Preview

Case 3 Death Summary Putul Barua

Satisfactory Essays
Open Document
Open Document
434 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Case 3 Death Summary Putul Barua
Death Summary
Patient Name: Putul Barua
Hospital No.: 135799
Room No.: CCU4
Admitted: 01/07/2009
Deceased: 01/15/2009 0041 hrs
BRIEF HISTORY: This 42-year-old gentleman was admitted on January 7th and died on January 15th. He was admitted with progressive cardiac palpitation, hemoptysis, and dyspnea. Please see his admission history and physical exam for details.

HOSPITAL COURSE: Mr. Barua’s hospital course was characterized by a progressively downhill course. He was initially hospitalized and found to be mildly hypoxemic which was rapidly corrected with supplemental low-flow oxygen therapy. However, he gradually became more oxygen dependent on high-flow oxygen, eventually requiring intubation with mechanical ventilation in order to maintain his oxygenation. He underwent an open-lung biopsy in an attempt to delineate the etiology of his pulmonary situation, and this was reported as idiopathic pulmonary fibrosis in alveolitis. The specimen was sent to the mayo clinic pathology department for further evaluation, and they were able to give no further help concerning the ideology of his pulmonary status. An echocardiogram showed left ventricular wall motion apocanesia and an injection traction of approximately 35%. Dr. Cecil Burnett and other members of the cardiology department consulted on the patient. They felt that his hypoxemia and breathlessness were not secondary to his cardiac status. He had supraventricular cardiac arrhythmias, including atrial fibrillation and atrial flutter. The cardiology staff utilized intravenous medications that control the cardiac rate adequately resolving these cardiac issues. I managed the patient’s ventilator and intensive care status along with my respiratory therapy team. Unfortunately the patient developed multiple infections, hospital acquired, including klebsiella pneumonia infection and probable fungemia. Multiple evaluations of the sputum and lungs for the presence of active pulmonary tuberculosis were

You May Also Find These Documents Helpful

  • Satisfactory Essays

    This 42 year old gentleman was admitted on January 7th, and expired on January 15. He was admitted with progressive tachycardia, hemoptysis and dyspnea. Please see his admission history and physical exam for details.…

    • 459 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.…

    • 1272 Words
    • 6 Pages
    Good Essays
  • Satisfactory Essays

    Death Summary

    • 306 Words
    • 2 Pages

    Dr. J.K. Mc Clain and other members of the cardiology department consulted on the patient. They felt that his hypoxia and breathlessness were not secondary to his cardiac status. He had supraventricular cardiac arrhythmias, including atrial fibrillation and atrial flutter. The cardiology staff utilized intravenous medications that controlled the cardiac rate, adequately resolving these cardiac issues. I managed the patient’s ventilator in intensive care status along with my respiratory therapy team. Unfortunately the patient developed multiple infections, hospital acquired, including Klebsiella pneumonia infection and…

    • 306 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Ms. Tesla comes into the cardiology office, complaining of fatigue, palpitations, shortness of breath with mild activity, ongoing consistently for the past week without any chest pain or syncopal episodes. She is a 75-year-old woman with a history of atrial fibrillation (AFib), controlled type 2 diabetes, myocardial infarction (MI) with a history of percutaneous coronary intervention (PCI) to right coronary artery, stage IV chronic renal failure, and a mild mitral regurgitation on ECHO 7 years ago. Her in-clinic ECG show AFib with ventricular rate of 111 and mild left ventricular hypertrophy, pulse 99 and irregular, blood pressure of 102/72, and grade 1/6 systolic murmur with no rubs or gallops. The rest of the…

    • 1131 Words
    • 5 Pages
    Good Essays
  • Satisfactory Essays

    The patient’s chronic renal failure worsened steadily, with increasing creatinine and BUN and decreasing CO2. At the request of the family no hemodialysis was done. Her chronic renal failure worsened further, and eventually she died at 4:30 p.m., 3 days after admission.…

    • 264 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    daughter insisted on taking him to the ED for evaluation. After orienting him to the room, call light, bed controls, and lights, you perform your physical assessment. The findings are as follows: he is awake, alert, and oriented (AAO) \3, and he moves all extremities well (MAEW). He is restless, is constantly shifting his position, and complains of (C/O) fatigue. Breath sounds are clear to auscultation (CTA). Heart sounds are clear and crisp, with no murmur or rub noted and with a regular rate and rhythm (RRR). Abdomen is flat, slightly rigid, and very tender to palpation throughout, especially in the RUQ; bowel sounds are present. A sharp inspiratory arrest and exclamation of pain occur with deep palpation of the costal margin in the RUQ (positive Murphy’s sign). He reports light-colored stools for 1 week. The patient voids dark amber urine but denies dysuria. Skin and sclera are jaundiced. Admission vital signs (VS) are 164/100, 132, 26, 36° C, SaO2 96% on 2 L of oxygen by nasal cannula (O2/NC).…

