Vertigo And Falls Case Study

The patient is a 59-year-old right-handed white female who was admitted in June to Portsmouth Regional Hospital for what was determined to be either transient global amnesia or complicated migraine. I did review those notes. She was seen by Galina Simkin, MD. The symptomatology discussed in the H&P is consistent with transient global amnesia. She was having problems asking questions inappropriately, repeating sentences, repeating questions over and over again, and seeming somewhat confused. There were no other neurological symptoms at that time. No evidence for seizure activity. No evidence for stroke. She was brought to the emergency room, where she underwent a CAT scan, which was

Patient is a 64-year-old right handed white female who presents with her sister for evaluation of an episode of loss of consciousness that occurred last month. She had been admitted to Portsmouth Regional Hospital for right-sided neck pain. She did have a fall resulting in right sided neck pain and problems moving her right upper extremity. This was a fall that occurred early in May and was a mechanical fall according to the patient's description. At that time, she did not lose consciousness. She was driving home from the physician's office on 06/24/2015 when she is suddenly came to in her car at one in the morning. She states she left the doctor's office around 4:45 in the evening. She actually tells me she does not recall the drive home, but she assumed that she drove home carefully and successfully as there was no evidence of an accident on her car. Her car was in the garage. The ignition was off and the garage door was closed, but she recalls coming to at about one o'clock in the morning and finding herself in that situation and has amnesia for the period of time after she left the doctor's office. She came to being upright in the driver's seat. There is no evidence for tongue biting. She has no other history to give regarding that particular event. She personally denies

Patient states that she has had no head injuries, past or present. Patient states she has never suffered from vertigo or dizziness. BB states that she rarely suffers from generalized headaches. Patient avoids taking pain relievers of any kind when she does present with head pain.

In 1958 Alfred Hitchcock released what is considered the greatest film of all time, Vertigo. Vertigo is a film noir thriller that stars James Stewart and Kim Novak. Stewart's character, Scottie Ferguson, is sent to follow and investigate his old friend’s wife, Madeline. He spies on her strange actions and at the time falls deeply in love with her. The viewer is given a restricted narrative through the eyes of former detective, who suffers from vertigo, as he follows Madeline through San Francisco. The audience views the film from the same perspective as Scottie. Hitchcock pompously puts the viewer into Scottie’s eyes in scenes where he is following Madeline give Scottie a voyeuristic sense. The narrative is later switched to unrestricted as

Patient is a 50-year-old-year-old left-handed white male who presents with his wife for evaluation of multiple symptoms that have been present since an MVA in 02/2013. At that time, he was T. boned and his car was totaled. He has amnesia for the event and is unaware whether or not he hit his head. The airbag did deploy. Afterwards, he was confused and noted significant pain in his neck and upper back. Since then, he has had multiple symptoms. He does have involuntary twitching on the right, more than left, both hands, legs, and sometimes feet. He demonstrates one of these twitches and it looks like a focal myoclonic jerk of a limb. These occur on a daily basis. He also has problems with his left thumb and index finger locking up. When he is fatigued, especially when his neck gets tight, he has some problems with word finding, paraphasic errors, and syntax errors. He did see Anthony P. Knox,

She converses appropriately. Blood pressure 92/60 supine. Blood pressure decreased to 72/50 standing. Pulse is 90 and regular. Weight 113 pounds. She has a normal appearance of her face and does not have a masked appearance of her face. She has good strength throughout her face. She has good strength of her extremities. She has only minimal cogwheel rigidity at the left wrist, but no cogwheel rigidity at the right wrist. She has no tremor of her hands. She moves her extremities freely and with normal speed. She is able to rise on her own from a sitting to a standing position, only minimal bradykinesia of standing. She walks fairly freely and there is a normal cadence of her gait. She did not have dyskinetic movements of her extremities. She is able to walk, including turning without losing her balance. She does not shuffle her feet when walking. She does not have en bloc turning. She has good posture stability

