Eric P. Dollard - Introduction to DIELECTRICITY & CAPACITANCE

2:17 AM | BY ZeroDivide EDIT
Electric Field of Circuit.

Electric Field of Conductor.

LINES OF FORCE AS REPRESENTATION OF DIELECTRICITY

Steinmetz continues, "There is obviously no more sense in thinking of the capacity current as current which charges the conductor with a quantity of electricity, than there is of speaking of the inductance voltage as charging the conductor with a quantity of magnetism. But the latter conception, together with the notion of a quantity of magnetism, etc., has vanished since Faraday's representation of the magnetic field by lines of force."

THE LAWS OF LINES OF FORCE

All the lines of magnetic force are closed upon themselves, all dielectric lines of force terminate on conductors, but may form closed loops in electromagnetic radiation. These represent the basic laws of lines of force. It can be seen from these laws that any line of force cannot just end in space.

FARADAY & LINES OF FORCE THEORY

Faraday felt strongly that action at a distance is not possible thru empty space, or in other words, "matter cannot act where it is not." He considered space pervaded with lines of force. Almost everyone is familiar with the patterns formed by iron filings around a magnet. These filings act as numerous tiny compasses and orientate themselves along the lines of force existing around the poles of the magnet. Experiment has indicated that a magnetic field does possess a fibrous construct. By passing a coil of wire thru a strong magnetic field and listening to the coil output in headphones, the experimenter will notice a scraping noise. J. J. Thompson performed further experiments involving the ionization of gases that indicate the field is not continuous but fibrous (ELECTRICITY AND MATTER, 1906).


PHYSICAL CHARACTERISTICS OF LINES OF FORCE

Consider the space between poles of a magnet or capacitor as full of lines of electric force. See Fig.1. These lines of force act as a quantity of stretched and mutually repellent springs. Anyone who has pushed together the like poles of two magnets has felt this springy mass. Observe Fig.2. Notice the lines of force are more dense along AB in between poles, and that more lines on A are facing B than are projecting outwards to infinity. Consider the effect of the lines of force on A. These lines are in a state of tension and pull on A. Because more re pulling on A towards B than those pulling on A away from B, we have the phenomena of physical attraction. Now observe Fig. 3. Notice now that the poles are like rather than unlike, more or all lines pull A away from B; the phenomena of physical repulsion.

MASS ASSOCIATED WITH LINES OF FORCE IN MOTION

The line of force can be more clearly understood by representing it as a tube of force or a long thin cylinder. Maxwell presented the idea the tension of a tube of force is representative of electric force (volts/inch), and in addition to this tension, there is a medium through which these tubes pass. There exists a hydrostatic pressure against this media or ether. The value of this pressure is one half the product of dielectric and magnetic density. Then there is a pressure at right angles to an electric tube of force. If through the growth of a field the tubes of force spread sideways or in width, the broadside drag through the medium represents the magnetic reaction to growth in intensity of an electric current. However, if a tube of force is caused to move endwise, it will glide through the medium with little or no drag as little surface is offered. This possibly explains why no magnetic field is associated with certain experiments performed by Tesla involving the movement of energy with no accompanying magnetic field.

INDUCTANCE AS AN ANALOGY TO CAPACITY

Much of the mystery surrounding the workings of capacity can be cleared by close examination of inductance and how it can give rise to dielectric phenomena. Inductance represents energy storage in space as a magnetic field. The lines of force orientate themselves in close loops surrounding the axis of current flow that has given rise to them. The large the space between this current and its images or reflections, the more energy that can be stored in the resulting field.

MECHANISM OF STORING ENERGY MAGNETICALLY

The process of pushing these lines or loops outward, causing them to stretch, represents storing energy as in rubber band. A given current strength will hold a loop of force at a given distance from conductor passing current hence no energy movement. If the flow of current increases, energy is absorbed by the field as the loops are then pushed outward at a corresponding velocity. Because energy is in motion an E.M.F. must accompany the current flow in order for it to represent power. The magnitude of this EMF exactly corresponds to the velocity of the field. Then if the current ceases changing in magnitude thereby becoming constant, no EMF accompanies it, as no power is being absorbed. However, if the current decreases and represents then a negative velocity of field as the loops contract. Because the EMF corresponds exactly to velocity it reverses polarity and thereby reverses power so it now moves out of the field and into the current. Since no power is required to maintain a field, only current, the static or stationary field, represents stored energy.

