Lab result all abrivation
Can you identify the lab result if it is normal or not and all of the things that you think i need to know about the lab result all abrivation please state the complete name thanks
Chief Complaint
“I’ve been having increasing stomach pain.”
HPI
Myrna Cook is a 54-year-old woman who presents to the ED
complaining of increasing abdominal cramping for several days.
Her last bowel movement was 6 days ago. She began “not feeling
well” 4 days ago, with some mild chills, bloating, decreased appetite,
and fatigue. She reports no fever, N/V, CP, or SOB. She reports that
yesterday, when her cramping was at its worst, she used magnesium
citrate, Miralax, and Fleet enema but still had no bowel movement.
She states that she typically has daily bowel movements, with no
straining, and spends less than 10 minutes, with little effort, having
a bowel movement. She reports having a similar episode approxi-
mately 1 year ago; however, at that time her symptoms responded
to magnesium citrate and Miralax. She does not use stool softeners
111CHAPTER 38 Constipation
on a regular basis. She reports drinking approximately 1 gallon of
water daily, even before her constipation began. Her last colonos-
copy, performed 6 years ago, was unremarkable.
PMH
Asthma
Obstructive sleep apnea
HTN
Mitral valve stenosis
Atrial fibrillation
Depression
Hypothyroidism
Iron deficiency anemia
GERD
FH
Her mother is in her 70’s and is healthy. Her father died in his 50’s
from lung cancer. She has three brothers and three sisters; one
brother has viral hepatitis. She has two sons who are healthy.
SH
She is married and works as a social worker. She quit smoking 20+
years ago. She does not drink alcohol and does not use illicit drugs.
ROS
(+) for constipation, lower abdominal fullness, and fatigue after not
using her CPAP machine for the past two nights; (-) for N/V, SOB,
CP, and fever/chills
Meds
Diltiazem CR 240 mg po daily
Digoxin 0.25 mg po daily
Flecainide 100 mg po BID
Atenolol 25 mg po daily
Buspirone 10 mg po BID
Duloxetine 60 mg po daily
Lansoprazole 30 mg po daily
Warfarin 2.5 mg po daily
Fluticasone/salmeterol 500/50 1 puff BID
Albuterol inhaler 90 mcg 2 puffs Q 4 h PRN
Levothyroxine 50 mcg po daily
Multivitamin 1 tablet po daily
Ferrous gluconate 324 mg po TID
All
NKDA
Physical Examination
Gen
Pleasant woman in mild distress; appears tired
VS
BP 122/60, P 57, RR 16, T 36.2°C; Wt 112.4 kg, Ht 5’5”
Skin
Normal skin turgor and color
HEENT
PERRLA and EOM full without nystagmus; no scleral icterus; oral
mucosa moist; no ulcerations noted
Neck/Lymph Nodes
Supple, no lymphadenopathy or JVD; no thyromegaly or bruits
CV
Regular, S1 and S2 without murmur
Lungs
Normal breath sounds; no crackles, rales, or wheezes
Abd
Soft, obese, tender; decreased bowel sounds; stool palpable on left
side
Rectal
External hemorrhoids noted; no stool in rectal vault; no masses felt;
tone fair; push strength fair; nontender
MS/Ext
No tenderness; strength good; sensation intact; no edema
Neuro
A & O × 3; CNs II-XII symmetric and intact; DTRs 2+
LAB
Na 138 mEq/L
Glu 133 mg/dL
RBC 6.05 × 106/mm3
RDW 15.4%
K 4.7 mEq/L
Ca 9.3 mg/dL
Hgb 15.5 g/dL
Cl 101 mEq/L
TSH 2.70 mIU/mL
Hct 48%
CO2 30 mEq/L
Free T4 1.2 ng/dL
MCV 79 fl
BUN 14 mg/dL
TIBC 251 mcg/dL
MCH 26 pg
SCr 0.8 mg/dL
Ferritin 85.4 ng/mL
MCHC 33%
Assessment
Constipation with secondary symptoms of abdominal discomfort,
etiology unknown
Plan
Obtain abdominal x-ray and CT scan to evaluate potential causes of
the constipation; consult GI service
Clinical Course
A plain x-ray of the abdomen showed gas-dilated loops in the colon.
An abdominal CT scan was then performed and showed a large
amount of stool in the colon. The GI service was consulted, and the
recommendation was made to hold warfarin for colonoscopy. The
laxative regimen used for colonoscopy bowel preparation was suc-
cessful in clearing her bowel for the procedure and also in relieving
the patient’s abdominal pain. Colonoscopy was unremarkable, and
she was discharged with directions to
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