Medical Terminology Argumentative

HISTORY: Eldon Drake is an 85-year-old Caucasian male who was brought to the hospital via an ambulance and subsequently admitted to the hospital on 08/01/2013 for fever and confusion. Mr. Drake was in his usual state of good health until 3 days before admission, when he began to show signs of confusion and disorientation accompanied by a fever of 38.5®C. His fever continued, and he showed a steady decline in cognitive function. He developed expressive aphasia.

OBJECTIVE FINDINGS: On physical examination the patient was conscious and alert but disoriented to time and place. Blood pressure was 160/80 mm Hg. Pulse, 96. Respirations, 20. Temperature 38.8®C. There were no focal neurologic deficits. Chest radiograph, urinalysis, and blood cultures were negative. A neurology consultation was obtained. Magnetic Resonance Imaging of the brain was performed which disclosed encephalitis. An electroencephalogram was markedly normal for his age.

TREATMENT SUMMARY: The patient was given acyclovir by intravenous infusion. On the second hospital day, the patient developed a generalized seizure. He was placed on intravenous Dilantin and Lorazepam. He later lapsed into a semi-comatose state. He responded to tactile and verbal stimuli but was completely incoherent. A nasogastric tube was placed, and enteral feedings were begun. After 14 days of IV acyclovir, the patient slowly began to improve and by the third week of his illness, he was talking normally and taking nourishment.

PART 1 – Using the information provided in Progress Note above, please complete the following information.

In this assignment, imagine you are a medical professional working at Main Street Hospital and Medical Center. Your patient is Mr. Drake. His daughter, Ella Smith, has just arrived from California and is concerned about her father’s well-being. You need to update her on what has occurred during his hospital stay. Use the information from the Progress Note to update Ella Smith on her father’s condition. In your update, include what type of follow up care Mr. Drake should receive. You will be translating the medical information from the report into layman’s terms.

Please be sure use complete sentences, proper grammar and spelling. You can use medical terms, however, you must also use layman’s terminology. Remember, it is your job to explain to the patient’s daughter what has occurred. You may need to use outside sources.

Your explanation to Ella Smith should be 500 words or more.

Cite your reference/references in APA format at the end of your explanation.

Good Afternoon Mrs. Smith. Your father, Eldon Drake, was brought into Main Street Hospital and Medical Center by ambulance and then admitted to the hospital on August 1, 2013 due to a fever of 101.3 F and confusion. Your father did not have a sense of time, place, or identity. Due to his confusion, he did not know what day it was, what year it was, where he lived, and I’m afraid he did not even know what his own name was. Eldon started to show these symptoms of confusion and disorientation three days prior to admittance to the hospital. As his fever of 101.3° F continued, he also showed a decline in cognitive function. Cognitive function pertains to the mental processes of comprehension, judgment, memory, and reason. Your father developed what we call expressive (motor) aphasia. Expressive (motor) Aphasia is a neurological condition that occurs when words cannot be formed, expressed, or may be absent due to an injury to the cerebral cortex. (Brooks & Brooks, 2012).

During the physical exam, your father was conscious and alert but yet he was also disoriented and confused as to what day and year it was. Eldon also had no idea as to where he was. His blood pressure level was 160/80 mm Hg, which is high, but we closely monitored his levels. His temperature increased from 101.3° F during transport to 101.8° F during the exam. We found that there were no focal neurologic deficits, meaning that we did not find any deficiencies or diseases of the nervous system. Chest x-rays, urinalysis, and blood cultures were also negative as well. When the radiology technicians performed a Magnetic Resonance Imaging or MRI on Eldon, The MRI image showed that he had encephalitis. Encephalitis is an inflammatory condition of the brain. The condition is characterized by headache, fever, and nausea. Neurological disturbances can include seizures, personality change, restlessness, and disorientation. In some cases, a comatose state might occur.

We also performed an electrocephalogram or EEG to record Eldon’s brain wave activity. Your father’s brain wave activity was normal for his age and showed no signs of abnormalities. The Doctor prescribed Eldon take Acyclovir, which is an antiviral agent for encephalitis. On the second day of admittance, your father had a seizure that consisted of involuntary muscle contractions and a brief loss of consciousness lead to him being unresponsive. The Doctor placed Eldon on two anticonvulsants called Dilantin and Lorazepam to control the seizure and future seizures. Your father later then fell into a semi-comatose state where he was in an abnormally deep sleep and unconscious. His body responded to touch and verbal sounds but he himself was completely incoherent. We then had to insert a nasogastric tube through his nose and into his stomach to immediately begin tube feedings to nourish his body. After two weeks of administering Acyclovir through an IV, Eldon slowly began to improving. By the third week, your father was communicating verbally as well as eating well.

Eldon will need to follow up with a neurologist in one month and then in three months to have an MRI, SPECT, and PET scan of his brain just make sure that there are no abnormalities. He will also need to consult with his primary physician in one month as well.

Reference
Brooks, M. L., & Brooks, D. L. (2012). Exploring Medical Language A Student-Directed Approach (8th ed.). St. Louis, Missouri: ELSEVIER.

PART 2 – Respond to these questions using layman’s terminology. You want to imagine you are speaking to the patient’s family member or friend. You answers to each question must be a minimum of 200 words.

1. Meningitis can be another cause of confusion and disorientation. A patient with the suspected diagnosis may have brain imaging performed such as a CT scan. Another diagnostic test is a lumbar puncture. Please explain this condition and the two methods that can be used for diagnosis.

