The Clinical Picture of the 78-Year-Old Patient and the Palliative Care Aspect of the Patient Free Essay Example, 2500 words

The patient was a 78 year old man who denies a history of allergies, and medications. He was brought in by the emergency medical services after he was found down and altered by a close friend. The friend noted that the patient had lost about 30 pounds since they last met (4 weeks). Patient has difficulty in remembering what he ate before the previous day. He denies having any form of pain, and reports that he has been coughing. On physical examination, the heart rate was in the 110 s and improved to 130 and then to 140 s systolic with fluid resuscitation. On further examination; the patient is noted to be cachetic, and malnourished. He was alert, oriented, awake and talking. The mucous membranes were very dry. He had tachycardia with inspiratory rales on the right upper lobe of the lung. The abdomen was non distended and non tender. His laboratory results revealed a white blood cell count 16.1 with a left shift, the sodium concentration was 128, the creatinine level was 2.0, and lactate at 5.1. His chest x ray was clear and the head CT scan of the head revealed moderate hypoattenuation of the white matter. We will write a custom essay sample on The Clinical Picture of the 78-Year-Old Patient and the Palliative Care Aspect of the Patient or any topic specifically for you Only $17.96 $11.86/pageorder now The patient has evidence of having an acute kidney injury and hyponatremia. The patient displays evidence of failure to thrive. The initial diagnosis made included altered mental status, acute kidney injury, failure to thrive, malnourishment, starvation, weight loss, history of alcohol abuse, severe chronic obstructive pulmonary disease, dehydration, and hyponatemia, The condition of the patient was determined to be critical and he was admitted into the medical intensive care unit. While in the MICU, the patient complained of increasing cough, difficulty swallowing and abdominal pain. On auscultation of the lungs, there were scattered rhonchi across the lung fields both posterior and anterior. The patient grimaced on palpation of the abdomen and had a productive cough. The bowel sounds were hyperactive and the abdominal x-ray revealed a large amount of stool within the rectosigmoid colon.