PLEASE READ THE CASE STUDY AND ANSWER THE QUESTIONS TO THE BEST OF YOUR ABILITY:
Mr. Jackson is 86 years old. He is admitted to HUMC for congested heart failure. He also has a history of renal failure and goes for dialysis on Mondays, Wednesdays and Friday. He has an AV fistula in his right hand. He also has a history of diabetes, hypertension and depression.
He is allergic to shrimp. He is a nonsmoker. He lives with his wife and two sons.
He is on a renal, low sodium, low cholesterol diet.
He is positive for clostridium difficile.
He suffered a stroke while he was in the hospital and now has left sided weakness.
1. What could be a head to toe objective assessment for Mr. Jackson (Be creative)
patient in propped up position, altered sensorium, tachypnoeic
Periorbital edema +
facial puffiness +
xanthelsma +
cyanosis +
pallor +
low grade fever +
uremic frost(small white crystalline deposits) on face +
dry mouth
elevated JVP
distended neck veins
acanthosis nigricans +
AV fistula in right hand
muscle weakness in left upper limb and lower limb
cold clammy skin in the periphery
loss of skin turgor
localized erythema +
scratch marks +
blisters +
dull red papules on bony prominences
uremic fetor +
half and half nails( proximal half white, distal half pink)
abdominal distension +
ascites +
Bilateral pedal edema +
diabetic foot +
Decreased chest movement
Down and out apical impulse
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