Video Case of the Week

A hospital progress note...

CC: F/U CHF

INTERVAL HISTORY: Feels a little worse today.

Vitals: 160/90, 18, 82, 98.6
General: NAD, well-nourished, looks stated age
Neck: FROM, trachea midline; no JVD
Lungs: Bibasilar crackles; normal respiratory effort
CV: RRR, no MRGs, normal PMI in the MCL
Abdomen: Soft, non-tender; no HSM
Ext: 2+ peripheral edema; no digital cyanosis
Skin: Warm and dry; well-perfused

Labs: Sodium 138, K 3.1, creatinine 0.8, BNP 1450

Assessment

1. Severe, worsening CHF exacerbation
2. Poorly controlled HTN
3. Mild hypokalemia

Plan

1. D/C PO LASIX
2. Start IV BUMEX 2 mg Q 6H
3. Replete potassium per protocol
4. Renal profile and BNP in a.m.

This week's answer (video)

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