andersenpa Posted June 4, 2011 Share Posted June 4, 2011 You, the intrepid on-call surgical PA, are on call once again and settling into the end of your day shift. It is approaching evening when the clinic calls you for an admission. 51 yo M, POD# 11 s/p ascending aortic dissection repair. Recent history shows that he was discharged POD#5, and then returned to the ED 2 days later c/o productive cough. He was treated for PNA and sent home. He came to clinic today for his routine follow up. He says that yesterday he noticed blue discoloration of his toes, on both feet. The nurse specialist who saw him in clinic tells you that the pt is c/o persistent cough, some SOB, as well as the toe discoloration. She is concerned about the constellation of findings and the clinic is arranging an admission for YOU to work up. You take a long slow sip of delicious cafeteria decaf and head over to the hospital to see the pt. What are your thoughts en route to the patient, and what else do you want to know before the vitals/exam/etc…..? To save time: Other PMH: Hyperlipidemia Depression Colonic polyps PSH: Dissection repair as mentioned Rotator cuff SH: Naturopathic physician Married Nonsmoker/nondrinker NKA Meds azithromycin metoprolol lisinopril ASA Oxycodone PRN amiodarone Link to comment Share on other sites More sharing options...
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