Fill in order details

  • Submit your instructions
    to writers for free!

Chat with the writer

  • Chat with preferred expert writers
  • Request a preview of your paper
    from them for free


  • Project edited by the quality evaluation department

Download Your Completed Project

  • Download the completed project from your account or have it sent to your email address

Felipe is a 70 year old Hispanic male who presents

Musculoskeletal and Neurological Disorders

Felipe is a 70 year old Hispanic male who presents to the urgent care clinic accompanied by his wire and neighbor. He was transported by ambulance. According to the history, he had been on a ladder cleaning windows and then had fallen to the floor, called out and his wife, Lucinda, heard him and went to help him up.  He had fallen before, several times, so she was not concerned at first. When she reached him  to help him up, she noticed that he could not tell her what happened, he could not speak words that made sense to her at all, instead, his face was drooping on the right and he was trying to speak to her but she could not understand him.  Since he could not move his right arm and there was blood on his shirt sleeve, and he seemed to be in pain she called the neighbor who helped drag him into the car and they went to the urgent care clinic where Felipe had been for a couple of broken bones after falls. At the urgent care, a staff person came to the car and did a brief assessment. At this time Felipe could speak, slowly, to say that his right arm hurt and that he could not move it. He had no idea what had happened.

Relevant history is that Felipe has worked as a painter for over fifty years, having been brought to the US from Mexico as a child by his parents. His father got work as a painter and as soon as the boy was old enough and able enough he began to help with the painting work. More recently, he had begun to speak of retirement, however, he had not become a citizen and so was not entitled to retirement in the US system. His need to retire was to get away from fumes that made him cough and sometimes the chemicals made him dizzy. Of course he had no health insurance as an independent painting contractor. He had “made them a good living” according to the wife, but she worries that he will not be able to work much longer, the kind of work he does, and she cannot keep him from repair in their own home. He has fallen several times, maybe he falls because he is dizzy as she does not think he has forgotten how to use a ladder. She has asked him if he has been dizzy and he has denied any dizziness. She took a job cleaning a few months ago anticipating becoming the bread winner sooner rather than later. She asks if there is any help for them financially as Felipe has never been in the hospital and his care has not cost more than he could pay over time. She said she is healthy, having had two children with her care funded by some sort of grant. However, she does not have health insurance.

Felipe had been told he had high blood pressure last year when he went to the urgent care for falling and they casted his arm. He wore the cast and the arm healed but he thought the medication for blood pressure was too expensive so he just added to his water intake and felt better. Other than all the falls and the high blood pressure she said he had had no health problems. His mother and father had something like high blood pressure, she thought. He has no siblings. Their children are healthy. Felipe does not use tobacco or drink, except when he falls and has pain he takes some whiskey for the pain. They eat a Mexican diet, always have. Felipe’s weight has been the same since she has known him. The neighbors are friendly and they are their friends. Both children live miles away and do not visit but neither has health problems that she knows about.

The tech at the urgent care notes that Felipe can now speak, but does not recall what happened. He can move his arm but motion is limited either by pain or injury. He is very anxious and asking the cost of the visit, wanting a cast on his injured arm and to leave. VS 165/95   H/R 68   R 18  T97.8

Felipe is speaking but his speech is slurred at times, his memory is not clear, his vision is 20/60 in both eyes and he does not wear glasses, a screening clock drawing test is normal, on the affected side, he is unable to flare his fingers, grip is weak, cannot rotate shoulder, sensation is grossly intact. The remainder of his neuro exam is normal. His ortho exam is normal with exception of his arm weakness and inability to do range of motion. The remainder of his physical exam is normal. You plan to do a more extensive exam following diagnostics that you know need to be done asap. He is given some Tylenol for pain until his diagnostics are completed.

The UC has x-ray and laboratory capability and there is a CT available to the UC as it is connected to a hospital. Initially, you order a CT of his head without contrast, a CT of his chest for the cough and the bruising injury to his left chest, a right humerus and shoulder x-ray, two views. You order a lab series of CBC with differential, full chemistry panel, as a baseline, anticipating there could be more needed. A laceration to his upper arm is wrapped for later suturing. He is taken to the hospital radiology department.

What do the social determinants of health tell you about this patient that will assist you with helping him? Consider each one and discuss the implications.

What other professionals (at least 3) would you consider bringing to this case? (You have access to them from the hospital)

What other tests do you anticipate possibly ordering? Why?

At this point you have to consider that this patient may need to be admitted, even though he is refusing for now. You understand that his wife will accept Felipe’s decisions unless it is obvious that there is a greater problem than he understands. What do you anticipate?

Differential DX (May be more than one system and may require further testing to determine) Anticipate the findings of his diagnostics and then go forward as if accurate.

What about pain?  What about suturing?  What about his blood pressure?

What about health insurance? What about his continuing to work? Who do you consult? What about health insurance for Lucinda?

What about future social determinants of health, especially that could offer support for this couple?

