Discussion Part Two (graded)\t\u00a0\t\u00a0\tPhysical examination:\t\u00a0\tVital Signs\t\u00a0\tHeight: 5 feet 2 inches Weight: 163 pounds BMI: 29.8\u00a0\u00a0 BP 110\/70 T 98.0 po P 100 R 22, non-labored; Urinalysis: Protein 2+, Glucose: 4+\tHEENT: normocephalic, symmetric. Bilateral cataracts; PERRLA, EOMI; Upper and lower dentures in place a fitting well. No tinnitus\tNECK: Neck supple; non-palpable lymph nodes; no carotid bruits. Thyroid non-palpable\t\u00a0\tLUNGS: Decreased breath sounds in bases bilaterally with rales, expiratory wheezing with prolonged expiratory phase noted throughout all lung fields. No costovertebral angle tenderness (CVAT) noted. Increase in AP diameter noted.\t\u00a0\tHEART: Irregularly irregular rhythm; Unable to detect S3 or murmur\tABDOMEN: Normal contour; active bowel sounds all four quadrants; no palpable masses.\t\u00a0\tPV: Pulses are 2+ in upper extremities and 1+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally;\t\u00a0\tNEUROLOGIC: Achilles reflexes are hypoactive bilaterally. Vibratory perception to the 128 Hz tuning fork placed at the MTP of her great toe is absent bilaterally; She is unable to discern monofilament placement in 3 locations on her left foot and 2 places on her right foot.\t\u00a0\tGENITOURINARY: no CVA tenderness; not examined\t\u00a0\tMUSCULOSKELETAL: Heberden’s nodes at the DIP joints of all fingers and crepitus of the bilateral knees on flexion and extension with tenderness to palpation medially at both knees. Kyphosis and gait slow, but steady.\t\u00a0\tPSYCH: normal affect; her Mini-Cog Score is 3. Her PHQ-9 score is 22.\tSKIN: Sparse hair noted on lower legs and feet bilaterally with dry skin on her ankles and feet.\t\u00a0\t\u00a0\t\u00a0\tDiscussion Part Two:\t\u00a0\t\u00a0\tSummarize the history and results of the physical exam. Discuss the differential diagnosis and rationale for choosing the primary diagnosis. Include one evidence-based journal article that supports your rationale and include a complete treatment plan that includes medications, possible referrals, patient education, ICD 10 Codes, and plan for follow up.<\/p>\n","protected":false},"excerpt":{"rendered":"
Discussion Part Two (graded) \u00a0 \u00a0 Physical examination: \u00a0 Vital Signs \u00a0 Height: 5 feet 2 inches Weight: 163 pounds BMI: 29.8\u00a0\u00a0 BP 110\/70 T 98.0 po P 100 R 22, non-labored; Urinalysis: Protein 2+, Glucose: 4+ HEENT: normocephalic, symmetric. Read More …<\/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-230098","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230098","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=230098"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230098\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=230098"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=230098"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=230098"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}