[Expert Solution]: CASE STUDY #14: GARY ELLIOTT SUBJECTIVE…

CASE STUDY #14: GARY ELLIOTT SUBJECTIVE FINDINGS: The patient said that he slept well last night. OBJECTIVE FINDINGS: General: The patient is a well-developed, obese male in no apparent distress. Vital signs: Temperature 98.6 degrees, pulse 72, respirations 18, and blood pressure 158/80. HEENT: Head is normocephalic Neck: Supple to palpation Extremities: Examination of the extremities shows incision site to be healing well without any sign of infection or skin breakdown. Peripheral pulses are intact. Minimal edema in the left lower extremity. Homans sign is absent. FUNCTIONAL STATUS: Functionally, the patient is able to demonstrate improvement with full range of motion, –5 to 80 degrees of flexion actively and 86 degrees passively. His functional gait has advanced 200 feet with the use of front-wheel walker with supervision. He is supervised level with his bedside commode transfers and contact guard assistance with shower chair transfers. He is modified independent level with his eating and set up with his grooming skills. He requires moderate assistance with lower body dressing. IMPRESSION: Polyarthritis Left total knee arthroplasty Status post coronary artery bypass graft Chronic obstructive pulmonary disease PLAN: We provided the patient with a Continuous Positive Airway Pressure (CPAP) machine with headgear and instructed both Gary and his wife on how to use it properly. Instructions are provided in writing. I emphasized the importance of using the CPAP machine every night. Continue with current treatment program. We will continue to monitor the patient’s hypertension, which is still out of control. Code for the provision of the CPAP machine with headgear.