4. Comment on the physical assessment findings.

PE
Gen
WDWN, severely obese, white woman in NAD
✓ Obesity is a medical condition in which there is excess body fat or adipose. There is a close association between obesity and Type 2
diabetes. Being overweight or obese is the main modifiable risk factor for type 2 diabetes. The likelihood and severity of type 2 diabetes are
closely linked with body mass index (BMI). There is seven times greater risk of diabetes in obese people compared to those of healthy
weight, with a threefold increase in risk for overweight people.
Obesity may also be related to hypertension, since an increase in fatty tissue increases vascular resistance and in turn increases heart
workload.
Hyperlipidemia is also an obesity-related condition

VS
BP 154/90mmHg, P 98bpm, RR 18, T 37°C; Wt 100kg, Ht 5’8”waist circ 38 in
✓ According to ACC/AHA Guidelines, the patient’s blood pressure is elevated and is classified under Stage 2 hypertension.
✓ Her pulse rate, respiratory rate, and body temperature is normal (No apparent findings)
✓ The patient’s BMI is 36.5 indicating that the patient is obese (BMI: 30 or greater)
o The patient’s waist circumference is greater than the normal/standard which is 35 inches in women. Her waist circumference is
associated with health problems such as type 2 diabetes, heart disease, and blood pressure
HEENT
PERRLA, EOMI, R and L fundus exam without retinopathy
✓ No apparent findings

Neck/Lymph Nodes
No LAN
✓ No apparent findings

Lungs
Clear to Auscultation & Percussion (A&P)
✓ No apparent findings

Cardiovascular
Regular rate & rhythm (RRR). No murmurs, rubs, and gallops (m/r/g)
✓ No apparent findings

Abdomen
Non-Tender, Non-Distended (NTND)
✓ No apparent findings

Genital/Rectal
Deferred
✓ No apparent findings

Muscoskeletal & Extremities

Carotids, femorals, popliteals, and right dorsalis pedis pulses 2+ throughout. Left dorsalis pedis 1+ Feet show mild calluses on metatarsophalangeal
joints (MTPs)
✓ Normal pulse rate on carotids, femorals, popliteals, and right dorsalis pedis (No apparent findings). Left dorsalis pedis pulse is palpable but
thread, weak and easily obliterated possibly due to the calluses present on the feet that may press on a bone, nerve, or blood vessel
underneath three layers of skin Callus formation on the feet may be due to excessive stresses on the upper layers of the epidermis from
inappropriate footwear or foot care. Calluses can lead to further problems in pressure distribution and may impair proper delivery of
oxygen and nutrients to deeper tissue layers. In addition, the presence of callus may obscure underlying tissue damage, making it harder to
identify areas of inflammation or infection. This is particularly true in patients with diabetic nephropathy

Neurological
Deep tendon reflexes (DTRs) 2+ throughout. Feet with normal sensation (5.07 monofilament) and vibration
✓ No apparent findings