Reflection Of Genetic Communication For Nurses For Patients

A 68 year old male presented to the emergency department at 0800 hours via ambulance after experiencing chest discomfort and intermittent palpitations since 0500 hours. Prior to presentation, the patient stated he

Mr. XXXX is a 44 years old Caucasian male, a general construction worker who works on a nearby highway for the bridge project, and checked in this urgent care center for complaining of chest pain and shortness of breath (SOB). The chest pain is constant dull and pressure like pain, and started 3 hours ago. The pain is located on the center of chest. He rates the pain 4 out of 10 on a pain scale 0 to 10 while resting. The pain gets worse and increases after eating. He experienced increased chest pain and SOB with simple walking from the parking lot to this office. The pain was not resolved with taking PO 365mg of Aspirin 2 hours ago and resting. He was diagnosed with hyperlipedemia 10 years ago. He is taking medication to manage his high cholesterol level. He denies past history of chest pain, hypertension, and coronary artery disease. He denies any history of heart surgery or cardio artery bypass surgery. He is anxious and fearful for his first chest and SOB. He smokes a half pack a day for past 20 years. He drinks one bottle of bear every evening with meals. He denies taking any herbal medication or illicit drugs. He has been a good appetite. He reported 20 lbs weight gain since his retirement from military. He has an irregular meal time and does not exercise as much as he used to do in the military.

D.Z., a 65-year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD; emphysema). He has a past medical history of hypertension, which has been well controlled by Enalapril (Vasotec) for the past 6 years. He has had pneumonia yearly for the past 3 years, and has been a 2-pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 F, SaO2 88%. His admitting diagnosis is an acute

D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and

PHYSICAL EXAM: Temperature 98.6, Blood pressure 140/90. Pulse 110. Respirations 26. Her lungs are clear, showing mild signs of distress. Heart sounds are normal, irregular rhythm and bradycardia noted. No edema noted in extremities. Patient skin is cool to touch, slightly clammy. EEG shows prolonged QRS wave, with ischemic ST changes and PVCs. Chest radiograph clear.

Another Consultation Report dated 12/06/2016, indicated that the claimant presented with exacerbation of COPD, acute bronchitis, and pseudomonas aeruginosa. The CT scan of the chest revealed bilateral lower lobe atelectatic changes, fibrosis, and a small 1 cm left lower lobe nodular density. A pulmonary consultation was recommended. His blood pressure was 142/79 mmHg. The physical examination revealed bilateral decreased breath sounds and scattered wheezes. His glucose was 189. DuoNeb, IV Solu-Medrol, and IV antibiotics were prescribed.

History of Present Illness: Ms. Manock is a very pleasant 60-year-old woman with a history of severe COPD. She was previously seen by Elvira Aguila, MD. Her last office visit was in February 2015. Since that time, she states that over the last few weeks, she feels her dyspnea has worsened which is a result of increased humidity, which is normal for her. She has had a stable cough over the last six months, which is intermittently productive of sputum. She is using her supplemental oxygen at 2 L/minute with exertion and with sleep. She also notes postnasal drip, which is related to seasonal allergies.

Patient “DD” is a 56-year-old woman who was admitted to a nearby hospital for respiratory failure. With the only previous medical history being chronic bronchitis, she was diagnosed upon admission with COPD, anemia, hypoxia, moderate anxiety, and dyspnea.

Admitted through the Emergency Room at 4 PM to a semi-private room is Maggie P., a 78-year-old retired Registered Nurse with end-stage Chronic Obstructive Pulmonary Disease (COPD). Her temperature is 98.7, B/P 130/92, heart rate 124 and respirations are labored and irregular at 37 per minute. She appears frail and weighs 89 pounds. She is pale with a bluish hue to her lips and nail beds. Oxygen at 3 liters per minute is applied via nasal cannula. She is alert and oriented to time, place, and person. She coughs intermittently, expectorating copious amount of thick gray, blood-tinged sputum. She complains of back and rib pain and 5mg of Morphine Sulfate in administered intramuscularly. On assessment the nurse lists, between

c. 34 years old male who complained of shortness of breath. He was obese and had a history of COPD. He was on two liters nasal cannula. After admitting at the ER, he was tranfered to med-surge floor for further evaluation.

This is a 50 years old male with no significant past medical history presented initially with shortness of breath and hypoxia and was transferred to the ICU. He was treated for bilateral pneumonia that required prolonged mechanical ventilation via a tracheostomy. He has necrotizing pneumonia and he has been in the hospital for 6 weeks due to the development of multi-organ failure. He was weaned from mechanical ventilation to the point he was tolerating a CPAP/PS mode. Later on, it was noticed that he

Notified by the patient. Two patient verifier completed. Per PA Alford the patient was advised that her x-ray result were negative for pnuemonia. Currently the patient states that she is doind much better. She states that sh still has a cough but is improving. The patient denies fever, chill, SOB, and chest pain. Instructed the patient if she starts having this symptom report to the ER. Also instructed the patient if her symptoms worsen please scheudle an apt with her provider. The patient agrees and verbalize

I started my morning by reviewing his Kardex and noticed that chest pain had been noted and that he had an ECG and CT of his chest. I went into his room to find him wide-awake in bed. I performed my safety check and took his vitals. His resp rate was quite high at this time and his Sp02 was on the lower side. MK expressed through nodding that he was having chest pain during that time. I also did a respiratory assessment because I was concerned with his SpO2 and resp rate. I found decreased air entry to his bases, expiratory wheeze, and a visual use of accessory muscle to breath. His breathes where short and labored. When asked if he was experiencing SOB, he nodded and this directed my care for that morning. I reported to my instructor with my findings as this was the first time I had a client say yes to chest pain. I quickly addressed his SOB with his PRN bronchodilator using a spacer and put him on two liters of O2 via nasal prongs. I checked back in after 5 minutes and his resp rate had lowered and his SpO2 had risen to a more adequate level. I noticed he did not have audible wheeze any longer and was not using his accessory muscles. Overall he looked way more relaxed in his bed after addressing his respiratory distress. Unfortunately, he still was nodding yes to chest pain in that moment. The RN on my team left a doctors note about another CT and ECG and noted that the client was still

Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity

A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right