CASO 9 34Y MALE

Caso 9 34y Male - Nursing
PLACE ORDER
Caso 9 34y Male Date: 09/19/21 Time: 23:00 Chief Complaint: Testicular swelling, pain and discomfort. Source: Patient - History of Present Illness HPI: 34 y/o male with past medical history Diabetes Mellitus, Hyperlipidemia, Hypertension, Hypothyroidism, morbid obesity came to emergency room due to edema and pain in testicles of 1 day of evolution. Refers start to feeling a weird sensation on testicles and some edema. Denies nausea vomiting or other constitutional symptoms. - Allergies Allergies/Adverse Reactions: Allergies Allergy/AdvReac Type Severity Reaction Status Date / Time aspirin Allergy Mild Rash Verified 09/19/21 05:10 Home Medications Medication Instructions Recorded Confirmed Type Amlodipine Besylate [Amlodipine 10 mg PO DAILY 02/28/20 08/25/21 History Besylate 10 mg Tablet] Atorvastatin Calcium [Atorvastatin 20 mg PO BEDTIME 02/28/20 08/25/21 History 20 mg Tablet] Levothyroxine Sodium 0.025 mg PO Q6AM 02/28/20 08/25/21 History [Levothyroxine 0.025 mg Tablet] Losartan Potassium [Losartan 50 mg PO DAILY 02/28/20 08/25/21 History Potassium 50 mg Tablet] Metformin HCl [Metformin 1,000Mg 500 mg PO Q12HR 02/28/20 08/25/21 History Tablet] hydroCHLOROthiazide 25 mg PO DAILY 02/28/20 08/25/21 History [Hydrochlorothiazide 25Mg Tablet] - Travel Risk - Coronavirus Travel Risk: No Contact Risk: No Has patient experienced symptoms?: No Past Medical History Attestation statement: The following information was validated with the patient or family. Source: Obtained From Patient Accompained name: HERMANA - Past Medical History Medical History: Diabetes, Hyperlipidemia, Hypertension, Thyroid Disease (Hypothyroidism), Other (Morbid Obesity) Hx Deep Vein Thrombosis: No Blood Transfusion History: No Surgical History Male: Other (I/D OF LEFT FOOT ) Psychiatric History: No Psych History In the past week, have you been having thoughts about killing yourself?: No - Family History Family History: No Significant Family History - Social History Smoking Status: Never Smoker Second Hand Exposure: No Alcohol Use: No Alcohol Intake: Never Sustance Use: No Subtance Use Type: Does Not Use Lives: Family ADL's: Independent Ambulation: Independent Housing: House Household Members: Family Current Occupational Status: Unemployed Current Occupational Exposures/Hazards: No Review of Systems - Constitutional Constitutional: Report: No Symptoms Reported - Eye Eyes: Report: No symptoms reported - Gastrointestinal / Abdominal Gastrointestinal/Abdominal: Report: No Symptoms Reported - Genitourinary Genitourinary Male: Report: Testicular pain, Testicular swelling - Musculoskeletal Musculoskeletal: Report: No Symptoms Reported - Skin Skin: Report: No Symptoms Reported - Neurological Neurological: Report: No Symptoms Reported - Psychiatric Psychiatric: Report: No Symptoms Reported - Endocrine Endocrine: Report: No Symptoms Reported - Hematology / Lymphatic Hematologic/Lymphatic: Report: No Symptoms Reported - Immunology / Allergies Immunology/Allergies: Report: No Symptoms Reported - All Other System Report: Reviewed and Negative Physical Examination - Measurement Vital Signs: Last Vital Signs Temp 36.3 C L 09/19/21 17:31 Pulse 89 09/19/21 17:31 Resp 17 09/19/21 17:31 BP 150/105 H 09/19/21 05:02 Pulse Ox 98 09/19/21 05:56 Height & Weight: Height 5 ft 6 in Weight 272.155 kg - General Exam General Limitations: Physical Limitations (Cant walk ) General Condition: Oriented x3, Awake, Alert, Active, No Aparent Distress Physical Exam General Appearance: Comfortable, Cooperative, Mild Pain Physical Exam General Nutrition: Morbidly Obese - Head Exam Head Exam: Normal Exam - Eyes Exam Physical Exam Eyes: Normal Appearance - ENT Exam Physical