12/24/15 Progress Report describes that the patient has right knee pain. The pain is frequent. It is aching and burning in quality. The current pain level is 0/10 and worst pain is 4/10. Bending, squatting, walking, weight bearing, changing clothes and ROM aggravate the pain. Rest, ice,
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
A review of her medical records indicates that she has not had any significant health events, such as falls or hospitalization since her last visit. She suffers from chronic stable hypothyroid, chronic DM which is mange with medication and chronic neuropathy.
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.
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.
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
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
She had history of end-stage renal disease, diabetes mellitus type 2, bipolar disease, and peripheral vascular disease. She had underwent, arteriovenous fistula creation, partial parathyroidectomy, and right midfoot amputation for ischemia. Her parathyroid hormone and creatinine levels were increased, while serum calcium level was low. She smoked 2 packs of cigarettes per day. For past 12 years, she was receiving hemodialysis treatment.
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.
She had seen different specialists at other hospitals as well.She was investigated extensively by the gynaecological team with regards to her chronic pelvic/abdominal pain symptoms as well.She also underwent a total abdominal hysterectomy.She was reviewed by the Musculoskeletal specialists regarding her low back pain and had her coccyx was removed due to an angulation probably following physical abuse.The MRI showed minor spondylotic changes of the disc without any nerve compression and normal sacroiliac joints.She was also under the treatment from Psychiatrists for depression.During consultation, she was tearful and anxious.She was accompanied by her partner during the consultation who was also concerned about the situation.There was also a history of multiple hospital admissions with acute pain conditions which was often inconclusive and there was difficulty in treating the acute episode by the medical
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.
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
A review of the medical records indicates that she suffers from multiple medical illnesses which include, advanced dementia, ADFT with 6 lb weight loss since March-BMI 16, chronic stable hypothyroid, chronic stable hyperlipidemia, chronic anxiety and chronic depression.
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