Cоnsider the prоject depicted in the Figure. Bаsed оn the informаtion provided, which аctivities can be delayed one day without impacting the expected project completion date?
Nurse Nоte: Pаtient here tоdаy fоr а Check-up. Patient is still coughing, might still have fluid in lungs. Patient's daughter thinks patient has depression. Patient is having trouble sleeping. SUBJECTIVE CC: Issues as above. Wakes after few hours, some daytime naps. Sometimes gets up at night and sits at table and falls asleep. HPI: Gets frustrated with limitations by poor health and that depresses her. ROS: Constitutional: Denies chills, fatigue, fever and weight change. General health stated as fair. Eyes: Some squinting so going for re exam. CV: Denies chest pain and palpitations. Respiratory: Denies dyspnea and wheezing. Some cough, can't get phlegm up. Gastrointestinal: Denies constipation, diarrhea, dyspepsia, dysphagia, hematochezia, melena, nausea and vomiting. Genitourinary: Urinary: denies dysuria, frequency, hematuria, incontinence, nocturia and urgency. Musculoskeletal: Denies arthralgia and myalgia. Skin: Denies rashes. Neuro: Denies neurologic symptoms. Psych: Denies symptoms other than depression stated above. Current Meds: Indomethacin 50 mg. Lanoxin 0.125 mg. Iron 325 mg. Lasix 40 ma Glyburide 2.5 mg, Xalatan 0.005 %. Synthroid 125 meg, Lisinopril 40 mg, Mag-Tab SR 84 mg. Ditropan 5 mg, Vitamin B-6 50 mg. Allergies: NKDA PMH: Medical Problems: Hypertension, Atrial Fibrillation, Non-insulin Dependent Diabetes SH: Marital status: widowed. Patient lives alone. There are no pets in the home. Advance directive includes living will. Pt feels safe at home. Personal Habits: Cigarette Use: Never Smoked Cigarettes. Alcohol: Rare consumes alcohol. Drug Use: Denies Drug Use. Daily Caffeine: Consumes on average four cups of coffee per day. Reviewed and updated. Objective BP: 142/70. Pulse: 72. T: 98.5. HT: 63" 5'3." WT: 134lb. Exam: Constitutional: Appears well. No signs of apparent distress present. Elderly, wrinkled w/o bruises. Alert and converses. Slightly HOH. ENMT: Auditory canals normal. Tympanic membranes are intact. Nasal mucosa is pink and moist. Dentition is in good repair. Posterior pharynx shows no exudate, irritation or redness. Neck: Palpation reveals no lymphadenopathy. No masses appreciated. Thyroid exhibits no thyromegaly. No JVD. Respiratory: Respiration rate is normal. No wheezing. Auscultate good airflow. Lungs are clear bilaterally. CV: Rhythm is irregularly irregular. Heart Murmur is still 3/6. Extremities: No clubbing, cyanosis or edema. Abdomen: Bowel sounds are normoactive. Palpation of the abdomen reveals no CVA tenderness, muscle guarding, rebound tenderness or tenderness. No abdominal masses. Musculoskeletal: Uses a cane to ambulate. Skin: Skin is warm and dry. Assessment#1: Atrial Fibrillation Comments: On digoxin. Not on COUMADIN due to falls. Plan for #1: Med Current: Lanoxin 0.125 mg 1 po q d Assessment #2: Arthritis Climacteric Multiple Sites Plan for #2: Med Current: Indomethacin 50 mg take as needed Assessment #3: Congestive Heart Failure Unspecified Comments: digoxin, no edema Assessment #4: Insomnia Assessment #5: Adjustment Disorder With Depression Comments: situational, with sleep issues. Med Current: Remeron 15 mg 1 po hs Med New: Remeron 15 mg 1 po hs Assessment #8: Cough Comments: Has infiltrates vs CHF on CXR’s. CXR next week Plan for #8: X-ray: Chest, 2 Views