Browse Over 3 Million Questions

Let Our Professionals Assist You With Research and Writing. 

student_PNG181-2.png

History of Present Illness

Chief Complaint“My left foot feels weak and numb. I have a hard time pointing my toes up.”History of Present IllnessD.T. is 42-year-old Caucasian woman who has had an elevated blood sugar and cholesterol 2 years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed her fasting blood sugar was 160 and her cholesterol was 250. However, she felt “perfectly fine at the time” and did not want to take any more medications. Except for a number of “female infections,” she has felt fine recently.Today, she presents to the clinic complaining that her left foot has been weak and numb for nearly 3 weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. She does report that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 50 pounds since her last pregnancy 10 years ago, 20 pounds in the last 6 months alone.Past Medical HistorySeasonal allergic rhinitis (since her early 20s)Breast biopsy positive for fibroadenoma at age 30Gestational diabetes with second child 10 years agoMultiple yeast infections during the past 3 years that she has self-treated with OTC antifungal creams and salt bathHypertension for 10 yearsPast Surgical HistoryC-section 14 years agoOB-GYN HistoryMenarche at age 11Last pap smear 3 years agoFamily HistoryType 2 DM present in older brother and maternal grandfather. Both were diagnosed in their late 40s. Brother takes both pills and shots.Mother alive and wellFather has COPDTwo other siblings alive and wellAll three children are alive and wellSocial HistoryMarried 29 years with 3 children; husband is a school teacherFamily lives in a four bedroom single family homePatient works as a seamstressSmokes 1 pack per day (since age 16) and drinks two alcoholic drinks 4 days per weekDenies illegal drug usesNever exercises and has tried multiple fad diets for weight loss with little success. She now eats a diet rich in fats and refined sugars.AllergiesNKDAMedicationsLisinopril 10 mg dailyLoratadine 10 mg dailyReview of SystemsGeneralAdmits to recent onset of fatigueHEENTHas awakened on several occasions with blurred vision and dizziness or lightheadedness upon standing: Denies vertigo, head trauma, ear pain, difficulty swallowing or speakingCardiacDenies chest pain, palpitations, and difficulty breathing while lying downLungsDenies cough, shortness of breath, and wheezingGIDenies nausea, vomiting, abdominal bloating or pain, diarrhea, or food intolerance, but admits occasional episodes of constipationGUHas experienced increased frequency and volumes of urination, but denies pain during urination, blood in the urine, or urinary incontinenceEXTDenies leg cramps or swelling in the ankles and feet; has never experienced weakness, tingling or numbness in arms or legs prior to this episodeNeuroHas never had a seizure and denies recent headachesDermHas a rash under her bilateral breast and in groin areaEndocrineDenies a history of goiter and has not experienced heat or cold intoleranceVital SignsBP 165/100, T 98 F, P 88 regular, HT 5 feet 4 inches, RR 20 non labored, WT 210 lbsWhat you need to do:Develop an evidence-based management plan.Include any pertinent diagnostics.Describe the patient education plan.Include cultural and lifespan considerations.Provide information on health promotion or health care maintenance needs.Describe the follow-up and referral for this patient.Prepare a 3–5-page paper (not including the title page or reference page).FormatThe paper should be no more than 3–5 pages (not including the title page and reference pages.Assignment Requirements:Before finalizing your work, you should:be sure to read the Assignment description carefully (as displayed above);consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; andutilize spelling and grammar check to minimize errors.Your writing Assignment should:follow the conventions of Standard American English (correct grammar, punctuation, etc.);be well orderedlogical, and unified, as well as original and insightful;display superior content, organization, style, and mechanics; anduse APA 6th Edition format as outlined in the APA Progression Ladder.

Order a similar paper and get 15% discount on your first order with us (Coupon Code: SAVE15)

Dr. Thea Watson
98% Success Rate
Read More
“Hello, I deliver nursing papers on time following instructions from the client. My primary goal is customer satisfaction. Welcome for plagiarism free papers”
Ivan L. Myers
98% Success Rate
Read More
Hi! I am an English Language and Literature graduate; I have written many academic essays, including argumentative essays, research papers, and literary analysis.
Dr. Evelyn Dougherty
98% Success Rate
Read More
"Hi, count on me to deliver quality papers that meet your expectations. I write well researched papers in the fields of nursing and medicine".
Dr. Paul P. Klug
99% Success Rate
Read More
"A top writer with proven reliability and experience. I have a 99% success rate, overall rating of 10. Hire me for quality custom written nursing papers. Thank you"

We Offer the Custom Writing Service with 3 Key Benefits

Affordable Writing Service

We guarantee a perfect price-quality balance to all students. The more pages you order, the less you pay.

The Best Support Service

Get 24⁄7 help with proofreading and editing your draft – fixing your grammar, spelling, or formatting.

Quality Essay Help

Our team of professional writers guarantees top-quality essay writing results.

Stay In Touch!

Leave your email and get discount promo codes and the best essay samples from our writers!
Chat With Us
Chat With Us