Case
Evan Tyson: "Tired and Peeing at Night"
- Course
- Institution
Evan Tyson: "Tired and Peeing at Night"
[Show more]
Seller
Follow
SOUTHUNIVERSITYQUIZ
Reviews received
Content preview
Evan Tyson: "Tired and Peeing atNight"
Evan Tyson: "Tired and Peeing at Night" iHuman: questions, physical exams, management
plant, problem statement, MSAP, problem categories.
, Student: S.B.
SOAP NOTE # Hank Torrez Patient Initials: (H. T. Male, 39 Y.O.)
I. Subjective Data
A. Chief Complaint (CC): “Tired and peeing at night”
B. History of Present Illness (HPI): Mr. Torrez is 39 y/o married male and active duty in
sale. He presented to the clinic with a cc of “Tired and peeing at night”. He reports
polydipsia with 4L/day of fluid intake, polyphagia with recent weight of 5lbs. and
polyuria with getting up three to four times at night. He also reports blurred vision,
peripheral neuropathy in the soles of his feet, and erectile dysfunction, with
symptoms worsening in the last few months. Pt reports light headiness when getting
up fast . He denies SOB, dyspnea, chest pain, and headaches. Decreased vision,
BMI:29.3. HTN, Hx. of thyroiditis, waist 48''.
C. Last Menstrual Period: (LMP- if applicable): N/A
D. Allergies: NKA
E. Past Medical History: Autoimmune thyroiditis. F. Family History:
Father: myocardial infarction; deceased (age 55).
Mother: Age 60; congestive heart failure; kidney disease (NOS).
Siblings: Sister fairly diagnosed with Diabetes mellitus.
Spouse & offspring: healthy.
Grandparents: N/A
G. Surgery History: None reported
H. Social History: Pt is married and lives with his wife for 19 years. Has two
teenager children, he is active duty living off base and works in sales. Drinks 1-2 beers
on weekends.
Does not smoke or use illicit drugs.
I. Sexual Activity: Yes, active with spouse.
J. Preventive health and health Maintenance:
Up to date on his immunization
Up to date on his health screening Has
been exercising less due to fatigue.
Fast food and snacks on most days K.
Current medications:
Synthroid 75 mcg PO daily
L. Review of Systems (ROS):
• Constitutional (General overall health state): Denies fevers, chills, fatigue, night
sweats. Reports increased fatigue, thirst, appetite, frequent urination, disturbed
sleep, tingling and numbness in feet, and 5lbs. weight loss
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller SOUTHUNIVERSITYQUIZ. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $18.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
72841 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now