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Week 3: Case Presentation Summary Chamberlain University NR603: Advanced Clinical Diagnosis and Practice Across Lifespan

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SOAP Week 3 Patient Information: L.M., 60-year-old male, African American, insurance unknown. (S) Subjective: CC: chest pain three days ago HPI: "My wife made me come, I feel fine." Three days ago, Larry M. felt short of breath, had this heavy feeling in his chest, and he got kind of nauseous and sweaty. It lasted only about 3 minutes, and it has not happened again, but he does feel a little more tired. "It could be that I have not worked out since it happened." Current Medications: None Allergies: NKDA PMHx: Reports general health as good. He Had been feeling great since starting to work out and lost weight. Had lots of energy and felt great until this episode three days ago. Now he is a little concerned because he feels a little more tired when he works out. He has not done as much strenuous running and has not worked out since the episode. Hypertension- lifestyle changes recommended. Elevated cholesterol, lifestyle management was initiated

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Uploaded on
January 14, 2023
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Written in
2022/2023
Type
Summary

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