1 Mid 50âs African American male who is overweight and lethargic looking. Individual has a noticeable bulge in left upper arm, and right below the knee amputation.Â This person could be a dialysis patient who is in kidney failure, and the below the knee amputation could be a result of diabetic neuropathy or PVD.Â The additional physical assessments that could be performed would be to check vitals as well as the individuals A & O status as if he needs to be dialyzed than he could potentially be altered. I would ask if he had a history of diabetes, or any other disease processes in the family that could lead me to make a firm diagnosis of this individual. I could also check the patientâs blood glucose as well.
- Mid 70âs white female with a raspy and deep voice heard as she was talking to a man standing next to her outside. She was seen smoking a cigarette while carrying an oxygen cylinder that had her hooked up to a nasal cannula. Looking and listening to this person, the deduction could be made that the individual potentially has COPD or emphysema, and that they have wheezes in the lung bases from fluid accumulation. Additional assessments that could be done would be to check the tidal volume, check the individuals O2 saturation levels, check pulse rate and respiratory rate as well as the amount of oxygen that she is receiving by way of nasal cannula on her portable tank. A full respiratory assessment could be done which would include inspecting the CVA, palpating, percussing and auscultating the chest and listening to lung sounds.
- White female that appears to be in her 60âs who is seen walking hunched over an using an assistive device (cane). The woman seems to be walking very slowly and cautiously although it appears difficult for her to grasp the can she is using as her fingers on both hands look contracted and contorted or misshapen. Each step she takes causes her to grimace as though she is in pain. This Individual could potentially have kyphosis, rheumatoid arthritis, or osteoarthritis. The further assessments that would be conducted would be to do ROM of the upper arms and lower extremities to determine what her ROM is and the functionality of her movements, as well as her pain level tolerance is. Check her pulse motor sensory of this person, and also I would check her vitals and I would be interested in what a 24 hour nutritional recall would present for this person. Is she getting enough protein, and calcium?
- Mid 60âs white male with a noticeable left sided deficit as he is walking with an abnormal gait to the register. His left arm appears flaccid and looks as though he is talking to the cashier out of the right side of his mouth. The patient could possibly and most likely be post stroke. I would perform a F.A.S.T assessment on him. I could check his pulse motor sensory, check vitals to ensure that he is not hypertensive. Ask the individual, if I could discuss his disease process with him; if the deficits that he presents with are new deficits or are they existing and whether they acute or chronic issues.
- Early to mid-20âs Hispanic female who is very obviously pregnant, as her abdomen is grossly distended and her umbilicus is protruding. Her fingers, toes and ankles all look extremely swollen.Â She waddles when she walks so her gait is obviously affected by her the protrusion and weight gain. Person is undeniably pregnant and close to delivery as she is carrying very low. The assessmentâs that might be done on this individual would be to Â check for pitting edema, check vitals on patient since pregnancy induced HTN is common.Â Check glucose for gestational diabetes, check capillary refill time in her edatmous fingers. Also ask her about prenatal care,Â ask for a 24 hour nutritional recall and if she takes prenatal vitamins.