Discussion: Epigastric and Substernal pain

Want create site? With you can do it easy.

Discussion: Epigastric and Substernal pain

Discussion: Epigastric and Substernal pain

Discussion: Epigastric and Substernal pain

Struggling to find relevant content or pressed for time? – Don’t worry, we have a team of professionals to help you on
Discussion: Epigastric and Substernal pain
Get a 15% Discount on this Paper
Order Now

Week 3 discussion PART 1 Mr. M.J. is a 64-year-old patient of Hispanic descent who presents to the clinic today with concerns about epigastric and substernal pain that has gotten progressively worse over the past 3 months. He complains of mild “heartburn after eating a large meal for at least 2 years. He has tried over the counter products occasionally with adequate response. Three months ago, he was awakened with severe burning discomfort that extended from his mid-chest to his jaw that lasted 30 minutes before he was able to fall back to sleep. He is now experiencing these attacks about 3 times per week. He has tried avoiding large meals and is now sleeping on two pillows at night to relieve his pain which has improved his pain. The pain now occurs regularly after meals and randomly during the day. He takes antacids with each meal, but the pain still persists. Overall, he considers himself to be very healthy. Past Medical History Depression diagnosed 6 months ago Family History Unknown; was adopted from an orphanage when he was 3 months old; Wife died of breast cancer approximately 8 months ago. They were unable to have children. Social History Drinks beer occasionally when out with friends No smoking history Current Medications Multivitamin daily Discussion Questions Part One Describe how you would work-up this patient’s abdominal pain based on current clinical guidelines. Provide further ROS questions needed to develop differential diagnoses. Provide the differential diagnoses (DD) with rationale. Decide whether or not this patient should also be worked-up for depression. Why or why not? Based on the data provided, what types of screening tools would be useful in this patient’s case? PART 2 S. (Subjective) CC – Mild “heartburn” after eating a large meal for at least 2 years. Background: Mr. M.J. is a 64-year-old patient of Hispanic descent who presents to the clinic today with concerns about epigastric and substernal pain that has gotten progressively worse over the past 3 months. He has tried over the counter products occasionally with adequate response. Three months ago, he was awakened with severe burning discomfort that extended from his mid-chest to his jaw that lasted 30 minutes before he was able to fall back to sleep. He is now experiencing these attacks about 3 times per week. He has tried avoiding large meals and is now sleeping on two pillows at night to relieve his pain which has improved his pain. The pain now occurs regularly after meals and randomly during the day. He takes antacids with each meal, but the pain still persists. Overall, he considers himself to be very healthy. HPI: Current Medications: PMH: Social Hx: Family Hx Focused ROS and Physical Exam: ROS: Objective: Physical examination: Primary Diagnosis: Differential Diagnosis: Plan: Week 4 discussion PART 1 Mrs. R. is a 66-year-old Caucasian female who presents to the clinic with pain in her left hip that worsens with walking, bending, standing, and squatting. When asked to describe where the pain occurs, she places her fingers around the anterolateral hip region. She denies any back pain, or pain in the posterior hip or along the lateral thigh. Denies any previous injury, stumbling, tripping or falling. She states that the pain has been getting gradually worse and is almost constant if she walks or stands for a long period of time. She denies back pain, numbness, tingling, or weakness in the extremities. She reports taking Ibuprofen 800 mg approximately 3 times/week whenever she has significant hip pain. She is concerned that she doesn’t know what is causing the pain and that she is having to take increased doses of ibuprofen to manage the pain. She reports a current pain level of 8/10 on the pain scale. Background Information She walks approximately 1 mile a day. She recently retired as an office manager 4 years ago. PMH Unremarkable Immunizations All vaccines are current Screenings Never had a colonoscopy Last mammogram was 5 years ago Social History Has an occasional glass of wine with dinner Does not smoke Surgical history Cholecystectomy 20 years ago Hysterectomy 10 years ago Current Medications Ibuprofen 200-800 mg prn for hip pain Discussion Questions Part One What risk factors does this patient have that might contribute to her hip pain? What ROS would you conduct on this patient? What is your primary diagnosis? What evidence-based resource and patient data supports this diagnosis? What two differential diagnoses are appropriate in this patient’s case? What evidence-based resource and patient data supports these two differential diagnoses? What screening would you choose to best evaluate this patient’s chief complaint? PART 2 Physical Exam: Vital signs: blood pressure 128/84, heart rate 80 respirations 20, temperature 98.5 height 5’3”, weight 130 pounds General: no acute distress HEENT: Head normocephalic without evidence of masses or trauma. PERRLA, EOMs intact. Noninjected. Fundoscopic exam unremarkable. Ear canal without redness or irritation, TMs clear, pearly, bony landmarks visible. No discharge, no pain noted. Neck negative for masses. No thyromegaly. No JVD distention Skin: intact CV: S1 and S2 RRR, no murmurs, no rubs Lungs: Clear to auscultation Abdomen: Soft, nontender, nondistended, bowel sounds present all 4 quadrants, no organomegaly, and no bruits Musculoskeletal: No pain to palpation; Antalgic gait noted when patient rises from seated position to standing and begins to walk. Active and passive ROM decreased with stiffness Neuro: Sensation intact to bilateral upper and lower extremities; Bilateral UE/LE strength 5/5. Discussion Questions Part Two For the primary diagnosis explain how you would proceed with your work-up and include the following: lab work and imaging studies How would you manage this patient pharmacologically? Is it appropriate that she is taking Ibuprofen prn? What non-pharmacological strategies would be appropriate? Describe patient education strategies. Describe follow-up and any referrals that may be necessary.

Did you find apk for android? You can find new and apps.

Calculate the price
Make an order in advance and get the best price
Pages (550 words)
$0.00
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with MyCoursebay
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
Testimonials
See why 20k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
DISCUSSION D SCIENCE 210
GREAT
Customer 452813, June 28th, 2022
Other
GOOD
Customer 452813, July 10th, 2022
Management
Comprehensively done. Thank you
Customer 452583, July 20th, 2021
Other
Thank you for a well written paper!!!
Customer 452557, January 19th, 2022
Medicine
Thank you for the great services
Customer 452635, April 24th, 2022
Professions and Applied Sciences
Amazing work!
Customer 452707, May 29th, 2022
Nursing
Thank you!
Customer 452707, April 3rd, 2022
Classic English Literature
Nicely done. Ty. Worth every penny.
Customer 452455, June 6th, 2021
Social Work and Human Services
Thank you
Customer 452559, July 2nd, 2021
Nursing
Thank you for helping with my assignment.
Customer 452707, July 8th, 2022
Other
AWESOME
Customer 452813, June 19th, 2022
Other
Awesome Work!
Customer 452587, February 24th, 2022
11,595
Customer reviews in total
96%
Current satisfaction rate
3 pages
Average paper length
37%
Customers referred by a friend
OUR GIFT TO YOU
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat

Get your perfect essay with a 15% discount. Use DC15

NEW

Thank you for choosing MyCoursebay. Your presence is a motivation to us. All papers are written from scratch. Plagiarism is not tolerated. Order now for a 15% discount

Order Now