The patient is an 84-year-old female who had a history of a fall approximately 2 weeks ago. She was seen in the ED at St. Joseph 's in Wayne at which time she had right hip and pelvic x-rays and also a CT of the of the hip. There was some question as to whether she had developed a fracture or dislocation of a previous hip prosthesis. The patient was in excruciating pain and was having difficulty ambulating. Her medical history is significant for diabetes mellitus, hypertension, Alzheimer 's disease, right hip fracture surgery back in January 2014.
Jean Russell of Michigan Insurance Company referred this file for medical case management. Instructions were given to meet with Flavia Tocco and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING I met Ms. Tocco at the St. John’s physical therapy department. Ms. Tocco was open to providing me information on her current and prior medical history.
Issues She has Type II diabetes. Due to her compromised immune system, it is more likely that her injuries will take her longer to heal. Daily stressors and financial responsibilities may cause health concerns to take second priority. As a result, health issues
Evidence-Based Clinical Practice Paper J.D. is a 62 year old divorced Caucasian female. Patient is a reliable historian. She is allergic to Lisinopril. She currently has a desk job at a local call center. She went through menopause at age 50.
High blood pressure (hypertension) is defined as having a systolic reading equal to, or more than 140mmHg and a diastolic reading equal to, or more 90mmHg. Hypertension can be caused by stress, medication (steroids), obesity, diet, alcohol, smoking and hereditary factors. The renal system works with the circulation system to remove waste products and fluid from the body. Blood pressure rises if the volume of blood increases, due to fluid retention in the body or from disease of the kidneys. The effects of hypertension include angina, heart attack, heart failure, stroke, kidney failure and peripheral arterial disease (poor circulation in the
Mildred Pasek, my friend and colleague died on August 8th 2017 following an anterior approached back surgery on July 28th at the New England Baptist Hospital. Before you read on, my goal is not to criticize the orthopedic or vascular surgeon’s professionalism, immense skill or personal care of Mildred as these cases affects all providers on a deep emotional and professional level. My concern is for the post-operative care of patients, like Mildred, who have comorbidities, are not necessarily in the ideal condition going into surgery, or at a critical time can advocate for themselves. As well as the debilitating arthritis, she had hypertension required three antihypertensive medications to control. Those meds were held pre surgery, and never resumed.
Patient has had progressive pain, numbness, and weakness in both lower extremities. He has had an epidural, physical therapy, and medications. It was reiterated that the patient has lost over 30 pounds. He has clear-cut instability as documented by the pars fracture and the spondylolisthesis, which is mobile on flexion/extension films.
I had a condition called Ehlers-Danlos Syndrome that caused hip capsulitis and an unrelated issue of iliopsoas bursitis. I had finally received closure about what was torturing me for the past two years. I was left with a sudden feeling of relief; I could finally return to the runner I once was, and the runner I wanted to be. However, because of the Ehlers-Danlos Syndrome, I had to begin to go to several different appointments about my heart, for I even found out that I have a heart disease. The appointment with Dr. Lavallee has left a permanent memory of the WellSpan Orthopedic’s doctors office because it was the first glimmer of hope I had through the process of developing a diagnosis for my incomprehensible hip pain, for I will always have an intimate bond with the simultaneously cluttered yet simple doctor’s
a.) 99204 b.) 99205 c.) 99214 d.) 99215 2. A European American male patient with a history of Lupus presents for a follow up visit. The patient diagnoses are Chronic Kidney Disease stage 4 and lupus erythematosus with an expanded problem focused history and exam.
High blood pressure normally started in the arteries. There are different stages of high blood pressure, there is stage 1 and stage 2 of high blood pressure. High blood pressure is caused from being overweight, little no exercise, genetics,smoking, family history high blood pressure, salt, alcohol, old age, stress, and the food intake that is the diet. High blood pressure is one of the top that kills African American women each year. High blood pressure mostly affects the ages between 40 through 70 (Kovesdy, Csaba P.; Furth, Susan; Zoccali,
With Audrey’s condition, blood pressure should be controlled and monitored as well as her cholesterol levels and heart rate to prevent stroke (John V Amerena, 2013) Digoxin and Warfarin medication will be given as per doctors order. 2. Hypertension means that the blood is pumping with more force than normal through the arteries, which are the vessels that carry blood from the heart to the rest of the body (Better Health Channel,
(Marieb and Hoehn, 2016) In my clinical setting, it was expected that a level of proffesional protocol is carried out for a correct, and safe arterial reading while maintaining a hygienic and aseptic approach that is safe, and reduces the risk of detrimental harm to myself as a healthcare professional and to the patient in my care. Bp is read from patients as a matter of determining illness by monitoring what is known as a NEWS score, presenting a validating number to recognise the level of health of an individual. (Royal College of Nursing, 2015) Hypertension, high blood pressure, or hypotension, low blood pressure, can be a sign of a decreased state of health for my patients, therefore it was imperative that a bp exam is carried out in the correct way for the
What are the important discharge instructions that should be given to patients admitted with a hypertensive crisis? The discharge instruction should mainly focus on the complications of hypertension, signs, and symptoms of hypertensive crises, etiology and prevention of the hypertensive crisis. The teaching should also involve the importance of taking antihypertensive medication as per order and not skipping medications. The complications of not following the medication schedule should be reinforced to the patient.