58 yom living in shelter for homeless. History of alcohol abuse. Hemoptysis occurred during coughing spell and patient was taken to Emergency department at local hospital. Pt. anxious, chronically and acutelly malnourished, weak and in obvious respiratory distress. Nails beds cynotic and fingertips yellow.
At this time what test would you order and what therapies would you begin?
Yellow finger tips indicates jaundice is present which may be due Liver failure caused by alcohol abuse.
Hemoptysis indicates COPD or bronchiectasis. Sometimes cardiac abnormalities also will cause this.
Cyanotic fingerbeds indicate less oxygen perfusion in the tissues caused by may be ARDS.
Test ordered are
ABG
serum electrolytes
Vitals
X ray of chest CT scan
ECG
ECHO
nose and throat swabs
Liver Function tests such as AST, ALT, Albumin, Bilirubin, Prothrobin time etc
CBC
Pulse oximetry
Cardiac function tests such as Ejection fraction etc
Pulmonary function test.
Therapy:
ABC
Mechanical ventilation
Fluid IV therapy
Antibiotics
Beta agonist
Expectorants
corticosteroids
Iron supplements for anemia etc
Antiviral if it is hepatitis
Support
Nutrition
Alcohol intoxication treatment etc
58 yom living in shelter for homeless. History of alcohol abuse. Hemoptysis occurred during coughing spell...
58 yom living in shelter for homeless. History of alcohol abuse. Hemoptysis occurred during coughing spell and patient was taken to Emergency department at local hospital. Pt. anxious, chronically and acutelly malnourished, weak and in obvious respiratory distress. Nails beds cynotic and fingertips yellow. What questions would you ask him?
58 yom living in shelter for homeless. History of alcohol abuse. Hemoptysis occurred during coughing spell and patient was taken to Emergency department at local hospital. Pt. anxious, chronically and acutelly malnourished, weak and in obvious respiratory distress. Nails beds cynotic and fingertips yellow. Would you admit this patient? If so why? If not why?
58 yom living in shelter for homeless. History of alcohol abuse. Hemoptysis occurred during coughing spell and patient was taken to Emergency department at local hospital. Pt. anxious, chronically and acutelly malnourished, weak and in obvious respiratory distress. Nails beds cynotic and fingertips yellow. ABG done on RA pH 7.53 PaCO2 51 O2 50 HCO3 41 Sat 88% on pulse ox carboxyheoglobin level is 8.5% --what does this indiciate?
58 yom living in shelter for homeless. History of alcohol abuse. Hemoptysis occurred during coughing spell and patient was taken to Emergency department at local hospital. Pt. anxious, chronically and acutelly malnourished, weak and in obvious respiratory distress. Nails beds cynotic and fingertips yellow. ABG done on RA pH 7.53 PaCO2 51 O2 50 HCO3 41 Sat 88% on pulse ox Would you admit this patient? If so why? If not why?
58 yom living in shelter for homeless. History of alcohol abuse. Hemoptysis occurred during coughing spell and patient was taken to Emergency department at local hospital. Pt. anxious, chronically and acutelly malnourished, weak and in obvious respiratory distress. Nails beds cynotic and fingertips yellow. ABG done on RA pH 7.53 PaCO2 51 O2 50 HCO3 41 Sat 88% on pulse ox If patient not admitted what discharge plans from the ED would you recommend?
RC 200 Cardiopulmonary Pathology SOAP Assignment #4 Case Study: Tuberculosis Name:___________________________________ Date:___________________________________________ ADMITTING HISTORY A 58-year-old Caucasian man was well known and liked by the staff at the Samaritan Shelter for the Homeless. The social workers at the shelter had spent a great deal of time and resources working with the man on a number of areas, including his alcohol addiction. Their records showed that they had not seen him for about 6 months. When they last had seen him,...