Fever Manifestation

She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft palate. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate.

No scalp lesions. Dry eyes with conjunctival injection. Mild exophthalmos. Dry nasal mucosa. Marked cracking and bleeding of her lips with erosions of the mucosa. She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft palette. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. SKIN: She has some mild ecchymosis on her skin and some erythema, she has some patches but no obvious skin breakdown. She had some fissuring in the buttocks crease. PULMONARY: Clear to precussion and auscultation, bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, non-tender, protuberant, no organomegaly, and positive bowel sounds. NORALOGIC EXAME: Cranial nerves ii – xii are grossly intact, diffuse hyporeflexia. MUSCULAR SKELETAL: Erosive destructive changes in elbows, wrist, and hands consistent with rheumatoid arthritis. Has had bilateral total knee replacements with stovepipe legs and perimalledal pitting edema 1+. I feel no pulse distally in either leg. PHYCIATRIC: Patient is a little anxious about these new symptoms and there significance. We discussed her situation and I offered her psychiatric services, she refused for now.

Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows

3. Finally, try to find data concerning prevalence and incidence for this year in comparison to prior years. Are we making any progress?

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

As stated on the clinical assessment, Sam has recorded a temperature of 37.8oC, “body temperature averages 37C +/- 0.5C and with a range of 35.8-38.2C” as published in (Marieb & Hoehn, 2011, p950), so I would assess Sam’s temperature as initially a low grade fever. As the majority of fevers in hospitals are due to infections (Marshall, 1993, p208). Low-grade fevers can occasionally accompany serious medical conditions with symptoms such as Sam’s difficulty breathing, confusion, decreased levels of consciousness and rapid heart rate. http://www.healthgrades.com/symptoms/low-grade-fever

The lesson and case studies presented for evaluation was a great learning exercise. A better understanding of how to interpret data was gained. Also, weighing the clinical significance versus the statistical significance to show relevance is invaluable. All research is not quality research and one must be equipped to recognize bias, threats to validity and proper population representation. Moreover, critiquing the credibility of a study is essential to the health care advances.

Good job on your project so far. Management of chronic illnesses is necessary to reduce readmissions. A major contributor of health care cost is high numbers of hospital readmissions, especially for people with chronic illness such as diabetes. Post discharge interventions such as telephone reminders by trained individual who asked patients are they taking their medication? Educating patients about treatment plan, how to detect warning signs, monitoring of blood glucose and self-management (2014).

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.

The patient does state she has a lesion on her left calf that gets red and scaly. Sometimes it is there and sometimes it looks like it is almost gone away. It does not bleed.

Skin- she has some mild equimosis on her skin and some anathema. She has patches but no obvious skin breakdown. She has no fissuring in the buttocks crease.

Thank you for sharing your knowledge about statistical information and how that helped you make a decision on what tests you can use for a patient’s problem. To be honest with you, I find it difficult to understand statistical information and quantitative data. So, I’ll be focusing on the research that I found about qualitative data for two tests that we commonly use in our facility.

The first step in a therapeutic plan in patient-centered medicine is to empathize with the patient and let them know you will be with them through this journey. Next, the patient and I would set goals realistic blood glucose and hgbA1c goals for future appointments. We will discuss the consequences of poorly controlled diabetes such as heart disease, neuropathy, kidney damage and risk of diabetic ketoacidosis to further emphasize the importance of striving for good diabetes control. We would also discuss if the patient could obtain/ afford diabetic test strips for self-testing and the importance of keeping a log of blood glucose levels. I would then offer resources to help them achieve these goals such as a referral to a diabetic nutritional

How this scale helps identify who requires urgent and less urgent needs. By triaging has increased my knowledge and understanding about triage scale.