Question
Offered Price $60.00

Week 3: Case Discussion: Cardiovascular Part One

Question # 00706314
Subject: Nursing
Due on: 07/14/2018
Posted On: 07/11/2018 09:18 PM

Rating:
4.1/5
Expert tutors with experiences and qualities
Posted By
Best Tutors for school students, college students
Questions:
4717
Tutorials:
6365
Feedback Score:

Purchase it
Report this Question as Inappropriate
Question

Week 3: Case Discussion: Cardiovascular Part One

No unread replies.No replies.

Week 3: PBL Case Discussion: Cardiovascular

Setting: large rural clinic; family practice clinic that employs physicians and nurse practitioners

You open the chart to review for your next patient, and you see it is Larry M. Larry is a 60 year-old African American male with a history of hypertension. You note he is not due for a follow up at this time, so you look at the chief complaint.

CC: chest pain three days ago

You enter the room and introduce yourself. Larry M. is sitting in the chair. You ask what brings him in today. Larry M. smiles, shaking his head and says “My wife made me come, I feel fine.” Three days ago Larry M. felt short of breath, had this heavy feeling in his chest, and he got kind of nauseous and sweaty. It lasted only about 3 minutes, and it has not happened again, but he does feel a little more tired. “It could be that I have not worked out since it happened.

PMHx: Reports general health as good. He had been feeling great since starting to work out and lost weight. Had lots of energy and felt great until this episode three days ago. Now he is a little concerned because he feels a little more tired when he works out. He has not done as much strenuous running and has not worked out since the episode.

Childhood/previous illnesses: chicken pox.

Chronic illnesses: Hypertension- lifestyle changes recommended. Elevated cholesterol, lifestyle management was initiated.

Surgeries: T and A, cholecystectomy, vasectomy

Hospitalizations: None aside from surgeries listed above

Immunizations: Does not receive the flu shot.

Allergies: NKDA

Blood transfusions: None

Enjoys a beer or a glass of whiskey and the occasional cigar when playing poker with his buddies

Current medications: None

Social History: Married for 20 years, works as an architect.

Family History: Parents are deceased. Father had lung cancer and mother died from complications of a stroke. Brother died at 44 from malignant melanoma. Other sister and brother are healthy.

PE:

Height: 5’8” weight: 220 pounds; BMI 33.5 vital signs: BP 146/90 P 70 Sao2 97%

General: African American male in NAD. Alert, oriented, and cooperative. Pain: 0/10 at present

Skin: Skin warm, dry, and intact. Skin color is light skinned brown, no cyanosis or pallor.

HEENT: Head normo-cephalic. Hair thick and distribution even throughout scalp.

Eyes: Sclera clear. Conjunctiva: white, PERRLA, EOMs intact. No AV nicking noted.

Ears: Tympanic membranes gray and intact with light reflex noted. Pinna and tragus non-tender

Nose: Nares patent without exudate. Sinuses non-tender to palpation, Right-sided Deviation

Throat: Oropharynx moist, no lesions or exudate. Teeth in poor repair, gums reddened and receding, filled cavities noted. Tongue smooth, pink, no lesions, protrudes in midline.

Neck supple. No cervical lymphadenopathy or tenderness noted. Thyroid midline, small and firm without palpable masses. Mild JVD in recumbent position

Lungs: Lungs clear to auscultation bilaterally. Respirations unlabored. No rashes or vesicles noted on chest. CV: Heart S1 and S2 noted, RRR, no murmurs, noted. No parasternal lifts, heaves, and thrills. Peripheral pulses equally bilaterally. PMI 5th ICS displaced 4cm laterally. No edema in lower extremities.

Abdomen: Abdomen round, soft, with bowel sounds noted in all four quadrants. No organomegaly noted.

Labs from 3 months ago:

Total Cholesterol: 230
Ldl 180
Hdl 38

· EKG In office TODAY: ST depression

.courselearn.net/lms/content/1490/49385/NR603/EKG-ST%20Depression.jpg">Click here to access the EKG (Links to an external site.)Links to an external site.

Discussion Questions:

· What is your primary diagnosis causing Larry M.’s chest pain? Include ICD 10 codes (no differentials)

· List any relevant labs/diagnostic tests and link them to Larry’s specific case. Remember to include evidence-based support for any testing you order along with rationale if you feel no testing is warranted.

· What leads demonstrate the ST depression?

· What other secondary diagnoses does Larry M. have that need to be addressed?

· Include the rationale and a reference for your diagnoses

· Based on JNC 8 guidelines, is Larry M. hypertensive?

· Review the ACA 2017 Recommendations for Antihypertensive Therapy and design a plan for Larry M. Please discuss the pharmacological properties of the therapy you chose including rationale for why this is the best choice for Larry M.

· Plan for your primary diagnosis (Include referral, education and follow up) based on one current evidence-based journal article.

· Further diagnostic work-up not included above

· Medications

.jpg">

Tags cardiovascular discuion case week larry noted chest include does intact history feel days pain weight little head worked works felt tired feeling medications evidencebased primarydiagnosis testing based plan therapy external bilaterally brother lifestyle skin

Tutorials for this Question
Available for
$60.00

Week 3: Case Discussion: Cardiovascular

Tutorial # 00706144
Posted On: 07/11/2018 09:26 PM
Posted By:
Best Tutors for school students, college students mac123
Expert tutors with experiences and qualities
Questions:
4717
Tutorials:
6365
Feedback Score:
Report this Tutorial as Inappropriate
Tutorial Preview …Case…
Attachments
Chest_Pain_Diagnosis_and_Treatment.doc (61 KB)
Preview: drugs xx alleviate xxx rate of xxxxx hypertensive Some xx the xxxxxxxxxxx xxxxxxx include xxxxxxx which helps xx prevent heart xxxxxx at xxxxx xxxxx you xxx a physician xxxxx should also xxxxxxxx doing xxxxxxxxx xxxx will xxxx him reduce xxxxxx Eating healthy xx another xxxxxx xxxx is xxxxxxxxx to patients xxxxxxxxx with heart xxxxxxxx For xxxxxxxxx xxxxx should xxxxx eating food xxxxx has a xxx of xxxx xxxx deep xxxxx snacks and xxxxxx fries among xxxxx fast xxxxx xxxxxxx diagnosis xxxxx pain has xx many causes xxxxxxxxxx with xx xxxx Larry xxxxxx be advised xx always have xxxxxx medical xxxxxxxxx xxxxxxxx he xxxxxxx any chest xxxx He should xxxx avoid xxxxxx xxxxxxxx he xxxxx that he xx not feeling xxxxxxx because xxxxx xxxx may xx an indicator xx a bigger xxxxxxxxxx health xxxxxxx xxxxxxx et xx , 2017) xxxxx are different xxxxxxxxxx that xxxx xxxx put xx place to xxxx in the xxxxxxxxxxxxx of xxx xxxxxx of xxxxx pain and xxxx will involve xxxxxxxx out xxxxx xxx the xxxxxxxxxx an echocardiogram xxxxxx be used xx check xxx xxxxxx part xx everything is xxxx with it xxxxxx test xxxxxx xxxx be xxxxxxx out on xxxxx to see xxx the xxxxx xxx the xxxxx vessels react xxxx stressed which xxxx indicate xx xxx chest xxxx is heart-related.....
Purchase this Tutorial @ $60.00 *
* - Additional Paypal / Transaction Handling Fee (3.9% of Tutorial price + $0.30) applicable
Loading...