{"id":230092,"date":"2018-09-17T15:06:25","date_gmt":"2018-09-17T15:06:25","guid":{"rendered":"http:\/\/localhost\/wordpress\/index.php\/2018\/09\/17\/nr-601-week-4-case-study-discussionspart-1\/"},"modified":"2018-10-24T08:48:15","modified_gmt":"2018-10-24T08:48:15","slug":"nr-601-week-4-case-study-discussionspart-1","status":"publish","type":"post","link":"https:\/\/www.benedictsol.com\/blogs\/nr-601-week-4-case-study-discussionspart-1\/","title":{"rendered":"NR 601 Week 4 Case Study Discussions(Part-1)"},"content":{"rendered":"<p>Discussion Part One (graded)\t\u00a0\tYou are seeing S.F., a 74-year-old. Hispanic male in the office this morning for difficulty breathing.\t\u00a0\t\u00a0\tBackground:\t\u00a0\tS.F. presents with increased dyspnea on exertion that has become progressively worse over the last 3 days. You observe that he is using pursed lip breathing as he explains his chief complaint. He reports that he has been coughing up a moderate amount of thick, green sputum for approximately one week that was accompanied by a fever of 100.6 and chills. He took Ibuprofen 400 mg every 4 hours and increased his fluid intake for the last week. Two days ago he noticed that the sputum is now yellow rather than green and that he has not experienced any more fever. Overall, he feels like he is getting better. However, the dyspnea on exertion developed three days ago without relief despite the use of his Spiriva HandiHaler. He reports that he lost his rescue inhaler and has not had it to use in over 2 months.\t\u00a0\tPMH:\t\u00a0\tCOPD\t\u00a0\tHypertension\t\u00a0\tOsteoarthritis\t\u00a0\tCurrent medications:\t\u00a0\tAsprin-81 daily\t\u00a0\tCyclobenzaprine 10 mg prn\t\u00a0\tMeloxicam 15 mg daily\t\u00a0\tMetoprolol 25 mg daily\t\u00a0\tSpiriva HandiHaler daily as directed\t\u00a0\tTramadol 50 mg daily prn\t\u00a0\tSurgeries: \ufffd\t\u00a0\tAppendectomy as a child (date unknown)\t\u00a0\t2004-Left cataract extraction with intraocular lens placement\t\u00a0\t2008-Right cataract extraction with intraocular lens placement\t\u00a0\tAllergies: NKA\t\u00a0\tVaccination History:\t\u00a0\tInfluenza vaccine- October 2013\t\u00a0\tPneumovax-2010\t\u00a0\tHis last TD-can&#8217;t remember\t\u00a0\tHas not a TDAP\/TD in 20 years\t\u00a0\tScreening History:\t\u00a0\tLast Colonoscopy was 2012-normal\t\u00a0\tLast dilated retinal and glaucoma exam was 2013\t\u00a0\tSocial history:\t\u00a0\tRetired roofer-stopped working in 2004 due to arthritis and pain in his rotator cuff. Is married and lives with spouse. They have 4 grown children who live within a 10 mile radius of them. Currently smokes-is down to \u00bd pack cigarettes daily. Has smoked for 45 years total.\tFamily history:\t\u00a0\tFather is deceased and had a history of hypertension and diabetes; Mother is deceased and had a history of CAD\/MI; Sister-history of colon cancer.\t\u00a0\t\u00a0\t\u00a0\tDiscussion\u00a0 Part One:\t\u00a0\t\u00a0\tProvide differential diagnoses\u00a0 (DD)with rationale.\t\u00a0\tFurther ROS questions needed to develop DD.\t\u00a0\tBased on the patient data provided, choose geriatric assessment tools that would be appropriate to use in conducting a thorough geriatric assessment. Provide a rationale on why you are choosing these particular tools.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Discussion Part One (graded) \u00a0 You are seeing S.F., a 74-year-old. Hispanic male in the office this morning for difficulty breathing. \u00a0 \u00a0 Background: \u00a0 S.F. presents with increased dyspnea on exertion that has become progressively worse over the last <a href=\"https:\/\/www.benedictsol.com\/blogs\/nr-601-week-4-case-study-discussionspart-1\/\" class=\"read-more\">Read More &#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-230092","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230092","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=230092"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230092\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=230092"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=230092"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=230092"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}