THE LIMITS OF ZERO AND INFINITY

Many interesting features of inductance manifest themselves in the two limiting cases of trapping the energy or releasing it instantly. Since the power supply driving the current has resistance, when it is switched off the inductance drains its energy into this resistance that concerts it into the form of heat. We will assume a perfect inductor that has no self resistance. If we remove the current supply by shorting the terminals of the inductor we have isolated it without interrupting any current. Since the collapse of field produces EMF this EMF will tend to manifest. However, a short circuit will not allow an EMF to develop across it as it is zero resistance by definition. No EMF can combine with current to form power, therefore, the energy will remain in the field. Any attempt to collapse forces increased currents which pushes it right back out This is one form of storage of energy.

INSTANT ENERGY RELEASE AS INFINITY

Very interesting (and dangerous) phenomena manifest themselves when the current path is interrupted, thereby causing infinite resistance to appear. In this case resistance is best represented by its inverse, conductance. The conductance is then zero. Because the current vanished instantly the field collapses at a velocity approaching that of light. As EMF is directly related to velocity of flux, i tends towards infinity. Very powerful effects are produced because the field is attempting to maintain current by producing whatever EMF required. If a considerable amount of energy exists, say several kilowatt hours* (250 KWH for lightning stroke), the ensuing discharge can produce most profound effects and can completely destroy inadequately protected apparatus.
[* The energy utilized by an average household in the course of one day.]

ANOTHER FORM OF ENERGY APPEARS

Through the rapid discharge of inductance a new force field appears that reduces the rate of inductive EMF formation. This field is also represented by lines of force but these are of a different nature than those of magnetism. These lines of force are not a manifestation of current flow but of an electric compression or tension. This tension is termed voltage or potential difference.

DIELECTRIC ENERGY STORAGE SPATIALLY DIFFERENT THAN MAGNETIC ENERGY STORAGE

Unlike magnetism the energy is forced or compressed inwards rather than outwards. Dielectric lines of force push inward into internal space and along axis, rather than pushed outward broadside to axis as in the magnetic field. Because the lines are mutually repellent certain amounts of broadside or transverse motion can be expected but the phenomena is basically longitudinal. This gives rise to an interesting paradox that will be noticed with capacity. This is that the smaller the space bounded by the conducting structure the more energy that can be stored. This is the exact opposite of magnetism. With magnetism, the units volumes of energy can be though of as working in parallel but the unit volumes of energy in association with dielectricity can be thought of as working in series.

VOLTAGE IS TO DIELECTRICITY AS CURRENT IS TO MAGNETISM

With inductance the reaction to change of field is the production of voltage. The current is proportionate to the field strength only and not velocity of field. With capacity the field is produced not by current but voltage. This voltage must be accompanied by current in order for power to exist. The reaction of capacitance to change of applied force is the production of current. The current is directly proportional to the velocity of field strength. When voltage increases a reaction current flows into capacitance and thereby energy accumulates. If voltage does not change no current flows and the capacitance stores the energy which produced the field. If the voltage decreases then the reaction current reverses and energy flows out of the dielectric field.As the voltage is withdrawn the compression within the bounded space is relieved. When the energy is fully dissipated the lines of force vanish.

AGAIN THE LIMITS OF ZERO AND INFINITY

Because the power supply which provided charging voltage has internal conductance, after it is switched off the current leaking through conductance drains the dielectric energy and converts it to heat. We will assume a perfect capacitance having no leak conductance. If we completely disconnect the voltage supply by open circuiting the terminals of the capacitor, no path for current flow exists by definition of an open circuit. If the field tends to expand it will tend towards the production of current. However, an open circuit will not allow the flow of current as it has zero conductance. Then any attempt towards field expansion raises the voltage which pushes the field back inwards. Therefore, energy will remain stored in the field. This energy can be drawn for use at any time. This is another form of energy storage.

