Question

Mrs. Prather is a 54 year old female who arrived at the emergency department, complaining of nausea and dizziness that came on suddenly while working out at the sym this morning. Identifying Information: S4yr old female History of Present Illness; 54 yr old female presented to the ED c/o of severe nausea & dizziness while running on a treadmill this morning. She states she had eaten breakfast this morning before working out. She states "I have never been this nauseous in my life and I felt like I was going to faint." Past Medical History: Hypertension Diabetes Past Surgical History: Surgical resection-c-section with first child Current Medications: • Lisinopril-hypertension • Insulin-NPH • Insulin-Regular Allergies: No allergies Family History: Mother-alive-arthritis Father-deceased-CAD, hypertension, myocardial infarction, heart failure Social History: Occupation: High school teacher Tobacco Use: never Illicit Drug Use: never Alcohol Use: occasional use Review of Systems: (what patient tells you) Skin: no changes in hair, no changes with nails Mental Health: no current feelings of sadness, no sleep disturbances, no suicidal ideations Neurological: + light-headedness,+ dizziness, no paresthesia to feet & hands, no balance problems Head and neck: no headache, no neck pain, no stiffness Eyes: no vision changes, no eye discharge, no redness, no edema Ears: no change in hearing, no tinnitus, no discharge Nose: no change in sense of smell, no nasal discharge or congestion Throat and mouth: + toothache, no pain, no trouble swallowing Lymphatic: no swelling, no tenderness Cardiovascular: no chest pain, no leg swelling, no palpitations, no sob, no orthopnea

Answer 1

1, Patients with hypertension and diabetes when they making exercise their muscles use more sugar than usual which is the primary source of energy. The patient is on medication for diabetes and hypertsnion.when there is a drop in blood pressure suddenly due to hypotension and low blood sugar due to hypotension they feel dizziness and nausea.
2, For diabetic patient usually blood glucose levels may drop after a meal due to a high insulin level. when the patient doing exercise her blood pressure level drops especially for hypertensive patients. hypotension and low hypoglycemia occur usually for a patient with hypertension and hyperglycemia. when the patient is on medication and making workout their blood pressure drop too much and blood sugar level come down too much and that cause dizziness, sweating, nausea, and fainting.
3, The patient needs serum blood glucose level check-up with blood glucose meter, ECG and ECHO, and continuous blood pressure monitoring.
4, Blood sugar level drops below 70mg/dl, blood pressure level drops of 20mmHg in systolic and drop of 10mmHg in diastolic blood pressure. ECG measures the heart rate and rhythm and ECHO exam the heart for cardiac complications.