Charles Gibson
Presented to the Emergency Room complaining of a fluttering in his chest for the past couple of weeks on and off. The time of onset of the dizziness and syncope was approximately 30 minutes ago.
Has history of the following
• Gout, usually affecting the left big toe. He had an acute exacerbation one week ago, but only minor pain now.
• Enlarged prostate with minor hesitancy and urgency
• Hypertension
• Diabetes Mellitus Type II
• Benign prostatic hyperplasia
He refuses to take the medication prescribed for him for hypertension. Patient states “I feel fine without it.” He has the medication but has not yet opened the prescription bottle. He has been taking his other medications as prescribed.
Keeps up with his doctor’s visits, which are scheduled every four months.
Smokes a half of a pack of cigarettes every day. Has cut down from one pack per day over the past couple of years as his doctor told him.
Enjoys all kinds of food, including fried food, fast food and “soft drinks.”
He has no acute distress.
BP: 160/100
HEART RATE: 106 rhythm- Atrial fibrillation
RR: 26 even, slightly labored
Pulse ox- 97% on 2L/min oxygen
IV- normal saline 75ml/hr
TEMP: 100.5
WEIGHT: 250 pounds
HEIGHT: 6’0″ / 113.398 kg
BMI: 33.9
You have been assigned to the rehabilitation center and you have assigned Mr. Gibson- This is your opportunity to help your student With a complex
topic related to the 3 Ps- Based on the potential for either deliriurn or dementia in Mr. Gibson, devise and share a table that illustrates the difference
between deliriurn and dementia. Then describe (1) Why Mr. Gibson might be vulnerable to both deliriurn or dementia and (2) What assessments or
factors you would use to determine Which condition is occurring-