INSTANT ENERGY RELEASE AS INFINITY

Phenomena of enormous magnitude manifest themselves when the criteria for voltage or potential difference is instantly disrupted, as with a short circuit. The effect is analogous with the open circuit of inductive current. Because the forcing voltage is instantly withdrawn the field explodes against the bounding conductors with a velocity that may exceed light. Because the current is directly related to the velocity of field it jumps to infinity in its attempt to produce finite voltage across zero resistance. If considerable energy had resided in the dielectric force field, again let us say several KWH the resulting explosion has almost inconceivable violence and can vaporize a conductor of substantial thickness instantly. Dielectric discharges of great speed and energy represent one of the most unpleasant experiences the electrical engineer encounters in practice.

ENERGY RETURNS TO MAGNETIC FORM

The powerful currents produced by the sudden expansion of a dielectric field naturally give rise to magnetic energy. The inertia of the magnetic field limits the rise of current to a realistic value. The capacitance dumps all its energy back into the magnetic field and the whole process starts over again. The inverse of the product of magnetic storage capacity and dielectric storage capacity represents the frequency or pitch at which this energy interchange occurs. This pitch may or may not contain overtones depending on the extent of conductors bounding the energies.

CHARACTERISTIC IMPEDANCE AS REPRESENTATION OF PULSATION OF ENERGY FIELD

The ratio of magnetic storage ability to that of the dielectric is called the characteristic impedance. This gives the ratio of maximum voltage to maximum current in the oscillatory structure. However, as the magnetic energy storage is outward and the dielectric storage is inward the total or double energy field pulsates in shape or size.The axis of this pulsation of force is the impedance of the system displaying oscillations and pulsation occurs at the frequency of oscillation.

ENERGY INTO MATTER

As the voltage or impedance is increased the emphasis is on the inward flux. If the impedance is high and rate of change is fast enough (perfect overtone series), it would seem possible the compression of the energy would transform it into matter and the reconversion of this matter into energy may or may not synchronize with the cycle of oscillation. This is what may be considered supercapacitance, that is, stable long term conversion into matter.

MISCONCEPTIONS OF PRESENT THEORY OF CAPACITANCE

The misconception that capacitance is the result of accumulating electrons has seriously distorted our view of dielectric phenomena. Also the theory of the velocity of light as a limit of energy flow, while adequate for magnetic force and material velocity, limits our ability to visualize or understand certain possibilities in electric phenomena. The true workings of free space capacitance can be best illustrated by the following example. It has been previously stated that dielectric lines of force must terminate on conductors. No line of force can end in space. If we take any conductor and remove it to the most remote portion of the universe, no lines of force can extend from this electrode to other conductors. It can have no free space capacity, regardless of the size of the electrode, therefore it can store no energy. This indicates that the free space capacitance of an object is the sum mutual capacity of it to all the conducting objects of the universe.

FREE SPACE INDUCTANCE IS INFINITE

Steinmetz in his book on the general or unified behavior of electricity The Theory and Calculation of Transient Electric Phenomena and Oscillation, points out that the inductance of any unit length of an isolated filamentary conductor must be infinite. Because no image currents exist to contain the magnetic field it can grow to infinite size. This large quantity of energy cannot be quickly retrieved due to the finite velocity of propagation of the magnetic field. This gives a non reactive or energy component to the inductance which is called electromagnetic radiation.

WORK OF TESLA, STEINMETZ, AND FARADAY

In the aforementioned books of Steinmetz he develops some rather unique equations for capacity. Tesla devoted an enormous portion of his efforts to dielectric phenomena and made numerous remarkable discoveries in this area. Much of this work is yet to be fully uncovered. It is my contention that the phenomena of dielectricity is wide open for profound discovery. It is ironic that we have abandoned the lines of force concept associated with a phenomena measure in the units called farads after Faraday, whose insight into forces and fields has led to the possibility of visualization of the electrical phenomena.

QUESTION AS TO THE VELOCITY OF DIELECTRIC FLUX

It has been stated that all magnetic lines of force must be closed upon themselves, and that all dielectric lines of force must terminate upon a conducting surface. It can be inferred from these two basic laws that no line of force can terminate in free space. This created an interesting question as to the state of dielectric flux lines before the field has had time to propagate to the neutral conductor. During this time it would seem that the lines of force, not having reached the distant neutral conductor would end in space at their advancing wave front. It could be concluded that either the lines of force propagate instantly or always exists and are modified or conjugate space exists within the same boundaries as ordinary space. The properties of lines of force within this conjugate space may not obey the laws of normally conceived space.

