A 65-year-old female with a history of diabetes, coronary artery disease, dementia, and chronic obstructive pulmonary disease (COPD) develops diarrhea. She is a long-term care (LTC) resident, and the diarrhea is profuse and watery, with up to 20 bowel movements per day. The nursing staff reports malaise, abdominal pain, and nausea. When she develops a temperature of 102 degrees, she is sent to the ED for evaluation.
ED exam reveals a distended, tender abdomen, BP 120/70, heart rate 115, and oral temperature of 102.5 degrees. Labs demonstrate leukocytosis of 24, 000 with a left shift, creatinine 2.5 mg/dl and albumin of 3.0 g/dl. Abominal flat plate demonstrates an ileus.
1. Are rectal temps preferred and if not why? (10 points)
2. What questions do you have for the nursing staff? (10 points)
After further discussion with the nursing staff, she has been a resident of the LTC facility for more than 2 years, she recently was assigned a new roommate when her prior roommate became aggressive after a hospital stay.
3. What further testing do you need? (20 points)
4. What are your differential diagnoses? (10 points)
5. What is your treatment plan? (30 points)
6. What are your discharge instructions (20 points)
Type of service-Academic paper writing
Type of assignment-Case study
Pages / words-1 / 275
Number of sources-1
Language style-US English