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.
In 2005, his wife Ann donated one of her kidneys to Lopez. The transplant was successful; Lopez lost 45 lbs. after the operation due in part to the improvement in his health. He brought awareness to the issue on his show; his character's son Max was diagnosed with a similar illness George Lopez whose kidneys had literally been poisoned over the years from a congenital abnormality that caused a narrowing of his ureters, the tubes through which urine travels from each kidney to the bladder. The kidney's primary function is to filter the bloodstream.
Meet the Client: Bert Graham Sixty-three-year-old Bert Graham visits the health care clinic complaining of increasing fatigue and difficulty breathing. Physical assessment findings include a rapid, irregular heart rate of 138 beats per minute, BP of 140/86, and a respiratory rate of 28. His breath sounds are clear with fine crackles in the bases bilaterally. He has positive jugular vein distention (JDV) bilaterally and 1+ pitting edema of his ankles bilaterally. His initial medical diagnosis is heart failure (HF).
Case Study #1: Patient on Hemodialysis A 47 year-old man is being sent back to the hospital unit after undergoing hemodialysis in the dialysis unit. The patient was initially admitted for pneumonia but has been receiving hemodialysis Mondays, Wednesdays, and Fridays for the past year for kidney failure. He has a functioning arteriovenous fistula on the left arm. On assessment a positive thrill and bruit are confirmed. The nurse from the dialysis unit informs the unit nurse assigned to the patient that 1 L of fluid was removed.
Case Study Questions: 1.) Explain the renin-angiotensin-aldosterone system. When the kidneys sense decreased profusion pressure, they try to increase this pressure by increasing blood volume through the renin-angiotension-aldosterone system. Once the decreased pressure is sensed renin is released, which increases conversion of angiotension to angiotension I. Angiotension I is in turn converted to angiotension II by the angiontension converting enzyme (ACE). Angiotension II causes vasoconstriction, which raises the blood pressure.
Group D Screening Project Anh Nguyen, Jamie O'Farrell, Michael Seeley and Christopher Wilson Maryville University Group D Screening Project Client B is a 54 year old Caucasian male with a family history of heart disease. Some relatives have experienced heart disease prior to the age of 55, with his mother dying from a myocardial infarction at age 63. The client states that he has never smoked, but drinks daily, exercises 5 days a week and has no other significant medical history. For this particular client several preventive screening recommendations can be made. According to the CDC preventive screening are recognized to be cost effective in treating and identifying health problems in at risk individuals ("Healthier Worksite
His color and heart rate improved but he looks pale, his capillary refill is 4 seconds. Mean blood pressure is 29. List the differential diagnoses: * Prematurity * Birth Depression * Possible Hypovolemia vs Metabolic Acidosis What would you order for this admission? Why? * 0.9 NS bolus 10ml/kg (25ml) IV x1 over at least 20 minutes, for volume expansion to improve perfusion and mean BP * Maintenance IVF at 60ml/kg of D10W
OLDER ADULT Beverly J Sinclair Franklin Pierce College ABSTRACT K.J is a 76-year-old white male that was admitted to a health and rehab nursing home for strengthening. K.J is planning to go home with continuous oxygen. K.J is a 75-year-old white male admitted to Rowan court Health and Rehabilitation from Central Vermont Hospital. Resident’s reason for seeking health care was for Rt knee pain. KJ states that he has had right knee pain for about a month.
* First, read about the pathophysiology of your patient(s) medical diagnosis(es). You may want to start drawing your concept map at this time. * Review head to toe physical assessment, and transfer to care map the relevant physical findings that correlate with your patient’s (s’) medical diagnosis(es) * Review remaining objective data (labs, meds, etc.) and transfer relevant items to diagnostics
Niskayuna Hospital 1234 Meadowview Drive Niskayuna, New York (518)345-1000 REPORT May 7, 2010 McDonnell, Joseph CHIEF COMPLAINT: Numbness, partial paralysis of his left side of his face, crocodile tears, increased thirst, some loss of taste, and experiencing pain in both ears. HISTORY OF PRESENT ILLNESS: Mr. Joseph McDonnell is a 50 year old man with Type II Diabetes. He administers insulin as part of his treatment and tests his glucose levels regularly. He has no history of hypertension or stroke. He had Sarcoidosis three years ago and it was treated with Prednisone prescription at onset to control severe rash symptoms and then with Dexamethasone afterwards, to clear the redness, swelling and irritation.