Is gravity actually dielectric acceleration?

9:54 PM | BY ZeroDivide EDIT
SUMMARY OF PETER ROBERTS' THEORY FOR THE NATURAL CREATION OF GRAVITATIONAL FORCE (GRAVITY) CAUSED BY THE PARTIAL ABSORPTION OF GRAVITATIONAL WAVES AS THEY PASS THROUGH MATTER.
It is important to recognise that this is not a theory of how matter behaves in relation to gravitational force. Both Newton and Einstein did that satisfactorily. This theory provides a proposed, realistic, mechanism for how gravitational force is created—which neither Newton nor Einstein succeeded in doing.
The basis for the theory.
Before describing a theory, it is important to state up-front what are the assumptions on which it is based. These are called its presumptive tenets. If these are not acceptable to the reader, then the theory itself will not be accepted.
This theory has four presumptive tenets:
Firstly, that gravitational waves exist—as measured by the LIGO equipment in February 2016, having a frequency range of between 35 and 250 Hz, thus being extremely long wavelength, as predicted by General Relativity. It is reasonable to take this tenet as now being factual.
Secondly, that owing to the vastness of the universe with its quadrillions of galaxies and even greater number of gravity-generating events such as neutron star mergers, the universe is full of gravity waves travelling in all directions, such as to form an omni-directional flux, particularly in the more central regions of the universe. This is just the same as light travels across the universe from every direction.
Thirdly, as is easily demonstrable—gravitational waves pass through matter with great ease, in a similar way to x-rays, but with an immensely greater ease.
Fourthly, that—in the same way that light is absorbed by water, such that there is none left at a depth of a thousand metres—gravitational waves passing through a planet or a star are slightly absorbed, giving up energy to create a minute drag force on each atom.
None of these four tenets is far-fetched; certainly not when compared with the unbelievable invention of Newton's infinite attraction of atoms across the universe, nor when compared with Einstein's unbelievable proposition of an infinite distortion by matter of spacetime across the universe.
Let us look at the four tenets and consider them:
1 Gravity waves exist. The existence of gravitational waves has been proven by the LIGO detection equipment between 2016 and 2018.
2 Gravitational waves are everywhere. They travel out spherically from their sources, like light, and so are present throughout the universe in much the same way as is EMF radiation (light, radio waves, microwaves, or X-rays). I call this an omni-directional gravitational wave flux.
3 Gravitational waves penetrate matter easily; we just don't usually think about it. If I were to take you down a mineshaft that was, say, 2 km deep, and then if we were to walk along one of the mine workings, we would still be attached to the floor, wouldn't we? And if I were to pick up a small piece of rock from the floor and let go of it, it would fall to the floor with an acceleration of about 9.8 m/sec2 just the same as it would at the surface of the Earth. So, if gravity is affecting that small piece of stone, it must have penetrated either 2 km of rock cover from above, or over 6 thousand km of rock below from the core. Or both. We know that this is true. Either way, gravity travels through an entire planet or a star with ease.
4 Gravitational waves have a physical effect on matter. If we consider that the recently-detected gravitational waves penetrate and stretch the length of the arms of the LIGO apparatus, we can see that these waves are different from EMF waves. When gravitational waves interact with matter they have a physical effect The LIGO recordings show that they physically altered the length of the measuring arms in the apparatus. This proves that they penetrate matter and react with the atoms in the matter creating a physical drag.
The LIGO experiments confirmed that gravity waves interact physically with matter and actually drag the atoms of the test apparatus so that they physically change length. See the following quotation taken directly, and unaltered, from the CALTECH LIGO laboratory web site, referenced below.
——————————————————————
“A gravitational wave does stretch and squeeze the wavelength of the light in the arms, but it turns out that doesn't matter. What matters is how long the laser beams spend traveling in each arm. When a gravitational wave passes, it changes the lengths of the arms, which changes how far each laser beam needs to travel before being reunited with its partner beam."
"The result of a misalignment in merging laser beam light is an interference pattern, and the level of misalignment tells us how much the arms changed length during the light-beams' journeys.”
——————————————————————
It is, therefore, demonstrated that the four tenets upon which Roberts' theory is based are scientifically simple, effective, and observable processes that we see all about us in our scientific, engineering, and even domestic lives.
