Comprehensive Case Study Examples

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

Mr. Howard, a 57-year-old man, had a 3-month history of progressive typical anginal chest pain. He reported that the symptoms first occurred with heavy exertion and involved what he described as“heaviness” in his chest. The symptoms were promptly relieved with rest. Over the past weeks, he had been experiencing increasingly frequent episodes of chest pain and diaphoresis. The episodes had become more prolonged, and he had experienced one episode of pain occurring at rest after a heavy meal. Mr. Howard was moderately obese and had a 20-year history of hypertension, which was being treated. Other risk factors in Mr. Howard’s history include hypercholesterolemia (350 mg/dL), which he was attempting to treat with dietary modifications, and a 30-year two-pack-a-day smoking history which continued up to the present time. Mr. Howard previously had surgery for a bilateral inguinal hernia repair, cholecystectomy, and arthroscopic surgery on his left knew. He also gave a history of problems with gastric reflux and was currently taking cimetidine (Tagamet).

HEENT: No thyroid enlargement, masses or adenopathy, JVP was 5 cm above sternal Angle, carotid pulse was strong and regular

“The patient is Adam Rudd, a 78 y/o white male with a history of hypertension. He has been diagnosed with hypertension past 15 years and is on anti-hypertensive medications and aspirin. He is very weak and short of breath. He is accompanied with his longtime friend Jennifer, who reports that Rudd was looking very weak and was complaining of severe headache and blurred vision before coming to the hospital. He is 5’9” and weighs 270 lb. Vital signs recorded were: oral temperature 98.20 F, BP 224/120 mm Hg with a heart rate of 102 beats/minute and respiration of 24 breaths per minute. The pulse oximetry reading was 94% on room air. He is complaining of severe headache and blurred vision. Rudd said that he did not take his antihypertensive medication or aspirin since he ran out of pills. He has not been taking his medication for past 15 days. He reports no known allergies to any medications or other substances.”

The purpose of this study is to minimize the risk of hypoglycemia among the elderly. As people with diabetis age, the physiological changes affect the diabetic. The purpose of this study is to consider whether HbA1 goals can be attained without undue treatment burden and decrease the risk of severe hypoglycemia. Though client teaching and minimizing the risk factors of hypoglycemia can prevent further exacerbation of catastrophic events that could have potential lethal outcomes to an older patient with diabetes. The one patient’s case, Mr. J., an 86 year old man who has had type 2 diabetes for 15 years is a quantitative study that focuses on prevention of hypoglycemia in older adults. Interventions include diet, meal planning, medication, glucose

- One of the issues is the fact that Senator’s are appointed by the Prime Minister. In other words, senators are appointed to the Senate for being loyal to the Prime Minister’s party which is seen as undemocratic and gives the Senate an illegitimate image.

5. CVS’ additional competitor Walgreens is behind them by a market cap of roughly $10

Diabetes develops when an individual’s body cannot properly produce or respond to insulin. In a normal functioning body, after food is consumed it is converted into glucose, or sugar, that the body will use for energy. When the body is not able to appropriately respond to the glucose it builds up in blood and can create complex health complications such as a diabetic coma or even premature death. The HbA1C is a blood test a doctor uses to determine an individual’s blood sugar control over a ninety day time period as well as to make an accurate diagnosis of diabetes. The red blood cells carry oxygen from an individual’s lungs to other cells within the body. When sugar is elevated it will attach to hemoglobin and the higher concentration noted in the blood cells results in decreased control and the individual is said to have and a greater risk of severe health complications (Mayo Clinic Staff, 2013).

Last, hospital visit was to the emergency room. Last year she had an episode of SOB, and she was prescribed an albuterol inhaler. GL has been treated for hypertension for the past 13 years, her current medications are propranolol 40 mg twice daily and hydrochlorothiazide 15 mg daily. GL’s physical assessment and vitals are as followed; HR: 60 bpm, RR: 30 bpm, and B/P 152/85 mm Hg. Upon auscultation of her lungs, revealed an expanded chest, with diminished breath sounds and faint wheezes. Heart sounds were normal. The diagnosis includes COPD and asthma. Physician had ordered albuterol inhaler 1 unit does x 3 times a day and fluticasone provide anti-inflammatory, decreasing edema of airways 40 mg x 3 times a day, and oxygen 2L/NC PRN. With GL’s increasing fatigue fall precaution should be initiated and while ambulating CNA should monitor patient. Educate GL about using call light when needed and not to try and get up alone. She should also be educated daily on cessation of smoking and how to prioritize her days. Physician wants to admit

In 2009 the International Expert Committee, which consisted of experts from the American Diabetes Association (ADA), the European Association for the Study of Diabetes, and the International Diabetes Federation, released a report that recommended the use of Hemoglobin A1c (HbA1c) to diagnose diabetes (American Diabetes Association [ADA], 2013; International Expert Committee, 2009). HbA1c is a widely used marker of chronic glycemia, because it reflects an individual’s average blood glucose levels over a 2-3 month time period (ADA, 2013). Also, HbA1c is largely used as the standard biomarker for the adequacy of individuals’ glycemic management (ADA, 2013; Bao et al., 2010).

A 54 year old black female presents with dyspnea and chest discomfort on exertion, postural lightheadedness, palpitations and a functional limitation of less than one flight of stairs. She denies fever or chills. Further questioning reveals she has been experiencing worsening shortness of breath for one week. Past medical history includes hypertension, Epstein Barr virus and osteoporosis. Surgical history included hysterectomy. She is a 1 ppd smoker and admits to drinking 3-5 alcoholic drinks per week for 10 years. Medications include candesartan, multivitamin, and calcium

The study had an overall total of 1150 participants. Although there were many participants to begin with, they did not provide all of the feedback the researchers had requested.  This resulted in the expulsion of their participation, so their results were not included in the final reports of the study. The number of patients that did provide the essential information added up to a total of 901. The profile for a participant was a patients diagnosed with Type 2 diabetes in the last 6 months, but has been diagnosed no more than 10 years ago. They had to be between 35-70 years of age. Their BMI had to be more or less than 24 kg/m2 and have an HbA1c more or less than 6.5%. They also had to have treatment with a diet or oral glucose lowering medication. Those needing insulin shots, had been diagnosed with chronic diseases, or had a change in diet or lifestyle 3 months prior to the study were not included in the overall

A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right

According to the results, the mean level of HbA1c was significantly lower at the 3 month follow up compared to baseline (8.09 +/- 0.31 versus 8.51 +/- 0.26, P < 0.001). In the male participants, the mean level of HbA1c was 8.59 +/- 0.26 at baseline and 8.21 +/- 0.29 at the 3-month follow-up (P < 0.001). These values were respectively obtained as 8.39 +/- 0.03 and 7.94 +/- 0.04 in the female participants (P < 0.001). The study results indicated a significant decrease in HbA1c levels in both male and female participants by the end of the educational course, although the duration of follow up was relatively short (three months). Another limitation was that the study only evaluated the effect of the intervention on HbA1c as a measure of glycemic control. Thus, further studies are recommended to assess clinical parameters (e.g. blood pressure and BMI). Moreover, behavioral or educational theories must have a more

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