HTN: A Case Study

2/10/2016, 1600, Vital Signs: BP 140/85 P132 RR32 Temp 102.2 SpO2 85% on 2 liter by nasal cannula. Jacquline Catanzaro is 45 years old female on disability admitted to Medical Unit Hospital. Sister with patient. Reason to admit is can’t breathe. Diagnosis is 30 year of asthma exacerbation, psychiatric schizophrenia, obesity, pneumonia and herniated disc. Smokes 40 packs year. Drinks 2 pots of coffee a day. Drinks 3 beers each day. Frequency ED visits and hospitalization dependence on rescue inhaler. Patient refuses wear nasal cannula because of worry that it contains poison. Patient has a long history of stopping taking psychiatric medication and asthma medications. Patient has isolated herself from others. Sister is only caregiver. Neuro

The patient was a female on her 80s who was admitted to the hospital because of the COPD exacerbation. She had a history of stroke with minor residual effects, smoking, hypertension, and schizoaffective disorder - a chronic mental condition that is manifested mainly by the symptoms of schizophrenia, such as hallucinations or delusions, and mood disorder symptoms like manic or depressive episodes (NAMI, 2017). Patient length of stay was more than 300 days. She had two daughters who visited her everyday.

This is 38 year old white female. Patient has several issue, chronic back pain, left eye blindness, leg neuraliga and numbness, insomnia, depression Hep B&C positive. Patient reports MVA 18 years ago, lost her mother and father and injured her back and lost her right eye sight. Patient has a history of chronic depression and night terror and she was taking seroquel. Patient has impaired hip joint immobility related injury and chronic pain. Patient reports she is depressed but denies thoughts of suicide or homicide. Patient states she has a history of iv drug use, and her sexual encounter are only with other females. Patient was diagnosed with Hep B &C and doesn't know what to do. Also it has been a long time since she had her eyes checked.

What major government HIT initiatives have been taken by the government in the last twenty years? Include relevant key terms in your post. For example, RECS is a key term. RECS are regional extension centers that offer training and support for primary care providers in the process of transitioning to EHRs.

The offender returns to clinic today for a number of issues. 1. Diabetes mellitus type 2: This has been well controlled on oral metformin and the patient reports that she has no concerns in this regard. Last hemoglobin A1c was 5.9 about a month ago and all other labs within normal limits except for a quite high LDL at 171. She has not been on cholesterol-lowering therapy in the past. In addition, her TSH was very slightly elevated at 4.740 which can be considered the upper limit of normal. She has not noticed any significant constipation, excessive fatigue, or cold intolerance but she has had continued trouble with weight gain and thinks she may benefit from some low-dose thyroid replacement. 2. Chronic low back pain: At

This is a 51 year old male who is here for his medication refill. Patient is a non-smoker with history of generalized seizer disorder. Patient denies resent event of seizer. Patient reports he is depressed but denies thoughts of suicide or homicide. Patient reports his lack of monetary resource. Patient denies chest pain, SOB, N/V/D, or fever. current pain

In the ER, I have an African American female patient, age 32, who presents with sickle cell anemia. She has come into the emergency room with 2-day history of heart palpitations, headache, dyspnea, fatigue, and back pain. She states her appetite has decreased. She states that she is voiding well and having regular bowel movements. The backache extends from above the lower T-spine to the lumbosacral spine. The patient is allergic to codeine, but states she is able to take morphine. She is currently taking folic acid and Tylenol. She has had no previous surgeries and denies any smoking or drug use. Upon examination, her vitals were the following; a temp of 38 degrees tympanic, pulse was 105 BPM indicating tachycardia, and blood pressure is 115/50

No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,

A review of her medical record indicates she was admitted to MHS on 5/7/2017 with Weakness, fever and chills for 2 days and diagnosed with lower respiratory tract infection and possible UTI. She was started on antibiotics and IV fluids with adequate response. She was also noted to have mild fluid overload and pulmonary congestion on chest x-ray which were treated with. Patient had a 2-D echo on April which shows a preserved systolic function of left ventricle with only mild diastolic dysfunction. She is on marijuana adjunct therapy for her pain. She suffers from chronic HTN, chronic depression, which remained unchanged and chronic anemia. She is current follow by Dr. Iannotti for oncology and is currently on chemotherapy.

Claimant reports history of multiple medical complaints. Since the age of 60 she reports struggling with urinary incontinence, which impacts her functioning at work. She reports feeling ashamed and guilty that she is unable to control her urination and has the need to periodically utilize the restroom or go to her car taking time away from her responsibilities. In the past few years claimant has severe intensification of physical symptoms, including back pain, right shoulder and hand weakness, blood pressure, headaches, sleep difficulty, and depression-related fluctuating appetite, fatigue and sluggishness. She reports experiencing heart palpitations present (racing heart), dizziness, and fear of actual fainting, a feeling of choking and not being able to breathe, chest pains, nausea or intestinal pains, shortness of breath, tremors in the hands, hot flashes and tunnel vision. The claimant reports that she sleeps very minimally; averaging 3-4 hours of sleep per night on an interrupted basis due to physical and emotional pain. She reports that she has very poor mobility due to pain and depression-related poor motivation.

She also was receiving Reglan at scheduled intervals as well as Phenergan and Zofran as needed and asked for them around the clock. She had a flat affect and slept the majority of my shift both days. When the gastrointestinal doctor assessed her on daily rounds they stated that her stay would be one to two months longer until her pain and nausea was controlled with oral medications or resolved and she was able to tolerate taking foods by mouth. When questioned about the length of stay, I was told that she was unable to go home with her current medications and no other place would accept her as a patient.

A 50 years old female patient, with a history of tobacco use, alcohol consumption and bleeding disorder, presents to the clinic stating insomnia, fatigue, and unusual mood changes. The patient reports waking up several times at night sweating that lasts for several minutes and having difficulty going back to sleep. For the last year, she has experience irregular periods and denies heavy blood flow. She reports smoking 3-5 cigarettes/day, which is lower than the amount she said during her last

Patient C.P.’s medical history is essentially unremarkable until approximately two months prior to admission. Details regarding the patient’s decline will be discussed later. Socially, patient C.P. is the younger of her parent’s two daughters. She is a high school student who is active in ballet and cheerleading. Patient denies any tobacco or illegal

L.V. is a 51-year-old Hispanic female. She is 5’4 height and 150 lbs. Patient denies pain, discomfort, or chest pain during physical assessment. Patient is allergic to Aspirin she states that she gets rashes when she takes it. She was diagnosed with thyroid cancer 5 years ago and got her thyroid glands surgically removed. Patient denies the use of tobacco and drinks 2-3 beers on special occasions. Patient works for an American Restaurant as a server, she’s been serving for over ten years. Patient states that she’ll be getting her first colonoscopy next month and she just recently got her yearly mammogram done and results were normal. Immunizations are up to date and she gets the flu shot every year. Patient has four daughters and has been happily married for 20 years. Patient denies using glasses or contacts she visits her optometrist every year and has never had a problem with her vision.

Patient is a Caucasian 83 year old female that came into the emergency department from Wynwood assisted living facility with an increase of fatigue, worsening confusion and a 1 day history of a fever. Patient weighs approximately 90 pounds upon admission with a height of 64 inches. Patient has known COPD and is a former heavy smoker that also has a history of pneumonia, hypertension, atrial fibrillation, and dementia. Upon presentation to the emergency department patient has had increased nasal drainage and cough. Patient came into the hospital about a year and a half