EH is a 68-year-old male who comes into the clinic complaining of a fever with a temperature of 103 °F. He has had a cough for the last three days that is producing some thick green brown mucous. The MD feels he most likely has bacterial pneumonia. He also has a history of having rheumatoid arthritis, and being immune compromised as he is on an immunosuppressant methotrexate. He has noted that over the last year he has lost weight unintentionally and feels he is underweight. 1. Understanding epidemiologic concepts of the chain of transmission of organisms from host to victim, describe how EH could have been infected. * Pneumonia is refers to an infection in the lungs that causes swelling in the lungs tissue and this inflammation …show more content…
His wife can use automated bicep, wrist cuff but I don’t think she can use the scope. KH’s most primary factor risk is an HTN because of his age and also the extra 30Ibs of his DM. but his 30Ibs over is not a significantly bad if KH were health of metabolically but the overweigh can lead to cause of hypertension.
2. What is the rationale for treating KH with an ACE inhibitor? What is the mechanism of action? What part of the blood pressure formula do they affect? The prescribed of medications are also ethnicity needs to take because some of the medications works better some of the groups ethnicity than other people. It is an angiotensin II of vasoconstrictor that elevates of B/P angiotensin II are also formed of angiotensin 1in the bloods enzyme and enzyme can cover ACE and interfere activity of enzyme of ACE because it decreases the angiotensin II. Most of all if he has vasodilation and blood pressure is reduces.
3. KH’s hypertension is not adequately controlled. What other intervention might be considered? The other interventions are if there is no well treatment of couple of things, I think there would be damage to the heart, arteries and that could be a heart attack, heart disease, stroke and more.
4. What tips can you give KH’s wife to improve the accuracy of her blood pressure measurement technique? Used the better way to measure the blood and for the cuff to wrap
The algorithm begins with an indication that is used for adults over the age of 18 and noted that lifestyle interventions should be continued throughout management. Goal blood pressures are separated by age and presence of chronic disease. The goal for patients over 60 is SBP < 150 mmHg and DBP < 90 mmHg. The goal for patients under 60 is < 140 mmHg and DBP < 90 mmHg. Different goal values are presented for patients with chronic conditions. Treatment with medication is categorized by: general population nonblack, general population black, chronic conditions black, and chronic condition all races. Based on the algorithm black patients should only be prescribed thiazide type diuretics and/or calcium channel blockers. While non-black patients can take all of the medications listed in JNC 8 (thiazide type diuretics, ACEI, ARB, and/or CCB). If patient does not reach goal blood pressure then three strategies are listed, along with lifestyle adherence. The algorithm also explains not to use ACEI and ARB together. The final option for patients not at goal blood pressure includes additional medications and/or referral to physician with an expertise in hypertension
I will be discussing a clinical case of a 49-year-old patients: problems, pathophysiological changes occurring in his eyes and heart; the possibility of developing congestive heart failure (CHF); and medications of at least two antihypertensive drugs.
Bronchitis is the inflammation of the bronchioles secondary to possible infection. The inflammation produces mucus production and shortness of breath. As the victim coughs the body not only attempts to clear the airways, but can cause irritation to the already inflamed bronchioles causing a blood tinged sputum production and chest discomfort in which the patient is positive for. Patient is negative however for associated symptoms such as fever and chills. Bronchitis comes on quickly over the course of 2-3 weeks and can be ruled out with further testing. (Dunphy & Winland-Brown,
She was seen by her new primary care provider to present episodic cough, dry, irritative, in paroxysms and nocturnal predominance also exacerbating by physical exercise in her case by swimming. She cannot precisely when this problem began to develop, just refer periods of a lot of coughs. No concerns during this period of evolution of other accompanying symptoms. There has been no runny nose and catarrh of the upper airways, has not presented fever or concerns epigastric discomfort or heartburn. She has received several treatments that included several antitussive (dextromethorphan, chlorpheniramine, Dimetapp) with no obvious improvement of the acute episode. The patient has not sought any other treatment. Otherwise the patient reports that she is in good health.
