Immunosuppressive Therapy Case Summary

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A review of his medical record indicates that a history of ESRD, chronic immunosuppressive therapy post cardiac transplant in 1988, hypertensive kidney disease, RT AVG infection, Cad, MRSA and skin cancer. He has had multiple hospitalizations for AVG infection. His last hospital admission was 10/14/16 for left AVG infection which as removed by DR. Thai, treated for MRSA bacteremia and placement of Right AVG. At today’s visit he is accompanied by his wife. He is awake, alert and oriented. He reports increased edema/lymphedema in right arm from fingers up to upper arm. His right arm is weeping clear fluid and noted to be edematous. He states “last night I had to wrapped my arm in a towel and with saran wrap to prevent if from wetting up my bed”. He also has edema in BLE. His…show more content…
He reports that yesterday he last his balance and had a fall. He sustained small wound to right upper extremities. His gait is unsteady, he has generalized muscle weakness. Increased SOB with exertion. He is at risk for increase falls. He reports that he is receiving SN form Aloha home health agency, which visit him earlier today and is schedule to discharge him. He is requesting another home health agency to follow him. He has decreased/limited ROM in left upper extremity. When ask to raise his left arm he was unable to and had to use his right hand to pick up his left arm. He state “I have no use of this arm, I have had it for a long time, I think it is arthritis”. He is assist with his ADLS. He has a poor appetite; he drinks Nephro nutrition
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