Case study one page | Nursing homework help

 

Week 6 Case Study III

Patient With Fatigue

EM is a 74-year-old male with a history of rheumatoid arthritis (RA) who presents in the clinic with a complaint of fatigue. EM is ambulatory with a walker and recently has had intermittent flare-ups of his rheumatoid arthritis (RA) disease activity, with increasing pain and swelling in his affected joints. His energy has been declining over the past few months, so he thought it was a good time to come in for follow-up laboratory testing and reassessment of his medications. Most troublesome, he has fainted twice in the past 2 weeks, which resulted in falls onto his carpeted floor. He is afraid to go out into public and even more afraid to drive his car. He has also had some chest pains with exertion. He is eating and sleeping okay, although he does sleep better if his head is elevated on a few extra pillows. He lives alone and gets meals delivered by a local organization.

Past Medical History

  • RA for 35 years, affecting hands, feet, knees, hips, and cervical spine
  • Systolic hypertension
  • Presbycusis

Medications

  • Ibuprofen, 600 mg three to four times per day as needed
  • Methotrexate, 7.5 mg weekly
  • Atenolol, 25 mg daily
  • Hydrocodone/acetaminophen, 5 mg/500 mg every 6 hours as needed for pain

Physical Examination

  • Height: 71 inches; weight: 160 lbs.; BMI: 22.3; blood pressure: 162/60; pulse: 84; respiration rate: 16; temperature: 98.6 °F
  • Well-developed, well-nourished elderly male in no distress; pale
  • Lungs: bibasilar rales
  • Heart: regular rate and rhythm, grade 3/6 systolic murmur, audible S3; positive carotid bruit on the left
  • Abdomen: no masses, nontender
  • Rectal: prostate 3+ enlarged, hemoccult negative brown stool
  • Extremities: marked ulnar deviation of MCP and IP joints in both hands

Labs and Imaging

  • Hemoglobin: 8.9 g/dL
  • Mean corpuscular volume (MCV): 80 fL
  • White blood cell count: 10.7 × 109/L
  • Platelets: 250,000/L
  • Reticulocyte count: 0.8%
  • Ferritin: 415 mcg/L
  • Electrocardiogram: no acute findings; some evidence of left ventricular hypertrophy

Discussion Questions

1.What is EM’s diagnosis?

2.What is the underlying pathophysiology of EM’s condition?

3.What is the best therapeutic approach to the treatment of EM’s condition?

Place your order
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

Read more