Case Study Of Patient

Few days back, the patient had a CABG surgery and was send home under stable conditions. Family member noticed SOB and weakness from the patient and was directed to attend the ED. As they got to the ED, the emergency department nursing staff noticed SOB with pericardial hematoma and immediate drainage was necessary. A chest tube was placed as a treatment option.

Patient states he is “in very good shape overall,” he has had some concerns in the past with his blood pressure which was too high, but it's been a long time since

Mr. Garcia’s BP is 154/94, HR is 92, and respiratory rate is 20. The health care provider found him to have lightly bluish color to his lower extremity. The patient also had visible varicosities as well as 1+ edema that ends just above his ankles.

Medical involvement included pharmacological intervention. An infusion of Sotalol 40mg was administered intravenously at approx 0930 over thirty minutes with continuous cardiac monitoring. Sotalol, an antiarrhythmic drug, depresses the sinus heart rate, decreases atrioventricular conduction, decreases cardiac output and decreases systolic and diastolic blood pressure (Bryant, Knights, & Salerno, 2003). As the patient was already hemodynamically compromised, a bolus of fluid (Gelofusion 500mls) was administered prior to the Sotalol infusion. The aim was to increase the circulating volume and raise blood pressure. Vital signs remained stable during the infusion, however the heart rate was neither converted to sinus rhythm or reduced to a normal rate.

As mentioned, the patient’s name is Joshua John Laurane. He is an African American male of 69 years with a past medical history of diabetes (Type II), hypertension, congestive heart failure, and high cholesterol. He first presented with these underlying

Data gathered tonight includes electrocardiogram is unchanged from previous showing slightly low voltage, left anterior fascicular block. No definite ischemic changes. White count of 6.2, hemoglobin 11.00, platelets 117, glucose 90, BUN 43, creatinine 2.56, sodium of 138, potassium of 3.4, chloride 106, CO2 of 24.8, calcium of 8.2, bilirubin 0.92, alkaline phosphatase 307, ALT of 23, AST of 21, magnesium of 1.8, a troponin is 0.06, BNP is 2650. Labs done almost 24 hours ago had a lower BUN at 41, and a lower creatinine 2.23, a higher potassium at 3.7, BNP that was higher earlier at 3350, and a troponin that was slightly less at 0.04. Chest x-ray may have more congestion now than previous. Frontal view this morning was obtained the radiologist says the findings are concerning for minimal congestion versus atelectasis in lung bases and a stable mild to moderate cardiac

Analyzing Mr. Edward blood pressure (140/85) during his last visit to the doctor, plus the constipation and the GERD, and also the level of his cholesterol, it show that he has all the condition to develop myocardial

On Tuesday August 30, 2016 a Male 63 years of age came into Christus Spohn South Heath Center with a diagnostic order for chest and rib x-rays. He was being seen because of chest pain on his right side due to a fall. He had an extensive patient history of x-rays that went as far back as 2014. For the year of 2016 he received approximately 12 different x-ray series. For example, on January 12, 2016 he received a chest 1 view image and cardiac catheterization. On May 21, 2016 he received a chest 1 view and a complete 4 view foot. On May 30, 2016 he received a cardiac catheterization. On June 1, 2016 and again on June 2, 2016 he received a chest 1 view. On June 10, 2016 he received a catheterization. On August 25, 2016 he received a chest 2 view. On August 26, 2006 an upper extremity without contrast. The patient also has a history of open heart surgery and receives dialysis treatments and is on oxygen.

On Tuesday 06/27/2017, veteran Mr. Saenz walked very angrily in my office with his wife about 11:00 AM. I greeted them and offered to sit down; Mr. Saenz and Mrs. Saenz were very upset and asked me where they need to go as they have VA examination, they both said “nobody tells them anything; they have been sitting in waiting room”. They told me that the lady on the desk told them to come to me.

Patient is a 45 yo male; 5’7”, 221 lbs who entered the emergency room at 6:30 am on 9/7/14 with severe chest pain (onset at 6:00 am) radiating to his arm, L arm numbness and nausea and vomiting. Past medical history reported by wife includes peptic ulcer, tobacco use (1-2ppd for 27 years), elevated blood pressure (controlled by lopressor). Wife did not know of any family history but reports patient’s father is deceased, died at 42 in his sleep. Mother alive and with high blood pressure.

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

This is 50 year old AAF. Patient is here complaining of her elevated BP for the past several days. Today, her BP is 197/118. Patient states he has moved out of her daughter's home and now she is staying at a motel. Her stress level has been increased for the past week. Patient denies chest pain. Patient reports headache. Patient reports some depressive moods, denies thoughts of suicide or homicide.

Mrs. J. arrives at the emergency department with her 6 year old son, PJ, who has a history of Cystic Fibrosis (CF). He is febrile (101.7° F orally), BP 98/66, HR 122, RR 32 with the use of accessory muscles. Mother states PJ has, for the last five days, exhibited signs and symptoms of upper respiratory infection, runny nose, low grade fever, cough, and fatigue. He has lost 2 pounds over the past 5 days due to anorexia though he has not had vomiting. He weighs 36 pounds and height is 3’2”. Today, PJ became more lethargic and his fever was difficult to control with pyretics.

Although there is a multitude of pre-existing as well as new medical conditions that are concerning, my focus during this annual check-up is the laboratory findings that are indicative of coronary artery disease (CAD). This is concerning because the patient has extensive nonmodifiable and modifiable risk factors for CAD. Nonmodifiable risk factors include that he is a male,

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.