Exam ENT: Normal Exam - Ear Exam Physical Exam Ears: Normal Exam - Nose Exam Normal Exam - Throat Exam Normal Inspection - Neck Exam No Lymphadenopathy - Thyroid Exam Physical Exam Thyroid: Normal Inspection - Cervical Lymph Node Exam No Lymphadenopathy - Chest Exam Physical Exam Chest: Normal Inspection - Respiratory Exam Respiratory Exam: Normal Expansion, Normal Lung Sounds, Normal Respiratory Effort - Cardiovascular Exam Normal Rhythm, Normal Heart Sounds, Edema - GI/Abdominal Exam Normal Bowel Sounds, Flat, Soft - Extremities Exam Edema - Lower Extremity Exam Knee: Swelling Ankle: Swelling Lower Leg: Swelling - GU Male Exam Physical Exam Male Genitourinary: Swelling Scrotal Exam: Swelling, Tenderness Testicular Exam: Bilateral: Swelling - Integumentary Exam Other (scabiasis ) Distribution: Generalized - Neurological Exam Neurologic Exam: Normal Mood / Affect, Oriented x3, Alert, Normal Speech, Normal tone Patient Oriented To: Person, Place, Time - Psychiatric Exam Normal Affect, Normal Mood, Cooperative - All Other System All Other System: Are not pertinent at the moment Diagnosis Impression (1) Anasarca Code(s): R60.1 - Generalized edema Status: Acute (2) Fluid overload Code(s): E87.70 - Fluid overload, unspecified Status: Acute Qualifiers: Hypervolemia type: unspecified Qualified Code(s): E87.70 - Fluid overload, unspecified (3) CHF (congestive heart failure) Code(s): I50.9 - Heart failure, unspecified Status: Acute (4) Diabetes mellitus with hyperglycemia Code(s): E11.65 - Type 2 diabetes mellitus with hyperglycemia Status: Acute Qualifiers: Diabetes mellitus type: type 2 Diabetes mellitus long term insulin use: with long term use Qualified Code(s): E11.65 - Type 2 diabetes mellitus with hyperglycemia; Z79.4 - Long term (current) use of insulin (5) Hypothyroidism Code(s): E03.9 - Hypothyroidism, unspecified Status: Acute Qualifiers: Hypothyroidism type: unspecified Qualified Code(s): E03.9 - Hypothyroidism, unspecified (6) Systolic congestive heart failure with reduced left ventricular function, NYHA class 4 Code(s): I50.20 - Unspecified systolic (congestive) heart failure Status: Acute (7) Type 2 diabetes mellitus with morbid obesity Code(s): E11.69 - Type 2 diabetes mellitus with other specified complication; E66.01 - Morbid (severe) obesity due to excess calories Status: Acute (8) Type 2 diabetes mellitus with diabetic polyneuropathy Code(s): E11.42 - Type 2 diabetes mellitus with diabetic polyneuropathy Status: Chronic (9) Diabetes mellitus type 2, uncontrolled Code(s): E11.65 - Type 2 diabetes mellitus with hyperglycemia Status: Acute Qualifiers: Glycemic state: with hyperglycemia Qualified Code(s): E11.65 - Type 2 diabetes mellitus with hyperglycemia - Assessment and Plan Assessment and Plan: 34 y/o male with past medical history Diabetes Mellitus, Hyperlipidemia, Hypertension, Hypothyroidism, morbid obesity came to emergency room due to edema and pain in testicles of 1 day of evolution. Refers start to feeling a weird sensation on testicles and some edema. Denies nausea vomiting or other constitutional symptoms. PE shows a calm, cooperative, oriented x3 male without any pain in testicle or any other complaints. Sinus tachycardia; rest of exploration within the normal limits. Assessment: Fluid overload, systolic congestive heart failure, anasarca hypothyroidism, diabetes mellitus with morbid obesity, DM with polyneuropathy. Plan: Furosemide, enoxaparin, carvedilol, insuline, levothyroxine, abx, valsartan, spironolactone, BMP, Diabetic diet, TSH, Hgb A1c monitor for acute changes, follow up. - Labs 09/19/21 05:50 [Image 0] 09/19/21 05:50 [Image 1] Labs Result: Abnormal lab results 09/19/21 09/19/21 09/19/21 Range/Units 05:45 05:50 05:50 RBC 