Auscultation

Janice has returned six weeks since the last appointment. Overall Janice is feeling better with minimal cough present. She does report some nocturnal wheeze and chest tightness and does at time note a slight constricted feeling in the throat. As you would be aware, a recent RAST assay has demonstrated sensitisation to a number of allergens but in particular dust mite. A couple of weeks ago Janice put in place some dust mite minimisation strategies including vigorous cleaning of her…

I have caught up with Mario a months since his last appointment. During that time, I have obtained copies of previous lung function tests that actually reveal normal spirometry and gas transfer. Static lung volumes are essentially normal. Interestingly at the time of testing in October last year, oxygen saturation was reduced at 92-94%. I also note a stress echocardiogram from twelve months ago did not reveal any ischemic changes, whilst the HRCT report has made comment on some mild…

Miss Hawthorne has presented her six year old domestic short hair cat for having difficulty seeing. Terra is frequently missing her jumps from one couch to another and also has decreased her time looking out the window. The owner states that Terra is an indoor cat, not spayed, and has not received any vaccines. Terra also receives a homemade diet that is vegetarian based. The homemade diet includes: Rice, green leafy vegetables, fruits, mashed beans, soy beans, and tofu. The owner states that…

Assessing Heart and Neck Vessels Physiology Blood usually flows through the heart silently, but when there is a swooshing or blowing sound heard upon auscultation it is referred to as turbulent blood flow (Weber & Kelley, 2014). This occurs in a variety of conditions such as increased blood velocity, structural valve defects, valve malfunctions, and abnormal chamber openings (Weber & Kelley, 2014). The heart has four chambers two atria, which are the upper chambers of the heart and two…

to move, to take a bath, to eat, to get dressed, etc. • Before delivering care and other non-invasive treatment: applying oxygen mask, giving a massage. • Before performing a physical non-invasive examination: taking pulse, blood pressure, chest auscultation, recording ECG. Before clean / aseptic procedure To protect the patient against infection with harmful germs, including his/her own germs, entering his/her body. Clean your hands immediately before accessing a critical site with infectious…

usually complains shortness of breath when going to the dialysis clinic. For his physical assessment the PMI is 3cms left apex site was noted also with 2+ pitting oedema up to mid-calf and ascites together with a JVP >3cm above sternal angle. Upon auscultation crackles and wheezes were heard over lower lung fields. Recently he complains general weakness, shortness of breath and chest…

AP is an active and pleasant 12 months old infant, who is well dressed and appears to be clean. He plays with variety of toys at home. He seems very closely bonded with his mother. He sits in her lap for comfort. His mother is relaxed and have no complaints. Vital Signs: HR 105 regular, RR 30 breath per minute, BP 92/60mmHg. Temperature is 99.4 F. He is 31 inches tall (90.3 percentile). He weighs 22.5 lbs. (72.6 percentile). Head circumference is 43.5 cm (61.8 percentile). BMI is 16.5. No…

CC Cough. Body aches. S The patient is a 39-year-old female who has been sick for the past one week. She states it started last Wednesday with a cough. She is coughing quite consistently, it is productive to her throat, but she does not spit it out. She also states she started having body aches, which began on Saturday. She has been moving a lot of boxes, as she and her husband are moving to North Carolina at the end of this month. She states, however that the body aches are different than…

1 Emphysema 2 Pulmonary fibrosis – likely asbestosis 3 Type 2 diabetes 4 Hypertension 5 Depression Thank you for Lindsay Cullen. Unfortunately, a referral letter was not available at the time of consultation, but I gather Lindsay is a retired Telstra maintenance worker who reports asbestos exposure over a ten-year period, up until 25 years ago. Lindsay is also an ex-smoker of approximately 20 pack-years, having ceased this habit 25 years ago. As you are aware, for a number of years Lindsay…

The patient is a 24 -year-old Mexican female. She is Catholic and is currently a Bachelor’s student at West Coast University, Ca. There is no history of surgeries. She has a family history of diabetes from her mother’s side and hypertension from her father’s side. She mentioned that she is not diabetic but her mother is. She recalled her last physical examination was during her junior year in high school but it was not a full physical assessment. It was a requirement to attend her physical…