593883
Descrição
Mapa Mental por swimsalot90, atualizado more than 1 year ago
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Criado por swimsalot90
aproximadamente 10 anos atrás
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Doris
- Cardiac Event
- Vitals: 60/40,
37.2-150-30,
Sat 92% on 3L
- Sudden complaint of
chest pain, weakness and
shortness of breath
- Doctor notified of
findings and arrived
to assess patient
- Moved to
trauma room
- Sedated with Versed
- Electrical
Cardioversion
at 200J
- Reverted to Normal Sinus
Rhythm and recovering
- Vitals: 90/50, HR
100, RR 30 Sat
100% on 8L
- Bolus of 750cc NS
- 14F Foley Catheter inserted
- Vitals: 90/50, HR
100, RR 30 Sat
100% on 8L
- Reverted to Normal Sinus
Rhythm and recovering
- Put on
telemetry
- Moved to
trauma room
- STAT Labs
- ECG showed
new onset
uncontrolled A-fib
- Troponin 0.6 -
Positive, indicator for
cardiac damage
- CBC, Chemistry: no
significant changes
- ECG showed
new onset
uncontrolled A-fib
- Doctor notified of
findings and arrived
to assess patient
- Anxiety
- Sudden complaint of
chest pain, weakness and
shortness of breath
- Dementia
with Paranoia
- Blames Medications
for unrelated symptoms
- Poor Compliance
- Poor Compliance
- Doesn't
trust staff
- Blames Medications
for unrelated symptoms
- Health History
- Dislipidemia
- Anemia with
previous rectal
bleed
- Renal Insufficiency
- Rheumatoid
Arthritis
- Dislipidemia
- Cardiac
History
- Previous MI
- Ex-smoker 3 years ago
- Severe Aortic Stenosis
- 3/6 Ejection Fraction
- 3/6 Ejection Fraction
- Hypertension
- Previous MI
- Medications
- No known allergies
- C.difficile orders:
Vancomycin PO,
Metronidasole IV,
IV Fluids
- Furosemide, Ramapril
- Atorvstatin,
Ezetrol
- Hydroxychloroquine
- Ferrous Gluconate
- Quetiapine,
Galantamine
- No known allergies
- Main Complaint:
abdominal pain,
diarrhea over 4 months,
genaralized weakness
- Initial Assessment
- Vitals: 102/52,
36.8-80-20, Sat
92% on 3L
- Lungs clear,
occasional
cough,regular
heart rhythm
- Abdominal pain,
bowel sounds
present, abdomen
distended
- Not oriented to
place or day,
lethargic, confused
- 90 year old
female, lives
alone, DNR
- Fall Risk
- Rheumatoid
Arthritis stiffness
- Frequent diarrhea
- Confusion
- Polypharmacy
- Weakness
- Rheumatoid
Arthritis stiffness
- Vitals: 102/52,
36.8-80-20, Sat
92% on 3L
- Strain on Body
- Diagnosis:
C. Difficile
colitis
- Initial Assessment
- Initial Labs
- WBC 24.7 - Elevated,
sign of infection
- Lactate 0.9 -
Normal, rule out
sepsis
- Lactate 0.9 -
Normal, rule out
sepsis
- Liver function tests normal
- Chemistry: Na 132,
K 4.1, Normal
- Urea 23, Creatinine
199, Expected high
- Hgb 107 - Result
good considering
anemia, also
rules out rectal
bleed
- WBC 24.7 - Elevated,
sign of infection
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