1 Of 1 011 Case 2 Sam Spade Sam Spade Is A 56 Year Old Male Admitted Through The Emergency Department Of Yti Hospital 1 (43.81 KiB) Viewed 30 times
1 Of 1 011 Case 2 Sam Spade Sam Spade Is A 56 Year Old Male Admitted Through The Emergency Department Of Yti Hospital 2 (21 KiB) Viewed 30 times
1 of 1,011 Case #2 Sam Spade Sam Spade is a 56 year old male, admitted through the Emergency Department of YTI Hospital. He arrived in the ED complaining of abdominal pain; imaging revealed a small bowel obstruction. He underwent emergency surgery to correct the obstruction 2 days ago and is on Med/Surg 3. Patient is awake and oriented. He has a peripheral IV infusing normal saline. He is on room air. Chief complaint: Abdominal pain Subjective: Post-operative pain, complaints of no bowel movement for 3 days, demanding "real" food. Objective: Patient is morbidly obese, refusing to get out of bed or to participate with Physical Therapy. He is requesting pain medication before due and sleeping much of the time. He has a 34 pack year smoking history, quitting 6 years ago after his cardiac pacemaker insertion. His surgical dressings show no sign of drainage, abdominal binder in place as per surgeon's recommendation. Physical findings: . Heart rate 115 . Blood pressure 162/94 . Temp 39.2C Respiratory rate-26
. Respiratory rate - 26 . Breath sounds very decreased, especially in the bases . . • Cough-occasional weak non-productive cough ABG on room air: pH 7.47/CO2 32/PO2 51/SaO2 88% / HCO3 23 Hemoglobin 11.4 WBC 12,600 The hospitalist asks you for recommendations. The nurse wants you to make him better so he can b discharged. You review his chart and assessment information and recommend:
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