How To Write A Hyponatremia Case Study

Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.

Her drug screen showed positive benzodiazepines and blood alcohol was negative. Troponins were negative. Also, her initial work up showed acute kidney injury with a creatinine of 1.84, and potassium of 5.8. Her chest x-ray showed small amount of infiltrate in the right lower lobe. The CT scan of the head did not show any acute changes. The abdominal CT scan showed constipation and 6 mm opacity in her bladder. She had an electroencephalogram (EEG) which revealed diffuse generalized nonspecific encephalopathy. In addition, there was slowing of the left hemisphere consistent with left intracerebral lesion. The assessment diagnoses were acute respiratory failure (ABG of 87.287, pCO2 of 45.2, pO2 of 380 and biacarbonate of 20 on vent settings), altered mental status, attempted suicide, infectious process, medication use, hyperglycemic nonketotic, and less likely cerebrovascular accident given that her CT scan of the head was normal. She was admitted to the Intensive Care Unit under the care of Dr. Modupe Kehinde. She was intubated for airway protection and remained intubated until 5/23/2016 (7 days). She was on ventilator and was given nutritional support

They give a long list of diagnoses but the most prevalent is the fact that she has a rapidly progressing dementia. Note that she has a rapidly progressing dementia as well as a B12 deficiency. They describe a subdural hematoma in the CT scan reports. The one on 01/03 shows a lot of microvascular changes, a lot of cortical atrophy, and apparently, she had bilateral subdural hematomas that had converted to hygromas, but apparently the larger one on the left side still had some blood in it. When they repeated the CT scan of the head on 01/19, they commented that the hygromas were still present but there was less blood in the larger subdural. She had extensive blood testing, which basically was unremarkable. It did not appear that she had a urinary tract infection. Appears that since she has been here her status has been fairly stable. She was weak, but apparently, underwent physical therapy and made some improvement to where she became ambulatory in her gait. It looked like from the very beginning she was having a day/night confusion, was having a lot of un purposeful movements that might be have been contributed to either delusions or hallucinations. They gave her some Risperdal for the behavioral problems, but according to Cynthia she had taken Risperdal in the past and had an allergic reaction, and today when I have seen the patient there is a marked amount of periorbital edema

“Patient is currently having blurred vision, facial pain, numbness in both upper and lower extremities,

Mr. S, a 69-year-old patient was admitted into the hospital, after he presented at home a sudden severe headache, vomits and neck stiffness. In A/E this patient presented a Glasgow Coma Scale (GCS) of 15/15 (E-4, V-5, M-6), both pupils, equal and reactive to light (3mm) and normal motor power. Also he complained about severe pain in his head, which was measured at 7/10, using the numeric pain scale (which 0 means “no pain” and 10 means “extreme pain”) (British Pain Society, 2006).

At today’s visit she is accompanied by her son and husband. She is awake, alert but confused. She follow some simple commands, she is not able to express most of her needs. The husband reports that the patient suffers from depression and she is not on any medication. The son reports that the patient appetite is poor to fair. He state that she started Megace a few weeks ago and her weight is now 86 lb from 82 lbs. The husband states that the patient ambulates with an unsteady gait and often forgets to use her walker. He states that the patient often speak to her decease relative, refused showers. The patient has not had any recent falls. The patient denies pain, shortness of breath and dysphagia. Her PPS is 50%, Fast 7c, able to perform some

Based on the medical report dated 12/15/16, the patient complains of constant pain to her neck, bilateral shoulders and bilateral knee/leg. Pain is described as sharp, stabbing, achy and

All cranial nerves tested within normal limits. Pt passed visual fields exam and no problems with gag reflex. Pt moved muscles evenly and bilaterally and was able to shrug shoulders and move head from side to side.

Lack of appetite: Based on the history taken from the patient, she has a lack of appetite, going so far as to consuming just a grilled chicken sandwich and water over the course of an entire day. The lack of appetite came around the same time as her fatigue and may play a role in it. Her

HPI: Patient has history of morbid obesity and DMII. Patient started having headaches a month ago. Patient had present to clinic with a B/P 154/89, wt. 383 and BG 124. Patient was ordered to have B/P checks weekly x 4 and to keep a daily log of B/Ps (obtained twice a day). Patient did not follow up as scheduled. Patient into day following an ER visit for headache with numbness down right arm. Patient had EKG, CT scan and lab work performed at hospital. All the test were normal, EKG normal sinus rhythm, B/P 154/92. The ER doctor

Symptoms: Increased discomfort in her back, needs help repositioning, resistance to pain recovery medication, no apparent distress, tiredness, stomach ache, and high pulse rate.

G.M. was then immediately transferred to Rady Children’s hospital Emergency Room by her parents. Upon nursing assessment she presented with vital signs within the same range from her clinic visit. These were repeated every fifteen minutes until stable. Her skin was flushed and diaphoretic. Mucous membranes appeared dry with significant skin cracking around the mouth. Patient was alert and oriented times three and pupils were equal, round, and reactive to light and accommodation. Her breath sounds were clear and equal bilaterally, with no adventitious sounds noted. However, patient G.M. appeared to have

At today’s visit she is awake, alert and oriented times 3. She reports that she was been followed by Dr DeBonet for pain, but due to the increased lymphedema and pain in left lower extremities she has become nonambulatory and unable to make it to her appointments. Because of her increased immobility, she spends all day sitting or lying and unable to

Client reported pain in her shoulder and neck; she is scheduled to see the neurology at Mount Sinai Hospital on 11/11/2015 for an assessment.

A previously healthy 33-year-old woman was brought to the Emergency Department with chief complaint decreased of consciousness. She couldn’t be woken up since 3 hours ago. She had no history of nausea, vomiting, headache, blurred vision, fever, night sweat, weight loss, cough, extremity weakness, movement disorder, seizure or personality change. Her family denied any drug intake, substance abuse, pre-existing illness or hereditary disease. Her hemodynamic and temperature were normal. Her Glasgow Coma Scale (GCS) at admission was 235. On physical examination, she showed no extremity weakness, no tremor, and negative Kernig and Brudzinsky test. The laboratory examination was normal, including normal leukocyte count and serum chemistry. Her serum toxicology profile was negative. Non-contrast head Computed Tomography (CT) was done (Fig. 1a-b), followed by CT Angiography (CTA, Fig. 2a-c).