House Painter Patient Evaluation and Management Plan
Ericka Echezarreta
The House Painter Patient Evaluation and Management Plan
Additional information that should be obtained about the pain experienced by the patient includes asking for the onset of pain, characteristics, pain duration, location of the pain, relieving factors, aggravating or associated factors, and pain quality. The chest pain can be diagnosed by having the 52-year-old point to the pain. Angina pain is usually situated across the anterior chest or substernal (Moores & Biggers, 2019). The patient reported that the pain radiated to his left arm, which can be described as angina. It is also vital to ask the patient how his chest pain feels. If the pain is crushing, dull, or heavy, it is often angina whereas burning, sharp, or stabbing pain is not typically angina (Crosta & Oen-Hsiao, 2020).
The additional physical assessments that should be done with this patient include checking pulse rate to rule out bradycardia and performing cardiovascular system checks to look for signs of heart failure such as swelling of legs caused by peripheral edema, hepatojugular reflux, and increased jugular venous pressure. Auscultation can be performed to rule of paradoxical splitting and systolic murmurs. Hypotension can be ruled out by checking the patient’s blood pressure. Respiratory systems checks are also vital to check for shortness of breath and respiratory rate (Moores & Biggers, 2019). Genitourinary assessment can be used to identify decreased urinary output. Other critical physical assessments include skin, psychological, and neurologic assessments.
If the CRP level of the patient is elevated, the important considerations to remember including ruling out any underlying conditions such as infection, heart attack, or cancer. This is because an elevated CRP level is a marker of inflammation (Landry et al., 2017). It can also show there is inflammation in the heart arteries, which can lead to an increased risk of a heart attack.
Differential diagnoses to be considered for this patient include angina pectoris, gastroesophageal reflux disease, musculoskeletal pain or costochondritis, pulmonary embolism, myocardial infarction, pneumonia, pericarditis, aortic dissection, rib fracture, and tumors of lungs.
The patient’s teaching that can modify the risk factors of the patient includes reduction of weight to lower his blood pressure and avoiding walking against the wind, and extremes of cold and heat. The patient should also avoid any activity that can lead to dyspnea, chest pain, or fatigue (Moores & Biggers, 2019). He should also change his diet to reduce the risk of hypertension. He should take a diet that is rich in low-fat dairy products, fruits, and vegetables. He should also reduce total and saturated fat. The patient should also look for alternative activities with rest periods. It is important for the patient to pursue activities that reduce tension (Moores & Biggers, 2019). The patient can also compensate for limitations by using personal strengths.
I would respond to the patient’s statement that he does not have time to be sick by educating him about the possible complication and conditions because of ignorance of treatment. The patient can recover from the illness as fast as possible by getting plenty of rest. Resting by the day allows the body to allocate more resources to fight the disease or infection. Sleep is also significant since it allows the body to focus on improving the immune system of the patient.
References
Crosta, P., & Oen-Hsiao, J. (2020). Angina (chest pain): Types, symptoms, and more. Medicalnewstoday.com. Retrieved 8 September 2021, from https://www.medicalnewstoday.com/articles/8886 (Links to an external site.).
Landry, A., Docherty, P., Ouellette, S., & Cartier, L. J. (2017). Causes and outcomes of markedly elevated C-reactive protein levels. Canadian Family Physician, 63(6), e316-e323.
Moores, D., & Biggers, A. (2019). Why Am I Having Chest Pain?. Healthline. Retrieved 8 September 2021, from com/health/chest-pain” rel=”noreferrer noopener” target=”_blank”>https://www.healthline.com/health/chest-pain (Links to an external site.).
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