Patient Case Study

The author read Mrs. X’s medical notes prior to their initial consultation to afford herself the knowledge she required should she need to prescribe for her when fully qualified. It was evident from reading her medical notes that there were a few considerations to take note of before commencing any treatment, such as her medical history, drug history and allergies. Her past medical history consisted of Type 2 diabetes mellitus, which was diet controlled, hypertension, hypercholesterolaemia, neuropathy, rheumatoid arthritis and raynauds syndrome.

Scenario: Mr. B, a 67-year-old-man, came to the ER complaining of severe pain to his left hip and leg after falling over his dog at home. Left leg appears shortened with swelling in his calf, bruised, and limited range of motion.Mr. B has a history of impaired glucose tolerance and prostate cancer. Home medications include atorvastatin and oxycodone for chronic back pain. Mr. B’s labs, taken during a previous visit with his primary care doctor, revealed elevated cholesterol and lipids.

Case Scenario 1: It has become necessary to ration a vaccine for a contagious disease. There is only enough vaccine available to cover 75% of the U.S. population. It is necessary to determine an appropriate method for doing this. Analyze this case by applying each of the theories of Utilitarianism, Rights-based, Justice-based and Virtue-based ethics as discussed in Module 2. (20 points)

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.

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.

D.D is a 16 yr old male who was in his usually state of health until he developed right-sided abdominal pain approximately 5 days prior to arriving at the hospital. His pain progressively worsened and spread throughout his abdomen. He also had nausea non-bloody, non-bilious vomiting, some diarrhea, as well as fevers, when pain did not improve he presented to ER. He was admitted and diagnosed with sepsis and perforated appendicitis. He had a laparoscopic appendectomy and a central venous catheter was placed. Following surgery he was then transferred to the med-surg floor. His parents are both Spanish speaking and at the bedside.

JG, a 34-year old Caucasian female presented to the primary care physician office with complaints of losing weight and feelings that "her heart is beating out of her chest". On assessment it was noted that JG had lost twenty pounds in 3 months. JG exhibited tremors in hands, bulging eyes, and pretibial edema. On physical examination there was a goiter, or enlarged thyroid gland noted.

Rationale: Patient is currently suffering from high blood pressure, postural hypotension and urinary stress continence. She has been taking medications which are

Nitroglycerine was administered to aid in getting oxygenated blood to heart muscles. Aspirin was given for antiplatelet effect (Deglin, Sanoski, Vallerand, 2013).

A review of the medical records indicates that she suffers from multiple medication illness which include, end stage liver disease with associated abdominal ascites-Her live disease is related to her history of alcohol abuse, anemia related to her liver disease, chronic edema, and chronic hypothyroid and chronic pain. She was hospitalized twice in the last month for her end stage liver disease.

The patient is a 44-year-old gentleman who presents to the ER because of bone pains in his hips, back and shoulders. He is known to have sickle cell disease, iron overload disease from multiple transfusions and cardiomyopathy. He has had persistent bone pain in his hips, lower back and shoulders. He was seen at an urgi center the day prior to admission where he was given IV Dilaudid and IV normal saline. The patient is presently on MS Contin 90 mg twice a day and in the ED he required a total of 18 mg and Dilantin with Motrin, Benadryl and IV fluids without any improvement. He was admitted. His hemoglobin was 8.3 with a hematocrit of 23.7 with 35% sickle cells. Retic count is 8.2. His potassium was 5. BUN is 25 and creatinine 1.76.

DOI: 06/06/2015. Patient is a 61-year-old female full time housekeeper at a hotel resort who sustained a work-related injury when she fell and broke her wrist when taking trash out. Per claim notes, she was initially diagnosed with right comminuted fracture radius and right wrist contusion. Submitted medical report is handwritten and most of the notes are illegible.

Our patient was a 55-year-old female who came for laparoscopic omega gastric bypass surgery to lose weight because of excessive obesity (with a BMI of 46.6). In her past medical history she had hyperlipidemia and depression and in her past surgery history, she underwent mastoidectomy surgery in her right ear and hysterectomy due to menorrhagia 12 years ago. In that time she was on OCPs because of menorrhagia and after she didn't respond to the treatment they had to do hysterectomy surgery after which she developed DVT in her right leg so she was treated with warfarin for six months and after that warfarin was discontinued. Currently, she is taking propranolol 20mg, nortriptyline 25mg, atorvastatin 40mg and fluoxetine 20mg daily. In pre-operation

The patient, Don (name changed to protect patient confidentially), was a very pleasant 78 year old male with a medical history consisting of insulin dependent diabetes mellitus, neuropathy with a below knee amputation, high cholesterol and peripheral vascular disease. His current home medications were as follows:

Mrs. J. arrives at the emergency department with her 6 year old son, PJ, who has a history of Cystic Fibrosis (CF). He is febrile (101.7° F orally), BP 98/66, HR 122, RR 32 with the use of accessory muscles. Mother states PJ has, for the last five days, exhibited signs and symptoms of upper respiratory infection, runny nose, low grade fever, cough, and fatigue. He has lost 2 pounds over the past 5 days due to anorexia though he has not had vomiting. He weighs 36 pounds and height is 3’2”. Today, PJ became more lethargic and his fever was difficult to control with pyretics.