Case History Of The Emergency Department Essays

722 Words May 3rd, 2016 3 Pages
Case History
A 23-year old man, came to the emergency department because of shortness of breath, fatigue, a cough, muscle pain, nausea, and a fever. His shortness of breath was due to minimal activity and returned to normal after several minutes of rest. His fatigue has limited him to only doing daily required activities. He did not complain of having any chest pain while breathing. His cough was nonproductive and had no aggravating or relieving factors to it. He also complained of feeling sick to his stomach. The day before he came to the emergency department, he had a fever of 104 degrees Fahrenheit.
The patient does not use tobacco or alcohol. He lives in an apartment with his girlfriend and works as an editor for his local newspaper. He has an indoor cat and he has not traveled recently. His girlfriend has also been away for two weeks for work.
In the emergency department, Harry still had a fever of 104 degrees F and was slightly short of breath. He still felt sick to his stomach as well. Due to his shortness of breath he was his arterial oxygen saturation was checked and it was at 84% when he was breathing room air. Due to this he was put on 50% oxygen through a face mask which increased his breathing to 95%. His blood pressure was 90/40 mm Hg, and his heart rate 110 beats per minute. Rales were present in one third of the lung fields bilaterally along with dullness at the base of the right lung.
Some tests were ordered and the results are in the table below:…

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