When discharging the patient, teach them to monitor for s/s of MI or angina, infection, bleeding. This includes fever, swelling, oozing or bruising around cath site. The patient should also report numbness, tingling or pain in the leg used for the procedure as this might indicate a thrombosis. The patient will be taking medication, such as: antiplatelet medication (aspirin or clopidogrel) a statin and a beta blocker. The patient should also be taught to avoid pressure on the cath site, avoid lifting things heavier than 10lbs for two weeks and not to drive for a few days after the…
week of pregnancy complaining of dyspnoea. Her symptoms had become increasingly more debilitating over a period of eight weeks. On the day of admission she felt dyspnoeic at rest, and was unable to lie flat. There was no past history of note, other than an admission for repair of a dislocated lens two years previously. This was her first pregnancy. Urine dip-stick was negative for protein. Inpatient investigation culminated in cardiac catheterisation, the data from which are shown below: Anatomical site Superior vena cava Inferior vena cava Right atrium (mean) Right ventricle Pulmonary artery Pulmonary capillary wedge pressure Left ventricle Aorta Oxygen saturation (%) 76 72 74 75 74 98 97 Pressure (mmHg) End systolic/End diastolic 9 60/8 58/26 30 150/25 150/44…
Dr. Jones wants to repeat the CT of the brain again on 6/8/17 to monitor the fluid on the left side. He will then see Mr. Stevens again to review the results. In the meantime he would like Mr. Stevens to add a gait program to his current physical therapy program. I will meet Mr. Stevens at the appointment with Orthopedic Surgeon Dr. White on 6/6/17. Mr. Stevens has a large hernia that is not related that will be repaired soon. Dr. Jones said that was okay for him to have the sedation for the surgery…
“I hereby give the consent to the staff at Johns Hopkins Hospital to perform any operative procedures and under any anesthetic either local or general that they may deem necessary in the proper surgical care and treatment of:______ (31).”…
REVIEW OF SYSTEMS: A 12-point review of systems was performed and is negative except as noted above in the History of Present Illness, Past Medical and Past Surgical History. Careful attention is paid to endocrine, cardiac, pulmonary, hepatobiliary, renal, integument and neurologic exams.…
As to the specifics of these previously authorized surgical procedures (i.e. essentially Carotid Angiography, Angioplasty and Stenting), they were:…
DESCRIPTION OF OPERATION: Patient was brought to the operating room and identified by name and bracelet. General endotracheal anesthesia was administered in the supine position. Patient was then flipped into the prone position on a Jackson table with a Wilson frame. Neurophysiologic monitoring was applied to the patient.…
You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.…
The criterion for success is stenosis < 50%. Failure is defined as progression to stenosis > 50% or a repeat procedure performed on that segment. If a second procedure is performed on the same anatomic artery proximal or distal to the index stent, that artery is censored and classified as a success up to the date of the new procedure. Percent stenosis was determined by comparing the minimal luminal diameter within the stented segment with the diameter of normal adjacent artery using hand-held…
“I hereby give the consent to the staff at Johns Hopkins Hospital to perform any operative procedures and under any anesthetic either local or general that they may deem necessary in the proper surgical care and treatment of:______ (31).”…
Hilda placed a 22gauged IV catheter in the left cephalic vein. I helped restrain and hold of the blood vessel.…
The performing of higher quality treatment in the Vernon Russell’s case, will require the prescience of less errors. I will make sure that assess the patient pain before the administration of any drug. Furthermore, I will prevent patient adverse effect by just assisting the patient in a comfortable position and providing water before administrating oral…
The disadvantage of Dr. Ruiz waiting until the follow up to inform the patient about the error and the fact that the patient needs more surgery runs the risk of compromising the physician and patient relationship. That relationship is built on trust. Patients trust that the physician is skillful, knowledgeable, and trustworthy. Also, the patient may become angry, and angry enough to initiate a lawsuit. Even worse, the patient may not trust any medical professionals and choose not to seek medical attention for other conditions. Also, the patient could have become more ill from the lack of treatment. The only advantage of waiting for the follow-up to discuss more surgery is that the patient may have suffered more harm undergoing anesthesia for a longer period of time. This is also a disadvantage of returning the patient back to surgery once the mistake was discovered, during the same event. The advantage of returning the patient to surgery is that it strengthens the physician and patient relationship. The physician recognized the error and desired to fix the error, which may appear noble in the eyes of the patient.…
Abby, is 21 years of age and is a female patient who received a permanent atrial-ventricular pacemaker for the diagnosis of sick sinus rhythm, a disorder that leads to periods of tachycardia and periods of extreme bradycardia or sinus arrest. The nurse received the end-of-shift report and arrives at Ms. Abby’s’s room where she assesses the patient’s incision dressing on the upper left chest and it is dry. The patient’s left arm is edematous and ecchymotic and twice the size of the other arm. The patient states that her left arm feels numb and tingling. The distal pulses are present and at baseline. None of the findings were noted in the end-of-shift report.…
The cardiologist must take into account the the patient is not dying from the removal of the device. The cause of death may be deemed to be the underlying disease.…