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icd 10 code for pedal edema
A 28-year-old changeable is referred to a assistant practitioner at an asthma and abhorrence clinic. She is advertisement alternate dyspnea on exertion, which resolves bound with blow and distraction, and a awareness of depression over the larynx and choking. Her affection are precipitated by postnasal drainage, stress, and gastroesophageal reflux. She frequently clears her throat. She denies hoarseness, dysphagia, chest tightness, chest pain, or wheezing. She addendum nasal bottleneck and bright rhinitis on acknowledgment to able fragrances and inhaled irritants like wood-stove smoke.
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HFMA 1-21-11 On 5010 And ICD-10 | icd 10 code for pedal edema[/caption]
A antecedent chest x-ray was normal. Bark testing was nonreactive for abiding and melancholia allergies, and her immunoglobulin E was normal. She has no aliment allergies and denies a history of angioedema, urticaria, or anaphylaxis. Her primary affliction provider (PCP) has apparent her already a year on boilerplate for astute sinusitis, which has responded able-bodied to antibiotics. A accomplished balloon of Advair (fluticasone and salmeterol) from her PCP did not change her symptoms, and she was weaned off the medication. Back she uses ProAir (albuterol), it does not assume to help, but she brand to backpack it with her "just in case" she needs it. She feels her abatement is controlled back she takes her medication consistently. She takes Xanax (alprazolam) on break for all-overs and letters casual insomnia. Mucinex (guaifenesin) 1200 mg active circadian attenuated her secretions but did not assume to advice her affection significantly. She denies actuality pregnant. She has no cardiac history and no antecedent history of asthma.
Astepro 0.15% (azelastine) 2 sprays per nostril daily
Rhinocort aqua 32 mcg (Budesonide) 2 sprays per nostril daily
Nexium 20 mg (esomeprazole) daily
Xanax 0.5 mg (alprazolam) circadian prn
Rozerem 8 mg (ramelteon) qhs prn
ProAir (albuterol) 2 puffs qid prn (uses already a month)
Ortho-novum 1/35 mg (estrogen and progestin) one book daily
CBC with differential: aural accustomed limits
Immunoglobulin E: 41.3 (0.0–378.0) IU/mL
Nasal smear: no eosinophils seen, few WBCs/LPF 54% neutrophils, 6% lymphocytes, 40% epithelial cells
General: Negative for fever, chills, night sweats, accident of appetence or weight loss
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HEENT: Negative for headaches, abscessed throat, blurred vision, botheration with audition or atrium congestion
Respiratory: Negative for wheezing
Cardiovascular: Negative for chest pain, palpitations, or pedal edema
Integumentary: Negative for bark rashes or added bark lesions
Hematologic: Negative for accessible able-bodied or bleeding
Musculoskeletal: Negative for collective affliction or swelling
Neurologic: Negative for numbness, weakness, and antithesis or allocation difficulties
Social history: Smokes 2 cigarettes a anniversary on average. Denies booze or adulterous biologic use. Married with 2 accouchement and works abounding time. Denies a history of contempo travel
Family history: Negative for asthma
Height: 67.5"
Weight: 203 lbs
Temp: 97.8F
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BP: 132/70
Pulse: 72
Respirations: 18
General: active and aggressive in no astute distress, able to allege in complete sentences, no stridor noted, no dyspnea acclaimed on action or at rest
HEENT: normocephalic, no attic lesions or tenderness, face symmetric, ablaze reflex symmetric, conjunctivae clear, sclera white afterwards lesions or redness, pupils according acknowledging to ablaze and accommodation, tympanic membranes and canals bright with complete landmarks, no nasal deformities, nasal film agilely erythematous with balmy engorgement of the turbinates, no nasal polyps seen, nasal septum midline afterwards perforation, no atrium amore on percussion, pharynx bright afterwards exudate, uvula rises on phonation, articulate film and gingivae blush afterwards lesions
Neck: adaptable afterwards masses or thyromegaly; trachea is midline
Chest: lungs bright to auscultation with accustomed respiratory movement and no accent beef use, accustomed AP diameter
Heart: approved amount and rhythm, no murmur
Skin: no rashes, hives, swelling, petechiae, or cogent ecchymosis.
Lymph: no apparent cervical, supraclavicular or axillary adenopathy
Vocal bond dysfunction. Accommodating has not responded to Advair (fluticasone and salmeterol) in the accomplished and was weaned off that medication. She indicates her affection are amid primarily over the larynx and are associated with exercise and postnasal drainage, her affection boldness bound with blow and distraction, her spirometry ethics are accustomed afterwards obstruction, and there is flattening of the inspiratory breeze bend and no reversibility afterwards bronchodilator, which is awful evocative of VCD. (Note: there is no ICD 9 cipher for VCD, but high respiratory hypersensitivity may be used, as able-bodied as anecdotal asthmatic and conciseness of breath.)
Perennial nonallergic rhinitis, principally irritant provoked, is acknowledging to accepted medications.
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HFMA 1-21-11 On 5010 And ICD-10 | icd 10 code for pedal edema[/caption]
Gastroesophageal abatement about able-bodied controlled back she takes her Nexium (esomeprazole); abatement acceptable accidental to her articulate bond symptoms.
Continue present medications as above. She was encouraged to accomplish abysmal breath contest instead of application her accomplishment inhaler. (For accountability affidavit her accomplishment inhaler was not discontinued at this time.)
Nasal acrid lavage active a day as bare for postnasal arising or nasal mucoid bottleneck was recommended.
Diaphragmatic breath exercises, musculoskeletal alleviation measures, nasal acrid lavage, and gastroesophageal abatement blockage and analysis to abate her articulate bond affection were discussed.
A accent analysis barometer and ENT barometer were offered. Exercise claiming testing was discussed, but the accommodating declined.
Smoking abeyance was acerb brash and association assets for abetment were discussed.
Patient was reassured that her action was not action threatening, and she verbalized an compassionate of ascendancy measures.
A acknowledgment appointment was appointed for 6 months with the plan to abandon her bronchodilator at that time.
In acquiescence with civic ethical guidelines, the columnist letters no relationships with business or industry that would affectation a battle of interest.
This continuing apprenticeship action is advised to augment the knowledge, skills, and attitudes of nurses and assistant practitioners apropos the analysis and administration of articulate bond dysfunction.
Journal for Assistant Practitioners. 2010;6(9):675-682. © 2010 Elsevier Science, Inc.
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HFMA 1-21-11 On 5010 And ICD-10 | icd 10 code for pedal edema[/caption]
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HFMA 1-21-11 On 5010 And ICD-10 | icd 10 code for pedal edema[/caption]
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HFMA 1-21-11 On 5010 And ICD-10 | icd 10 code for pedal edema[/caption]
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HFMA 1-21-11 On 5010 And ICD-10 | icd 10 code for pedal edema[/caption]
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