complains of chronic, dull, intermittent, burning pain in her thighs which radiates down her legs. She rates her pain as a 3/10. She states that taking the
Objective She is currently on sliding scale insulin, 1200 Kcal diet, and Captopril 50 mg orally twice daily. She has high random blood glucose of 325 mg/dL. Her vital signs are generally normal except for BP (150/97mmhg). Physical exam revealed dry nasal and throat mucus membranes and mild cool leg edema. She is overweight with a BMI of 31kg/m2.
MEDICAL UPDATE: Client continues to report arthritis in her left leg and hand, high blood pressure. She also reports she will need surgery but she is waiting to be housed.
At today’s visit she is found sitting in the chair, she is awake, alert, and confused. I am asked to seek this pain for new onset pain. The patient complains of acute pain in pubic area and right hip area, pain is dull, achy, severity 4/10, pain is worse with walking. At this time the patient is not taking anything for pain. The ALF staff reports that the patient has daily anxiety and has to be given Ativan three times daily. The patient ambulates with a walker. Gait is
A 59-year-old woman visited hospital for worsening bilateral hip pain for past 6 months. She had been receiving hemodialysis treatment for 12 years. She was admitted to the hospital as she was unable to ambulate due to bilateral hip pain.
Mr. Valentine is a 34-year-old patient who is seen at the medical clinic today in regard of follow up with his chronic care of his left hip pain. Patient reports that he had a gunshot wound on the right hip and because of that he will compensate all of his body weight or pressure, so then his left side accommodate by dominant for the right side hip. Patient's stated over time of doing that he developed chronic left hip pain. Patient has narrowing or arthritis on his left hip; otherwise, he also is taking Indocin 50 mg three times daily with food and he also has Keppra 1000 mg twice daily. He took all of his medication as directed and he is doing well to control his left hip pain. He stated
Musculoskeletal System (joint pain; stiffness; swelling, heat, redness in joints; limitation of movement; muscle pain or cramping; deformity of bone or joint; accidents or trauma to bones; back pain; difficulty with activity of daily living, medications):Denies pain or stiffness in joints. Denies swelling, heat, or redness in her joints. Denies deformity of bones or joints. States no self or family history of arthritis. Complains of “achy fatigue” in lower legs at the end of the day. Uses a walker for increased stability. States she is “afraid of falling” so uses a walker at all times. States she fell in her kitchen late one night and bumped her head on the laundry room door. States she did not feel dizzy, just tripped over a kitchen chair with her walker. Called 911 for assistance but refused to go to the hospital for evaluation. Denies fractures or traumas to bones. States she has mild back pain when standing for prolonged periods of time. States she uses a shower chair to avoid fatigue in shower. States she bathes, grooms and dresses herself without assistance. Grandson assists with
M. H. states that she is generally in good overall health. No cardiac, respiratory, endocrine, vascular, musculoskeletal, urinary, hematologic, neurologic, genitourinary, or gastrointestinal problems.
Similarly, patients with long-standing hypertension with hypertensive retinopathy and a family history of hypertension and CKD are likely to have hypertensive nephrosclerosis, particularly if urinalysis reveals minimal proteinuria and no hematuria22. It is worth noting that the presence of diabetes or hypertension does not rule out another cause of CKD, particularly since hypertension is a consequence of CKD. In addition, distinguishing between diabetic and hypertensive nephropathy is frequently challenging. However, a biopsy is usually not recommended because distinguishing between hypertension and diabetes as the underlying cause of CKD does not change management.
One the outside people can seem to be heathy, but we never know what may be going on with them internally. I spoke with a 45 year old man who is married with a full family of 7. He is a detective with the local police department. As he is a man of faith he works in his church. His friends and family can always depend on him. On a normal week, he can been seen going to work, the gym, church, cutting grass for family and friends, taking care of his widowed mother and playing with his 2 year old grandson. From the outside looking in, people would say he has a very blessed life. What many people do not know is that he is battling a very deadly disorder. He is in stage 3 renal failure, also known as CKD Chronic Kidney Disease. There is no cure for this disorder, all that can be done is to take measures to slow the progression.
S.P. is admitted to the orthopedic ward. She has fallen at home and she has sustained an intracapsular fracture of the hip at the femoral neck. The following history is obtained from her: She is a 75-year-old widow with three children living nearby. Her father died of cancer at age 62; mother died of heart failure at age 79. Her height is 5’3 and weighs 118 pounds. She has a 50 pack year smoking history and denies alcohol use. She has severe Rheumatoid Arthritis (RA) and had an upper GI bleed in 1993 and had Coronary Artery Disease with CABG 9 months ago. Since that time, she has engaged in “very mild exercise at home.” Vital signs are 128/60, 98, 14, 99 degree farenheight (32.7 degrees C) SAO2 94%
The study introduction presents an overview of information on Chronic Kidney Disease (CKD). Specifically, the problem statement includes the definitions and diagnostic symptoms of CKD, its prevalence, consequences and risk factors associated with CKD and health-related quality of life (HRQoL). The researcher briefly discusses medical and psychosocial interventions as non-conventional treatment approaches for patients with CKD. Furthermore, the chapter explains peer intervention as an effective proven intervention and prevention approach for improving HRQoL in patients with CKD. Later sections include the research purpose, significance of the study, and relevance to social work. A chapter summary is added in the
Chronic kidney disease (CKD) affects 10% of the adult population and this number is trending upward due to increasing prevalence of diabetes, hypertension and obesity (Lopez-Vargas et al., 2013). Individuals with CKD are required to invest immense time and effort into managing their health such as, attending appointments, modifying their diet, and managing their medications. This can have a great impact on all aspects of people 's lives physically / mentally / socially. This essay will analyse the issues related to these concepts. People with CKD have a vast range of needs, such as emotional support, continuing education, dialysis, as well as traditional basic care . Due to the complexity of this environment, it is the responsibility of