12 Jun Bertha, a 58 – year – old Hispanic female, presents to the primary care clinic to establish care.
Case Study week 6
Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references.
The answers must be in your own words with reference to the journal or book where you found the evidence to your answer. Do not copy-paste or use a past students work as all files submitted in this course are registered and saved in turn it in program.
Turn it in Score must be less than 20 % or will not be accepted for credit, must be your own work and in your own words. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.
All answers to case studies must-have reference cited in the text for each answer and a minimum of 2 Scholarly References (Journals, books) (No websites) per case Study
Week 6 case study
Bertha, a 58 – year – old Hispanic female, presents to the primary care clinic to establish care. She states that in 1985 she received a blood transfusion after sustained an MVA. She had tested positive for hepatitis C virus ( HCV ) in the past, but ignored any advice regarding treatment options. She brings a previous lab result with her today that shows :(ALT) level of 85 IU/mL (range 8 – 35 IU/mL). The lab form also states, “ HCV antibody is positive by enzyme immunoassay — confirmation is suggested. The patient also arrived with diagnosis with exacerbation of A-Fib (pulse 110 beats per mint. and COPD exacerbation as well (O2 sat: 87%)
Past medical h story: Hypertension, dyslipidemia, hepatitis C.
Family history: Unremarkable
Social history: She works as a case manager of an HMO and is married with 2 children. Denies use of illegal drugs, denies alcohol abuse, and has no tattoos.
Medications: HCTZ, 12,5 mg daily; Atorvastatin 20 mg daily, Metoprolol Succinate 25 mg and Pro-Air HFA 90mcg one puff q 4- 6 hrs as needed x pain.
Allergies: No known drug or food allergies.
OBJECTIVE General a ppearance: 58 – year – old female; pleasant, in no acute distress; good eye contact. Vital signs: T: 96.8; P: 110; RR: 23; SaO 2 : 87; BP: 150/100. Her weight is 214 lb, and her height is 6.3 inches.
HEENT : Negative. Neck: Thyroid nonpalpable. No lymphadenopathy.
Cardiovascular: A-fib rhythm. irregular and rapid heartbeat.
Respiratory: Crackles and Wheezing.
Abdomen: Mild tenderness in right upper quadrant. BS x 4 no bruits. Nondistended, soft. No organomegaly. No ascites.
Neurological: A & O × 4, CN II – XII grossly intact.
Depression scale: negative. Musculoskeletal: Full ROM. No deformities. Muscle strength is 5/5.
CRITICAL THINKING
Which diagnostic or imaging studies should be considered confirm the
diagnosis?
What is the most likely differential diagnosis?
What is your plan of treatment?
Are there any emergency referrals needed?
What is first line treatment for AFib in patients with the mentioned comorbidities?
What is the first line of treatment for COPD exacerbation?
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