Port-A-Cath Removal Case Study

MEDICAL HISTORY: Includes osteoarthritis, frequent urinary tract infections, hysterectomy 20 years ago, and some TMJ (The temporomandibular joint)

SKIN: She has some mild ecchymosis on her skin, and some erythema. She has patches but no obvious skin breakdown. She has some fissuring in the buttocks crease. PULMONARY: Clear to percussion and auscultation bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, nontender, protuberant, no orgonomegaly, and positive bowel sounds. NEUROLOGIC EXAM: Cranial nerves II through XII are grossly intact. Diffuse hyporeflexia. MUSCULOSKELETAL: Erosive, destructive changes in the elbows, wrists, and hands consistent with rheumatoid arthritis. Has bilateral total knee replacements with stovepipe legs, and perimalleolar pitting edema 1 +. I feel no pulses distally in either leg. PSYCHIATRIC: Patient is a little anxious about these new symptoms and their significance. We discussed her situation and I offered her psychologic services. She refused for now.

her last hospital admission. She reports gaining 1 to 2 pounds every day since her discharge.

M. H. states that she is generally in good overall health. No cardiac, respiratory, endocrine, vascular, musculoskeletal, urinary, hematologic, neurologic, genitourinary, or gastrointestinal problems.

7. The patient was admitted for epistaxis due to therapeutic anticoagulation medication for atrial fibrillation. There is recent history of resection of a mass of the vestibule of the mouth with graft repair and radiation therapy. When seen in the physician office, the patient’s Coumadin was discontinued due to high protime. Although the Coumadin was stopped, the protime continued to rise. Protime corrected with frozen plasma during hospitalization.

As soon as she will be able to sleep more and change her feelings about SAD, she will be able to feel better with her joint pain.

This surgeries were done with the purpose of stopping the tumor. However, she later found out that the tumor was not curable and that it will eventually continue to develop giving her a prognosis of 6 months to live.

She continues to take the following medications: GABAPENTIN 400MG , ASPIRIN 81MG, Oxaprozin 600mg and

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

MEDICAL UPDATE: Client continues to report arthritis in her left leg and hand, high blood pressure. She also reports she will need surgery but she is waiting to be housed.

able to tolerate side effects from disease modifying therapy. She also carries diagnosis of Diabetes

She has a follow up appointment with the orthotropic doctor on Friday 8 April 2016 to see if she will be returning back to on Monday 11 April 2016.

She has refused to have a shower and do her routine ROM exercises due to the pain in her knee. She requires assistance to perform ADLs at this stage and expresses feelings of embarrassment and frustration. Mrs. Green has also reported that she has not opened her bowels since the operation.

He says that pain is currently persistent and he is unable to perform his activities for the job since it entails a lot of heavy lifting. The patient notes allergies for Reglan; ondasetron; and Compazine. Physical examination notes that the patient abdomen is soft, nontender, non-distended, tender to palpation in bilateral groin area, which is more in the right. Assessment and plan notes that the patient has tissue pain rather than neurologic issues. The provider notes that it could be related to the plug. An addendum was also noted that the exam findings and dermatomal mapping is consistent with mesh issue. The provider recommends that open operation, plug removal and neurectomy is

Other method is to use the Foley catheter removal. It is a thin tube that is used to help trap smooth objects with the use of snares. It is used with the fluoroscopy machine to guide the catheter into place just beyond the foreign objects. There is a balloon at the end of the catheter which is inflated using contrast medium. The catheter is slowly withdrawn which then pulls the foreign object out ahead of it.