Physical Examination And Management For Patients With Multiple Comorbidities And Medication Management
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Rotated in Internal Medicine clinic for 4 wk. Opportunity to observe diverse cases in the outpatient setting. Took part in the history, physical examination and management for the patient. Involved in the discussion regarding health maintenance and education. Learned about management patients with multiple comorbidities and medication management. Participated by observing common outpatient procedures. Actively involved in continues learning by discussing topics with the attending.
12 wk, Observership. My rotation involved inpatient rounding in the ICU and Subacute nursing home in O’Connor hospital and observing the various cases in the attendings outpatient clinic. Participated in the morning multidisciplinary team discussion of each patient on rounds. In the outpatient setting, had the opportunity to see various cases of COPD, insomnia, OSA. Discussed the cases on the pertinent history and observed history taking and management reviewed with the patient. Learned to interpret sleep study during my rotation. Actively involved in learning by discussing the common cases and topics on Pulmonology.
8wk Observership in Intensive care medicine to cover the ICU, Neurology and CICU. This observership taught me the management of a broad spectrum of critical presentations. I was assigned cases, and was expected to perform a physical examination under the guidance of the resident physician. I learned how to evaluate and manage
Chronic Obstructive pulmonary disease (COPD) has been known as umbrella diagnosis of multiple pulmonary disorders. COPD is a complex disorder that is very prevalent in the older adult population and causes significant complications in the older adult due to age related aspects and multiple co morbidities that are involved. According to the World Health Organization, COPD is defined as chronic obstruction of lung airflow that can be irreversible and results in decreased pulmonary lung function. COPD
screening and evaluating patients. Genesis rehab policy is that clinicians must first conduct screens before enrolling patients on rehab services. The screening process helps to filter out patients who are indicated for physical therapy on outpatient services versus patients who requires skilled home-health services. The other benefit of screen is to recognize patients who requires consultation to a specialist. “In primary care setting, PTs should be routinely triaging patients for need of referral”
is confirmed with one of the below tests in combination with clinical evidence of diabetes OR one of the below tests repeated or in combination with a second test
– Fasting plasma glucose OR
– Oral glucose tolerance test OR
– Hemoglobin A1c
○ If patient is exhibits classic signs and symptoms of hyperglycemia (polyuria, polydipsia, polyphagia, unexplained weight loss, weakness, blurred vision), a
A Study of the Efficacy of Self-Management Education in Heart Failure Outcomes
Heart failure (HF) has been singled out as an epidemic and is a staggering clinical and public health problem, associated with significant mortality, morbidity, and healthcare expenditures, particularly among those aged 65 and older (Roger et al., 2013). HF is a major health care issue with a current prevalence of over 5.8 million in the USA and over 23 million worldwide, and rising. The lifetime risk of developing
morning during our medication rounds with my preceptor, our attention was drawn by one of the caregiver’s report about a resident who is experiencing difficulty in breathing.
The resident’s name is Map (pseudonym). He is 76 years old with a history of stroke. He has right sided weakness and has the inability to produce speech. He also has a history of multiple hospital admission over the years due to chest infection.
As soon as we heard her report, we stopped doing our medication rounds and attended
(APNs) play a vital role in research and practicing evidence based medicine. The many influences that may negatively impact a patients health
include social, environmental, and physical factors. This paper will discuss the importance of researching evidence on a health concern and the modalities developed through the implementation of programs for postural orthostatic patients. There is a need for more to take part in the research and contributions to evidence based research in understanding Postural
sensory in nature, that is, depending on loss of proprioception. A negative Romberg test suggests that ataxia is cerebellar in nature, that is, depending on localized cerebellar dysfunction instead (Khasnis & Gokula, 2003).
Mini-Mental State Examination (MMSE) is series of questions and tests each of which scores points if answered correctly. Maximum score of 30 is indicative
Introduction:
This case study discusses the management of a 68 year old male who presented with chest palpitations secondary to rapid atrial fibrillation. Atrial fibrillation is a common cardiac arrhythmia with serious complications if not treated correctly. This essay will discuss the initial clinical presentation of the patient and examine the management and outcome of the interventions applied. The significance of atrial fibrillation including its pathophysiology and aetiology will also be discussed
difficult, or;
o Fear that help may be unavailable if panic-like symptoms occur
o Physical symptoms of panic attack include [2, 3]:
o Excessive sweating
o Sudden flushing or chills
o Feeling sick or faint
o Upset stomach or diarrhea
o Chest pain
o Dysphagia
o Trembling
o Dizziness or lightheadedness
o Tinnitus
o Cognitive symptoms that the patient may feel include thoughts of [2, 3]:
o Life is in danger (patients may be worried that their heart will stop or they are unable to breathe)
o Inability
Gena Stockland
Nursing 109, Case Study 2
October 4, 2017
During an annual physical examination, Henry Oats, a 59-year-old hospital administrator, was diagnosed as having an abdominal aortic aneurysm. Abdominal CT angiography confirmed the diagnosis. The CT showed an abdominal aortic aneurysm greater than 10cm in diameter and he was scheduled for an open abdominal aortic aneurysm repair. Mr. Oats has arrived to the hospital for his scheduled surgery.
Mr. Oats is upset by his diagnosis stating