Patient Profile

DOI: 7/28/2014. Patient is a 33-year old male laborer who sustained injury when his left wrist twisted and snapped while using a drill. Per OMNI, he was initially diagnosed with dislocation of the left wrist. He underwent a tendon graft reconstruction on 08/07/14 and hardware removal on 09/11/14. Based on medical report dated 06/12/15, the patient reports that his left wrist is hurting significantly.

This is a 42-year-old male with a 7/14/2012 date of injury. The patient reported an injury to his mid back, low back and right shoulder that occurred when he repetitively ducked under a beam. Diagnosis: Other intervertebral disc displacement, lumbar region 11/26/15 note states an appeal to the denial of request for Valium. At his most recent visit on 11/25/15; psychological treatment had recently been authorized. The note reports that the patient continued to have back spasms.

History: The Pt had Left Total Knee Replacement (TKR) ON 06/03/2015, following immense pain due to degenerative joint disorder. Pt had been having the pain since little over 5 years, but since the past year it started being unbearable as per the patient. Past Medical History: Pt has a Past Medical History (PMH) of Degenerative Joint Disease (DJD), back pain, anxiety, depression, GERD and hypothyroidism.

Localization of the pain was consistent from the T4 to T5dermatome (on the right anterior, lateral and posterior chest wall). He described the pain as severe stabbing and lancinating with a numeric rating scale (NRS) of 8/10. The patient also reported sleep disturbances due to the pain, which had begun 20 day earlier but had aggravated within the last 1 week. He had a 3-year history of taking anticoagulants for the management of arterial fibrillation. At our pain clinic we prescribed tramadol and low dose pregabalin, but they failed to provide pain relief.

We know that Willis had suffered from stomach ulcers and died during surgery. The stomach ulcers were a sore that develops on the lining of the esophagus, stomach, or small intestine. Within the right care it would be resolved in months. During surgery of peritonitis the survival after a diagnosis of peritoneal mesothelioma was one year. Now in this generation with cytoreductive surgery and hyperthermic chemotherapy approximately 50% of patients can survive five years after diagnosis.

R/s on 12/21/2015, Mr. Schubert was admitted for pain in his knees and swollen feet. R/s Mr. Schubert is diagnosed with anemia, chronic knee pain, hypertension, gout, and chronic back pain. R/s it was reported that Mrs. Schubert had gallbladder surgery a couple a weeks ago. R/s it was reported that Mr. Schubert

DOI: 12/13/2012. This is a case of a 63-year-old male security officer who sustained a work-related injury to the right knee when he missed a step and fell down the stairs. As per Omni, the patient had a right knee meniscus tear. The patient had right knee replacement on 11/19/14. Per progress report dated 10/23/14 medicatiosn include Atenolol, Norco and cyclobenzaprine.

Concept Mapping Joshua Morillon Chamberlain College of Nursing   Concept Map Assessment: CR is a 45-year-old male who suffers from cerebrovascular accident, which has affected the right upper extremity and bilateral lower extremities. Patient is paralyzed upper right side (right arm) and bilateral lower extremities. Affect and facial expression appropriate to situation. Speech clear. Patient is oriented x3 to time and place.

Daryl Garrison is a 62 yeas old male with PMH of ESRD, HTN, Depression, chronic pain, neuropathy, tobacco abuse, recent GI bleeding, hyperkalemia, HLD, and acid reflex. He was recently hospitalized for GI bleeding and received multiple blood transfusions. During SOC, he was found to have unsteady gait (had falls without injury 2 weeks ago), generalized weakness, and increased back pain (on Percocet). He also will benefit with education about low potassium diet, HTN disease management, and teaching about medication purpose and regimen.

I write on behalf of my patient, Phil Robins, who is a sixty-five-year-old male facing acute urinary retention. Phil Robins shows several medical symptoms, including an inability to urinate, severe pain and discomfort in the lower abdomen, and bloating of the lower abdomen. My patient has been previously diagnosed with benign prostatic hyperplasia which has been obstructing his urinary tract. Because of this, he frequently has to use a catheter to empty his bladder. My main concern for Mr. Robins is the prevention of infections commonly associated with catheter use.

Introduction: 63 year old male arrived at the hospital complaining of hip pain accompanied by nausea and vomiting. During examination it was revealed he had a hip replacement three years ago and the sickness could be from eating an unhealthy supper. The gentleman was admitted and treated for gastroenteritis and bursitis. He received in injection in his left buttock for the bursitis. Two days later the same male patient came back to hospital due to red, raised blister appearing at the injection site.

These general objections then form into more clear shortcoming or decay that may bring about a doctor to suspect ALS ("Amyotrophic"). The body parts indicating early side effects of ALS rely on upon which muscles in the body are influenced. Numerous people first see the impacts of the sickness in a hand or arm as they experience trouble with straightforward undertakings requiring manual ability. In different cases, manifestations at first influence one of the legs, and individuals experience clumsiness when strolling or running or they see that they are stumbling or staggering all the more regularly. At the point when side effects start in the arms or legs, it is alluded to as "appendage onset" ALS.

DOI: 11/16/2015. Patient is a 57-year-old right hand dominant male mechanic who sustained injury while he was lifting a metal roller when he lost his balance and fell backwards. Per OMNI, he was initially diagnosed with head laceration which required 7 sutures and right shoulder full thickness supraspinatus tendon tear, confirmed by 12/29/15 MRI. MRI of the right shoulder obtained on 12/29/15 showed limited portions of the study due to motion artifact. There is a full thickness tear of the supraspinatus tendon.

DOI: 03/04/2014. This is a 61-year-old male liquid plant laborer who sustained an injury after he twisted his low back when a co-worker kicked the tool box he was installing. Patient is diagnosed with bilateral foraminal stenosis at L2 to L3, L3 to L4, L4 to L5, and L5 to S1 with radiculopathy, mild compression fracture at L1, right knee medial meniscus tear, right knee mild to moderate osteoarthropathy, left lateral epicondylitis, left shoulder calcific tendinitis, and left shoulder adhesive capsulitis. MRI of the right knee obtained on 05/23/14 revealed a complex tear of the posterior horn at the medial meniscus, cleavage tear of the anterior horn and myxoid change of the body. On the lateral meniscus, cleavage tears of the anterior and posterior horns and myxoid change of the body are noted.

Knee and ankle jerks are 1+, bilaterally. There is weakness of the quadriceps, hamstrings as well as the flexors and extensors of the hips. Assessments include cervical sprain, lumbar sprain, constipation, left carpal tunnel syndrome, lumbar degenerative disc disease, and retrolisthesis at L5-S1. Patient was given prescription for Norco 5/325 mg one tablet twice daily for severe pain #60, Motrin 800 mg 1 tablet twice daily as needed for inflammation and pain #60 and Flexeril 7.5 mg 1 tablet at bedtime for muscle relaxation #30. Requested from the provider’s office copies of recent urine d rug screen and Controlled Substance Utilization Review and Evaluation System (CURES) reports; however, no reports were received prior to the submission of this request to PA.