Question

In: Nursing

Mr. A., a 67 year old African American male is here at the clinic for medication...

Mr. A., a 67 year old African American male is here at the clinic for medication refill and annual physical exam. He doesn't remember all of his meds since he didn't write them down, but he remmbers taking St. John's Wort over the counter, ASA 81mg daily, Digoxin 0.125mg daily. He has a history of Rheumatic Heart Disease, Mitral valve replacement with mechanical device, and heart failure. He reported today that he has been feeling easily tired today. He has 2+ pitting edema in both legs. He also c/o pain when he walks but the pain subsides when he stopped working. The doctor just gave him an order for outpatient Chest xray. In the meantime, the doctor examined the patient and found the following: VS--96.8, 24, 66, 136/88, sats on RA--90%; crackles bilateral lower lobes, 2+ edema of the legs, abd tenderness, and dyspnea with exertion. Lower 1/3 of lower legs are shiny, cool to touch, and hairless w/ dark discoloration

1. What do you need to know about his support system?

2. Which referrals do you anticipate he will need

Solutions

Expert Solution

ANSWER:INFORMATION ABOUT HIS SUPPORT SYTEM:

  • IT IS REQUIRED TO KNOW IF THE PATIENT IS UNDER HOME EXERCISE PROGRAMME WHICH INCLUDES LEG EXERCISES OR WALKING ON A TREADMILL.
  • IT IS ESSENTIAL TO KNOW IF THE PATIENT IS UNDER SUPERVISED WALKING OR ANY OTHER EDUCATIONAL PROGRAMME ,THE EFFFECT OF WHICH IS FOUND ALMOST EQUAL TO THAT OF ANGIOPLASTY AND IMPROVES THE QUALITY OF LIFE.

REFERRALS THAT THE PATIENT REQUIRES:

  • THE LOWER ONE-THIRD OF HIS LEGS ARE SHINY,COOL TO TOUCH ,AND HAIRLESS WITH DARK DISCOLORATION IS DUE TO ACCUMULATION OF FLUID IN THE LOWER EXTREMITIES WHICH SHOWS THAT THE PATIENT IS IN THE STATE OF CHRONIC CONGESTIVE HEART FAILURE.IT IS ESSENTIAL TO KNOW ABOUT THE LEG ASSESSMENT SYSTEM.SO THE PATIENT MUST BE REFERRED TO THE LEG ASSESSMENT HEALTH PROFESSIONAL.
  • COMPLAINTS OF PAIN WHILE HE WALKS AND SUBSIDES WHEN HE STOPS WORKING REFERS TO A CONDITION CALLED INTERMITTENT CLAUDICATION.THIS CONDITION IS MORE COMMON IN THE AFRICO-AMERICAN RACE AND IS DUE TO PERIPHERAL ARTERIAL DISEASE.THEPATIENT IS REFERRED TO THE SURGEONS IF HE REQUIRES VASCULAR BYPASS SURGERY, OR ANGIOPLASTY .

