Choking-Medium risk: Michael will have 0 episodes of choking without signs/symptoms for the year. Michael did not experienced any choking episodes throughout the past year. Supports were effective. Refer to SLP for complete report. Dental-High Risk: Michael’s oral hygiene will improve from poor to fair, Goal was achieved. Michael attended a total of five dental consults on 7/25, 9/15, 10/24, 4/19, and 5/10. On 9/15/17 he underwent dental rehabilitation with general anesthesia at BVMC without any complications during or after the procedure. The following was accomplished: 1. Complete exam including radiographs and probe scores. 2. Full mouth debridement using cavitron and hand scalers. 3. Caries removed # 8 and 9 incisal and restored. 4. Routine …show more content…
No GI consults within this year. Cardiac Disease /Circulatory-Medium risk: Cholesterol, triglycerides and HDL levels will improve through the use of medication and diet within the next 12 months (current levels 204, 244, 33 respectively) Treatment for hyperlipidemia was effective as evidence by Lipid panel on 10/4/16, 1/4/17 and 4/4/17 all within normal range values. However, Michael continues taking Lopid 600 mg orally BID for Hyperlipidemia. Also noted slightly low WBC and RBC’s for which he is on Folic acid and Vitamin B12 as per recommendations on last Oncology consult (8/23/17). His last EKG on 7/4/17 with normal sinus rhythm with no acute ST changes. Osteoporosis-Fractures-Medium Risk: client will remain free of falls and fractures for the next 12 months Michael did not sustain any falls, trauma or serious injuries during the past 12 months; he continue on Prolia injections every 6 months that were initiated on 5/26/16. In addition he is taking Vitamin D3 and Calcium+Vitamin D2 for supplementation. His next Dexa scan is du e on
The Framingham study and others that followed showed us that HDL-cholesterol is an independent cardiovascular risk factor and that the increase of HDL-cholesterol of only 10 mg/dL leads to a risk reduction of 2-3% (PubMed.gov, Nov. 2012). Higher levels of HDL cholesterol result in a risk of cardiovascular disease closer to the default risk. Cardiovascular disease risk increases then plateaus with greater ratios between total cholesterol and HDL cholesterol. Thus, higher levels of HDL cholesterol proportionate to levels of total cholesterol relate to lower cardiovascular disease risk (Lecture #3). Having a HDL-cholesterol of 60 mg/dL and above is the best place for a person to be. A bit lower, but considered a good HDL-cholesterol level standing is 40-49 mg/dL for men and 50-59 mg/dL for women. All three of us, me, my mother, and the case study Danny are in good standing regarding HDL-cholesterol levels, my mother with 55 mg/dL, me with 50 mg/dL, and Danny with 40
Mary Martinez is a 72 year-old female that is here in Prep and Holding for a scheduled elective right knee replacement surgery. I am performing a final pre-op exam at 6am. The patient is awake, alert, and oriented to name, place, and date. Patient has no known allergies. Patient stated her past medical history included: atrial fibrillation, hypertension, coronary artery disease, Type II diabetes mellitus, hyperlipidemia, and osteoporosis. Medications were reviewed with patient. Patient stated taking Coumadin, aspirin, metformin, metoprolol, calcium, and simvastatin. The last time, she has taken her medications were last night at 2000, including her warfarin and aspirin. She has been NPO since midnight. Physical assessment was performed. Patient complains of chronic pain in the right knee. Pupils are equal and reactive. Lung sounds are clear with auscultation on all lobes without any respiratory distress noted. Respiratory rate is 18 breaths per minute. Patient is on room air with oxygen saturation of 97%. Heart sounds are irregular with no murmur noted. Heart rate ranges from 92 to 120 beats per minute (bpm). Blood pressure is 140/67. Labs were reviewed. Abnormal values were International normalized ratio (INR)
In February, I had the opportunity to volunteer as a student nurse at one of Fresno State’s SAFE Balance screening sessions. This event was not only specifically important to our community, but to the entire realm of medical field in general because people are living longer. Not only is the elderly population increasing, they also are having to live with many other health issues, which is where medical professionals’ come into play to promote disease prevention, wellness, and overall living a lifestyle in the healthiest and most independent way possible. Precisely, one of the major health concerns among the elderly, is their risk for falls, since falls are growing an increasing problem in fractures, which often lead to other health problems.
The patient was keen to get her oral hygiene up to a good standard and prevent any
Cardiac Disease/Circulatory Disease/Edema: Lina will maintain stable cardiac status and lipid levels through medication, diet and activity through June 2017(Trig<100, BP<140/88)
Agustin was uncooperative for dental recall on 12/14/16; Dr. Jackson was unable to examine patient. Recommended dental UGA on June/2017.
Consult speech therapist to assess if any training/ swallowing exercise can be provided in order to maximize patient’s swallowing ability.