Patient is a 60-year-old Latin American female, who presents with her husband for evaluation of some spells. She seems to have two different things going on. She did report intermittent episodes of feeling of weakness with blurred vision, diffuse paresthesias and a sensation she is about to pass out or the sensation of before undergoing generalized surgery, feeling like she is being sucked down. There is no loss of consciousness with this. She is unable to give any further history, except these events have been going on for about a month. They are almost daily. She does note they happen after eating, at which point, she will fall asleep easily. Otherwise, she denies any loss of consciousness,

Alfred Hitchcock’s stance in the film business is something to be marveled. His prominent position as the “Master of Suspense” is due in part to the textbook blueprint he created in the thriller genre. His catalogue has many examples, but the two with the most similar psychological depth would be Vertigo and Rear Window. Not only do these two movies thrill on the surface level, but they also thrill from the character’s emotional and psychological stand point. This makes the suspense less abrupt and more of a gradual progression into the classic Hitchcock climax. Hitchcock puts his viewers on a psychological roller coaster due in part to his three useful components: fear, guilt, and redemption.

Patient is a 58-year-old right-hand white male interviewed in the presence of his wife. He was previously seen by me last month for admission for the acute onset of vertigo with possible TIA or stroke as etiology. He stated that he awoke on 06/18/2015 in his usual state of health and then went to work and while there, he had the sudden onset of marked spinning vertigo. He was unable to walk straight, but denied any bilateral lower extremity weakness. He did have nausea and vomited several times. He initially denied any diplopia, visual field cut, blurred vision, facial asymmetry, facial or body sensory changes, dysarthria, or focal weakness. He continued to have marked vertigo in the emergency room,

The patient is an 85-year-old female who is brought to the ED by her family because of increasing confusion and supposedly she had a degree of altered mental status of two hours previous to presentation. In the ED she is completely worked up. CT shows advanced atrophy with microvascular changes and several lacunar infarcts nothing acute. Specific gravity in the urine reveals her to be markedly dehydrated. She culture completely, started on IV antibiotics, IV fluids and B12. On the day after admission she still presents as persistently confused. She is evaluated by PT. The patient who was formerly ambulating with a walker and allegedly driving a car is unable to be ambulated. Before the history indicates that she has a slow downward

Nursing intervention for fall prevention could improve older adult’ quality of life. Intermittently missing nursing care, also known as error of omission, is related to the staff’s education and skills level. According to Kalisch, Lee, and Tschnnen (2012), falls decreased 4% to 25% in health setting after giving education for fall prevention strategy. In other words, without providing education, there’s a possibility for older adults to fall by a health care provider who has inadequate knowledge for fall risks. Even if aging patients already have a high chance of falling due to their health condition, a health care provider could make the situation worse. Therefore, fall prevention education is important for both older adults and health care providers. Fall prevention requires participation from both sides.

The different diagnoses have a clear link. Ms. Snead is at risk for fall because of the diagnosis of UTI which leads to nocturia. Her diagnosis of multi-infarct dementia may make it difficult for her to recall when to take her medication leading to chronic UTI’s. Her diagnosis of mild arthritis may be causing her more pain than she can verbalize because of her dementia.

Patient is a 34-year-old left-handed white male who states that in January he was in a parking lot and was hit by a plow truck that was backing up. His back was turned and he did not know what was happening. He fell on his back and hit the back of his head on the tailgate. He denied any loss of consciousness. He did have a significant headache and neck pain, but no neurological symptoms. He did have some pain in his right hand and right ankle after this. He did present to the emergency room, where an unenhanced CAT scan was negative. Since then however, he has been having daily headaches. He has an almost constant, dull, mild bitemporal pressure sensation, but he also has significant

We need to measure the incidents then only we can improve it.so we need to counted and tracked falls rates for quality improvement program. Through tracking programs we know whether the care is improving, staying the same, or it worsening. Our unit is continuously assess our fall rates and fall prevention practice. Fall and fall-related injury rates can measure how well you are following in making patients safer related to falls. Compared to previous year we improved to prevent fall related

While BPPV may be the most common, Dr. Herman Jenkins, Professor and Chair of the Department of Otolaryngology at the University of Colorado School of Medicine and Health Science Center warns, "It can be many things in the elderly, from loss of function from a viral infection to dislodged crystals in the ear." Since vertigo may be caused by decreased blood flow to the base of the brain, blood clots,