A Lumbar Puncture (LP), also known as a Spinal Tap, is a lower back diagnostic or therapeutic procedure used to diagnose serious infections, disorders of the nervous system, as well as cancers of the brain and spinal cord. During a Lumbar Puncture, a hallow needle and stylet are inserted into the subarachnoid space between two lumbar bones, usually between the third and fourth lumbar vertebrae. (Brooks & Brooks, 2012). A sample of the fluid that surrounds the brain and spinal cord called the Cerebralspinal Fluid (CSF) is obtained for diagnostic purposes.

The pressure of the Cerebralspinal Fluid is measured with a manometer which attached to a catheter and stopcock. A manometer is a tube marked with a scale which contains a relatively incompressible fluid such as mercury. A stopcock is a valve or turning plug that controls the flow of the relatively incompressible fluid in the tube. (O’Toole, 2013).The fluid will then be visually examined and sent to laboratory for chemical, cytological, microbiological, or bacteriological analysis. Diagnostically, a Lumbar Puncture is used to collect Cerebralspinal Fluid to either confirm or exclude conditions such as meningitis or a subarachnoid hemorrhage. Therapeutically, a Lumbar Puncture is used to reduce increased intracranial pressure that may has built up.

2. Alzheimer’s is the most common form of dementia. Symptoms may include confusion, disorientation, changes in behavior, restlessness, dysphasia, and problems with gait. Describe the symptoms that the patient may experience.

A patient that has been diagnosed with Alzheimer’s disease (AD) may experience many symptoms such as disorientations, restlessness, dysphagia, problems with gait, and also changes in behavior. Disorientation is a state of mental confusion characterized by inadequate or incorrect perceptions of place, time, and even identity. (Brooks & Brooks, 2012). The patient may even get confused as to what the year, month, and day it is. As well as who they are, where they are, and who their family members are. Dysphagia occurs when a patient has a difficult time swallowing. Dysphagia is associated with obstructive or motor disorders of the oropharynx, hypopharynx, or esophagus. Patients with obstructive disorders are unable to swallow solids but the can tolerate liquids.

Patients with motor disorders are unable to swallow solids or liquids. With an obstructive disorder occurs, the patient will have to have a nasogastric tube (NG tube) inserted through the nose and into the stomach. Tube feedings are then the main source of nourishment for the patient’s body. Another symptom of Alzheimer’s disease for a patient is problems with Gait. Gait is a manner or style of walking which can include rhythm, cadence, and speed. When a patient is having problems with Gait, it usually means that the patient is having problems moving their legs. The patient will experience restlessness because their body and mind is continuously moving, which then leads to lack of or denying rest. A patient may experience changes in behavior because they have no idea what is going on around them and everything may be unfamiliar. A patient may be angered because they cannot move as well as they use to.

3. Aphasia is not considered a disease but rather a symptom of brain damage. Stroke is one common condition that causes aphasia. Please explain how a stroke can affect a patient’s brain and how it can cause aphasia to occur.

A Stroke occurs when there is an interruption of blood supply to either the left side of the brain or the right side of the brain. A stroke deprives nerve cells in the brain of oxygen and nutrients. Therefor which could then potentially lead to damaged brain cells and even leaving brain cells dead within a few minutes. (Brooks & Brooks, 2012). The parts of the body controlled by the involved damaged brain cells will experience dysfunction such as speech, movement, and memory. An Ischemic Stroke is a result of a blocked blood vessel caused by cerebral thrombosis or cerebral emission, where as a Hemorrhagic stroke is the result of bleeding caused by a ruptured blood vessel. The effects of the damage to the brain cells can lead to either complete aphasia or partial aphasia.

Aphasia is an abnormal neurological condition in which language function is disordered or absent because of an injury to certain areas of the cerebral cortex and when a left side of the brain stroke occurs. (O’Toole, 2013). A stroke usually only affects one side of the brain. The left side of the brain controls the ability to speak and understand language. The right side of the brain controls the ability to pay attention, hear, touch, and communicate properly. When a stroke affects the left side of the brain, patients will have problems with the right side of their body. When a stroke affects the right side of the brain, patients will have problems with the left side of their body.

4. Epilepsy is one condition that can cause seizures. SPECT and PET imaging can be used to evaluate a patient’s brain. Describe these two tests and how they can help make a diagnosis for a patient.

SPECT, which stands for a Single Photon Emission Tomography, is a nuclear medicine scan that visualizes the heart from several different angles. A Single Photon Emission Tomography is a variation of computed tomography in which the ray sum is defined by the collimator holes on the gamma ray detector that rotates around the patient. (Brooks & Brooks, 2012). Multiple detectors are used to reduce the length of imaging time. A radioactive tracer substance such as sestamibi or thallium is then injected intravenously. The Single Photon Emission Tomography scanner creates images from the tracer such as sestamibi or thallium that is absorbed by the body tissues. The Single Photon Emission Tomography is used in the medical field to detect and assess the damage that may have occurred to the cardiac tissue.

PET, which stands for a Position Emission Tomography of the brain, is a computerized radiographic imaging technique that uses radioactive substances that produce sectional imaging of the brain not only to examine blood flow but to examine the metabolism of the heart and blood vessels as well. (Brooks & Brooks, 2012). The images are then projected onto a viewing screen. A Position Emission Tomography of the brain is used to diagnose patients with diseases of the nervous system and can indicate the focus or origin if the seizures.

REFERENCES

Brooks, M. L., & Brooks, D. L. (2012). Exploring Medical Language A Student-Directed Approach (8th ed.). St. Louis, Missouri: ELSEVIER. O’Toole, M. T. (2013). Mosby’s Dictionary of Meicine, Nursing & Health Professions (9th ed.). (M. T. O’Toole, Ed.) St. Louis, Missouri: ELSEVIER.