iam required to do power point work. from the case study. i have posted what i was able to do . please perfect and finish

CASE STUDY XIII

Image result for older african american woman

Nancy Halpert (N. H.) is a 75-year-old African American female who lives in a one-bedroom apartment in Washington D.C. She is widowed. She had a daughter who passed away at the age of 40 due to breast cancer. Her remaining two children live in different states, one in Ohio and the other in California. Her 25-year old granddaughter stays with her on the weekends when she is not working. Nancy’s children call her every week to see how she is doing. She has a neighbor who checks on her daily to see if she needs anything. Nancy visits the senior citizen center located one block from her apartment once per week.

N. H. was diagnosed as a Type 2 diabetes five years ago. Her last physical exam was two years ago. She doesn’t like to go to the doctor because she is afraid she will need insulin. She takes glyburide daily and “tries to watch what I eat.” Her blood glucose has been consistent with an average AM reading of 180 mg/dl. She eats fast food from nearby restaurants frequently because she doesn’t feel like cooking for just herself and she likes to have her meals delivered. She often says, “I like to get visitors. I enjoy the company.” She sleeps only 3-4 hours per night, and sleep is often interrupted. She reports having difficulty sleeping ever since she turned 70. She complains of feeling tired most days. She has frequent periods of restlessness at night and must urinate frequently. She does not have difficulty with hygiene activities but states, most days she doesn’t feel like grooming herself since she doesn’t go anywhere. N. H. is 35 pounds overweight and reports she would like to lose some weight but doesn’t know what to do.

For the past five days, N. H. has been feeling “dizzy and more tired than usual.” She has been unable to keep any food down and reports nausea, vomiting, and abdominal pain. She noticed a fruity odor to her breath. When she checked her glucose this morning, it was

690 mg/dl. Also, she has been experiencing headaches, frequent urination, and increased thirst. When her neighbor came to check on her, she noticed N. H. was confused and had trouble concentrating. Her neighbor bought her to the to the E.R. immediately. Her blood pressure was 135/80. Lungs were clear upon auscultation. Her face was flushed, and she was restless and having some difficulty breathing. Lab tests revealed a blood glucose level of 750 mg/dl and a hemoglobin A1c of 8%. N. H. was treated with intravenous fluids, electrolyte replacement and insulin. After she was stabilized, she was admitted for two days for observation, and then released.

On discharge, the medical diagnoses were as follows:

1

Final Case Study Presentation Grading Criteria


Case Study # ____________ Team # __________________ Total Score: _______/50

Excellent- 5

Good – 4

Satisfactory- 3

Needs Improvement- 2-0

I. Presentation Content

Introduction

Score:____________

History of Present Illness/Health is well described with visual aids. Patient context, scenario, and reason for seeking care is clearly detailed to audience.

History of Present Illness/Health is well described. Patient context, scenario, and reason for seeking care is clearly detailed to audience.

History of Present Illness/Health is well described. Patient context, scenario, and reason for seeking care is stated to audience.

History of Present Illness/Health is poorly communicated. Patient context, scenario, and reason for seeking care is not clearly communicated

Review of Systems

Score: _________

Included comprehensive and specific subjective data of their Review of Systems on their patient.

Included basic subjective data of their Review of Systems on their patient.

Included minimal subjective data of their Review of Systems on their patient.

Included objective data and subjective data. Did not differentiate the findings during the Review of Systems and Physical Assessment Examination.

Physical Assessment and Examination

Score: _________

Included comprehensive and specific objective data of their physical assessment and examination on their patient.

Included basic objective data of their physical assessment and examination on their patient.

Included minimal objective data of their physical assessment and examination on their patient.

Included objective data and subjective data. Did not differentiate the findings during the Review of Systems and Physical Assessment Examination.

Medications

Score: _________

Team thoroughly describes:

· Why/How patient takes ALL their medications

· List >3 most common side effects & symptom(s) to report

· Address ALL patient medication related concerns

Team adequately describes:<

CASE STUDY XIII
Phina Jeannite

Dim Kuntong

Nabirye Abalinabyo

TABLE OF CONTENT

► Introduction
► Review of Systems
► Physical Assessment & Examination
► Medications
► Medications Educations Demonstrations
► Health Promotion
► References

Introduction:History of illness

★ Nancy Halpert (N. H.) is a 75-year-old African American female who
comes in the office today for her physical annual exam. she has been
diagnosed with :

★ uncontrolled diabetes mellitus type 2,

★ diabetic ketoacidosis,

★ obesity and possible depression.

Review of System

general overall health:N.H was diagnosed with type 2 diabetes mellitus

Subjective
● She denies any headaches, nausea, vomiting
● She reports Dysuria,
● she is “worried” and nervous about having to need insulin .

Physical
Assessment and
Examination

H: 5’2 wt: 235 lbs BMI: 43
snellen vision chart: No eye corrections
Right eye: 20/20 Left eye:20/20
BP: 119/78 mmHg left arm, sitting position
T: 98.7 F orally, P:96 bpm
R: 16/min o2 Sat: 98%Miss Nancy is alert and

oriented X4. General
appearance is appropriate
for her age but there is
noticeable obesity

Pain assessment: 0/10

Physical Exam

Skin: dry, good skin turgor

Head & face: symmetrical, no pain or tenderness, no lesions No lice.

Eyes: Nice and pink, symmetrical, reactive to light bilaterally

Nose: No discharge, tenderness, no nasal obstruction

Mouth: Oral mucosa pink, no gums bleeding, no toothache, gag reflex
present

Throat: clear speech, no sore throat, no pain

Neck: trachea in midline, no lymphoedema, jugular veins pulse present, no
bulging, no bruits- carotid pulse 2+

Physical Exam

Upper extremities: Full range of motion without pain, no abnormality noted

Chest and lungs: no SBO, bilaterally symmetric expansion of lungs, clear
breathing sound,

posterior & anterior: no crackles, no wheezing symmetrically bilateral

Breast: bilaterally symmetrical, no pain or tenderness, no lump or rash

Heart: regular heart rate and rhythm, no murmurs, no extra sounds or bruits.
no chest pain

Abdomen: symmetrical, flat, uniform in color, no tenderness, active bowel
sound present in all four quadrant; no abdominal pain.

Physical Exam

Inguinal area: no enlargement of nodes.

Lower Extremities: no injury or pain, no dislocation, 2+ pulse is bilaterally
present.

Neurological: no history of seizure, stroke, and no problem with coordination,
difficulty speaking or swallowing

Musculoske