    • 1681 Words
    • 7 Pages
    Good Essays
  • Good Essays

    Systolic Heart Failure

    • 332 Words
    • 2 Pages

    Ms. Boehmer has systolic heart failure. She has reported symptoms of dyspnea with exertions, orthopnea (evidenced by “sleeps on two pillows” at night), fatigue (evidenced by “she often feels tired”) and edema (evidenced by “reports that ankles are often swollen in the evening”) alterations in urination (evidenced by “nocturia X 2 and reports she sometimes has a strong urge to void and does not always make it to the toilet in time”). Physical examinations demonstrate S3 gallop. Cardiomegaly is present and cardiac output is decreased (evidenced by Echo result “mildly enlarged left atrium, ejection fraction 35%”). Other evidence includes a history of coronary artery disease and hypertension. (Brashers, 2012b).…

    • 332 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    Pt. has no past history of asthma or allergies and no known medical conditions. The pt does have a recent history of a trip that involved sitting in a truck for a long period of time during the past few weeks. There are no obvious signs of trauma and in the ER he had a normal EKG and echocardiogram, however a bloody pleural effusion was found during the ER workup. A CBC with differential shows no abnormal blood counts. Tuberculosis was ruled out by a CT scan and ACE level testing of his sputum. Multiple standard diagnostic imaging studies did not show any obvious abnormalities. The patient’s spleen ruptured and in surgery to remove the spleen, Wegener’s disease was ruled out by microscopic study of a tissue sample of the spleen when it was normal. Signs/symptoms that presented were a cough, pain that changed locations as treatment progressed, complaints of feeling like an anvil is sitting on his chest, a penile bleed and ruptured…

    • 1797 Words
    • 8 Pages
    Powerful Essays
  • Good Essays

    He was seen by Infectious Disease, Pulmonary, Cardiology, Endocrinology, and Psychiatry. It was noted that the claimant's breathing has been slowly improved over the hospital course. The CT scan of the chest revealed a 1-cm nodular opacity at the left lower lobe. There were fibrotic changes, significant calcification of the NAD, and a multi-nodular thyroid. The thyroid ultrasound revealed heterogenous masses. An uptake scan was recommended. Moreover, his 2D-echo revealed a normal LV size and function with an ejection fraction of 60%. An aortic valve sclerosis and a dilated left atrial cavity were noted. A follow-up visit with the specialist doctors was recommended. He was discharged in stable condition on…

    • 352 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    The patient is an elderly female who was out walking with her daughter started to feel dizzy sat on a bench and suddenly fell to the ground she was resuscitated by nearby fireman who actually initiated CPR on the patient. The patient's medical history is significant for diabetes mellitus, hypertension increased lipids, depression and probably some early dementia. In the ED the patient is evaluated at this time she is eating. She is awake, alert and oriented. She has no recollection of what happened to her. Her d-dimer is 0.77. Her troponins and CK are both negative. She is admitted inpatient to telemetry to be monitored. It is Dr. Tsi's opinion that this was not a true cardiac episode. The case is discussed with Dr. Joseph Vitale and…

    • 166 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Patient is a 61-year-old white male admitted through the ER with on December 10 with recurrent right pneumothoraxes. Patient is known to have COPD with emphysema and has multiple admissions for problems concerning this. At the time of initial evaluation, a small caliber chest tube was inserted in the anterior axillary line, which improved the patient’s respiratory distress but did not completely resolve the pneumothorax. I was called to the ICU to place a second small caliber chest tube in the posterior axillary line below this. This further improved the patient’s pulmonary status with his saturation improving from 76& to 89%. Since admission he has felt better but complained of pain at the chest tube insertion site. He has continued to leak out through the pleur-evac under water seal, and beginning yesterday he developed subcutaneous emphysema, which has gotten progressively worse. Earlier today he began having increased respiratory difficulty again, with his saturation dropping to approximately 80 % despite oxygen per nasal cannula. Chest x-ray today showed a worsening of the right lower lobe loculated pneumothorax, and on examination today he is not only leaking air through the pleur-evac system but also around the two chest tubes.…

    • 553 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    In the case study I will discuss a 70 year old man admitted due to a fall and acopia with a past medical history of copd and ribhadomylosis. The patient was already on 4 hourly observations and 3L oxygen due to shortness of breath and high blood pressure. I had noticed him holding an inhaler and he had been using it liberally. The patient began complaining of chest pain and further breathlessness and was panic stricken. The nurse in charge of his care notified the doctor and I noticed the doctor check his pulse and ask for a new set of clinical observations including heart rate. The patient was showing an abnormally fast heart rate or Tachycardia, he then asked the nurse to perform an Electrocardiogram or ECG to establish the pulse.…

    • 1206 Words
    • 5 Pages
    Good Essays
  • Good Essays

    At the clinic it was discovered that she was dyspneic. Dyspneic means difficulties breathing. Following procedures done were heart and lung investigations. They showed that the patient had pneumonia (which she was being treated for) and it also showed distant heart sounds.…

    • 542 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Third Degree Heart block

    • 805 Words
    • 3 Pages

    Mrs. Svoboda is an 81-year-old woman with congestive heart failure. She had smoked for 60 years, but was able to successfully quit when she received her diagnosis four years earlier. She was in the hospital because she had fainted at home. Her EKG pattern had revealed the presence of third-degree heart block and resulting bradycardia.…

    • 805 Words
    • 3 Pages
    Good Essays
  • Better Essays

    Recurrent life-threatening left ventricular arrhythmias despite an implantable cardiac defibrillator, antiarrhythmic therapy, or catheter-based ablation;…

    • 1118 Words
    • 5 Pages
    Better Essays