Evaluation For Candidacy For A Kidney Transplant

The patient has no family history of heart disease or diabetes, however both her parents are on medication for high blood pressure. Her paternal grandmother died of breast cancer at age 47. Her maternal grandmother

In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling and hitting her back on a large table. In addition, she states that her heart rate has been ranging from 130/ 90 to 140/92. Patient states her Primary care physician placed her on blood pressure medication 2 months ago due to the increase.

My patient is a 58-year-old female, who presents with controlled type II diabetes, hypertension, and possibly thyroid tumors that have been there for a few years. She is under the care of a physician for her diabetes and associated controlled hypertension. I recommended several times that she see her physician after feeling the tumors around her neck and thyroid. Her medical history also indicates that she had rheumatic fever twelve to thirteen years ago, has arthritis in her knees, and occasional headaches. She is 5”3 and weighs 216 pounds. Her blood pressure was 126/80, pulse was 88 BPM, respirations were 20, and her temperature was 98.2 Fahrenheit. She doesn’t smoke and I made sure that she had eaten lunch and wasn’t hungry. She is currently on 100 mg Metformin for her diabetes, 120 mg. Lisinopril for hypertension, 40 mg. of Lovastatin to lower cholesterol, 80 mg. of Aspirin to prevent cardiovascular disease, and daily insulin. Reviewing her medical HX, I was informed that she usually checks her blood glucose daily, but had recently run out of strips, so it had been a

The patient tells me his last visit with Peter Dourdoufis, MD was just last week. I do not yet have a note from that visit. He says that he underwent an EKG and a stress test evaluation. To his knowledge, everything was okay, but he actually has an appointment tomorrow with Dr. Dourdoufis to review everything. No medication changes have been made per his report. He tells me that his blood pressures have been in a good range. Here today, his blood pressure is 126/76. He is not having problems with chest pain, shortness of breath, dyspnea on exertion or lower extremity swelling. He is still working

Situation: the patient is a 78 year old male, with chronic obstructive pulmonary disease, demonstrating restlessness, agitation with a rapid heart rate, tachycardia.

Medical History: A 57-year-old Caucasian male, with a history of end-stage renal disease, secondary to biopsy proven IgA nephropathy, history of liver cirrhosis secondary to alcohol abuse, hypertension, thrombocytopenia, leukopenia, who presented for evaluation for candidacy for a kidney transplant. The patient was evaluated at Tampa General Hospital. He went through a full medical work up. He was not listed due to lack of financial clearance per their center.

Upon assessment, I found that both her lower legs had +1 edema, were red, skin was a bit peeling, and warm to touch. She reported a bit of tenderness on palpation. The right leg, however, had black “scabs” towards the outer side; upon palpation, I noticed that they were under the skin and I could not feel any bumps. Other than her lower legs, her skin was dry and intact, color consistent with her ethnicity, no surgical incisions, and mucous membranes were pink, moist, and intact. She had a #22 IV in her left hand, and the IV site was clean. She was oriented x3, calm and cooperative, had clear speech, had no weakness, no flaccid tone, and no numbness. Her strength was normal in upper extremity, and her lower extremities moved against resistance. Her pupils were round, equal in size, and reactive to light. Her blood pressure was 133/76, heart rate 94, oxygen saturation of 98% on room air, respiratory rate of 18, oral temperature of 36.7

The patient is alert and oriented to person, place, and time. Upon initial interaction, the patient is easy to communicate with and states she is doing well. Facial features are uneven and asymmetrical, as she has a slight left facial droop due to her stroke, which she states happened a couple of years ago. DG expresses multiple times that she has a hard time seeing and she wears prescription eyeglasses. PERRLA. Skin is pink, warm, dry; temperature is 97.5 and turgor is brisk. There is a 20 gauge IV in the right hand infusing Lactated Ringers at 20ml/hour per pump, no redness or edema noted at the insertion site. Respirations are even and non-labored at 22 breaths per minute. Lung sounds are bilaterally clear. The client has a nasal cannula infusing 2 liters of oxygen with an oxygen saturation of 96%. DG tells me she is a current smoker and she smokes

The patient had a medical history of hypertension, hyperlipidemia, coronary artery disease, myocardial infarction in 2010, COPD, pulmonary embolism, prostate cancer, gastro esophageal reflux disease, and small bowel adhesions. The patient had an echocardiogram six months ago with an ejection fraction of 45%. Individuals with “an EF of 25% to 50% have an intermediate risk for the development of postoperative low cardiac output

Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of

The article, “Prevalence and Predictors of Early Cardiovascular Events after Kidney Transplantation: Evaluation of Pre-Transplant Cardiovascular Work-Up” mentions how cardiovascular disease is the leading factor of deaths after a renal transplantation. Therefore, in order to prove their hypothesis correct a study was created to analyze if cardiovascular risk factors are developed after transplantation. The study includes first year patients who have had a renal transplantation. In addition, a pre-transplant work-up will be conducted in order to show if any type of disorders will be present beforehand. The following essay is a summary of the article, “Prevalence and Predictors of Early Cardiovascular Events after Kidney Transplantation: Evaluation of Pre-Transplant Cardiovascular Work-Up”.

7. A 56-year-old patient who has no previous history of hypertension or other health problems

“Sixth or seventh grade education; housewife and mother of five. Breathing difficulties since childhood due to recurrent throat infections and deviated septum in patient’s nose. Physician recommended surgical repair. Patient declined. Patient had one toothache for nearly five years; tooth eventually extracted with several others. Only anxiety is oldest daughter who is epileptic and can’t talk. Happy household. Very occasional drinker. Has not traveled. Well nourished, cooperative. Patient was one of ten siblings. One died of car accident, one from rheumatic heart, and one was poisoned. Unexplained vaginal bleeding and blood in urine during the last two pregnancies;

Past and Current Medical History: AICD/pacemaker,Atrial fibrillation, Benign hypertension, Chronic obstructive pulmonary disease, Coronary arteriosclerosis, Coronary artery bypass graft (in 2010), Diabetes mellitus, Home oxygen supply (4 liters) Transient cerebral ischemia (in 1989),Kidney stones, Partial nephrectomy.

For the purpose of confidentiality, the patient will be identified by the initials A. S. A.S was a 52- year old African American woman who was admitted to the hospital when she started to experience severe urinary retention and shortness of breath. She has three adult children and eight grandchildren, but recently lost her husband of 25 years to diabetes. The patient appears to be very independent because she lives alone in her home and is aware of the disease process. She has a past medical history of acute renal