Question

You obtain the following information from EPIC regarding your patient Mrs. Rodriguez. Mrs. Rodriguez was admitted to the hospital 2 days ago with a diagnosis of Hepatitis C. She is 43 years old, 5’3”, and weighs 140 lbs. She has a history of intravenous drug use but has not engaged in this behavior for over 10 years. Mrs. Rodriguez also has a history of angina. She came to the hospital complaining of severe right upper quadrant pain, nausea, and vomiting. She is currently NPO and has an IV with normal saline running at 125 mL/hr. Vital signs from night shift were 98.8°F, 72, 16, 128/72. Mrs. Rodriguez complains of stabbing pain in her left shoulder and complains of some shortness of breath.

Answer 1

The pain in the right upper quadrant with nausea and vomitingbis a typical sign of liver problems.Where it is expected in Hepatitis C patient where they can land up in Cirrhosis of liver but the stabbing pain in the left shoulder with shortness of breath is a sign of heart problem as she is a known case of angina.The following measures are required for this patient

• ECG can help to determine the cause of pain in left shoulder accompanied with shortness of breath
• Inform the healthcare provider for further assessment and treatment regimen
• Symptomatic treatment for nausea, vomiting and abdominal pain
• An ultrasound of abdomen can be helpful to assess the liver structure and for any portal hypertension ,cirrhosis ,inflammation which can be a cause of pain
• Check the electrolye levels in the body because it produces most of the enzymes necessary for metabolism