NR 601 Case Study Discussions Physical Examination Discussion

Discussion Part Two (graded)

Physical examination

Vital Signs:

Height: 5 feet 7 inches Weight: 170 pounds Waist Circumference – 32 inches BP 130/84 T 98.0 po P 92 regular R 22, non-labored

HEENT: normocephalic, symmetric. Evidence of prior cataract surgery in both eyes. PERRLA, EOMI, cerumen impaction bilateral ears. Several broken teeth, loose partial plate.

NECK: Neck supple; non-palpable lymph nodes; no carotid bruits.

LUNGS: Decreased breath sounds bases bilaterally, clear to auscultation
HEART: RRR with regular without S3, S4, murmurs or rubs. NR 601 Case Study Discussions Physical Examination Discussion

ABDOMEN: Bloated appearance, active bowel sounds, LLQ tenderness and 6 cm x 7 cm mass.

PV: Pulses are 2+ BL in upper and lower extremities; no edema
NEUROLOGIC: Negative

GENITOURINARY: no CVA tenderness

MUSCULOSKELETAL: gait fluid and steady. No muscle atrophy or asymmetry. Full ROM all joints. Strength 5/5 and equal bilaterally.
Hips: Discomfort on flexion in both hips; extensor and flexor strength symmetrical.

Knees: Left knee discomfort with weight bearing. No redness, warmth or edema. Full ROM in both knees with symmetrical extensor and flexor strength. Crepitus on extension of left knee.

Hands: No redness or swelling. Bilateral joint tenderness of the distal interphalangeal and proximal interphalangeal joints of the 2nd and 3rd digits. NR 601 Case Study Discussions Physical Examination Discussion

Calf circumference-31 cm; Mid-arm circumference- 22 cm

PSYCH: normal affect

SKIN: Pale. Areas of healing ecchymosis: Left knee- 3 cm x 2 cm x 0 cm. Right knee -2 cm x 2.5 cm x 0 cm. NR 601 Case Study Discussions Physical Examination Discussion

Discussion Part Two:

Summarize the history and results of the physical exam. Discuss the differential diagnosis and rationale for choosing the primary diagnosis. Include one evidence-based journal article that supports your rationale and include a complete treatment plan that includes medications, possible referrals, patient education, ICD 10 Codes, and plan for follow-up.

Description

Beyonce is 38 yrs and a nonsmoker, she has been actively dancing for the past 6 month and wants to prepare for her hectic travel schedule. Her heights is 174cm and weights is 70 kg. Her resting heart rate is 65 bpm with a resting blood pressure of 114/80 hg. Her total cholesterol is 189mg/dL, LDL is 100mg/dL, and HDL is 60mg/dL. Fasting blood glucose is 88mg/dL, she is a talented performer, uses no medication and has reported no symptoms. She wants to get stronger without looking bulky, and she does not like to lift weights not join a gym. NR 601 Case Study Discussions Physical Examination Discussion

She contracted you to assess her fitness and to help her to begin a regular exercise program so that she feels healthier. She wants to get stronger but does not want to get big. You have her perform a squat and notice that she flexes her back when she drops into a very deep squat. Use the 3 article in class that you have read to create a strength training program for Beyonce

Step1. Status resistance training

Step 2. what is her goal?

Step 3 using the article from Class (3 article) to prescribe exercise for total body training