The arterial duplex ultrasound of the right lower extremity performed on 3/30/2016 revealed a mild to moderate atherosclerotic plaque in the visualized arteries with limited visualization and a large probable hematoma. A follow-up study was suggested to ensure resolution of the hematoma and for better arterial visualization. (Norman Regional Health System 1 379 )
An orthopedic surgery referral to Richard Kirkpatrick, MD was done on 3/30/2016. Dr. Kirkpatrick stated that it would be possible to place a drain the next morning if the size of Ms. Hoover's right medial thigh hematoma and the bleeding stabilize. Norman Regional Health System 2 023-024 )
Ms. Hoover was seen by nephrologist David Williams, MD on 3/30/2016. She was diagnosed with a spontaneous hemorrhage in the face of anticogulation, acute kidney injury secondary to hemodynamics, chronic kidney disease, and anemia secondary to blood loss. Dr. Williams ordered the discontinuation of Bumex and monitoring of serum electrolytes. (Norman Regional Health System 2 025-026 )
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Hoover's right medial thigh to proximal groin. Her oxygen saturation was 97% with an oxygen support of 2 liters per minute. Multiple ecchymoses were noted around the hematoma, near Lovenox injection sites, on the right forearm, and on the surgical site of her right eyelid. She had a positive fluid balance of 485 during the first hospital day. A hemoglobin and hematocrit was ordered then and one hour after the fourth transfusion was ordered. (Norman Regional Health System 2 015-020
A 54 year old female was presented with complaints of lethargy, excessive thirst and diminished appetite. Given the fact that these symptoms are very broad and could be the underlying cause of various diseases, the physician decided to order a urinalysis by cystoscope; a comprehensive diagnostic chemistry panel; and a CBC with differential, to acquire a better understanding on his patient health status. The following abnormal results caught the physician’s attention:
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
The cardiovascular system - The cardiovascular system is responsible for transporting nutrients and removing gaseous waste from the body. It consists of the heart, which powers the whole process, the veins, arteries, and capillaries, which deliver oxygen to tissue at the cellular level. The cardiovascular system carries blood that is low in oxygen away from the heart to the lungs via arteries, where oxygen levels are restored through the air once oxygenated, this blood is then carried throughout the body via arteries, keeping our organs and tissue alive. The cardiovascular system is the workhorse of the body, continuously moving to push blood to the cells. If this important system ceases its work, the body dies.
The signs and symptoms of a lower limb DVT varies from asymptomatic to extensive ilio femoral thrombosis(Narani, 2010). The most common clinical manifestation can be sudden swelling of one limb accompanied with pain or tenderness, Her BMI is 28 in the overweight zone. She had 4 episodes of DVT within 2 years.
The Structure and Functions of the Arteries Arteries are blood vessels that convey blood from the heart to the tissues of the body. The arteries expand and then constrict with each beat of the heart, a rhythmic movement that may be felt as the pulse. Arteries are usually named from the part of the body that they are found, for example; brachial artery found in the arms, metacarpal artery found in the wrist; or from the organ which they supply as the hepatic artery supplies the liver, pulmonary artery brings deoxygenated blood the lungs. The facial artery is the branch of the external carotid artery that passes up over the lower jaw and supplies the superficial portion of the face; the haemorrhoidal arteries are three vessels that supply the lower end of the rectum; the intercostal arteries are the arteries that supply the space between the ribs; the lingual artery is the branch of the external carotid artery that supplies the tongue. The structure of the artery enables it to perform its function more efficiently.
Ms. Bardsley functions as a hemodialysis liaison and leader in clinical practice with the following roles: charge nurse, preceptor, and mentor for her colleagues. She is the resource person for the Hct-Line monitoring tool. The tool is used to monitor patient’s fluid removal during treatment to avoid hypotensive episodes associated with decreased perfusion to the heart. She routinely monitors the patient outcomes which to date has resulted in 0 admissions. She recently updated the policy to make it more user friendly for the staff and to maintain staff competency.
Mrs. Jones, 78 years old, arrived in the emergency department (ED) via ambulance. She was alert and oriented, but was having episodes of lost consciousness. She was put on the cardiac monitor and her vital signs were obtained. Her cardiac rhythm was normal. Her vital signs were as follows: Temperature 97.3°F, Pulse 43, respirations 26, blood pressure 100/58 and O2 saturation of 94% on room air. Additionally, Mrs. Jones was vomiting and had 2 loose, incontinent stools. She was pale, cool to touch and diaphoretic. Auscultation of her lungs revealed expiratory wheezes.
During my morning rounds I began my assessment of Mrs. M., and I noted that she had shortness of breath and she was making gurgling sounds. I immediately auscultated her lungs and noted bilateral wheezing throughout all fields, her heart was irregular and rapid and she had 2plus pitting pedal edema. I noticed she had an IV running at 125ml/hr, which I quickly stopped. The patient did not have orders for IV fluid there was only an order to KVO. I raised the head of the bed and paged respiratory to the floor.
After a thorough examination, J.P. was diagnosed with a deep vein thrombosis (DVT). “DVT develops most often in the legs but can occur also in the upper arms…” (Ignatavicius & Workman, 2013). Due t...
The patient was first placed in the lithotomy position and underwent right ascending pyelography to confirm the diagnosis (typical image in the form of a hook or S-shaped (Figure 1). A right JJ catheter was then placed. After that, the patient was placed in right- side-up flank position and a transperitoneal approach was used.
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media,
Characterization of peripheral arterial diseases can be broadly performed noninvasively and invasively by computed tomography angiography (CTA), magnetic resonance (MR), digital subtraction angiography as well as Doppler ultrasonography (Stanford 2005). Invasive digital subtraction angiography has been classified as a gold standard method to evaluate the lower extremity vascular diseases (Ota et al 2004). However in a certain circumstances due to limitation of this technique it is seemly inapplicable for some cases.
The patient is a 30 year old male with an active bacterial infection on his right leg attacking his Integumentary system. The patient is from Tanzania, Africa but came back to work in a factory that produces plastic. If he has Cellulitis, it can get bad enough to travel to other organs like the Liver and Kidney and cause failure. If this happens, Edema can form, usually on one half of the body; this is the Urinary system being attacked. The main system being attacked is the Lymphatic system because Cellulitis attacks the lymphatic draining system. For Cellulitis to travel to organs, it had to go through the blood, so the cardiovascular system is also in effect.
Cardiovascular System: He does not experience any chest pain or palpitation. He does not have dyspnea or leg swelling.
Rumack, C. M., Wilson, S. R., & Charboneau, J. W. (2005). Diagnostic ultrasound (3rd ed.). St. Louis: Elsevier Mosby.