Hypertension (HT), defined as a chronic elevation of systolic and/or diastolic blood pressure (BP), is in all probability the most common chronic disease today. Clinically hypertension is not a disease at usual sense it is a risk factor for many future vascular diseases1,2. In human body blood pressure is maintained by several factors such as kidney, sympathetic nervous system, hormonal mechanisms along with the diet taken. These include lipids, magnesium, sodium, potassium and the total energy intake3.
Patient WS is a 52 years old male his complained of crushing chest pain, shortness of breathe with exertion and diaphoretic. His has history of present illness of angina. The patient has a history of hypertension, high cholesterol, and cholecystectomy. He is a full-time carpenter, no known allergies, smokes one pack per day, and no active exercise. The patient takes one heavy meal per day and mostly skips breakfast and eats fast foods for lunch.
Surprisingly, Chaz has little to no systemic risk factors. Answering yes to only two medical conditions on his health history, high blood pressure and thyroid disease, he is taking two medications to combat these diseases. The first medication is Micardis. This is an angiotensin receptor blocker (ARB) used to treat hypertension. ARBs work by preventing the hormone, Angiotensin II, from having an effect on our body. When Angiotensin II is released into the blood stream it causes vasoconstriction and water retention, in turn raising blood pressure; if we prevent the effects of Angiotensin II the result will be vasodilation and less water retention, leading to a lower blood pressure. (Angiotensin receptor blockers (ARBs) – blood pressure medication,
The warning signs of acute bronchitis tend to be confusing together with the symptoms of cold as well as flu. Overall tiredness is usually recorded with some individuals who've had other sorts of warning signs for instance drippy nose, sore throat, temperature and many others. Intense cough, followed by mucus of green-colored or yellow-colored color, is known as a manifestation that signifies that a man or woman presently has chronic bronchitis. A strong and irritating experience in the upper body is additionally found.
My patient’s blood pressure is between 120/80 and 139/89 mm Hg concluding the diagnosis to be pre-hypertension. The lifestyle choices that I would encourage to keep his blood pressure in control would be to exercise on a regular basis, eat healthier, eat less sodium, and to cut out smoking he if has an persistent everyday continuation. Exercising daily may possibly lead to eating healthier and eating less sodium by reading nutritional labels. An everyday routine of exercising can set the trend for other healthy habits. This is due to the fact that good habits tend to cluster. With these everyday lifestyle changes, my patient can keep his blood pressure under control and lower his risk for developing hypertension.
Historically pneumonia has been of the most persistent and deadly diseases known to man. As there are multiple causative factors, the incidence of respiratory infection has always been high. It has only been relatively recently with the advent of anatomy and modern diagnostic tests has medicine sought to understand the pathophysiology and the etiology used to diagnose this often-deadly condition. Diagnosing the what has caused the infection is often the first step as this is what determines the course of treatment. It is also important to clinicians and practitioners of medicine that one must understand what an infection of the lungs can do to a human body. Lastly, the treatments and medications used to bring the patient back to health must be understood and the clinician should take steps to be familiar for every common type of pneumonia.
Pneumonia has many different causatives; Bacterial, Viral, Fungi or Parasitic (Tannehill-Jones, 2010). If there is no infection present, the patient may only have a hypersensitivity to dust or other allergens, the term used in this instance is Pneumonitis, meaning inflammation of the lung tissues (Association, 2015a). Common bacteria that cause pneumonia include; bacterium Streptococcus
Mycoplasma pneumoniae is an atypical bacterium that may result in lung infection by causing damage in the lining of the respiratory tract.
So what is Pneumonia anyways? Well, it is an infection of your lungs. The air sacs inside of your lungs begin to fill with fluid, and this makes it difficult for oxygen to reach the bloodstream. Most common symptoms are; having difficulty breathing, high fevers, and coughing. This illness can be spread in a number of ways. The viruses and bacteria that are commonly found in a child's nose or throat, can infect the lungs
The clinical manifestations of pneumonia will be different according to the causative organism and the patient’s underlying conditions and/or comorbidities (Smeltzer, et al). Some of the manifestations are
Pneumonia is an inflammation or infection of the lungs most commonly caused by a bacteria or virus. Pneumonia can also be caused by inhaling vomit or other foreign substances. In all cases, the lungs' air sacs fill with pus , mucous, and other liquids and cannot function properly. This means oxygen cannot reach the blood and the cells of the body.