Hey doc! Question?

k..here is a case. Pt, 81 yrs m, adm for DIB, shortness of breath and bil. peripheral edema....Hx includes COPD, CHF, chronic renal dx, DM2..80-120PKY, no ETOH...labs: BUN-high, creat-high, hgb-low, hct-low, rbc-low, wbc-normal...CXR bil. base consolidation, neg. emphysema..home meds include lasix, albuterol, steroids, insulin, and aspirin...imperative signs: 98.5 156/87 85 24 91(a)4L....lung sounds dim at base, NSR, 2+ bil pitting edema.....

so here i am reviewing his meds, he is on lasix and florinef together...back to his history..presyncope.....k..florinef is understood...possibly lasix did too much trick then.....sure give him some florinef....crap..he can't breathe, he is all swelled up, present him some lasix...oh no....he is dizzy...let's feed him some florinef...i am sick to my stomach at this cycle...i didn't want to give florinef but was told it's ok..it's not ok....doc...if this pt is your father...what you would do?
Answers:
The xray treated seniors own better stabilities. A person
over aged, is only one condition :transferencing. Dying is
what it is called for as long as 50 more years. To use
any hormone, or sterols is to integrate to some extent than take
a stand. Many seniors need air, and lots of nouns is inhale
exhale, with aids. More seniors in the finest facilities use
asthma, cough and fresh breath candy than any other
treat-mint. Look at it this mode, the whole United Nations
pushed the availible equipment world wide, so be updated
on that area we give the name Care. Dont pay for it again, U.N. said no, and this applies to options for senior living assisted.
You may understand the Florinef, but I don't. I'd also be darned measured about trying to cure cor pulmonale with Lasix. It just ain't gonna evolve. 2+ edema is probably as good as you're gonna get, and trying to do better is going to be a disservice to him. Sometimes the perfect is the rival of the good. The other steroid you mentioned only in endorsement, and not at all in terms of its effect on his sugars.
Sorry, I'd love to make a contribution you the magic key about which dyspnea is pulmonary and which cardiac, but later we wouldn't have the enjoyment of listening to the salesmen unfolding us why their natriuretic peptide test is better than the others. It's always an unsatisfying crap shoot, and simple clinical gestalt seems as obedient as anything. Just try to keep in mind that we all are contained by the same boat.


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