When you consider that Roberts’ theory is based on these simple truths, it is reasonable to expect that the theory be regarded as credible.
How is the force of gravity created?
The force of gravity is actually the response of matter to gravitational waves passing through it and creating a drag on the constituent atoms. Thus there is no direct, mystical ‘connection’ between the atoms of the Sun and the atoms of the Earth, as proposed mistakenly by Isaac Newton.
The mechanism is simple: the universe is full of gravitational waves. These were probably created in the big bang, and are still there, in the same way as is the Cosmic Background Radiation that scientists measure today. For the purposes of the theory, the source of gravitational waves is not critical.
Gravity does not extend its influence between objects across the universe.
In the case of a single planet, for example, the constant absorption of waves from every direction drags the constituent matter of the planet towards its centre. That’s how the planet formed in the first place. Similarly, any object or person standing at the planet’s surface is being dragged down towards the centre of the planet by the drag force being exerted on their atoms by incident gravitational waves. The net drag difference between full-strength waves coming into the planet from outer space and the depleted waves that have passed through the planet and are coming outwards, partially absorbed, is the force of gravity that we experience at the surface of the planet, being about 9.81 m/sec2.
In the case of two planets such as the Earth and the Moon, the reason that they are dragged towards each other is that between them there is a 'shadow' zone of depleted-amplitude gravitational waves, and so, both planets try to move into that zone. i.e. they try to move towards each other. This tendency is resisted by their orbiting centrifugal force. This concept is best appreciated using diagrams. So here are a few from my paper.
The first shows my first 1978 paper's concept for how gravitational waves impact on the nucleus of atoms, imparting a miniscule physical, not electromagnetic, drag on each atom. The overall effect is to impart a drag on the whole planet. It is highly stylised and can only be taken as being indicative of the concept.
The diagram below shows a planet such as Earth, and shows how a full-strength (full-amplitude) gravitational wave is degraded and balanced by an equally-degraded but opposite-direction wave to produce a net inward force of 9.8 m/sec2 at the Earth's surface. This principle applies to any cosmic body. It is what causes dust clouds to coalesce and form stars and planets. This means that gravity waves can be very powerful, because the force of gravity that we experience is the balance of two opposing-direction wave fronts: the incoming full-strength wave and the outgoing degraded-strength wave that has lost energy to the constituent atoms when imparting drag to them.
The diagram below shows the concept of the effect of wave degradation on two planets, causing them to try to move towards each other. The degradation of gravitational waves passing through both planets creates a 'shadow' effect between the planets such that there are fresh full-strength wave fronts incident on the 'outer' surfaces of the planets dragging them towards each other, but only lesser-strength gravitational waves trying to drag them apart. So, they automatically try to move towards each other unless they are held apart by the centrifugal force of an orbit.
Notice the important, and essential, point that the Moon does not drag the Earth towards it; the Earth is dragged by differential gravity wave absorption. Similarly, the Earth does not drag the Moon towards it, the Moon is dragged by differential gravity wave absorption. So there is no time lag to account for as distances become large, unlike both Newton's and Einstein's theories that have to allow the attraction to operate faster than the speed of light, which conflicts with the basic principle that nothing can travel faster than the speed of light.
Coming in from outside, there are full-strength waves dragging both the Earth and the Moon towards each other, but between them there are reduced strength waves which, when they enter, will try to drag each of them away from each other. The balance is the difference between the two. There is nothing in the form of any attractive force acting in the gap between the two planets. Under the Roberts theory all forces are generated internally within each body, and are caused by differential drags balancing out to create a net force without reference to any other matter.
This is the simple and logical explanation for why bodies do not need to be affected by one another gravitationally across the universe. They are not linked by some mysterious attractive force that somehow is supposed to exist between every atom.
Engineering Considerations
