He has a 22-year-old son and an 18-year-old daughter who are in good health. A paternal uncle has hypertension and a maternal uncle has prostate cancer. There is no known family history of diabetes mellitus. On review of systems, he has occasional headaches, experiences shortness of breath when he walks up stairs, and gets up once a night to urinate. Questions: 1.
Recommend right or left heart catheterization. Day 4: Patient seemed calm with no new complaints still denies any chest pain or palpitations. Plan for a TEE and heart rate still not under control; will defer to cardiology. Patient received heart catheterization and another preliminary EKG was ordered. Day 5: Patient’s heart rate would increase rapidly when he gets out of bed but would decrease rapidly back to normal.
Tympanic sound noted during percussion, Liver and spleen intact, no enlargement noted, no hepatic friction rub or splenic rub heard on auscultation. Renal and iliac artery present with no bruits. Denies pain on palpation, femoral pulse present + 3 and no enlarged inguinal Lymph nodes seen. Lower extremities noted with even hair distribution, skin warm to touch, Popliteal, posterior tibial and dorsalis pedis pulse are present bilaterally. No edema noted, toes are absent of cracks and present of hair, cap refill 3 seconds; presents good vascular circulation.
Lack of prenatal care and alcohol/drug use were reported during the pregnancy; however, Billy’s delivery was indicated to have been spontaneous and no problems were indicated in regard to his condition at birth. Walking was indicated to have occurred within average expectations, while toilet training, talking, and speaking
Extraocular movements intact. HEAD AND NECK: Normocephalic and atraumatic. Trachea midline. Neck is supple. No evidence of masses.
Family Demographics The H family is an extended family consisting of grandparents raising their grandson. GH is the grandmother she is 59 and currently disable from back surgery, she has an unsteady gait and ambulate with a cane. The only other medical history she has is hypertension, which is control by medication but has constant pain from her back. She possesses a college degree and worked as a paralegal in a law firm prior to becoming disable that forced her into early retirement and currently a homemaker. KH is the grandfather he is 60-year-old, self-employed, and retired from the United States Army.
He never asked his dad. Sonny was diagnosed with a blood disorder and had to receive shots twice a week, which started his hatred of needles. When his stepmother left with Barger's stepsister and all of their things, his father
Joseph reports that he has no spiritual concerns in reference to death and dying. CLIENT SUCCESSES, STRENGTHS, AND RESOURCES: Joseph reports that his strengths as being his family, including his parents, sister, and children. His successes are finishing taxidermy school and having his own business in the past. He states, “Having a trade in taxidermy, could one day give me something to fall back on, if I ever get my energy back and fight my drug addiction.” MEDICAL HISTORY/HEALTH STATUS: He reports having back injuries, due to a fall that occurred in 2003. He reports having Hepatitis C. His primary care physician Dr. Arnold Hopland and a counselor with Watauga Behavioral Health are treating him.
He is retired and has been for many years. He worked as a dairyman for many years. KJ’s support system is his nephew and niece. His niece works as assistant director of nursing at this facility. KJ has concerns about the changes in his life.
English 105 September 28, 2011 “Great Falls” “Great Falls”, written by Richard Ford, is a short story based off the universal issue of separation and isolation. It is a first person narrative which focuses on the issues Jackie, the main character, undergoes throughout most of his lifetime. Jackie is forced to become an adult in a shorter amount of time than most people have. This is all due to the separation of his parents which causes him to be isolated from them, therefore in life. On the way back to the house from fishing and hunting, Jackie's father asks Jackie if he ever worries about girls and sex.