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Group 49 - The Basic Midwesterners Activity 6 - Coggle Diagram

- - - - Retired Construction Worker
      - Smoker for 45 years, had heart attack in early 50s. History of hypertension
      - 67 Y/O
      - white Male
      - Physical Activity: yard work, walking to market to buy groceries
      - says dinners are meat and potatoes, no daily intake of colorful fruits and vegetables
        
        Also enjoys fried foods and soda often on the weekends
      - Height: 71 inches
      - Weight: 99 kg
        
        BMI: 30.4
      - usually lays down after eating to watch TV with the family
    - - Mother: diabetic
      - Father: passed due to MI. High blood cholesterol.
      - HTN: both parents
    - - takes antacid as needed
      - prescribed amlodipine for HTN but admits to sometimes missing days
      - Takes pepto bismal for occasional stomach pain
      - High blood cholesterol
    - - lives with wife
      - gets together with friends for drinks ~1 time per week, consumes 3-4 drinks
  - - - Nausea/Stomach Pain
      - Shortness of breath
      - Sweating
      - Tachycardia
      - Chief Complaint: feeling anxious/onset of severe abdominal pressure
      - Pale, clammy skin
      - Dysphagia
      - Swelling of extremities (legs)
      - Vomiting
      - Chest pain/heartburn
- - - - Any lesions?
  - - - Do you have history of heart disease?
        
        What about your family members?
      - Have you experienced any changes in heart rate or blood pressure?
      - Does your chest pain get worse when you smoke?
      - What was the proposed cause of your heart attack?
    - - Any nausea, vomiting, or diarrhea?
        
        How frequent?
      - Ask about bowel movements - have they been bloody, tarry, contain mucous?
      - Constipation/diarrhea?
        
        Color of stool? Consistency?
        
        For how long?
        
        Does it happen after certain foods or beverages?
        
        On and off, or consistent?
      - Examine vomit
        
        Check for blood, mucous, etc.
    - - O- When did this pain start happening? What happened before the pain started?
      - L- Where in your abdomen is the pain located?
      - D- How long does the pain last?
      - C- Can you describe the pain?
      - A- What triggers the pain? Is it worse when lying down? Does anything make the pain feel better?
      - R- Does the pain radiate? To where?
      - T- How frequently do you experience this pain?
      - S- On a scale to 1-10 how painful is it?
- - - - ECG: $1500
      - Abdominal Ultrasound: $654 -- https://health.costhelper.com/abdominal-ultrasounds.html
      - CT Scan: $4000
      - Blood Test (CBC): $50
  - - - Treatment
        
        Open abdominal surgery if necessary
        
        Stop smoking
        
        Schedule follow-up with patient to determine best course of action and what kind of surgery may be best for the patient
        
        Diet changes
        
        Considering patient's food security
        
        If possible, aim for low fat, lean protein, plenty of fruits and veggies
        
        cut out soda and fried, greasy foods
        
        Endovascular repair to place a graft in order to prevent rupture
      - History
        
        Pt has history of smoking
        
        Worked in construction
        
        Symptoms indicated condition including: clammy skin, abdominal pain, bloody stool, hypertension, history of heavy lifting and
        
        History of hypertension
        
        Patient's risk factors: white, male, age over 65 years, tobacco use
        
        His fried food-heavy diet may have contributed to vascular stress
  - - - radiates to butt and legs