6001-W1-D12

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School

Fazaia Degree College, M.R.F, Kamra, Attock *

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Course

6001

Subject

Medicine

Date

Nov 24, 2024

Type

docx

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2

Uploaded by maryamberlas

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Discuss history of present illness that you would take on this patient in preparation for the clinic visit. Onset: The patient states that the chest pain started approximately 3 months ago Location: The pain is located in the middle of her chest Duration: The patient did not mention a specific amount of time that the pain lasts. Characteristics: Burning with a tingling sensation Aggravating Factors: It is aggravated with any sort of activity. Relieving Factors: The pain is alleviated with rest. Treatment: The patient did not mention any specific treatments that she does for the pain. Severity: Patient states that the pain is 6/10. Describe physical exam and diagnostic tools to be used for Ms. Johnson. Are there are any additional you would like to have included that were not? The patient had an ECG done in the office that showed NSR with assorted flat T and inverted T waves. These abnormalities are considered non-specific to the patient and may be considered normal for the patient. The patient then had a stress test that showed 2mm downslopping ST segments that resolved after the patient had a chance to stop and rest. Because of the stress test results, the patient was sent to the hospital where a coronary angiography was performed that revealed the left anterior descending artery was occluded. There was no other testing that I would like to have performed, the testing performed on the patient was appropriate. What plan of care will Ms. Johnson be given at this visit; what is the patient education and followup? Once home, the patient should be educated on monitoring the insertion site for signs and symptoms of infection or bleeding such as odd pain, swelling, discoloration, fever, or redness. The insertion site should be kept clean and dry so during this time swimming or bathtub use is discouraged (John Hopkins Medicine, 2023). Strenuous activities should be avoided and the patient will be instructed on when she can return to work and resume normal activities (John Hopkins Medicine, 2023). The patient should be educated on the importance of a balanced diet with lean proteins, fresh produce, decreased sugary beverage intake, and decreasing the amount of fast food consumed. The patient should also be instructed on a heart healthy diet that includes lowering sodium intake (American Heart Association [AHA], n.d.). The patient should be educated on the importance of keeping her blood pressure within a normal range through dietary intake, exercise, and taking prescribed medications (American Heart Association, 2017). The patient should monitor her blood pressure at home and know understand the numbers as well as when to contact her physician or go to the ER. Finally, Ms. Johnson should keep up with all appointments scheduled by the provider to ensure proper follow up care. References American Heart Association. (n.d.). Managing blood pressure with a heart healthy diet. American Heart Association. (2017, November 30). Five simple steps to control your blood pressure. heart.org. Retrieved April 12, 2023, from https://www.heart.org/en/health-topics/high- bloodpressure/the-facts-about-high-blood-pressure/five-simple-steps-to-control-your-blood-pressure
John Hopkins Medicine. (2023). Angioplasty and stent placement for the heart. hopkinsmedicine.org. Retrieved October 26, 2023, from https://www.hopkinsmedicine.org/health/treatment-tests-and-
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