We are asked to see Mr. Preston. He is a pleasant 70-year-old gentleman recently diagnosed with myeloma, who is found to have a creatinine around 2.0. He appears to have been worked up in Florida for the creatinine around 2, and myeloma with 20% plasma cells was found. He was transferred here for chemotherapy. On review of his old record, he was diagnosed in the Butner systems based on our excellent electronic medical record in 02/2011 with hypertensive nephropathy.
Al Waysmoking was a 72 year-old retired factory worker who was a chain smoker. He is experiencing fatigue, shortness of breath, but continues to smoke. Upon exam his Nurse Practitioner notes that he has a prolonged expiratory phase, expiratory wheezes, and an increased anteroposterior chest diameter. His nail beds were cyanotic and he had moderate pitting edema. Pulmonary Function Testing (PFT) revealed that Al had a decreased VC and an increased RV and FRC.
Patient 1 Medication History Patient Initials: M.K Reason for Physical Therapy: 62 years male Three weeks post right (Rt) CVA, Pain on leftshoulder, left shoulder subluxation, Lt side weakness inability to perform functional ADL. Diabetic, Unstablehighblood pressure,______________________ ___________________________ PT Treatment Plan (Specific Interventions, Frequency, and Duration): 1hour program 3 times weekly, Increase PROM-10mins Lt UE/LE strengthening muscles of (Lt) shoulder. Lt side muscles-30mins, relieve pain on the Lt shoulder, IRR to the Lt shoulder-10mins STM ( Lt) UE/LE, Balance training in all postures 10mins Sitting-standing reducation-10mins Trade Name Generic Name Prescribed for: Dosage Rehab Implications Prisolec Omeprazole
She is a diagnosed patient with type 2 diabetes mellitus for last 10 years and was taking oral metformin for the control. Her glycemic control was not satisfactory and she was told that her renal functions were slightly impaired since last year. Latest creatinine clearance done 3 months back was 60 mg/dl/min. Physical examination revealed a mild hypoxia and tachypnea with mild respiratory distress. Her vital signs were; temperature - 103.7 0F, pulse rate - 126/min, respiratory rate - 28/min, blood pressure - 139/82mmHg and SpO2 of 81% on room air.
Medical records (2015-2016) indicated that the claimant had a history of thyroid disease, obesity (360 pounds), benign hypertension, and severe sleep apnea. His medical issues, including sleep apnea were under control; he was fitted for a new prosthetic arm. He reported that was working 15-18 hours a day. Per mental health records (2015-2016), the claimant reported that he was doing well, was taking his psychotropic medications with positive result and no adverse side effects. He denied symptoms of depression, suicidal ideation, or others, with the exception of anxiety that he controlled with medication.
His gait improved slightly with modalities, like deep tissue massage, ultrasound and also some home exercises but the pain was still present. Roger lee kilfoil jr Therapist treated the gentleman with iontophoresis of 4% acetic acid using phoresor PM900 at 2.0 mA DC current for 20 min of a period of 2 weeks. The positive electrode was on midshaft of fibula, and the negative electrode over the Achilles tendon insertion bilaterally. After two weeks, the patient’s pain scale improved and after the third treatment the patient no longer need the assistance of the rail for the stairs. The fifth iontophoresis treatment, he was discharged from physical therapy, and reached a goal of decreased posterior heel pain.
But the staff understood and Dr. Westwood got an ambulance and reached to ED. He presented with diaphoresis, motor dysfunction, paresthesia, nausea, and ascending paralysis from his leg to the upper body, arms, face and head. He became cyanotic and hyperventilating and it turned to be bradycardiac with a BP 90/50mmHg. After five hour long clinical treatment procedures were followed for tetrodotoxin poisoning, his vital signs were
He is a deadbeat father, he is “mentally” addicted to aspirin, he has been eating about 10-15 tablets a day for 3 years straight. Albert thinks it is a solution for his problems, but it has landed him in the hospital multiple times. Aspirin if taken many times, can become a blood thinner, kill off a liver, and can rip your stomach lining. He got his act together, when he learned he was very close to
Most stroke victims, who undergo the usual course of rehabilitation, rarely achieve great improvements in their motor skills. A prime example is Dr. Michael Bernstein, an eye surgeon who experienced a debilitating stroke that paralyzed his left side of his body at the age of 44 (Doidge, 2007). He went through a week of physical therapy, occupational therapy, speech therapy, and another three weeks of rehabilitation, but his recovery was for from finished. His left hand barely functioned and he relied on a cane to walk. Dr. Bernstein was one of the first few patients to undergo the Taub Therapy, where Dr. Edward Taub established the use of (CI) Movement therapy.
Telling Mike that he had a concussion for sure from the falling, and that his heart rate went down so his blood pressure went up, so he fainted. Mike said that he had this problem when he was younger. The doctor said he was fine to go, but he must rest and stay away from screens like his phone. Resting for weeks, he steadily recovered from the injuries that he suffered from. After he fully recovered, he is supposed to take these pills to keep his blood pressure down.