NR 511 Week 6 CASE STUDY 2023 100% CORRECT

NR 511 Week 6 CASE STUDY 2023 100% CORRECT Greetings Professor and class, NR511 Week 6 Case Study CC: “Fatigue” HPI: A 56-year-old Caucasian female presents to the office today with complaints of generalized fatigue for the last 2-3 months and worsens on exertion, thus causing progressive worsening since onset. She reports feeling tired all of the time, sleep 8hrs per night, but does not feel wellrested. She stated that she has no energy to do the things she usually does and reported missing “1 day of work 2 weeks ago” because she could not get out of bed. She denies pain and reported no treatments or relieving factors. ROS: Constitutional: Denies fever, chills, or recent illnesses. She reported a 5lb weight gain since her last office visit 6 months ago. HEENT: HEENT: Negative. No visual changes or diplopia. Denies any ear pain, coryza, rhinorrhea, or ST. She reported having a tonsillectomy as a child. Denies snoring or a history of sleep apnea. Denies any lymph node tenderness or swelling. Respiratory: Denies cough, SOB, DOE or wheezing CV: Denies chest pain GI: Denies N/V/D. + Constipation GU: Denies polyuria, polydipsia. + cold intolerance. Menopause status x 5 yrs. Skin: Negative. No changes in skin, hair, or nails Psych: Reports worsening of depressive symptoms but thinks it might be contributed to being “unproductive” and tired all of the time. Negative for SI/HI. No changes in sleep pattern, gets 8- 9hrs of sleep per night but not feeling rested. Musculoskeletal: Reports generalized weakness and intermittent muscles cramping in calves Allergies: Iodine dyes Medications hx: Multivitamin, B-Complex, Prozac 20mg, Bisoprolol-HCTZ 2.5mg/6.25mg, Calcium 500mg & Vit D3 400IU. Medical history: HTN, Depression, Postmenopausal status PSH: Tonsillectomy lOMoARcPSD| Family hx: Maternal GM & GF deceased with CHF, T2DM & HTN; Mother alive (82-y.o) +HTN, +hyperlipidemia, +T2DM; Father alive (84-y.o.) +HTN, +Hyperlipidemia, +T2DM, +ASHD (s/p +DVT & +PFO; remains anticoagulated); Oldest child (26 y.o.) has seasonal allergies, youngest child (24 y.o.) has bipolar depression and ADHD & anxiety Social hx: Employed F/T, she is married with 2 adult children, denies smoking cigarettes or illicit drug use. Drinks wine (1-2 glasses p/month) socially. Physical Examination Constitutional: Middle-aged, caucasian female AxO and cooperative Vital Signs: BP 146/95, Temp 98.2, P 74, RR 16, Hgt 5’7”, Wgt 180lbs HEENT: Head normocephalic, atraumatic. Eyes PERRLA. The tympanic membranes are gray, intact with light reflex noted. Nares patent; turbinates no bogginess, no swelling, nasal drainage is clear. Oropharynx moist, no lesions or exudate. Bilateral tonsils surgically removed. No dental caries noted. Neck supple, thyroid small, firm, & midline no palpable masses; no lymphadenopathy noted. Cardiopulmonary: Lungs clear b/l with auscultation respirations unlabored and S1 and S2 noted and no M/G/R. No pedal edema. GI: Soft, non-tender, BS active x 4 quad Skin: Skin overall dry, hair coarse and thick, nails without ridging, pitting or discoloration Psych: Mood pleasant and appropriate. Msk: Normal strength throughout Neurological: DTRs 2+ at biceps, 1+ at knees and ankles DDx: Hypothyroidism: In hypo