In closing, let us look at whether Roberts' theory supports what engineers measure in practice with common materials such as water or concrete. If we imagine the sea. At 1 m depth, the pressure is 1 tonne/sq m. At 2 m depth, it is 2 tonnes/sq m, and so on. At 10 m depth, the pressure is 10 tonnes/sq m. The reason for this is that the net gravitational drag downwards is applied to each atom in the water individually. Each atom experiences a force which would, if it weren't obstructed, accelerate it to the core of the Earth at the rate of 9.81 m/sec2. It is not that the water is experiencing a load from above. You can't apply a simple surcharge load to water, can you?
The same applies to a concrete column, as any civil engineer knows. The weight of a concrete column is a self-weight. i.e. a gravity-induced weight, such that at the top of the column there is no vertical stress, and the internal stress increases linearly downwards until the bottom of the column is reached. That is because gravity is acting internally within the column dragging it downwards and stressing it increasingly downwards from top to bottom.
Unlike water or gas, solid materials can transmit loads and can, therefore, support a surcharge. If we have a vertical column of, say, expanded polystyrene which has virtually no self-weight, we can place a surcharge on the top of, say, 10 kg/sq m, and the stress downwards in the polystyrene will be the same all the way to its base—10 kg/m2. That is a surcharge load. Gravity doesn't impose such an externally-applied load on things. Gravity is not a surface pressure forcing things downwards. it is an internally felt force dragging the constituent atoms of matter downwards towards the centre of the Earth.
So why is Roberts' theory at all relevant? Roberts' theory is the first working theory to be proposed for the actual localised production of gravity, and one that avoids the 'faster than light' paradox of Newton's and Einstein's theory.
Roberts' theory explains the greater pressure created in materials of greater density. The greater the density of the body, the greater the absorption of the gravity waves, and the greater the differential between the fresh incoming waves and the heavily absorbed and depleted outgoing waves that have passed through the planetary matter. This results in a greater net difference and a greater inward net drag on the constituent atoms.
Roberts' theory also explains the laws of momentum and inertia, which no other gravitational theory addresses. There is also no other theory available that explains the generation of both inertia and momentum. Roberts' theory does and neither Newton's nor Einstein's do. Again, diagrams explain this more clearly. And my forthcoming paper contains more than a hundred diagrams. In the diagram below, showing a 1 tonne object suspended on a balance, as explained in the paper, accelerating the object laterally, creates a synthetic gravitational resistance directly proportional to its mass. You are accelerating the object through the gravitational field and thus causing a resistance to every atom in the mass. Hence, the theory provides a reason, for the first time, why inertia is directly proportional to mass.
—————————————————
Also, the theory explains why momentum and inertia are exactly the same thing and not two different things. It is very interesting.
To date, there is no observation we can make that is contradicted by the behaviour of Roberts' theory, and therefore, not only must it be taken seriously, but it must be recognised that there is no other competing theory in existence for the creation of gravitational force.
What I do consider to be most important is not whether I am ultimately proven to be correct or incorrect, but that my theory of a possible mechanism for the creation of gravitational force itself is the first one ever to be put forward. And it is the first one whose working mechanism fits in with all the things we observe and with the mathematics of the great Isaac Newton and Albert Einstein. It supplies the 'missing element' that they could not provide.
My theory is radical in its simplicity and does not contradict the Einsteinian mathematical and metaphysical theoretical modelling of the universe that has so carefully been constructed without bringing us one step closer to being able to understand how gravity is created, how to control it, or how to create it. Given these harsh facts, does it not seem reasonable to ask people to give this theory of natural gravitational force creation some serious consideration. It cannot be any worse than the present situation, can it? And if it is correct, then, surely, it will lead to new avenues of research that will change our world on terms of every aspect of our lives, such as transport and energy, to mention only two.
Doesn't that make any sensible person think that, maybe, hundreds and hundreds of mathematicians and physicists have been barking up the wrong tree for all of these hundreds of years? Think about it.
I hope that this brief summary of what is an extensive theory has helped you.
Regards,
Peter Roberts.