What else may be helpful?

Make some assumptions about the findings of the diagnostics, report them, and initiate a plan of care, working with Felipe and Lucinda for immediate and follow up care.  Remember that you have access to the hospital for an admission, a panel of specialists for referrals, and a home-based care program sponsored by the hospital.

To Prepare:

  • Review this and previous weeks’ Learning Resources as needed.
  • Review the case study provided by your Instructor. Based on the provided patient information, think about the health history you would need to collect from the patient.
  • Consider what physical exams and diagnostic tests would be appropriate in order to gather more information about the patient\’s condition. Reflect on how the results would be used to make a diagnosis.
  • Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.
  • Consider each patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
  • Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with their condition(s).

The Assignment:

Use the Focused SOAP Note Template to address the following:

  • Subjective: What details are provided regarding the patient’s personal and medical history?
  • Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any morbidities or psychosocial issues.
  • Assessment: Explain your differential diagnoses, providing a minimum of three. List them from highest priority to lowest priority and include their CPT and ICD-10 codes for the diagnosis. What would your primary diagnosis be and why?
  • Plan: Explain your plan for diagnostics and primary diagnosis. What would your plan be for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan.
  • Reflection notes: Describe your “aha!” moments from analyzing this case.

Place your order now for the similar assignment and get fast, cheap and best quality work written by our expert level  assignment writers.Felipe is a 70 year old Hispanic male who presents

Use Coupon Code: NEW30 to Get 30% OFF Your First Order

Solved Questions:

SOLVED! Choose one skin condition graphic (identify by

SOLVED! A 58-year-old obese white male presents to ED

SOLVED! Mr. EBR is a 74-year-old retired Hispanic gentleman

SOLVED!! My stomach hurts I have diarrhea and nothing seems

SOLVED!! A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain

What our customers say

  • Essay was good; although need to do few amendments and add few things, overall it was good and justify money paid.


    FinanceProfessional assignment help services
  • it was good
    it has introduction, body paragraphs, and conclusion as well
    it was really helpful

    PsychologyProfessional assignment help services
  • Great service. Always provide quick response and best online support and have very very less plagiarism.

    EconomicsProfessional assignment help services
  • Thanks for giving my assignment on time. I really appreciated the work done. This keeps me submitting new assignments.

    HealthcareProfessional assignment help services
  • Thank you my writer. Good job and I really enjoy you fast response. I definitely will recommend to my friends.


    NursingProfessional assignment help services
  • Thanks for giving my assignment on time. I really appreciated the work done. This keeps me submitting new assignments.

    NursingProfessional assignment help services
  • Great service. Always povide quick response and best online support and have very very less plagiarism.


    Business LawProfessional assignment help services
  • Good writer that fulfil all the requirements that i have been told to the writer. The writer even called to discuss everything with me to continue my assighnment


    FinanceProfessional assignment help services
  • Great work on time delivered for work, good understanding well prepared. References was well written in APA format

    NursingProfessional assignment help services
  • The writer had clear communication and ensured to give me a brief overview of how my assignment was going to be structured including an average of the words used in each section in order to avoid going over the limit. Didn't need to escalate even once because the quality of the work was in line with the Standard quality that I chose.

    AccountingProfessional assignment help services
  • It was okay. Not bad, could do better! But marks were good, feedback was also good, so overall 4/5


    ProgrammingProfessional assignment help services
  • The solution was excellent and all the requirements was taken into consideration.

    ChemistryProfessional assignment help services
  • On time and the assisgment is veryy well done. thank you very much. i'm happy and this is not the last time of me getting help


    ManagementProfessional assignment help services
  • This is solid work thankyou for all the help with this PowerPoint; I m curious what grade ill get in it


    NursingProfessional assignment help services
  • Great Work Completed in under a Hour thank you so much. I got a 100 percent on my assignment.

    NursingProfessional assignment help services
  • I got 87%. Thanks for that. I am quite satisfied as You reviewed and changed when I ask for some changes.


    ChemistryProfessional assignment help services
  • I got a Distinction in this course. Highly satisfied with the expert work and effort.


    Business LawProfessional assignment help services
  • I am very happy with this assignment. Thank you very much to the expert who has done this for me.


    Business LawProfessional assignment help services
  • So far this is the highest marks I got for an assignment done by you guys. I got 42/50 for this assignment. The exact feedback from my lecturer was:
    Introduction: Good introduction to assisted dying, especially in relation to laws within Australia. Introduction was a little too long.
    Aim or Purpose: Good purpose but improved grammar needed. Good use of PICO.
    Method: The method, while explained is very out of order. Try to write a methods section that can be followed in a step by step fashion

    NursingProfessional assignment help services
  • You did a good job just some details were missed enough attention. To be honest, you did much better job than the other websites. I would like to have more experience with you then I can give you more detailed feedback.


    ManagementProfessional assignment help services

You cannot copy content of this page