Sunday, January 5, 2014

An Unusual Case Of Multiorgan Failure

------------------------------------------------- An Unusual Case of Multiorgan Failure Background A 70-year-old cleaning lady was recently set in the hospital for a adjust hip fracture, weakness, and inveterate atrial fibrillation with a speedy ventricular response. Two days after she was discharged to a semipermanent care facility, she is readmitted for urinary retention and recurrent tachycardia. In addition, she complains of reason weakness and midplane lower abdominal pain. She denies each previous history of urinary retention, as well as experiencing any fever, dysuria, hematuria, vomiting, trouble breathing, or chest pain in standoff with this presentation. Her past medical and surgical history includes a concussion with left hemiparesis, hypertension, atrial fibrillation, epilepsy, and hemiarthroplasty; she is nonambulatory subsidiary to the stroke. Her medications include atorvastatin, enoxaparin, levetiracetam, metoprolol, omeprazole, and warfarin (7.5 mg daily) . On somatic examination, the patient is in distress secondary to her abdominal pain. She is hypotensive, with a blood pressure of 73/45 mm Hg, and tachycardic, with a middle rate of 180 bpm. No fever is mention (temperature, 98.9°F). Her oxygen saturation is 97% on 2 L per minute. Her head, neck, and pulmonary examinations are all normal.
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The heart rate is rapid and periodically irregular, but no vena jugularis venous dilation or peripheral edema is detected. She has abdominal wall bruise from enoxaparin injections. The abdomen is firm and diffusely ships boat to palpation, without rebound or guarding, and hy poactive bowel sounds are noted. On neurolog! ic examination, an unvaried chronic left hemiparesis is found. The rest of the somatic examination is unremarkable. investigating: A complete blood kiosk count (CBC) and metabolic panel reveal leukocytosis (28.1 kU/L), anemia (hemoglobin 7.3 gm/dL, hematocrit 21.1 %), hyperkalemia (5.9 mmol/L), renal insufficiency (creatinine 1.6 mg/dL, blood carbamide nitrogen (BUN) 32...If you indispensability to get a full essay, aver it on our website: OrderCustomPaper.com

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