Lecture Powerpoints - Applying clinical reasoning to care...

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Applying clinical reasoning to care
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Dennis is 18 yrs old, lives with parents & 14 yo brother. Just admitted to medical floor w/ complaints of still feeling badly after a “stomach bug” last week, frequent urination, and a dry cough. 10 days ago, began having abdominal pain, vomiting “off and on”, and diarrhea. A couple days into this, also started coughing and
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During admission history: NKDA; no daily medications, takes Tylenol 1-2 x/ mo. for occas. headaches. Denies cigarette smoking, alcohol and other drug use. Currently in pre-season basketball practices 4 days/wk for 3 rd straight year on varsity team.
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Last health visit: sports physical 4 weeks ago. Says the NP told him he was “healthy”. No hospitalizations or surgeries; no chronic illness or repeated acute illnesses. Diet: His Dad makes breakfast every morning; eats turkey or roast beef sandwiches at lunch; Mom makes dinner. 4-5 fruits/vegetables/ day.
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Physical assessment: VS: T99.2 axil P110 R35 BP110/70 R arm Ht: 6 ft., 2 in.; Wt: 150 lbs. he asks how tall he is, you tell him his ht & wt---he says that he was same ht but weighed 159 lbs. at his physical
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A + O x 3, pupils =. Skin dry, eyes appear sunken. Mucus membranes dry, sticky. Heart: S1 S2, no extra sounds. Pulses ¾ to all extremities.
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