4.43 L (4.63-6.08) X10^6/uL Hgb 10.8 L (13.7-17.5) g/dL Hct 36.2 L (40.1-51.0) % MCH 24.4 L (25.6-32.2) pg MCHC 29.8 L (32.2-36.5) g/dL RDW Std Deviation 46.6 H (35.1-46.3) fL RDW Coeff of Var 15.6 H (11.6-14.4) % Immature Gran % (Auto) 1.0 H (0.0-0.4) % Lymph % (Auto) 11.7 L (19.3-53.1) % Lymph # (Auto) 0.84 L (1.18-3.74) X10^3/uL Mono # (Auto) 0.89 H (0.24-0.86) X10^3/uL Immature Gran # (Auto) 0.07 H (0.00-0.03) X10^3/uL BUN 45 H (9-20) mg/dL BUN/Creatinine Ratio 43.2 H (7-25) Glucose 337 H (74-106) mg/dL Serum Osmolality 293.0 H (261-280) mOsm/Kg Alkaline Phosphatase 355 H (38-126) U/L NT-Pro-B Natriuret Pep (0.0-125.0) pg/mL Albumin 2.8 L (3.5-5.0) g/dL Globulin 4.2 H (2.4-3.5) g/dL Albumin/Globulin Ratio 0.7 L (1.1-2.2) Amylase Less than 30 L (30-110) U/L Urine Protein 100 mg/dl A (Negative) Urine Occult Blood Small A (Negative) Urine Urobilinogen 2.0 eu/dl A (0.2 - 1.0) Ur Leukocyte Esterase Moderate A (Negative) 09/19/21 Range/Units 05:50 RBC (4.63-6.08) X10^6/uL Hgb (13.7-17.5) g/dL Hct (40.1-51.0) % MCH (25.6-32.2) pg MCHC (32.2-36.5) g/dL RDW Std Deviation (35.1-46.3) fL RDW Coeff of Var (11.6-14.4) % Immature Gran % (Auto) (0.0-0.4) % Lymph % (Auto) (19.3-53.1) % Lymph # (Auto) (1.18-3.74) X10^3/uL Mono # (Auto) (0.24-0.86) X10^3/uL Immature Gran # (Auto) (0.00-0.03) X10^3/uL BUN (9-20) mg/dL BUN/Creatinine Ratio (7-25) Glucose (74-106) mg/dL Serum Osmolality (261-280) mOsm/Kg Alkaline Phosphatase (38-126) U/L NT-Pro-B Natriuret Pep 9970.0 H (0.0-125.0) pg/mL Albumin (3.5-5.0) g/dL Globulin (2.4-3.5) g/dL Albumin/Globulin Ratio (1.1-2.2) Amylase (30-110) U/L Urine Protein (Negative) Urine Occult Blood (Negative) Urine Urobilinogen (0.2 - 1.0) Ur Leukocyte Esterase (Negative) Admission Note - Admission Information Date of Admission: 09/19/21 Time of Admission: 14:01 Admission Diagnosis: Fluid overload, congestive heart failure, Diabetes mellitus type 2 Admission Note: 34 y/o male with past medical history Diabetes Mellitus, Hyperlipidemia, Hypertension, Hypothyroidism, morbid obesity came to emergency room due to edema and pain in testicles of 1 day of evolution. Refers start to feeling a weird sensation on testicles and some edema. Denies nausea vomiting or other constitutional symptoms. PE shows a calm, cooperative, oriented x3 male without any pain in testicle or any other complaints. Sinus tachycardia; rest of exploration within the normal limits. Assessment: Fluid overload, systolic congestive heart failure, anasarca hypothyroidism, diabetes mellitus with morbid obesity, DM with polyneuropathy. Plan: Furosemide, enoxaparin, carvedilol, insuline, levothyroxine, abx, valsartan, spironolactone, BMP, Diabetic diet, TSH, Hgb A1c monitor for acute changes, follow up. Admission Day #: 1 Education Given on Admission: Diagnosis, Treatment, Medications, Procedure Orientation to: Patient - Vaccine Hx Influenza Vaccination: No Hx Pneumococcal Vaccination: No DVT Prophylaxis (Adult) - Assign risk score using criteria below A. Risk Factors with value of 1 point each for PT > 41 years: Age 18-40 year (value-0), Bed confinement/immobilization > 24 hours, Obesity (>20% over IBW) B. RFs with value of 2 points each: N/A C. RFs with value of 3 points each: N/A Total Risk Score = (A+B+C): 2 DVT Risk Level: Moderate Risk Ambulation: Early ambulation for all patients when possible, with assistence if necessary. Patient is on therapeutic anticoagulation: Yes Instrucciones ; van a realizar el plan de cuidado final discutido en clase el 25 de Sept. Los datos no encontrados hipotéticamente los completan. Trabajaran 3 problemas de enfermería, 2 lab. 2 radiografia, Y 3 medicamentos. Favor seguir las instrucciones del instrumento y la rúbrica. Siempre a las órdenes.
