The patient’s ethnicity was German and Portuguese. Her primary language was English and she did not know any other languages. The patient believed in only going to the doctor when sick. She thinks it is a waste of time and money to go when you are not sick. She said many problems can be taken care of at home with rest and over the counter medication. She believes too many people go to the doctor for minor problems that could be taken care of at home.
Musculoskeletal Assessment There were no deformities, pain, or swelling in the extremities. She demonstrated full range of motion in her upper and lower extremities bilaterally. JA was unable to walk due to weakness. She was on several medications such as Fluconazole, Labetalol, and insulin that could cause dizziness. The patient was a high fall risk due to the muscle weakness and medications.
Psychosocial Assessment The patient was a widow and was married to her husband for over 40 years, before he passed away of a heart attack. Since her husband passed away, the patient’s support system became her younger sister. JA’s younger sister visits her and provides her assistance in any way she can. The patient received social security benefits from her husband, who was a military veteran. JA was compliant with her prescribed medical plan, but shortly before the hospitalization she was beginning to get to weak to take care of