60WF. On 09-19-2016 the decedent was complaining of hip pain and was taken to North East Baptist Hospital by NOK. She arrived on 09-19-2016 at 0515hrs and was diagnosed with Hyperkalemia and Renal Failure. RN Maricela Martinez stated the dec was responsive and alert when she first arrived to the hospital. The dec started declining in health and was treated until expiration. RN stated dec had ulcers on her legs due to her Vasculitis. She stated no trauma, no falls, no fractures, or injuries were noted. No concerns for foul play/neglect/abuse. No drug concerns. RN Adri White contacted Dr. Jeffrey Sorrell would be signing…
DOI: 7/17/2015. Patient is a 44-year-old male welder helper who sustained injury when he lost footing and his left foot got caught and he twisted his knee. Per OMNI entry, he was initially diagnosed with left knee internal derangement. He is status post left knee arthroscopic surgery with chondral debridement, partial mereial mebsisccetomy and resection of anterior plica on 04/29/16. Per the IME performed on 09/01/16, the patient underwent a second arthroscopic procedure as related to the left knee in 06/2016. The claimant subsequently underwent approximately 30 sessions of physical therapy. The combination of surgery and therapy was really of no benefit to him with continued difficulties noted as related to the left lower extremity.…
This patient was admitted for shortness of breath, fever and chills. He has a history of cystic fibrosis, with secondary diabetes.…
Mom states that her son woke up in the middle of the night crying two nights ago. She gave the child ibuprofen, and he went back to sleep. Last night he woke up in pain, and he was inconsolable. She felt he should be seen by the physician.…
1- How could his physician’s office have prevented this problem? I think that the physician with it avoid this situation if they have Communication this is the most important point for a successful resolution of this kind of problem .…
11/3/16 1800 Instill 1 drop in both eyes at routine for dry eyes. Gave PRN Tylenol 325mg 2 tablets for complaints pain on right thumbnail rated 6/10. Patient states that she is having shortness of breathing when she was walked back from the dining room to her room. O89% by NC. Reported to nurse. Gave routine albuterol and ipratropium 0.5 mg nebulizer. Offered 1 cup of protein shake mixing with nectar powder. Encourage pt to drink it because she didn’t eat much at supper, will get hungry later. Drank 60%. HDoan WATC PN 2.…
Hospital course: the pt hospital course was characterized by a progressively downhill course. He was initially hospitalized and found to be midly hypoxic, which rapidly corrected to his suuplemental low flow oxygen therapy hwoever, he gradually became more oxygen dependent on high flow oxygen, eventually requiring intubation with mechanical ventilationin in order to maintain his oxygenation. He underwent an open lung biopsy in an attempt to delineate radiology of his pulmonary situation, and this was recorded as idiopathic pulmonary fibrosis and alveolitis. This specimen was sent to the forest general pathology dept for further eval, and they where able to give no further help considering the idiolgy of his pulmonary status. An echocardiogram showed left ventricular wall motion hypokenisia and an injection fraction of approx. 35%.…
E.P. is an 88-year-old Caucasian male. He was admitted on 02/18/13. His code status is full code, and he declines to bring in his advanced directive. He reports that he is 68.5” tall, and his actual weight is 165 pounds. He and his wife are the sources of information, and they are reliable. His blood pressure is 124/62, taken on his right arm in a lying position, his oral temperature is 99.8, his right radial pulse is 74 beats per minute, his respiration rate is 16 breaths per minute and his pulse oximetry reading is 92 on room air. He is allergic to latex, cephalexin and sulfa drugs, with a reaction of hives, and to IV dye, with a reaction of moderate rash. He was admitted for TURB (Trans-Urethral Resection of the Bladder), and left ureteroscopy related to a bladder tumor, and kyphoplasty secondary to compression fractures of the L1 and L3 vertebrae. His significant past medical history includes hypertension, atrial fibrillation, and chronic heart failure. He had a permanent pacemaker placed in 2003, and a history of MRSA over five years ago. E.P.’s fall-risk score is 2; however, he is on fall precautions related to anesthesia recovery, as fall risk is deemed appropriate by clinical judgment. He reports a pain level of 6 out of 10 numeric scale.…
GENERAL: The patient is a well-developed, well-nourished male who appears to be in moderate distress with pain and swelling in the upper left arm. Vital signs: Blood pressure 140/90, temperature 98.3 degrees Fahrenheit, pulse 97, respiration 18.…
She became lethargic within one hour. She was immediately treated with “10mg activated charcoal, 3 h post ingestion”. The patient then went unconscious but did not need any tubes or extra ventilation. On arrival, her pulse was 110, blood pressure was 106/60, RR (melatonin level) was 20, body temperature 98.3, pOx 98 (RA). She had a disconjugated gaze. Her skin appeared dry, pink, and warm. Bowel sounds were decreasing. An ECG with 12-lead showed a sinus curve of 110. She was in stable condition with consistent vital signs and slowly awakened throughout a 24-hr period. On the second day, she slept for excessive periods at a time. She also suffered “truncal ataxia” while in the sitting position, which still existed during walking and standing up the next day. On the fourth day, she showed trouble with fine motor skills, but was discharged. The girl was monitored for seven days as symptoms receded and no abnormal condition resulted…
1) How might the binding of a molecule bound to the surface of Cell A be connected to the intracellular phosphorylation of protein Y in Cell B? (10 pts)…
His vital signs are as follows: BP 172/100, heart rate 92, and a temp of 102.2 F. The results from the lab results are as followed: RBC 3.1 million, WBC 22,000, K+ 5.4 mEq/L, Ca 6.8 mg/dL, phosphate is 4.3 mEq/L, urea is 37 mg/dL, creatinine 2.0 mg/dL, albumin is 2.9 mg/dL, and pH is 7.29 after these abnormal labs a Chemistry Panel was drawn. Labe results of the Chemistry Panel are as followed: Protein 1.7 gm/24 hours, GFR of less than 30 ml/minute, and urine sediment showed presence of gram negative bacilli, presence of white blood cells, presence of red blood cells, and granular and waxy casts.…
A 66-year old Mexican-American man came to the ER on 4-6-2014, for shortness of breath and respiratory distress. Patient also has a history of alcohol abuse, cirrhosis, kidney and gallbladder stones, and renal failure. Patient had family coming to visit and was 10 minutes from the hospital. They were informed the moment they walked into the hospital that the patient was not doing very well. Doctors had to take drastic measures to maintain his heart rate. The patient’s family members were not expecting this.…
Is aware of the case and I spoke with Dr. too, I emphasize the patient does not meet criteria for observation or admission.…
PHYSICAL EXAMINATION: The patient is a well-developed, well-nourished male who appears to be in moderate distress with pain and swelling in the upper left arm. VITAL SIGNS: Blood pressure 140/90, temperature 98.3 degrees Fahrenheit, pulse 97, respiration 18.HEENT: Head normal, no lesions. Eyes, arcus senilis, both eyes. Ears, impacted cerumen, left ear. Nose, clear. Mouth, dentures fit well, no lesions. NECK: Normal range of motion in all directs. INTEGUMENTARY: Psoriatic lesion, right thigh, approximately 1 mL in diameter. CHEST: Clear breath sounds bilaterally. No rales or rhonchi noted. HEART: Normal sinus rhythm. There is a holosystolic murmur. No friction rubs noted. ABDOMEN: Normal bowl sounds. Liver, kidneys, and spleen are normal to palpitation. GENITALIA: Tests normally descended bilaterally. RECTAL: Prostate 2+ and benign. EXTREMITIES: Pain and swelling noted above…