Healthcare teams often work together to augment the oral health of patients prior to cardiac surgery. This is commonly referred to as dental clearance prior to cardiac surgeries in this essay; I will focus on the rationale behind dental clearance for patients undergoing cardiac valve replacement. Dental clearance is the process when the patients who are referred from the cardiac surgery division, are assessed by the dental team for dental and oral concerns. And based on the finding the dentist might recommend a treatment plan before clearing the patient. These might include but not limited to, tooth extractions, dental hygiene, periodontal evaluation, fillings and oral surgery procedures.
Our body make 2000mg every single day and every single cell in our body make cholesterol. HDL levels appear to be strongly influenced by a mixture of genetic and environmental factors. Besides taking medication, there are other ways to boost the HDL levels which are do moderate exercise about 30 minutes five times a week. You can also even do the brisk walking to raise up your HDL levels. Other than that, Eat healthy by including lots of fruits, vegetables, whole grains and lean sources of protein in your diet. Also be sure to include monounsaturated fats in your diet. These are fats that are beneficial to your heart and include the fats found in seafood, and certain nuts, such as walnuts or almonds. Oils containing monounsaturated fat include olive oil and canola oil. Be sure to avoid saturated fats and trans-fats, since these fats not only lower HDL, but can also raise LDL levels. These fats are commonly found in foods such as cookies, chips, cakes, and fast foods. Higher levels of HDL cholesterol are generally associated with lower cardiac risk. There are several lifestyle choices we can all make that will reduce our cardiac risk in general, and our HDL levels in
The patient is an 87-year-old female who presented to the ED because of pain after fall 3 days prior to admission. She had she fell at home had a mechanical fall she was preparing for a colonoscopy, felt weak, dehydrated and fell on her way to bed from the bathroom. She was seen in St. Mary's Passaic emergency room and was given some fluids and discharged. They did nothing to work from her hip pain. She normally ambulates around her home without a walker she uses it normally when she goes outside. Since the fall she has been using the walker and ambulating with great pain. In our ED she ultimately undergoes a CAT scan which shows inferior and superior pubic rami fracture on the right. Her medical history is significant for hypercholesterolemia
He undergo Thyroid Sonogram and Dental UGA with Dr. Jackson on 8/25/16 with no complication; he has refused s/p dental follow up appointments twice; appointment are usually schedule early morning; will try at later appointment for the third time. He required antibiotic treatment for right elbow superficial cellulitis that resolved w/o complications. He continues on treatment for bilateral cerumen with hydrogen peroxide.
Fragility fracture is occasionally the first presentation of osteoporosis. The incidence of osteoporosis-related fractures has been reported to increase with age and over 50% of the incidents occurring in menopausal women aged > 75 years. Vertebral column and hip are the most common site of fracture contributing to a significant morbidity and mortality in the elderly. Additionally, patients with an episode of fracture has a higher chance for future fracture.
A higher level of fats in the body puts the patient at higher risk for Cardiovascular diseases(CAD). The patient's' family has a history of CAD. Her mom and one of her sister have CAD (Lewis et al., 2014, pp. 733-734). The patient states that she has been taking her meds for cholesterol atorvastatin regularly. Her lipase level was 8272 on 11/11/16 and 2829 on 11/12/16 U/L 1069 on 11/13/16 (Ref range 73-393 U/L). Her HDL cholesterol level was 21 ( ref range>49 mg/dl), LDL Cholesterol level 148 ( ref range: <130 mg/dL). Patient statin drug was on hold because it is contradicted on the patient with an elevated level of ALT 80, 61(Ref range 0-50 U/L) and AST 61 on 11/12/16 and 64 on 11/13/16 (ref range 0-45 U/L). The uncontrolled level of could be the cause of concern for stroke or acute myocardial
Hyperlipidemia affects nearly 30% of Americans (CDC, 2012). Hyperlipidemia may be better known as high cholesterol. Cholesterol is a fatty wax-like substance that is naturally produced in the body (NLM, 2013). People with high cholesterol may never even know they have the condition. But when they become aware, they have to make immediate changes in relation to adhering to specific diets, exercising regularly, and undergoing prescribed treatment or alternative therapies. Incorporating more fruits and vegetable in the diet, and less fried and processed foods should be one of the first steps taken after diagnosis. Exercising at least 3 days a week can serve as a fun and healthy way to reduce blood cholesterol levels. And taking natural
Hyperlipidemia is significant risk factor for developing atherosclerosis and heart disease. The cardiovascular system comprises the heart, blood vessels and blood. Blood has many life-sustaining responsibilities including transporting of oxygen, carbon dioxide, nutrients and hormones throughout the body. Cholesterol is a type of lipid and essential element contained in all human cells; however excess lipids and other fatty substances in the blood can cause hyperlipidemia and other lipid disorders.