Medical Case Study And Analysis

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

Mr. XXXX is a 44 years old Caucasian male, a general construction worker who works on a nearby highway for the bridge project, and checked in this urgent care center for complaining of chest pain and shortness of breath (SOB). The chest pain is constant dull and pressure like pain, and started 3 hours ago. The pain is located on the center of chest. He rates the pain 4 out of 10 on a pain scale 0 to 10 while resting. The pain gets worse and increases after eating. He experienced increased chest pain and SOB with simple walking from the parking lot to this office. The pain was not resolved with taking PO 365mg of Aspirin 2 hours ago and resting. He was diagnosed with hyperlipedemia 10 years ago. He is taking medication to manage his high cholesterol level. He denies past history of chest pain, hypertension, and coronary artery disease. He denies any history of heart surgery or cardio artery bypass surgery. He is anxious and fearful for his first chest and SOB. He smokes a half pack a day for past 20 years. He drinks one bottle of bear every evening with meals. He denies taking any herbal medication or illicit drugs. He has been a good appetite. He reported 20 lbs weight gain since his retirement from military. He has an irregular meal time and does not exercise as much as he used to do in the military.

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

Current symptoms or indicators: Recently admitted to emergency room with heart attack symptoms. Chest pain, inability to breathe and irregular heartbeat Client has admitted he is scared

On Tuesday 06/27/2017, veteran Mr. Saenz walked very angrily in my office with his wife about 11:00 AM. I greeted them and offered to sit down; Mr. Saenz and Mrs. Saenz were very upset and asked me where they need to go as they have VA examination, they both said “nobody tells them anything; they have been sitting in waiting room”. They told me that the lady on the desk told them to come to me.

We present a case of 51-year-old male who presented to emergency room with complaints of typical chest pain.

Client complains of chest pain and shortness of breath (SOB). Client states that he was working with heavy stones and has a sedentary office jobs and sedentary life styles. Client has a medical history of asthma & GERD. Client also complains of indigestion and has not eaten much today. Beside this information, the nurse would ask the following questions to the client in order to complete the client history which would help to make nursing diagnosis: Where exactly is the pain? Does it radiate/ go anywhere? When did the pain start? Was the onset sudden or gradual? What are you doing when it started? What does your pain feel like- burning /stabbing/ aching/ squeezing/ cramping/ sharp/ itching/ shooting/ crushing etc.? How severe is the pain,

Mr. Steward was pain free until this morning. He initially complained of right-sided chest pain and then complained about pain in his hip and ankle. We recognized this was a new onset of pain that persisted, despite giving him some pain medication. When Mr. Steward was discovered in his room clutching his chest, we recognized this as a non-verbal sign of pain and asked him whether he was having chest pain. Although Mr. Steward doesn 't provide a definitive answer, he displayed non-verbal signs of pain, such as restlessness, frequent shifting in bed, and act of clutching his chest. Recognizing Mr.

Chest pain is posed as life threatening-has many definitions ranging from either stabbing, dull, crushing or burning. In certain cases, pain travels up the neck, the jaw, can radiate to the back or down one or both arms. Many different problems can cause chest pain and it can be difficult to determine the exact cause of chest pain (Burman et al’, 2011). Patients’ experiencing chest pain is symptoms consistent with, myocardial ischemia and is a common reason for presenting to ED (Pub Med Central, 2010).

On 7/27/2015, HOH and client attended to ILP meeting with their daughter Emily. Child was observed well dressed for the weather. Client explaining to cm that her floating hospital was cancel and she doesn’t know the reason.

In the evaluation of patients with chest pain, the preliminary ECG is a more clear-cut tool for early risk stratification with more recent recommendations indicating that ECG should be performed as early as possible, within 10 minutes of ED admittance. Early indicators associated with MI or ischemic complication such as ST segment elevation or depression allows rapid treatment aligning with the indicated complication. While the ECG may reveal significant indicators in certain situations, in other circumstances findings may be limited due to low diagnostic sensitivity

As seen in this case study, TM was listed as a full code and no GOC conversation was had between the physicians and the patient until the day of his discharge to home. This led to an unnecessary swallowing study in which the patient needed to be uncomfortably scoped. Due to the lack of GOC conversation the patient also chose to go home with general nursing services instead of end-of-life (EOL) hospice support. In the inpatient medical oncology floors of a large teaching hospital like this one, most patients are covered by rotating interns and residents that are not comfortable having GOC conversations with patients and leave it up to the primary physician to come and discuss.

Mr Brown is a 76 year old male, which presented to the emergency department via ambulance with thoracic back pain, which commenced two days prior to the presentation. The triage assessment stated the patient is alert, orientated, distressed, chest clear and equal, neurovascular intact with equal strength in all extremities and good strong regular pulses. The nil injury stated patient said he ‘just woke up with it’. The patient’s observation displayed a temperature of 36.9°C, blood pressure of 169/105, pulse rate of 99 beats per minute, respiratory rate of 20 breaths per minute, Glasgow coma score of 15, and a blood glucose level of 5.4. Mr Brown’s has a past medical history of atrial fibrillation, asthma, emphysema, hypertension, chronic back pain, lumbar fusion (L1), total

Chest pain is a very common symptom, and around 20% to 40% of the general population will experience chest pain in their lives(149). In the UK, up to 2 % of visits to a general practitioner are due to new onset chest pain (150). Approximately 5% of visits to the emergency department are due to a complaint of chest pain, and up to 40% of emergency hospital admissions are the result of chest pain(149, 151). Approximately 52,000 new cases of angina per year are diagnosed in men and 43,000 in women. The incidence of angina increases with age(123).

Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.