Patient S Case Studies

Abdomen: Obtuse with minimal bowel sounds, slightly distended. There is RLQ (right lower quadrant) tenderness with guarding and with pinpoint rebound. Positive McBurney and obturator signs with a negative psoas sign.

PHYSICAL EXAMINATION: Vital Signs. TEMPERATURE: 101.0, Blood Pressure- 127/179, Heart Rate-129, Respirations- 185, Weight-215. Situations 96% on room air. Pain Scale- 8/10. HEENT-Normal cephalic, atrumatic pupils equally round and reactive to light. Extra ocular motions intact. ORAL: Shows oral pharynx clear but slightly dry mucosal membranes. TMS: Clear. NECK: Supple, No thrangegally or JVD. No cervical, subclavicular, axilarry or lingual lymphinalpathy.

No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,

How would Ed’s blood help protect him from a foreign invader such as the one now in his system?

No scalp lesions. Dry eyes with conjunctival injection. Mild exophthalmos. Dry nasal mucosa. Marked cracking and bleeding of her lips with erosions of the mucosa. She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft palette. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. SKIN: She has some mild ecchymosis on her skin and some erythema, she has some patches but no obvious skin breakdown. She had some fissuring in the buttocks crease. PULMONARY: Clear to precussion and auscultation, bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, non-tender, protuberant, no organomegaly, and positive bowel sounds. NORALOGIC EXAME: Cranial nerves ii – xii are grossly intact, diffuse hyporeflexia. MUSCULAR SKELETAL: Erosive destructive changes in elbows, wrist, and hands consistent with rheumatoid arthritis. Has had bilateral total knee replacements with stovepipe legs and perimalledal pitting edema 1+. I feel no pulse distally in either leg. PHYCIATRIC: Patient is a little anxious about these new symptoms and there significance. We discussed her situation and I offered her psychiatric services, she refused for now.

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)

Cardiovascular Assessment: No visible pulsations, no heaves or lifts. Apical pulse present in the fifth intercostal space at the left midclavicular line. Auscultation of apical rate 62 beats per minute, normal rhythm regular S1 - S2 heart sounds present. Pulsations present when supine and disappear at a 45 degree angle position. Extremities are brown color without redness, cyanosis, lesions or varicosities bilaterally. Temperature warm bilaterally, Allen test was negative. Homan’s sign negative. Carotids: +2 and present bilaterally. Right Radial +2, left radial +1 , Right Brachial: +2

1. I do believe that large pharmaceutical companies as well as doctors prescribing opioid medication should be held partially responsible in cases when patients are over-prescribed drugs. Although they are in no way actually forcing those patients who are over-prescribed these drugs to misuse them and it is ultimately the fault of the individual misusing the medication, they are, however, allowing for the the misuse.In regards to pharmaceutical companies, I think that they should be held responsible for marketing and allowing such drugs available to virtually the mass public opposed to only those that need it in order to increase their profits. If they would not advertise the medication to medical professionals as something that they could

Tympanic membranes flat pale. NECK: Supple without mass or lymphadenopathy. CHEST: Lungs clear to auscultation bilaterally. HEART: Regular rate and rhythm without murmur. ABDOMEN: Soft with normal active bowel sounds,

Then plaintiff realized that on January 03 2017, she suffered a minor stroke due to exposure to CO poisoning and as of result lack of oxygen to her brain, stroke is a disease when the brain is robbed of oxygen. It was approximately 700 over-flights from January 01, 2017 through the early morning of January 03, 2017 and at that time plaintiff’s heart and breathing condition were in a very bad shape.

On examination, Mrs. K. is pale and clammy sitting upright in a chair. She has bibasilar crackles to her scapulae, and her heart rhythm is irregularly irregular. She has pitting edema bilaterally to her thighs, jugular venous pulsation to the earlobe, and bilateral infiltrates. An ECG shows a left ventricular ejection fraction of 78% with

Michelle brought a sheet from home, and said she got it off a hand out EV Staff provided for fun things to do inside with your children. Michelle fed her children first at the table then they built a fort in the living room. Michelle told EV Staff that her doctor took her off some of her medications. Michelle said she hoped that her doctor would figure out what is best for her to calm down her high strung personality. Michelle was very loud at the visit today, and referred to herself as obnoxious multiple times.

Patient is a 30 year old male who presented to the ED via LEO with HI. The Patient is under IVC paperwork due to complaint aggressive behaviors towards family. The patient reports that his brother and him got into an altercation over him dating the same girl he did 10 years ago. TACT contacted family about event that took place and was able to reach mother and brother. The patients mother reports that he tried to punch brother because he would not let him use his credit card to buy something while they were out at the store. She reports that the patient has never dated the brother's girlfriend and only seen her once before. The Brother reports saying in Georgia and is home for the holiday's. Brother reports that his current girlfriend lives

This is 34 year old AAF. Patient is here to be establish as a new patient, and several compliants as listed above. Patient is a non-smoker, denies use of alcohol or illicit drug use. Patiet is acurrent resident at Lovelady Center. Patient deneis depressive moods, thoughts of suicide or homicide.current pain

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.