We discussed the differential diagnosis. She was thinking it might be more related to allergies, though I am suspicious there might be something more viral going on. I will send her strep test for a culture and I will review those results with her when they become available. We also drew a CBC with differential and a Monospot here today in the office. She will practice good hand hygiene to avoid new illness or spread to others.…
The assessment of Mrs. C. C. would need to begin with a complete history and physical exam that includes a visual exam of her entire body/skin. The step would need to include a complete history of the present illness to detail the mechanisms of injury, history of other related injuries, and identify any other signs of bleeding. Coagulation trends would need to be reviewed. Diagnosis Thrombocytopenic Purpura Treatment Supportive…
SUBJECTIVE Mr. Keith is a 45-year-old inmate from Stillwater who was referred by Dr. Quiram for evaluation of fibromyalgia. Mr. Keith has a long history of multiple medical problems, including hypertension, diabetes, hyperlipidemia, gastroesophageal reflux disease, and degenerative disk disease. His history dates back he says to age 12, when he first received the diagnosis of fibromyalgia. This was apparently in the early 90s, by 1998 he had developed diabetes mellitus and by the year 2000 he had a diagnosis of diabetic neuropathy.…
Hi Sarah, I am emailing you today to inform you that I would love to accept your offer to join the Ocotillo Ridge team! I am so excited to work along side the other first or second grade teachers next school year! Everyone has been so friendly and inviting so I can hardly wait to start working at this amazing school. Thanks so much for considering and choosing me for this position. I look forward to hearing from you, have an amazing day!…
A 64-year-old gentleman admitted with CHF. Diabetic, without any previous cardiac history. He is a former smoker. An echocardiogram demonstrated findings consistent with cardiomyopathy, and with injection fraction of 20-30%, and mild mitral insufficiency.…
On 10/13/2015, CM met with the client for Bi-Weekly ILP Review. Social Support Update: In the meeting client was alert, and satisfactorily groomed. She maintains eyes contact. She appeared in good health. She was in no acute distress.…
1.1 Juan de Fuca Ridge - case study In Salmi et al. (2014) they deployed thermal blankets in a 450-700m area of a segment on the Juan de Fuca Ridge to examine the effects of hydrothermal circulation on very young oceanic 2 crust. The Juan de Fuca Ridge is a tectonic spreading center located off the coast of Washing- ton in the United States. The ridge is considered an intermediate spreading ridge as it spreads 5.6-5.7 cm/yr.…
fascinated with necrophilia while listening to his father’s stories about working at the mortuary, he loved the idea of having sex with a dead female. “Having sex with someone who is dead because you wouldn’t get caught no feelings. She wouldn’t feel it.” (Reichert, 2004, p274) stated by Gary’s father. After Gary graduated high school he proceeded to go into Vietnam.…
He is not taking any OCT or prescription medications, he has drug allergy to Codeine and BioFreeze O: Right Wrist: some redness and mild edema present around SL ligament area. Warm to touch, palpation produced pain. Full ROM, audible crepitus, Radial and ulnar pulse +3, Tinel's Sign test – TM…
States 2 years ago she presented with a rash that went away with Benadryl. Patient reports headache and feeling fatigued. Patient denies sore throat and does not present with a fever. She denies chills, nausea, vomiting,…
The Ethical Dilemma of Treating Undocumented Patients “Approximately 11.2 million undocumented immigrants have settled in the United States… The Affordable Care Act of 2010 excludes undocumented immigrants (and legal immigrants here for fewer than five years) from its benefits” (Berlinger & Raghavan, 2013, p. 14). It is complex to treat and evaluate patients when financial and social constraints exist. How can resources be properly allocated among undocumented immigrants in the midst of multiple barriers to health care access?…
Introduction Perfusion is a very important aspect to the human body. Perfusion is defined as the flow of blood through arteries and capillaries that deliver oxygen and nutrients to the cells and removing cellular waste from the body (Giddens, 2013, p. 148). For us to maintain optimal perfusion, we need are heart to generate sufficient cardiac output. This means transporting the blood through patent blood vessels to supply the tissues throughout the body. Impaired perfusion may occur when the blood supply is reduced or completely interrupted (Giddens, 2013, p. 148).…
Cushing’s Syndrome Case Study, Manifestations, and Nursing Implications Introduction A 44-year-old male presents with complaints of body malaise and anorexia. He has noticed his attitude going from happy to depressed. He complains of weight gain, bruising easily, and frequent backaches. His arms and legs are thin.…
The patient may also present with a headache, stiff neck, and have increased…
Introduction: High-sensitivity cardiac troponin assays have provided a significant contribution for the early diagnosis of cardiovascular events due to their ability to detect lower concentrations of troponin levels more rapidly. There is significant evidence about the association between the absolute value of elevated cardiac troponin levels with the prognosis of patients with chest pain (3). However, it is well-known that elevated cardiac troponin levels may occur in situations other than acute coronary syndromes, as it happens with supraventricular tachyarrhythmias (4). There is no clear information about the magnitude of cardiac troponin elevation associated with these arrhythmias since the development of new high sensitivity troponin…