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NR 603 Week 7 Case Study Discussion (Collection)
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NR 603 Week 7 Case Study Discussion(Collection)
Week 7 Case Study
My case presentation involves a 42 year female patient seen in the hospital. The patient was
admitted to the med surg floor from the emergency room the night before with the diagnosis of
hyperemesis gravidarum, volume depletion and hypokalemia. Her OB/GYN is the admitting
physician. Unable to resolve her nausea, he asked the hospitalist to join the case. While in the
emergency room she was given Zofran 4mg IV, 2000 mL of normal saline IV, and Potassium
chloride 40 mEq PO.
Subjective findings
The patient went to the emergency room the night before with complaints of nausea and
vomiting for the last seven days and general weakness. She states that she is estimated to be 11
weeks pregnant, and the symptoms started one week ago when she was told she was pregnant by
her ob/gyn physician. She states that she feels more tired and weaker than her former
pregnancies. She reports an episode of blurred vision one day ago.
Objective findings
42 year old African American female lying supine in hospital bed. She 172 cm tall and weighs
73 kg, for a BMI of 24.48. She is Gravida 9, Para 7. She is awake, aware and alert to person,
place and time. She is polite and cooperative and answers all questions appropriately. She states
that she constantly feels nauseated but only vomited once every hour or two. She has been given
zofran IV with no change in nausea. She has received a total of 3300 ml of normal saline IV
since admission to hospital. She remains tachycardic at 120-130 and normotensive despite IV
hydration and potassium PO. She is currently NPO.
Review of Systems
Constitutional - Weakness and fatigue for the last 7 days. No fever, no night sweats, no pain,
other than abdominal soreness from vomiting.
EENT - no problems. Vision is normal today.
Cardiovascular - Hypertensive at 153/90, sinus tachycardia at 122, normal S1 and S2, no
gallups, no rubs, no murmurs.
Respiratory - No problems, no shortness of breath, no cough, no wheezing, no chest pain.
, NR 603 Week 7 Case Study Discussion
(Collection)
Gastrointestinal - Nausea and vomiting for the last seven days with no relief. No bloody stools,
no diarrhea and no constipation. Abdominal soreness for the last two days.
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