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,
History: Martha Wilmington, a 74-year-old woman with a history of rheumatic fever while in her twenties, presented to her physician with complaints of increasing shortness of breath ("dyspnea") upon exertion. She also noted that the typical swelling she's had in her ankles for years has started to get worse over the past two months, making it especially difficult to get her shoes on toward the end of the day. In the past week, she's had a decreased appetite, some nausea and vomiting, and tenderness in the right upper quadrant of the abdomen.
A review of his medial records indicates that he had a hemorrhagic stroke 4/20/16 with late effect left side hemiparesis. Since his CVA he has been in and out of the hospital and rehabs. He last hospitalization was 3 weeks ago. He was admitted to MMHS for hematemesis, diarrhea and fever. 2 weeks ago while in the hospital he had left knee revision due to infection in left knee. He has MRSA in wound and in his respiratory system. He had a 3 weeks hospital stay and was discharged home on Monday. For his MRSA he is getting IV vancomycin which is pay for and administer by the wife. Since been home he has started to decline. His wife reports that last night he started to choke up dark, black secretion and greenish bile secretion. He has difficulty
The process of wound assessment requires accurate and appropriate interventions while dealing with the patients. There are some major components which the operator must consider to effectively access an infection, and they require a range of skills and knowledge. These factors are the knowledge of relevant anatomy and physiology, the understanding of the various factors that accelerate wound growth, and the ability to listen and understand the patient’s needs. In wound accessing, the doctor should have an idea concerning the number and location of wounds, the required treatments depending on the type of infection, the type of wound in accordance to various grading given, and the procedures to follow to achieve the treatment
| This is important because we need to look at the relevant data and realize that she seems to be in distress and first take care of that. Also realize that she seems to have an infection. With this information we are able to prioritize
The patient is 101-year- old who is a bed bounded. He has very weak muscle and cannot perform his ADLs. He has a history of PVD, hyperlipidemia, diabetes mellitus type 2, CVA and coronary artery disease. All the above factors interfere with the normal blood flow; thus, the patient has developed a pressure ulcer. Furthermore, the patient has developed an infection that characterized by redness in the area and pain.
An infection is the invasion of the body microorganisms with pathogenic abilities such as bacteria, parasites and Viruses. Pathogens (Bacteria) invade the host cells, multiply greatly and secrete toxins that cause cellular damage or lysis that trigger an immune response that causes localised inflammation and activation of leukocytes to prevent the spread of pathogens to other areas of the body. Depending on the host’s immune system, sometimes the increase in the number of bacteria overwhelms the immune system causing the infection to spread to other parts of the body (Remick, Pathophysiology of sepsis, 2007). This is commonly attributed to gram positive and gram negative bacteria that usually cause severe infections that lead to an extreme inflammatory and immune response as a lot of cytokines are released as the
1SA1a. One of the inmates had a wound on the medial side of his left shin. He had been refusing the nurses to let them change the dressing all morning, but one of the nursing aids bartered a fluffier pillow in exchange for allowance for cares, which included a dressing change. He agreed. Upon unwrapping his bandages, it was apparent that the patient had re-wrapped the baggage wrap himself, at some point throughout the night. The problem was, it was rewrapped too tight. His leg was swollen around the bandage wrap. We loosened the bandage wrap, cleaned, and redressed the wound. The swollen leg indicated that he was already experiencing poor lymph exchange and poor blood circulation. further complications from these could have resulted in blood
On behalf of all the authors, I would like to submit our original manuscript entitled “Two cases of respiratory failure due to asthma treated with high flow nasal cannula” to be considered for publication in Allergology International as a case report in the Letter to the Editor category.
The vital signs show that the patient is presenting with a relatively low pulse and respiratory rate, and blood pressure despite clearly being sick. This is an unusual, because normally when someone is sick with a high fever, the pulse rate, respiratory rate and blood pressure are typically elevated above normal ranges. It is very common for diseases that cause a fever to also present with an increase in blood pressure, and pulse rate. When there is a high fever, but a person’s heart rate is below the expected value it is known as relative bradycardia. This is clinically important because there are a few diseases that often present with such a condition, one of them is typhoid fever.