Why Do Doctors Visit

A is an 87 year old women, with a long history of health troubles including chronic kidney disease, congestive heart failure, coronary artery disease, a pacemaker insertion for her atrial fibrillation, type 2 diabetes, dyslipidemia, colon cancer, breast cancer, mild cognitive impairment and most recently paranoid psychosis.

Susan is a 78 year old widowed lady who was admitted to a medical ward following an episode of coffee brown vomiting and breathlessness. Susan has a past medical history of chronic

John is 76 years old and lives at home with his wife Brenda who is 78 years old. He suffers from dementia which had a significant impact on communication and assessment. I was involved in John’s care during my time on a urology ward. John came to the ward due to urinary retention and was there for a period of 2 weeks. He needed to be prompted and guided on personal care, toileting and nutrition. It was also important to promote John’s independence,

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

Patient L.H. is a 69-year-old married Caucasian male that is a retired teacher that lives at home with his

On May 11,2017, beginning of lab, students were given an unknown fluid along with a patient’s background information. A physician has recently inserted a urinary catheter into 62-year-old Steve’s bladder. After a month, Steve has

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

Introduction: Jessie Buchanan, an 80-year old female, was admitted to Bethany Care Society in room 3088-1 at the center unit. She is an extensive assist, requires 1 staff assistance and uses the transfer belt to transfer from bed to her wheelchair. She was admitted here because none of her family members can look after her because they are all busy with their own personal life. Jessie prefers to stay at Bethany because she receives full-time care from the health care providers. Jessie had a history of edema on her right ankle because she was experiencing hyponatremia. Currently, she is on fluid restriction and every morning I would put her compression stockings to prevent the occurrence of edema. Her condition worsens when she was diagnosed with osteoarthritis(OA), delirium, depression, type 2 diabetes mellitus, schizophrenia, hypertension, and urinary tract infections. Her recent urine culture shows that she is positive for urine nitrite and urine leukocyte which caused the UTI. Jessie is incontinent and she wears an indwelling catheter. Jessie said that sometimes her knees are painful. She takes an analgesic to relieve the pain that she feels. Jessie 's blood sugar level is within the range. She is not taking insulin or any oral medications like metformin because she knows how to control it, by following the proper diet. Jessie always have a good sleep and never complains about her sleeping pattern. She is taking medications for GERD, iron supplement, bone health,

The patient is a 45 year old man who had GI surgery 4 days ago.  He is NPO, has a nasogastric tube, and IV fluids of D51/2saline at 100 mL/hr.  The nursing physical assessment includes the following:  alert and oriented; fine crackles; capillary refill within normal limits; moving all extremities, complaining of abdominal pain, muscle aches, and "cottony" mouth; dry mucous membranes, bowel sounds hypoactive, last BM four days ago; skin turgor is poor; 200 mL of dark green substance has drained from NG tube in last 3 hours.  Voiding dark amber urine without difficulty.  Intake for last 24 hours is 2500mL.  Output is 2000mL including urine and NG drainage.  Febrile and diaphoretic; BP 130/80; pulse 88; urine specific gravity 1.035; serum

Patient C.B. is a 32 –year-old African American female, G2P2 who came to clinic with complaint of burning and frequency with urination and foul odor urine that she said began four days ago.

M.T. has a 1-year history of atrial fibrillation. She takes warfarin daily, and her INR is within the therapeutic range, between 2 and 3. Her creatinine level is 1.3 mg/dL, and a normal level is 0.6-1.2 mg/dl for women. This indicates that she has slightly reduced renal function at this time, possibly due to her diabetes, medications, age, or urinary tract infection (UTI). She has been diagnosed with acute uncomplicated UTI. The 24-hour history of dysuria, urinary frequency, and urgency combined with the urinalysis result

The patient is 65-year-old gentleman who presented to the emergency room with fever, urinary urgency, lower abdominal pain, no nausea no vomiting. The wife also reported that the patient had a leak from the Foley catheter. The patient this has a history of hypertension, dementia and enlarged prostate. He is been followed by urologist at St. Hackensack University Hospital and currently has a urinary retention with indwelling Foley catheter. He presents to our ED with a temp of 102.3, white count of 24.6 which goes up to 25.5 and the left shift. Urinalysis reveals him to be dehydrated with specific gravity greater than 1030, positive nitrates, positive large, leukoesterase, a large amount of blood and his cultures immediately grew Escherichia

The treatment for this patient is to replace the fluid which should stop the release of angiotensin and aldersterone. This should be accomplished with normal saline. If there is hypokalemia you would need to supplement with potassium. A proton pump inhibitor would also need to be used like prilosec to prevent further losses in hydrogen ions. If she was on any diuretics they need to be discontinued and if renal failure is

Sometimes patients have been prescribed Diuretics to help prevent or ease accumulation of fluid in

For the purpose of confidentiality, the patient will be identified by the initials A. S. A.S was a 52- year old African American woman who was admitted to the hospital when she started to experience severe urinary retention and shortness of breath. She has three adult children and eight grandchildren, but recently lost her husband of 25 years to diabetes. The patient appears to be very independent because she lives alone in her home and is aware of the disease process. She has a past medical history of acute renal