Human NRNP6550 Week_4 iHuman Alvin Stafford Conditions of the Cardiovascular

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i-Human 198142 Alvin Stafford V6 PC Advanced Practice Care of Adults in Acute Care Settings II Note from 3 months ago (Provided by i-Human module) HPH: Yearly physical Mr. Stafford is a 63-year-... old male with an 94 pack-year history of smoking and medical history of COPD here for his yearly physical. No new complaints noted. PHH: • COPD x 20+ years • None • Minimal exercise • American diet • Colonoscopy at age 55 • Yearly flu vaccine at local pharmacy Family Hx: • Father died at 53 from MI • Mother died at 65 from pancreatic cancer • Brother had partial pneumonectomy, possible lung cancer Social Hx: • Began smoking age 16; smokes 2 packs (filtered) per day; has never considered quitting • Former heavy alcohol use; now 1 to 2 beers daily, CAGE negative • No recreational drugs • Lives alone, wife died 4 years ago, no children • No pets • Worked a desk job all of his life, retired • College-educated • Uses seat belts Observations: warm and sweaty (Provided by i-Human module) NOTES FROM i-HUMAN ASSESSMENT: 1) How can I help you today? I get out of breath really easily 2) When did your fatigue/tiredness start? I don’t have that problem. 3) When did you first notice feeling short of breath? I started feeling more and more out of breath 2 days ago. 4) What are the events surrounding the start of your difficulty breathing? It’s not difficult as much as being SOB. 5) Do you have any other symptoms or concerns we should discuss? Yeah, I’m coughing more than my normal smoker’s cough. 6) Are you coughing up any sputum? Yeah, I’ve coughed in the morning and brought up white stuff for years. I am used to it. Its not much; maybe a spoonful at most. Then I’d be fine for the rest of the day. The last few days It’s been something else though. Its nasty. Do you really want to know more? 7) What does your sputum look like? Nasty, yellow-greenish gunk. 8) Does anything make your cough better or worse? Well, going up the stairs makes it worse. Definitely. Can’t figure out how to make it better 9) What treatments have you had for your cough? Nothing 10) Do you have any pain, or any other symptom associated with your cough? Nothing that I have not told you. 11) Can you tell me about any current or past medical problems you have had? I feel sick 12) Any previous medical, surgical, or dental procedures? Nothing other than the colonoscopy I had a few years back. 13) When was your last physical? I think about 3 months ago. You could look it up in my chart to know for sure. 14) Do you have COPD? Yes, for a number of years. 15) Do you now or have you ever smoked or chewed tobacco? Yep, cigarettes my whole life, or just about. May be 50 years or so. And, no, I’ve never considered quitting. Period. 16) Have you ever been hospitalized? No. 17) Do you experience chest pain discomfort or pressure; pain, pressure, dizziness with exertion or getting angry; palpitations; decrease exercise tolerance; blue/col [Show More]

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