MedNote Dawson Dean

6:36 PM | BY ZeroDivide EDIT

Critical
CV/Pulm
Renal
Renal 2
Electrolytes
GI/Endo
PreExisting
Other




Chief Complaint:
History of Present Illness:


Review of Systems:
A fourteen (14) point Review of Systems was performed and is otherwise negative except as per the history above and also the following specific positive and negative findings:
Constitutional: no fevers, no weakness, no weight loss, normal appetite
Eyes: no dry eyes, no blurred vision, no vision changes
HENT: no hearing loss, no oral lesions, no rhinorrhea
Cardiovascular: no chest pain, no palpitations, no edema
Respiratory: no shortness of breath, no cough, no dyspnea on exertion, no change in sputum production
Gastrointestinal: no nausea, no vomiting, no diarrhea, no constipation, no abdominal pain
Genitourinary: no partial voiding, no weak stream, no urinary hesitancy, no dysuria
Musculoskeletal: no back pain, no shoulder pain, no hip pain, no knee pain
Integumentary: no rashes, no lesions, no bruising
Neurological: no headaches, no dizziness, no sensation loss, no burning
Psychiatric: no depression, no anxiety, no hallucinations
Hematologic: no melena, no hematochezia, no hematemesis, no coffee ground emesis, no hematuria
Endocrine: no heat intolerance, no cold intolerance, no excessive thirst
Allergic: no allergic reactions, no recurrent infections
All other review of systems are negative.

Medical History:

Surgical History:

Social History:
- Tobacco:
- EtOH:
- Illicits: None

Family History:
Reviewed and non-contributory
Mother:
Father:

Home Medications:

Allergies: NKDA

OBJECTIVE
Physical Exam:
General: AOx3, no acute distress, well-nourished
HEENT: oral pharynx clear, mucosa moist, anicteric
Neck: supple, no thyromegaly, no JVD
Cardiovascular: regular s1/s2, no murmurs, no JVD, no lower extremity edema
Pulmonary: clear, no crackles, no wheezes, non-labored
Abdom: normal bowel sounds, soft, non-tender, non-distended
Muskuloskeletal: full RoM in BUE, full RoM in Knees, full RoM in Hips
Neurologic: no asterixis, CN II-XII grossly intact, 5/5 BUE strength, 5/5 BLE strength, Negative Babinski
Dermatologic: no rashes, no lesions, no ulcers

ASSESSMENT/PLAN
History and Physical
Review of Systems






Physical Exam

#) Chest Pain
/Assessment:
The pain is non-cardiac, with 1 properties: substernal
The patient has 2 cardiovascular risk factors: Diabetes, Hypertension
The TIMI score is 1 with: elevated Troponins
/Plan:
- Check Troponins
- Aspirin 325mg PO once then 81mg daily
- Atorvastatin 80mg
- Lisinopril 2.5mg PO daily
- Risk stratify and check HgbA1c
- Continuous bedside Telemetry
NSTEMI    

   
Age: 
  • Contraindications to NTG: Sildenafil or other erectile dysfunction med in past 7 days, Bradycardia (HR below 60), Hypotension, R-side or inferior wall MI
  • Do not anticoagulate in a Type-2 NSTEMI caused by Hypertensive Urgency, as it increases risk of hemorrhagic stroke
  • ASCVD score http://tools.cardiosource.org/ASCVD-Risk-Estimator/
  • Not clear whether to hold PPI if on Clopidogrel

#) Diabetic Ketoacidosis
Diabetic Ketoacidosis           

 

#) GI Bleed
GI Bleed           

 

#) SIRS
Sepsis           

 
WBC: 
 

#) Stroke
Stroke    

   

#) Encephalopathy
Encephalopathy           

 

#) Syncope
Syncope           

 

#) Malignancy
Oncology           


#) Hepatitis
Hepatitis           

 
PT: INR: Tbili: Cr: 

#) Pancreatitis
Pancreatitis           

 

#) Pneumonia
Pneumonia           

 

#) Coronary Artery Disease
Coronary Artery Disease    

#) Heart Failure
Heart Failure    

 
  LVEF: 

#) Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease    

 
  FEV1: 
 
 

#) Preoperative Evaluation
/Assessment:
The patient has 0 cardiac risk factors which suggests a 0.4 percent risk of of major cardiac events based on RCRI
The patient has 0 renal risk factors which suggests a 0,1 percent risk of of perioperative AKI requiring Dialysis
The patient has 0 renal risk factors which suggests a 0.2 percent risk of for any perioperative AKI with a rise of Cr over 2
Pre-Op           