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Your assignment may be more than 5 paragraphs but not less. INSTRUCTIONS:  To access the FNU Online Library for journals and articles you can go the FNU library link here:  https://www.fnu.edu/library/ In order to n that draws upon the theoretical reading to explain and contextualize the design choices. Be sure to directly quote or paraphrase the reading ce to the vaccine. Your campaign must educate and inform the audience on the benefits but also create for safe and open dialogue. A key metric of your campaign will be the direct increase in numbers.  Key outcomes: The approach that you take must be clear Mechanical Engineering Organic chemistry Geometry nment Topic You will need to pick one topic for your project (5 pts) Literature search You will need to perform a literature search for your topic Geophysics you been involved with a company doing a redesign of business processes Communication on Customer Relations. 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Throughout your nurse practitioner program Vignette Understanding Gender Fluidity Providing Inclusive Quality Care Affirming Clinical Encounters Conclusion References Nurse Practitioner Knowledge Mechanics and word limit is unit as a guide only. The assessment may be re-attempted on two further occasions (maximum three attempts in total). All assessments must be resubmitted 3 days within receiving your unsatisfactory grade. You must clearly indicate “Re-su Trigonometry Article writing Other 5. June 29 After the components sending to the manufacturing house 1. In 1972 the Furman v. Georgia case resulted in a decision that would put action into motion. Furman was originally sentenced to death because of a murder he committed in Georgia but the court debated whether or not this was a violation of his 8th amend One of the first conflicts that would need to be investigated would be whether the human service professional followed the responsibility to client ethical standard.  While developing a relationship with client it is important to clarify that if danger or Ethical behavior is a critical topic in the workplace because the impact of it can make or break a business No matter which type of health care organization With a direct sale During the pandemic Computers are being used to monitor the spread of outbreaks in different areas of the world and with this record 3. Furman v. Georgia is a U.S Supreme Court case that resolves around the Eighth Amendments ban on cruel and unsual punishment in death penalty cases. The Furman v. Georgia case was based on Furman being convicted of murder in Georgia. Furman was caught i One major ethical conflict that may arise in my investigation is the Responsibility to Client in both Standard 3 and Standard 4 of the Ethical Standards for Human Service Professionals (2015).  Making sure we do not disclose information without consent ev 4. Identify two examples of real world problems that you have observed in your personal Summary & Evaluation: Reference & 188. Academic Search Ultimate Ethics We can mention at least one example of how the violation of ethical standards can be prevented. Many organizations promote ethical self-regulation by creating moral codes to help direct their business activities *DDB is used for the first three years For example The inbound logistics for William Instrument refer to purchase components from various electronic firms. During the purchase process William need to consider the quality and price of the components. In this case 4. A U.S. Supreme Court case known as Furman v. Georgia (1972) is a landmark case that involved Eighth Amendment’s ban of unusual and cruel punishment in death penalty cases (Furman v. Georgia (1972) With covid coming into place In my opinion with Not necessarily all home buyers are the same! When you choose to work with we buy ugly houses Baltimore & nationwide USA The ability to view ourselves from an unbiased perspective allows us to critically assess our personal strengths and weaknesses. This is an important step in the process of finding the right resources for our personal learning style. Ego and pride can be · By Day 1 of this week While you must form your answers to the questions below from our assigned reading material CliftonLarsonAllen LLP (2013) 5 The family dynamic is awkward at first since the most outgoing and straight forward person in the family in Linda Urien The most important benefit of my statistical analysis would be the accuracy with which I interpret the data. The greatest obstacle From a similar but larger point of view 4 In order to get the entire family to come back for another session I would suggest coming in on a day the restaurant is not open When seeking to identify a patient’s health condition After viewing the you tube videos on prayer Your paper must be at least two pages in length (not counting the title and reference pages) The word assimilate is negative to me. I believe everyone should learn about a country that they are going to live in. It doesnt mean that they have to believe that everything in America is better than where they came from. It means that they care enough Data collection Single Subject Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an I would start off with Linda on repeating her options for the child and going over what she is feeling with each option.  I would want to find out what she is afraid of.  I would avoid asking her any “why” questions because I want her to be in the here an Summarize the advantages and disadvantages of using an Internet site as means of collecting data for psychological research (Comp 2.1) 25.0\% Summarization of the advantages and disadvantages of using an Internet site as means of collecting data for psych Identify the type of research used in a chosen study Compose a 1 Optics effect relationship becomes more difficult—as the researcher cannot enact total control of another person even in an experimental environment. Social workers serve clients in highly complex real-world environments. 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After establishing where each member is in relation to the family A Health in All Policies approach Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum Chen Read Connecting Communities and Complexity: A Case Study in Creating the Conditions for Transformational Change Read Reflections on Cultural Humility Read A Basic Guide to ABCD Community Organizing Use the bolded black section and sub-section titles below to organize your paper. For each section Losinski forwarded the article on a priority basis to Mary Scott Losinksi wanted details on use of the ED at CGH. He asked the administrative resident