Symptoms And Treatment Of The Client

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.

The patient is a 76-year-old Hispanic gentleman brought to the ED by his wife because the patient has been anxious for 2 weeks and now unable to sleep much of the night. He denies any chest pain but has had on-and-off palpitations that seemed not to be related to activity or a particular time of day. He denies any shortness of breath, lightheadedness or loss of consciousness. He had two episodes of syncope three years ago. He was diagnosed with having an MI. He was at that time treated at St. Mary's Hospital in Passaic and underwent cardiac catheterization and he has had some stenting done to his coronary arteries. He saw his PMD approximately a week ago who prescribed some sleeping medicine and neurology consult which the patient has

Cardiovascular: No chest pain. She has dyspnea on exertion if she walks more than 20 steps. No orthopnea or claudication.

“The patient is Adam Rudd, a 78 y/o white male with a history of hypertension. He has been diagnosed with hypertension past 15 years and is on anti-hypertensive medications and aspirin. He is very weak and short of breath. He is accompanied with his longtime friend Jennifer, who reports that Rudd was looking very weak and was complaining of severe headache and blurred vision before coming to the hospital. He is 5’9” and weighs 270 lb. Vital signs recorded were: oral temperature 98.20 F, BP 224/120 mm Hg with a heart rate of 102 beats/minute and respiration of 24 breaths per minute. The pulse oximetry reading was 94% on room air. He is complaining of severe headache and blurred vision. Rudd said that he did not take his antihypertensive medication or aspirin since he ran out of pills. He has not been taking his medication for past 15 days. He reports no known allergies to any medications or other substances.”

Heart: has regular rhythm and rate, with no clubbing, cyanosis, or edema of the extremities.

Jones had the following childhood illnesses that included mumps, measles, and chicken pox. He also was vaccinated for whooping cough, diphtheria, polio, and rheumatic fever. He stated he had no serious illnesses as a child but did break his arm from a fall from a tree. At the age of thirty, he had his appendix and gallbladder removed. He was hospitalized three years ago for what he felt was chest pressure but was determined to be acid reflux. Client states that he had tetanus shot three years ago and had both the flu and pneumonia vaccines last September. Client denies any skin problems, difficulty swallowing, or weight changes. He denies any urinary or bowel difficulties but states that since he has been taking diuretics his urine output has increased. Last set of labs drawn were within normal limits but his pulmonary function test (PFT) was abnormal. Spirometry (PFT) is a test of how well your lungs work and diagnose COPD ((Vestbo, Hurd, & Rodriguez‐Roisin, 2012).Client is alert and oriented to person, place, time, and situation. No neurological deficits

Heart: Rhythm regular, no murmurs. Normal S1 and S2. No S3, S4 or murmurs. No peripheral edema, cyanosis or pallor. Extremities are warm and well perfused. No carotid bruits.

A full examination was done by the nurse practitioner from head to toe with a bed side ECG and

Following the principles of patient physical examination by Lawson and Peate (2009), her breathing would be described as tachypnoeic with a respiratory rate of 28 breaths per minute. There were equal rise and fall of the chest with no abnormal sounds on auscultation. Her oxygen saturation levels and end-tidal co2 were below normal range respectively at 93% and 3.8 kilopascals (kPa), whilst the capnography waveform showed signs of hyperventilation (South Western Ambulance Service, 2013). Her heart rate would be defined as regular and tachycardic for having

Patient denies chest pain, SOB, N/V/D. Patient is a current tobacco user, denies use of alcohol or illicit

The patient is six years old suffering from coughing , that means it’s a respiratory system related illness (lungs) smoking is ruled out that only leave few symptoms because he’s a child its either Asthma , Allergic reaction or Emphysema.

He stated that in order to ascertain heart conundrums it is essential to look at the spacing of the lines on the EKG. The thinner narrow lines on the EKG usually indicate regular heart beats, and in contrary, the thicker wider lines on the EKG generally indicate an irregular heart pulse or rhythm which is also known as arrhythmia. In addition, our second patient was suffering from shortness of breath and what she said she experienced was “fluttering” in her chest. In addition, psychological factors were in place as well, she mentioned expressing stressful feelings and anger to her husband based upon minor situational arrangements. In the past, our patient had also experienced a brain bleed also known as subdural hematoma. Dr. Katzenberg began to check her vitals, her pulse and lungs with his stethoscope and after he recommended that she takes a stress-echo test to study and get a read of her heart rate capacity. Next, our third patient is suffering from stage IV breast cancer, according to her pet/cat scan information it revealed that she had developed edema and possibly spasms of the esophagus. Due to this data, her oncologist has deduced that the cancer has metastasized (cancer-spreading) throughout her lungs resulting in her to pursue chemotherapy for 6 months to 2 years. During this transition, she has experienced much emotional distress as well as physical stress. She came in for a checkup because she was

Cardiovascular: EKG shows bradycardia. No extra clicks, rubs or murmurs. Capillary refill less than 3 seconds. Positive pulse throughout. No edema.

06/02/15 Progress report documented that the patient was unable to come to the appointment due to his physical condition and distance. Phone conversation with the patient was noted. He reported being frustrated that his Klonopin was not filled the last time and was feeling very anxious. He noted mild depression. He was sleeping poorly and noted 4-5 hours of sleep each night and was using a CPAP machine. He was hopeless about his future and had psychomotor agitation. However, he denied any suicidal ideations. His appetite was good and he weighed 427 pounds. He was keeping himself busy and was doing yoga. No side effects from his medications were noted. The patient was advised to continue Pristiq 100 mg daily for depression and was started on Valium 5 mg up to 2 times a day as needed for anxiety.

This is a 36 year old wihte femle who is here complaining of cough, sinus congestion, fever, and gneralized body ache for 4 days. Patient is a resident at Lovelady and reports many ladys are sick at the center. Patient is a smoker with a history of one pack for 20 year hisory. Patient denies use of alcohol or illicit drug use.Patient denies chest pain, N/V/D, but rports SOB and