Adela Torres free essay sample

Po daily recently discontinued because of questionable allergic reaction, HCTZ 25 mg Po every other day, and oral calcium supplements, in the past she has been on penicillamine, azathioprine, and hydroxychloroquine but she has not had azulfidine, cyclophosphamide, or chlorambucil. ALLERGIES: None by history FAMILY/SOCIAL HISTORY: None contributory PHYSICAL EXAMINATION: This is a conically ill appearing female alert, oriented, and cooperative. She moves with great difficulty because of fatigue imalays. VITAL SIGNS: Blood pressure 107/80, heart rate 100 and regular, respirations 22. HEENT: nurosentalic, no scalp lesions, dry eyes with conjunctival injection, exophthalmos, dry nasal mucosa, mark cracking and bleeding of lips with erosions of the mucosa she has a large laceration ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft pallet she has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. She has some mild ecchymosis on her skin and some erythema, she has some patches but no skin brake down, she had some fissuring in the buttocks crease. We will write a custom essay sample on Adela Torres or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page PULMONARY: Clear to precussion and auscultation bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, non-tender, protuberant, no organomegaly, and positive bowel sound. NORALOGIC EXAME: Cranial nerves 2 – 12 are grossly intact, diffuse hyporeflexia, muscular skeletal crosove destructive chambers in elbows, wrist, and hands consistent with rheumatoid arthritis. Has bilateral total knee replacements with slove pipe legs and perimalledal pitting edema 1+, I feel no pulse distally in either leg. PROBLEMS: 1. Swelling of the lips and dysphasia with questionable early Stevens-Johnson syndrome. 2. Rheumatoid arthritis class 3 stage 4. 3. Flare of arthritis after discontinuing methotrexate. 4. Osteoporosis with compression fracture. 5. Mild dehydration 6. Nephrolithiasis 7. Anxiety