Gastritis Case Study Hypertension

PLAN: I have reviewed the chest x-rays available here and agree with the finding of bleb formation in the right and left upper lobes. Despite the fact that the patient has had a high INR, because of his history of tuberculosis and hemoptysis I believe obtaining sputum for TB is very, very important. We should rule out any other endobronchial lesions as the cause for his bleeding. I have discussed this matter with the patient and his wife. I have told them that there is the possibility of observing the condition by x-rays and repeated tests of his sputum. They understand that this is an option; however, they decided that because of concern regarding his repeated hemoptysis, they would consent to bronchoscopy. We will arrange for the patient to have a bronchoscopy done. He is off Coumadin.

A 68 year old male presented to the emergency department at 0800 hours via ambulance after experiencing chest discomfort and intermittent palpitations since 0500 hours. Prior to presentation, the patient stated he

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

Mr BW had a surgical history of anterior resection for bowel cancer and had undergone a colectomy post iatrogenic perforation. He had known hypertensive and non-compliant with his medication. At the same time, he was known to be alcoholic abuse, seizure and had prostate cancer, which was treated with brachytherapy that was well controlled.

Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.

The patient did have black soot around his nose and mouth. Thats when first responders started manual ventilation's via BVM and 02 at 15 LPM. At this time Medic 1 assumed patient care. Medic 1 assigned first responders to obtaining vitals signs that are stated in the vital section of the report. It was at this time that Medic 1 applied a OPA after first measuring on what size to use. First responders also applied fast patches to the patients right upper chest and left midaxillary line At this time Medic 1 assigned first responders to start chest compressions a 15:2 ratio. Medic 1 at this time started a IO in the patients plateau region of the right leg. The Plateau region is inferior and lateral to the knee cap. At this time Normal Saline bolus was started with a 60 drop per ML set. Medic 1 found the patient to be in a sinus rhythm At this time miscommunication with Medic 1 and first responders happen with chest comparisons started. We then secured the patient on the cot via 4 straps and transported a code red patient to the nearest hospital. While enroute to hospital radio report was given with chief compliant and treatments listed in the appropriate category of the report. Vitals was continued to be taken every 5

Patient “DD” is a 56-year-old woman who was admitted to a nearby hospital for respiratory failure. With the only previous medical history being chronic bronchitis, she was diagnosed upon admission with COPD, anemia, hypoxia, moderate anxiety, and dyspnea.

Pt received AP diameter X-ray to confirm tube placement and to see if there were any kind of infiltrates because of possible aspiration and to eliminate possible pneumothorax and pleural effusion. Findings included mild patchy infiltrates in the right upper to middle lobes. The left lower lobe also has some similar findings but less concerning. This may either be due to lung infection or pulmonary

The patient Matt is a 19-year-old Caucasian male that was admitted to the unit and being treated for lethargy, excessive thirst, recent unexpected weight loss, fever and frequent urination. Patient is uninsured, a college athlete (runs 3-5 miles a day on the cross country team), works 16 hours a week on the night shift, lives with five of males and says his diet consist of fast food, prepackaged meals and admits to having 3-4 beers, 3-4 day a week and has an allergy to penicillin (hives) and sulfa drugs. Patient was treated for a UTI once 3 months ago. The patient’s current vital signs are: temperature of 101.6F, heart rate of 99, respiratory rate of 22, blood pressure of 119/76, SaO2 99% on

At CTPA study performed at the time excluded any pulmonary emboli and the report made comment of a moderate sized right-sided pleural effusion with compressive atelectasis. There was no comment on the report of any parenchymal infiltrate and I have not cited the images myself. CRP was 113. He was given a presumptive diagnosis of pneumonia with parapneumonic effusion and commenced an Augmentin Duo Forte and doxycycline. In

The patient, Ms. Wanda Johnson was treated Humana Hospital now Glen of Virginia for six weeks before

is Pneumonia. This is based on the patient’s subjective and objective data. The collaborative diagnosis to address this problem is Pneumonia r/t immobilization; r/t pleural effusion, and r/t debilitation (Carpenito, 2013, p. 859-860). The nursing goal for this patient on the day of care is to control and reduce the complication of pneumonia (Carpenito, 2012, p. 860). The nurse will monitor the patient’s respiratory status while assessing for sign and symptoms of infection, and inflammation (Carpenito, 2012, p.

He is a K/O of Coronary artery disease (CAD), Hypertension (HTN), Hyperlipidemia, and Diabetes mellitus type 2(DM).Blood pressure(BP) was 125/80mmHg, heart rate(HR)77 bpm, and tempereature36˚. 24 hours post of operative he was on positive airway pressure ventilation with 60% of fraction inspired oxygen,peep was 6 cmH2O, tridal volume 0.572 ml/kg and minute volume was 7.12 ml/min.gradually change to nasal cannula 6 liters, respiratory rate 14 breaths per minute.

Patient was here on 9/3/2015 for abscess in his groin for one week. The abscess is painful and is reacuring. This is 48 year old African American male who is here for medication refills,, fluid retention in his hands and feet. Patient denies any chest pain, SOB, palpitations, N/V/D, or fever. Patient is in a shelter. Patient is a current smoker (1/2 pack/day for 25 years).

Chronic Atrophic Gastritis (CAG) is one of the diseases that may progress to gastric cancer. Gastritis including CAG is highly correlated with lifestyle. On the other hand, tea is widely consume by around two-third’s population. The consumption of tea has been associated with anticarcinogenic, antimutagenic, and cardioprotective effects based on experimental studies using cell culture and animal models. 4