Chief Complaint From Her Inpatient Stay At Portsmouth Regional Hospital

S.P. is admitted to the orthopedic ward. She has fallen at home and she has sustained an intracapsular fracture of the hip at the femoral neck. The following history is obtained from her: She is a 75-year-old widow with three children living nearby. Her father died of cancer at age 62; mother died of heart failure at age 79. Her height is 5’3 and weighs 118 pounds. She has a 50 pack year smoking history and denies alcohol use. She has severe Rheumatoid Arthritis (RA) and had an upper GI bleed in 1993 and had Coronary Artery Disease with CABG 9 months ago. Since that time, she has engaged in “very mild exercise at home.” Vital signs are 128/60, 98, 14, 99 degree farenheight (32.7 degrees C) SAO2 94%

Mariam background is 60 year old lady admitted with left sided weakness and facial droop. Once confirmed stroke using the Recognition of Stroke in the Emergency Room (ROSIER) scale. Catangui (2015) states ROSIER scale is used to distinguish whether the patient is having a stroke or stroke mimics e.g. seizures or brain tumours. Computed tomography CT brain showed ischemic stroke. Ischaemic stroke is lack of sufficient blood supply to perfuse the brain/ cerebral tissue due to narrowing or blocked arteries in the brain (Morrison, 2014). According to Stroke Association (2015) statics shows that 1520000 strokes occur in the United Kingdom.

3000 word essay on patient with left sided stroke with one identified health need/problem: Dysphagia

Mr. Fix-it is a 59 year old man with a history of alcohol abuse and diabetic hypertension. Mr. Fix-it has been currently experiencing symptoms such as: rambling speech, poor short-term memory, weakness on the left side of his body, neglects both visual and auditory stimuli to his left side, difficulty with rapid visual scanning, difficulty with complex visual, perceptual and constructional tasks, unable to recall nonverbal materials, and mild articulatory problems. The diagnosis for Mr. Fix-it’s problem is most likely a right-hemisphere stroke. A right-hemisphere stroke is occurs when a blood clot blocks a vessel in the brain, or when there is a torn vessel bleeding into the brain. “A right-hemisphere stroke is common in adults who have

HISTORY AND PHYSICAL EXAMINATION_______________________ Patient Name: Chapman Robert Kinsey Patient ID: 110589 Room No.: 322-B Date of Admission: 23 February ---Admitting Physician: Martha C. Eaton, MD, Geriatrics Chief Complaint: Admitted from Dr. Max Hirsch’s office due to deep ulcer on left toe. Admitting Diagnoses 1. Severe peripheral vascular disease, status post deep ulcer on left toe. Rule out thrombolysis. The patient was admitted to a regular floor. Condition is serious. 2. ALLERGY TO PENICILLIN, which puts patient into anaphylactic shock. 3. Continue with home medications. DETAILS OF PRESENT ILLNESS: Mr. Kinsey is an 87-year-old white gentleman with history of (1) Chronic atrial fibrillation, on Coumadin. (2) Chronic deafness,

Alice Palmer has a mild brain tissue damage associated with the ischemic stroke as evidenced by a Glasgow Coma Scale score of 15. On the other hand, she has a normal heart rate of 89 beats per minute (HR 89) and a blood pressure of 155/90 mmHg. A blood pressure of 155/90 mmHg is an indication of stage 1 hypertension. Mrs. Alice Palmer is hypertensive because she refused to take medication while she was at home (Grace Meissner, 2011; Fortrat & Gharib, 2016). Further, Mrs. Alice Palmer has a left-sided hemiparesis which indicates damage to the right side of the brain. Left-sided hemiparesis is a weak muscle tone of the left side of the body which leads to faded movement and carrying out self-care activities such as dressing, bathing, and grabbing objects (Fischer et al., 2016). Moreover, damage to the right side of the brain is associated with poor memory since the limbic system is located in that region (Usher & Marriott, 2011). Also, Mrs. Alice had a bilateral visual field deficit because of the mild brain tissue damage associated with the ischemic

Joe Nelson, age 65, has been a brick layer for 33 years living as a single man for most of his life. He was recently admitted to the cardiac intensive care unit with mild stroke. He was found at his home with paralysis in his left arm and leg. He was rushed to emergency room at Hotel Dieu-Grace Hospital and received a diagnostic test CT scan, blood test and EKG to learn the extent of the

