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Brandon - Orthostatic Hypotension, Hello David, my name is Brandon and I…
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Hello David, my name is Brandon and I am going to be your nurse for this visit! What is your reason for coming in today?
Nice to meet you, Brandon. I came in because I had a fall recently and was told if this were to happen to see my doctor.
Perfect thank you for coming in! I see in your chart that you were diagnosed with Parkinson's Disease two years ago. Have there been any other problems beyond your fall?
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Ok well, why are you wasting our time? People are much worse off than you!
Ok, can you tell me more about this fall? When it happened, what you were doing, how did you feel?
Of course. Umm I was getting out of bed late last night to get a glass of water when I suddenly collapsed.
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Well, there is the area carpet that I could have tripped on but I don't think that was the problem. Now that you mention it I did notice feeling dizzy before I fell down.
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Before I start your assessment about your fall is there anything you feel is important to tell me? Anything at all no matter how little.
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Ok, let's get started then. Firstly, have you experienced in the last 6 months: lightheadedness, loss of consciousness, blurry vision, or an increase in lethargy? Lethargy as in a lack of energy.
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Uh, yeah I think I have been experiencing a bit of each of those occasionally
Perfect, thank you. Alright, lets just take your blood pressure. First I am going to have you lay down on the bed right behind you.
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Yes, that's ok I am just tired is all.
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There a just a few more questions, lets finish up.
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Causes complications in goals, interventions, suggested exercises, describing their sleep and sleep strategies, and final evaluation is incorrect. Leading to poor QOL for the patient
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Of course, thank you for being understanding.
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Ok, I think we should start talking about possible interventions for you. It seems like you are having orthostatic hypotension meaning that your blood pressure is dropping when you stand up. This is indicated by the dizzy feeling you are having followed by falling down. Now there are lots of ways to go about coping with this, firstly I want to mention that you should take your time going from a laying down or sitting position to a standing position. It is different for everyone, but taking a minute or two to stand up can greatly decrease your risk of falling again. Falling can be very dangerous especially as your body changes as you age so I felt like this was something worth mentioning and thinking about.
Oh ok, thank you, I had heard something about falling being a risk shortly after standing up but I never knew why. I will definitely try to implement this into my daily routine.
Consent is always important, and this includes patient care. If a patient does not wish to continue you can quickly give them a statement similar to the path where they said ok to continue talking but without forcing them to continue the conversation. At the end of the day, you are not responsible for the risks their take. Instead, you should be informing them on what they CAN do and what could benefit them. Health care is complicated and each person is different and should be treated as such.
Sounds good. Now, there are lots of ways that we can help you feel better beyond taking your time to stand up. Fall prevention is one important aspect, but there are other ways to improve your general quality of life! I'd like to start with my goals for you if that's ok.
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Decide which ones bother the patient, and focus in detail on those interventions according to the "Orthostatic Hypotension - CP" document
Now that you mention it, I have had a hard time sleeping.
Discusses in-depth about how to help the patient sleeping according to the interventions on the "Orthostatic Hypotension - CP" document
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Well, then that will conclude our visit. We will schedule you for a couple of weeks from now to do an evaluation of the current progress and steps for further improvements.
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