Nightingale answered 2 years ago
Next > < Previous

Related Solutions

Mr. A., a 67 year old African American male is here at the clinic for medication...
Mr. A., a 67 year old African American male is here at the clinic for medication refill and annual physical exam. He doesn't remember all of his meds since he didn't write them down, but he remebers taking St. John's Wort over the counter, ASA 81mg daily, Digoxin 0.125mg daily. He has a history of Rheumatic Heart Disease, Mitral valve replacement with mechanical device, and heart failure. He reported today that he has been feeling easily tired today. He has...
Carl Rogers is a 67-year-old African American male with a 20-year history of type II diabetes...
Carl Rogers is a 67-year-old African American male with a 20-year history of type II diabetes mellitus. On Tuesday at 1530, he was directly admitted from his physician’s office to the medical unit with a stage II nonhealing ulcer on his right heel. The nursing admission paperwork has been completed, and pain medication has been administered. Additional orders for a dressing change and insulin administration have been written but not yet implemented. The scenario takes place on Tuesday at 1700.
a 59 year old african american male presents to ambulatory clinic with increased shortness of breath...
a 59 year old african american male presents to ambulatory clinic with increased shortness of breath in the last week. He needs two pillows to sleep, swollen legs, malaise, weakness, and weight gain. his furosemide dose was decreased 2 weeks ago due to hypokalemia. shortness of breath is increasing with paroxsymal nocturnal dyspnea and ankle edema seems to be progressing
Malik Reynolds is a 12-year-old African American male who comes to the clinic with his father,...
Malik Reynolds is a 12-year-old African American male who comes to the clinic with his father, James, for a routine health visit. Malik is 5 ft 2 in tall and weighs 175 lb. A routine urinalysis reveals glucosuria with negative protein, WBC’s and Blood. A routine CBC shows WBC’s 18.1 RBC’s 12.24, HCT 38.2, Hgb 15.8. His vital signs are: HR 72, RR 18, Temp 98 degrees F, BP 122/86. What symptoms are significant and need to be reported to...
Mr. Smith is a 55 Yr. old African American male that came to the ED complaining...
Mr. Smith is a 55 Yr. old African American male that came to the ED complaining of chest pain and shortness of breath. Mr. Smith appears anxious, diaphoretic, and uncomfortable. He rates his chest pain as 9 on a pain scale of 10. Mr. smith has a history of hypertension, hyperlipidemia, and chronic bronchitis. He admits to smoking 1 back per day and tries to exercise but is usually too busy. Objective data: B/P-190/88, HR-120, R-20, Sa02-94% (Room air), T-99...
Mr. Wiggins is a 78-year-old African American male with chronic kidney disease, which requires dialysis. The...
Mr. Wiggins is a 78-year-old African American male with chronic kidney disease, which requires dialysis. The etiology of his renal disease was multifactorial—long-standing uncontrolled HTN and DM nephropathy. He has been on hemodialysis for the past 10 years and has done relatively well. Four weeks ago, he had a major CVA and is minimally responsive. His condition is not expected to change, and the family is having a difficult time with his recent health changes. Advanced directives were discussed with...
You meet Mr. Devon Jones who is a 40-year-old African American male with a long-standing history...
You meet Mr. Devon Jones who is a 40-year-old African American male with a long-standing history of uncontrolled hypertension. Both of his parents died from hypertension and his mother also had type II diabetes. Mr. Jones is a police officer in a high crime neighborhood. He stopped smoking about 5 years ago when diagnosed with hypertension. He states that he drinks several beers every evening and does not pay much attention to his intake of sodium, fat, or carbohydrates. He...
You meet Mr. Devon Jones who is a 40-year-old African American male with a long-standing history...
You meet Mr. Devon Jones who is a 40-year-old African American male with a long-standing history of uncontrolled hypertension. Both of his parents died from hypertension and his mother also had type II diabetes. Mr. Jones is a police officer in a high crime neighborhood. He stopped smoking about 5 years ago when diagnosed with hypertension. He states that he drinks several beers every evening and does not pay much attention to his intake of sodium, fat, or carbohydrates. He...
Depression Case Study Subjective Mr. AK is a 45 yr old African American male who is...
Depression Case Study Subjective Mr. AK is a 45 yr old African American male who is referred to begin pulmonary rehabilitation. His chief complaint is worsening shortness of breath with exertion due to sarcoidosis involving the lung. He reports that he can now only walk less than 0.75 mi on a flat surface; he cannot walk more than one and one-half flights of stairs without stopping. He states that prior attempts to improve functional capacity through regular exercise or increasing...
1. A 67-year-old male presents to the clinic along with his family with a chief complaint...
1. A 67-year-old male presents to the clinic along with his family with a chief complaint of having problems with his short-term memory. His family had dismissed these problems and attributed them to the aging process. Over time they have noticed changes in his behavior, along with increased confusion and difficulty completing basic tasks. He got lost driving home from the bowling alley and had to be brought home by the police department. He is worried that he may have...
ADVERTISEMENT
Subjects
ADVERTISEMENT
Latest Questions
ADVERTISEMENT