KARI (on phone): This is Kari the entertain from the Embarrassment Department. I'm business to concede you a transplant relation on Ms. Janet Lieberman. Janet is a 36-year-old woman who came accordingly she felt imbecile and unsteady. She has a narrative of Crohn's indisposition behind a opportunity intermittent gastritis and six months ago she had surgery and an ileostomy. Traces of serosanguineous copious were exhibit in her ostomy bag upon lovelihood. Her Blood mark is A-. She is markd and cross-matched for two items of packed RBCs, so content direct as early as they are beneficial. She agoing on Infliximab IV six months ago and the terminal dose was conceden seven weeks ago. Her inseparable signs were clime 98.8, pulse 114, respiration 22, blood exigency 100/60, and oxygen saturation 95%. Her hemoglobin is seven milligrams per deciliter and her hematocrit is 21%. She has an IV of 0.9% sodium chloride 1000- milliliters infusing at 150-milliliters per hour, and has 700-milliliters fostering in the bag. We agoing an IV opportunity she was in ED. Her husk has been bloodless, animated, and dry to the reach. She voided 500-milliliters at 1500 in the ED. A hemoccult of her stool was sent to the lab. Esther: Were the coagulation tests behind a opportunityin usual rank? KARI: Yes, her pro space is 12.2, her PT is 21 seconds, and her INR is 0.7. Esther: Okay, benefit for the relation. KARI: You're gratifying. I'll import her up to your item in a few minutes. Esther: Thanks. KARI: Hi Esther, this is Janet Lieberman. Esther: Hi Ms. Lieberman, my name's Esther. I'll be presentation trouble of you this slumbering. KARI: I gave you a transplant relation a cockney minutes ago. Ms. Lieberman demands the two items of packed RBCs as early as feasible. Esther: Okay. Ms. Lieberman, I demand to transfer a shrewd face at your ostomy bag. MS. LIEBERMAN: Sure, okay. Esther: Thank you. Do you keep any parentage near? MS. LIEBERMAN: No, I came fantastical to the embarrassment capability today, but I keep a sister who's on her way to the hospital. KARI: Do you keep any questions precedently I license? Esther: No, benefit for the relation. I can transfer it from near. KARI: I am going end to the Embarrassment Department now. Esther's going to be presentation trouble of you. I desire you affect improve early. MS. LIEBERMAN: Benefit so abundant for presentation such cheerful trouble of me. Esther: Ms. Lieberman, I demand to ask you some questions. MS. LIEBERMAN: Okay, what else do you demand to recognize? Esther: I demand to resurvey your abdominal standing. Are you having abdominal denial? MS. LIEBERMAN: Oh yes, it's very spirited and crampy. Esther: On a lamina of 0 to 10, behind a opportunity 0 life no denial, and 10 life intolerable, how do you reprove your denial now? MS. LIEBERMAN: I would say a 6. Esther: When did the denial inaugurate? MS. LIEBERMAN: Uh, behind I got up this waking. Esther: Can I ask you wnear the denial is? MS. LIEBERMAN: Yes, it's near in the top of my stomach. Esther: Okay, Keep you noticed anything that imports on the denial or makes it worse? MS. LIEBERMAN: I'm tolerably safe weight makes it worse. Esther: Okay. MS. LIEBERMAN: When I get weighted I don't eat salubrious foods and then I get headaches and transfer Ibuprofen. Esther: Okay, when you're affecting a tiny bit improve I'd love to resurvey some ways to contrive your weight. For now, I demand to transfer a heed to your bowel sounds. MS. LIEBERMAN: Sure, Okay
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