medical diagnosis

At least 500 words, APA format (if using outside sources).

Please use reliable medical references such as your Goroll text, your Current Medical Diagnosis and Treatment book, or up to date.

A 70-year-old female presents to the primary care provider for a health maintenance checkup. The patient has a history of hypertension but has not seen a primary care provider in over two years. The patient denies complaints or problems. She is a widower and lives alone. Her husband died 6 months ago due to COVID. She has two adult male children who live approximately 30 minutes away from the patient. Her current medications are over-the-counter ASA 81 milligrams daily as well as hydrochlorothiazide 25 milligrams daily. She has recently been getting her script refills from the local urgent care facility. She is accompanied by one of her sons who is concerned that his mother is confused or developing dementia because she is having trouble understanding what family members are saying especially during social events. The son has not noticed any weakness or gait impairment. No dysarthria. They deny falls or head injury. Vital signs BP 130 / 80, HR 72, resp 14, SPO2 99% on room air. Physical exam is as follows: skin is intact with some age-related changes, there is a skin tear on the left forearm. Head normal cephalic atraumatic (NC/AT), conjunctiva clear, oral mucosa is moist. external ear without cerumen impaction TM’s are intact, grey, cone of light normal. Heart rate is regular. Lungs are clear respirations are regular and easy. Abdomen with positive bowel sounds, soft, nontender, no rebound or guarding. Extremities are without deformity. She has 5/5 strength proximally as well as distally including 5/5 grip strength. Laboratory studies CBC, CMP, TSH, vitamin D and vitamin B levels are normal.

1. What are your top three differential medical diagnosis. This should include two diagnosis that the patient likely has and one diagnosis that you considered but the patient does not have.

…Please give an explanation of your medical reasoning.

2. What would you do next for this patient?

KEY TAKEAWAYS BEFORE ATTEMPTING THIS ASSIGNMENT

This essay will discuss a 70-year-old female patient who recently visited the primary care provider for a health maintenance checkup. The patient has a history of hypertension, has been widowed for six months, and her two adult male children live approximately 30 minutes away from her. After a physical examination, laboratory studies, and a discussion with the patient and her son, this essay will examine three differential medical diagnosis, evaluate the pros and cons of each approach, and discuss lifestyle changes that would improve
The two approaches to employee motivation discussed by V Boumová in 2008, extrinsic and intrinsic motivation, both have advantages and disadvantages. Extrinsic motivation refers to rewards or punishments that are externally imposed, such as a bonus or a reprimand. These rewards are used to motivate employees by either providing a positive incentive or penalizing poor performance. The advantage of extrinsic motivation is that it is measurable and can be easily adjusted according to performance. However, this approach can also have a negative effect on employees, as extrinsic rewards can be seen as controlling, or even manipulative. This can lead to employees feeling demotivated or unappreciated. On the other hand, intrinsic motivation is based on self-motivation and internal rewards, such as a sense of satisfaction or pride. This approach is beneficial for employees as it can help them to develop an intrinsic sense of personal achievement and motivation. However, this approach is less straightforward to measure and can be more difficult to use in a corporate setting. Additionally, it can be difficult to assess the effectiveness of intrinsic motivation, as it is based on personal feelings that can vary from person to person. Overall, both approaches to employee motivation have their pros and cons. Extrinsic motivation can be effective in providing immediate results, while intrinsic motivation can be beneficial in the long term. It is important to consider both of these approaches when creating an effective employee motivation plan. (V Boumová, 2008)
When discussing lifestyle changes with a patient, it is important to consider nutrition, physical activity, stress management, and other relevant lifestyle changes. According to NF Eshah (2013) in Nursing & Health Sciences, poor nutrition can lead to long-term health issues, such as diabetes, heart disease, and obesity. Therefore, it is important to discuss with the patient the importance of healthy eating. This includes limiting the amount of processed and sugary foods, eating a variety of fruits and vegetables, and making sure to include lean proteins. Additionally, physical activity is essential for overall health and well-being. The patient should be encouraged to be active for at least 30 minutes a day to reduce the risk of chronic diseases, improve cardiovascular health, and increase physical strength. Additionally, stress management is important for the patient’s mental and physical health. Stress can lead to excessive worrying, fatigue, and depression. Therefore, the patient should be encouraged to find ways to manage stress, such as exercising, meditating, or talking to a therapist. Finally, other lifestyle changes such as quitting smoking, limiting alcohol consumption, and getting adequate sleep should be discussed. Ultimately, discussing these lifestyle changes with the patient can help to improve their overall health and well-being.
It is important to discuss lifestyle changes with the patient to help improve her health. Nutrition is an important part of any lifestyle change and should be discussed with the patient. According to the NF Eshah article from the Nursing & Health Sciences journal published by Wiley Online Library in 2013, “Focusing on healthy nutrition is important in preventing and managing diseases” (Eshah, 2013, p. 98). This means that the patient should be encouraged to make healthier dietary choices, such as eating less processed foods, eating more fruits and vegetables, and minimizing sugary drinks. Physical activity is also an important part of improving overall health. It is recommended that adults get at least 150 minutes of moderate to vigorous exercise per week (Eshah, 2013, p. 98). The patient should be encouraged to find an activity that they enjoy, such as walking, jogging, yoga, or cycling, and to make it part of their weekly routine. Additionally, stress management is a key component of improved health. The patient should be encouraged to find ways to manage their stress, such as deep breathing exercises, mindfulness meditation, yoga, or journaling (Eshah, 2013, p. 99). Finally, other relevant lifestyle changes should be discussed, such as getting enough sleep, avoiding smoking, and limiting alcohol consumption. All of these lifestyle changes should be discussed with the patient to help improve her health. References Eshah, N.F. (2013). Nutrition in health promotion and disease prevention. Nursing & Health Sciences, 15(1), 97-99. doi:10.1111/j.1442-2018.2013.00664.x
In conclusion, this case study highlights the importance of understanding the patient’s history and the risk factors associated with aging when approaching the management of elderly patients. The patient’s recent widowing, living alone and lack of regular medical visits pose substantial concerns for the primary care provider. Based on the patient’s history and physical exam, the top three differential diagnoses are mild cognitive impairments, depression, and dementia. The laboratory studies should be interpreted in light of the patient’s clinical picture, and blood tests may be recommended to rule out infections, neurodegenerative disorders, thyroid disease, vitamin deficiencies, and malignancy. Further evaluation may include psychological and cognitive assessment, imaging studies, and a review of medications and supplement use. Regular medical visits are important for monitoring changes in the patient’s characteristics, self-care, and health condition over time, in order to identify and manage potential adverse reactions or changes in the patient’s status. In addition,, assessment of the patient’s social support and living arrangements should be considered. Ultimately, the primary care provider should provide to the patient and her family ample support, skillful guidance, and continued monitoring.
Work Cited
NF Eshah.”Predischarge education improves adherence to a healthy lifestyle among J ordanian patients with acute coronary syndrome.”https://onlinelibrary.wiley.com/doi/abs/10.1111/nhs.12018
NF Eshah.”Predischarge education improves adherence to a healthy lifestyle among J ordanian patients with acute coronary syndrome.”https://onlinelibrary.wiley.com/doi/abs/10.1111/nhs.12018
“Traditional vs. modern teaching methods: Advantages and disadvantages of each.”https://is.muni.cz/th/86952/ff_m_b1/mgrdiplomkaboumova.pdf
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