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- Aug 23, 2004
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50 something male admitted 2 days prior for dizziness, melena, HCT 20, now scheduled for EGD in an in-hospital GI suite 3 floors away from OR. Still having melena, on PPI gtt and octreotide gtt. Has been pounding EtOH and NSAIDs to treat toe pain (chronic osteo). Does not walk. Does not take prescribed meds as outpatient, as inpatient on lasix and beta blocker
PMH: EtOH/HCV cirrhosis, cocaine/meth abuse, HTN, CAD, pulmonary HTN, COPD, current smoker, Afib, BMI 36
Labs: HCT 23 after tranfusion, INR 1.5, PLT 80, Albumin 2.2, Creatinine 1.9 (down from admission 2.3), K 4.6, HCO3 22 baseline 31
Exam: sat 93 2L NC, HR 110-150's Afib, BP 120s/70s, RR teens, alert, angry and grumpy, appears short of breath, generally hyperesthetic (screams upon placing pulse-ox probe), no JVD, +spiders, abdomen obese no frank ascites, airway MP3, TMD OK, no neck ROM, teeth poor, 20g PIV in forearm
Your plan, doctor?
PMH: EtOH/HCV cirrhosis, cocaine/meth abuse, HTN, CAD, pulmonary HTN, COPD, current smoker, Afib, BMI 36
Labs: HCT 23 after tranfusion, INR 1.5, PLT 80, Albumin 2.2, Creatinine 1.9 (down from admission 2.3), K 4.6, HCO3 22 baseline 31
Exam: sat 93 2L NC, HR 110-150's Afib, BP 120s/70s, RR teens, alert, angry and grumpy, appears short of breath, generally hyperesthetic (screams upon placing pulse-ox probe), no JVD, +spiders, abdomen obese no frank ascites, airway MP3, TMD OK, no neck ROM, teeth poor, 20g PIV in forearm
Your plan, doctor?