Case Study #5 Heart & Neck Vessels, Lungs & Thorax Mrs. Lee, 80 year old Asian American female Admitted to the medical-surgical unit with a chief complaint of “breathing problems”. She speaks broken English & requests that her daughter be allowed to stay with her. She is on nasal cannula oxygen & sitting up in bed. At this time, she seems slightly short of breath, but is not in acute distress. You note that she is pale & has a petite frame. Her ankles are swollen. Her daughter tells you that she has been complaining of feeling more tired in the evenings & “unable to catch her breath”. While at home, she has been sitting up either in an easy chair or in bed with three pillows. Her daughter states that Mrs. Lee has not had to …show more content…
2. What additional questions should you ask regarding this patient’s chief reason for seeking care? Chest pain, dyspnea (especially on exertion), orthopnea, cough, fatigue, cyanosis or pallor, edema, nocturia, history of cardiac problems, family history of cardiac problems, cardiac risk factors, & current medications. 3. After completing the health history, you prepare for the physical examination. What steps should you include in your assessment? Inspection, palpation, percussion, & auscultation of lung sounds, heart sounds, & adventitious sounds. 4. What should you keep in mind, regarding this patient’s age, when assessing her neck veins? View the right internal jugular vein when measuring jugular venous pressure. With aging, the aorta stiffens, dilates, & elongates, resulting in decreased pulsations on the left side. In addition, use caution when palpating & auscultating the carotid artery. Pressure in the carotid sinus may cause a reflex slowing of the heart rate. 5. Describe how you would assess her heart sounds. Explain to her (through her daughter as necessary) what you will be doing. You might want to explain that t takes extra time to listen to her heart & that just because you listen for a long time does not indicate there is a problem. Move your stethoscope in inch-long increments, in a Z pattern across the chest, from the base of the heart, across & down, then over to the apex. Although heart sounds are generally lower in pitch,
The second choice for the alternative design for Dynacorp would be Functional / Product matrix of strategic design. Dynacorp manufactures a range of products in the field of global information systems and communications. Since it has the major functional structures defined such as engineering, manufacturing and marketing, it can be linked to the various products Dynacorp manufactures. This allows comparatively easier transformation from the existing structure.
1. Describe bone physiology and the bone remodeling cycle. Be sure to emphasize the two types of bone tissue and the roles of osteoblasts and osteoclasts.
In this case study, first year third grade teacher, Maggie Lindberg, is having trouble controlling her class. The children are well-behaved during their art period. However, when Ms. Lindberg is in charge, they are highly uncontrollable. They talk when they are not supposed to talk and they don’t listen to anything that Maggie says. There’s supposed to be a nature walk/field trip and Ms. Lindberg’s class has yet to complete the task.
As I did the physical exam I explained to the patient that I would listen to the arteries with a stethoscope for an abnormal sound which will let me know if there is poor circulation due to plaque? I also explained to the patient that by checking the pulse in the ankle and legs it would also indicate if
The main purpose or mission of the Greenhill Community Center was to provide human service programs for learning, growth, and enrichment throughout life within an intergenerational setting. The mission seems to fill the need in the demographical setting of the location. The center is located in one of the poorest cities on the East Coast. In the textbook it states a mission as being “the reason an organization exists, and it must be the starting point for its planning.” (Worth, p.172) The mission of the center is very sound, but in the process of hiring a new director, I think the mission focus was lost. I saw a couple of incidences of “mission creep“ in the reading. (Worth, p.173) One being the focus the trustees put on not
In this Assessment nursing course, one of the major things that is taught is the most important part of giving proper care to a patient. Correct patient assessment is needed before any nursing care plan or treatment can be implemented. This post-review of a person’s assessment will demonstrate the proper way to go about assessing a person’s health.
1. Look for factors that may lead to patients, staff and others, including yourself, being in danger of harm and
Scott Starson, a brilliant physicist has been in and out of mental institutions due to his bipolar disorder. He was lastly admitted again after he made death threats to his roommates and was found not criminally responsible for that offense. His physicians suggested different sorts of treatment for his illness. Scott Starson refused to give consent to the treatment for reason that he had a scientific research to finish and he didn’t want the medications to slow him down. His physicians not finding him competent enough to critically make that kind of decision, brought the case
b. Your patient is restless and complaining of feeling cold. What measures can you take to prepare your patient for the exam to ensure that you get a good reading? (5 points)
Functional magnetic resonance imaging (fMRI) technology would be best reveal the location and extent of damage to Tim’s brain produced by his
Cardiovascular. Client denies chest pain, palpitations, murmurs, any arrhythmias, hypertension, awakening at night with shortness of breath, or dizzy spells. Client has not had an electrocardiogram.
The physician will complete a thorough exam. He/she will listen to the heart and lungs looking for signs of heart failure. Gallops, rapid heartbeats, and murmurs of the heart valves may be heard. The physician will palpate the abdomen to feel if the liver is enlarged. He/she will also check the skin and nail beds on fingers and
Mr. Hugh Tudor (55 yrs) is a well-known person in Milville, where he has been living for 30 years. He is involved in lot of social activities and has a reasonable pension and savings. He is becoming restless in his retirement and shows interest in investing in The Leeds Livery, local British pub in Milville, which could provide him with more challenges. While discussing this matter with his friend, he found out that the pub has great potential to perform well as it once exceeded the profit percentage of the industry. Mr. Tudor is in the process of exploring this opportunity but still has several questions rising in his mind.
Additionally, as expressed by Rebecca Ratner, Hsieh’s commitment to merging the workplace with social lives could present risk to the company in the form of unprofessional or inappropriate conduct that is not addressed properly.
As the case explains, economic changes are a big concern for Danaher’s success. The following topics will be analyzed in addressing those concerns: Business-Level Strategy, Corporate-Level Strategy, External Analysis, Internal Analysis, Recommendations.