The patient is a 95-year-old female who is brought to the emergency room because of a fall at home and episodes of spacing out and staring. Her past medical history is absolutely negative for any previous and the patient is on no medications. There is a discrepancy in the history between what is described by the daughters, as well as what is documented in the ED records. and there is a question of did this patient have a seizure episode and fall or and did she simply loose her balance and fall. The patient herself was quite clear about her fall and does not have any recollection of any any other abnormal events. She sustained a fracture of the right superior and inferior pubic rami. She was markedly anemic with a hemoglobin of 7.1, which

The patient is 69-year-old gentleman who presents to the ED because he was unable to follow commands and answer questions. He had similar episode with weakness in February. He was just discharged from the Barnert Subacute Rehabilitation on 3/11/2015. The patient relates he just feels cold and he does not have any complaints, but he is unreliable because of a history of dementia. His medical history is significant for carotid stnosis endarterectomy, had multiple CVAs, dementia, hypertension, prostatic hypertrophy ,insulin-dependent diabetes mellitus, as well as having a left adrenalectomy in the past (reason for that is unknown at present time). His neurologic exam reveals him to be alert and oriented x2 to person, place but not to time.

Patient George Matthew was taken to the accident and emergency department and later admitted to the Acute Stroke Unit with issues caused by right sided weakness and slurred speech. When being admitted into hospital, his two daughters and his wife accompanied him. He is 75 years old and currently lives with his

Case 1: a 57-year-old female patient presented with a pinkish small nodule 3 x 3 mm in diameter on right palatal area near teeth 14. Overall clinical examination revealed benign epithelial lesion with the similar nodule in the right index finger of the patient. The final diagnosis was papilloma. High intensity diode laser (810 nm, 3 w and 1.5 w) was used to ablate lesion and stop bleeding. Post irradiated area was healed normally and no recurrence was observed.

Also, trouble speaking, confusion, loss of vision, problems with walking and understand. Robert was given Glucocorticoids because it helps with swelling and inflammation. The cause of a Cerebrovascular accident for Robert was numbness in his right hand and unable to speak. Roberts left the side of the brain was involved in CVA because the right hand was numb. Usually, it’s the opposite side of the body is affected. Roberts’s doctor told him that if he doesn’t ability to move then his hand will stay “flaccid”. It means that there will be no movement or muscle flinder in his hand or other body parts. Roberts’s recovery will require teamwork with seeing a physical therapist, occupational therapist, speech therapy and his social workers. A physical therapist will help Robert learn how to walk because after stroke people are usually unstable. Also, position and that’s at the very beginning after the stroke. It helps him with muscle pain, numbness, and stiffness. Occupational therapist will help with daily activities such as dressing, eating, drinking, bathing, writing, and reading. Speech therapist helps with producing and understing to speak. Social worker ill make sure that Robert will go to his therapy, and that he's

Great post and assessment. One thing I forgot to mention in my intervention is vital signs. For every patients that you are taking care of, it is always important to get those vital signs to determine to normal and abnormal. For Penny situation, since she is experiencing right side symptoms (ischemic stroke is affecting her left side hemisphere) it cause her right sides to be paralysis, which is important to know because when taking her BP, it should be take on her left arm.

I am writing to refer Mr Stephen to you for follow up care. He experienced cerebrovascular accident for 2 years ago. Because of this he has slight slurred speech, but is agile and mentally active. He was able to walk with limp unstably previously, so his wife, Sandra assisted his mobility.

Chandra, a 55yo Bhutanese refugee women, who has been living in for Australia 18 months experienced an episode of blurred vision with right arm and leg weakness. During the episode she fell over on the footpath obtaining significant pain in her left arm and unable to stand up. Hospital x-rays indicated that she fractured her left arm, this was set in plaster. CT brain scans showed no changes, and the right sided weakness had completely resolved within an hour of her fall. Testing revealed that Chandra had hypertension and hypercholesterolemia. The emergency department (ED) medical officer informed her that she had experienced a transient ischemic attack (TIA) and handed her an English brochure about TIA. Communication problems and Chandra’s limited English prevented her understand what the doctor was saying. She was discharged from the ED and asked to follow up with her local doctor within the next week in relation to TIA prevention, also providing a referral to the hospitals TIA group education sessions and an appointment time with the fracture clinic. Chandra’s son, Hari, collected her from the ED and was very concerned and unable to speak with a doctor. After discharge, Chandra revealed to her son that she had experienced a similar episode previously and was now concerned and very afraid. An appointment was made with the GP the next day. The receptionist referred Hari to the National Stroke Foundation website for information. Hari also