NSG6001 Advanced Practice Nursing I | Week 1: Cardiology Clinical Case

NSG6001 Advanced Practice Nursing I | Week 1: Cardiology Clinical Case He is the sole bread winner in the family. His stress level is very high because of the impending bills that he needs to pay while he is not able to work. He believes that a man should be able to care for his family and be strong enough not to suffer from any illnesses himself. The patient and his wife live in a one-bedroom apartment in an inner city, quite isolated from their community. They do not have any relatives living in the area nor do they socialize with neighbors. He has little emotional or social support. He is stressed most of the time and is now suffering from depressive symptoms such as sleeping excessively and over eating. This patient has health insurance through the union to which he belongs, but it does not offer complete coverage of all his prescription medications. Though he goes to a clinic that is associated with the hospital, he does not always see the same primary care provider. HABITS • Diet Habits The patient usually eats one large meal a day after work. He skips breakfast most of the times and eats fast food for lunch. He eats few fruits and vegetables; mostly pasta and meat at home. He feels that he got all the exercise he needed when he was a young man, and the exercise he gets as a carpenter now is sufficient to keep him healthy. Smoking: He smokes 1 pack per day from the past 30 yearsNSG6001 Advanced Practice Nursing I Page 4 of 5 © 2015 South University Alcohol: Does not drink Substance Use: Denies street drug use • WORK HABITS He’s always been a carpenter; has no hobbies and reads at home. • FAMILY HISTORY He has two older brothers who are being treated for high blood pressure and type 2 diabetes. Both brothers were diagnosed with these disorders in their early forties. Both parents are deceased; father from heart disease, and mother from breast cancer. PHYSICAL EXAMINTAION Vital Signs: BP: 160/92 left are sitting; P:60 ; R: 16; T: 98; Wt: 220#; Ht:– 70” HEENT: WNL Lymph Nodes: None Lungs: Decreased breath sounds throughout, no adventitious sounds Heart: RRR without murmur Carotids: Right bruit Abdomen: Android obesity, WC = 44 inches Rectum: Not examined Genital/Pelvic: NACOURSE CODE: LGS-NSG6001 Advanced Nursing Practice I WEEK 1 5 Extremities, Including Pulses: Decreased pedal pulses BL with lower leg edema from ankle to mid calf. Neurologic: Not examined EKG: No change from baseline