#) Cirrhosis
/Ascites:
- Furosemide 40mg
- Spironolactone 100mg
/Encephalopathy Stage 0 (none):
- Lactulose 30mL PO TID, titrate for 2-3 stools daily
- Rifaximin 550mg PO BID
Cirrhosis        
 
PT INR Na Cr TBili Albumin 
  
 

#) Renal Failure on Hemodialysis
Renal Failure on Dialysis   

 

#) Renal Transplant
Renal Transplant   

 

#) Acute Kidney Injury
/Assessment:
Since admission Cr=
Baseline Cr=
This is KDIGO Stage 1 (Cr rose 0.3 or 1.5x to 2x baseline within 48hrs or urine output below 0.5 mg/kg/hr for 6 hours)
Acute Kidney Injury
Cr Baseline Cr Na Urine-NaUrine-Cr
   
 

#) Chronic Kidney Disease
Chronic Kidney Didease           

 
Cr: GFR: 
Age: U Prot: U Albumin: U Cr: 
 
 

#) Nephrotic Proteinuria
Nephrotic Proteinuria
Urine-ProtUrine-AlbUrine-CrSerum Albumin 
   
 

#) IV Contrast
IV Contrast           


#) Dysphagia
Dysphagia           


#) Metabolic Bone Disease
Mineral Bone Disease           

Ca: Phos: PTH: Albumin: 

#) Hypertension
Hypertension           

 

#) Acid Base
Acid Base
Na: Cl: Bicarb: 
Albumin: ABG pH: PaCO2: 
Urine Na: Urine K: Urine Cl: 
 
Differential
Treat

#) Hypokalemia
Hypokalemia           

K: Mg: Ur-K: Ur-Cl: 
Serum Osm: Ur-Osm: 

#) Hyperkalemia
HypERKalemia           

K: Ur-K: Serum Osm: Ur-Osm: 

#) Hyponatremia
Hyponatremia           

Na: Glucose: Bicarb: Serum Osm  
Urine Osm: Urine Na: Urine K: 
 
 
 
 
 

#) Hypernatremia
HypERNatremia           

Na: Ur-Osm: Ur-Na: Ur-K: 

#) Hypomagnesemia
HypOMagnesemia           

Mg: 

#) HypoPhosphatemia - Present on admission
HypOPhos           

Phos: Ca: iCal: PTH: 

#) HypoCalcemia - Present on admission
HypOCalcemia           

Ca: iCal: PTH: Albumin: 

#) HyperCalcemia
HypERCalcemia           

Ca: iCal: PTH: Albumin: 

#) Vitamin D Deficiency
Vit D Deficiency           

Vit D: 

#) Diabetes
Diabetes           

 
A1c: 

#) Asthma
Asthma    

 
 

#) Obstructive Sleep Apnea
Obstructive Sleep Apnea           

 
 

#) Atrial Fibrillation
Atrial Fibrillation    

   
INR: 
 
 

#) Anemia
Anemia           

 

General:

Workup:

Monitor:

Treat:

#) Hypothyroid
Hypothyroid           


#) Gout
Gout           

 
Urate: 

#) Gastroesophageal Reflux Disease
GERD           


#) Benign Prostatic Hyperplasia
BPH           


#) Alcohol Abuse
Alcohol           


#) Substance Abuse
Substance Abuse           

 

#) Tobacco Dependance
Tobbaco           

Age Started: 

#) Calorie and Protein Malnutrition (Present on admission)
Malnutrition           

 
BMI: Prealbumin: 

#) Palliative
Palliative           


#) Obesity (Present on admission)
Obesity           

 
BMI: 

#) Mood Disorder
Mood Disorder           

 
I:II:IIIIV

#) Weakness - Present on admission
Weakness           

 

#) Pressure Ulcer (Present on admission)
Pressure Ulcer           

 

#) Chronic Hepatitis C
Hep C           

 

#) Femoral neck fracture
Leg Fracture           

 

#) Nephrolithiasis
Nephrolithiasis           

 
 


#) Fluids/Electrolytes/Nutrition
- Regular diet

#) Prophylaxis
- Enoxaparin subcu

#) Discharge Planning
- Followup appointments after discharge:

#) Code Status
- FULL CODE

Common Plans           

Diet

Prophylaxis

Discharge Planning
Barriers:
PT Recs:
Discharge Meds:

Code Status