Frank’s Chart Information
Past medical history
• DM type 2
• HTN
• HLD
Medications
• Metformin
• Lantus
• Lisinopril
• Pravastatin
• ASA
•
Frank Responds Transcript
• Nurse Practitioner (NP): Tell me Frank, have you gained or lost any
weight?
• Frank: Ah, I ‘ve gained about 10 pounds. I ate a lot of ham
during the holidays.
• NP: Have you noticed any changes in your vision?
• Frank: No, no changes.
• NP: Any sore throat or nasal congestion?
, • Frank: No, no sore throat or nasal congestion.
• NP: When did you notice the pressure in your chest?
• Frank: For the past two days I have been feeling this pain in
my chest, especially when I go up the stairs. That’s when I
noticed it first.
• NP: Have you been coughing or wheezing?
• Frank: No, none of those.
• NP: Have you noticed any changes in skin, any swelling?
• Frank: Yeah, my ankles feel a little tighter. The skin looks shinier. I
think they may be a little more swollen than usual.
Frank’s Physical Exam Information
After completing the review systems, you conduct a physical exam of Frank
and note the following results:
• VS: BP 100/68 P 110 R 24 T 98.6
• General: alert, appears in some distress
• HEENT: nose is clear, throat is without edema, thyroid is midline
• Cardio: tachycardic, no murmurs noted, no lifts or heaves. JVD is
present
• Respiratory: lungs have some crackles in bilateral bases
• Skin: 3 + pitting edema noted in bilateral ankles
Frank’s Test Results
After completing your review of his systems and a physical exam, you send
Frank to radiology and to the lab for a few tests. You receive these
results:
Radiology
Past medical history
• DM type 2
• HTN
• HLD
Medications
• Metformin
• Lantus
• Lisinopril
• Pravastatin
• ASA
•
Frank Responds Transcript
• Nurse Practitioner (NP): Tell me Frank, have you gained or lost any
weight?
• Frank: Ah, I ‘ve gained about 10 pounds. I ate a lot of ham
during the holidays.
• NP: Have you noticed any changes in your vision?
• Frank: No, no changes.
• NP: Any sore throat or nasal congestion?
, • Frank: No, no sore throat or nasal congestion.
• NP: When did you notice the pressure in your chest?
• Frank: For the past two days I have been feeling this pain in
my chest, especially when I go up the stairs. That’s when I
noticed it first.
• NP: Have you been coughing or wheezing?
• Frank: No, none of those.
• NP: Have you noticed any changes in skin, any swelling?
• Frank: Yeah, my ankles feel a little tighter. The skin looks shinier. I
think they may be a little more swollen than usual.
Frank’s Physical Exam Information
After completing the review systems, you conduct a physical exam of Frank
and note the following results:
• VS: BP 100/68 P 110 R 24 T 98.6
• General: alert, appears in some distress
• HEENT: nose is clear, throat is without edema, thyroid is midline
• Cardio: tachycardic, no murmurs noted, no lifts or heaves. JVD is
present
• Respiratory: lungs have some crackles in bilateral bases
• Skin: 3 + pitting edema noted in bilateral ankles
Frank’s Test Results
After completing your review of his systems and a physical exam, you send
Frank to radiology and to the lab for a few tests. You receive these
results:
Radiology
