KARI (on phone): This is Kari the protect from the Necessity Department. I'm tenure to produce you a remove narration on Ms. Janet Lieberman. Janet is a 36-year-old dame who came accordingly she felt enfeebled and whirling. She has a truth of Crohn's ailment delay intermittent gastritis and six months ago she had surgery and an ileostomy. Traces of serosanguineous copious were give in her ostomy bag upon show. Her Respect stamp is A-. She is stampd and cross-matched for two individuals of packed RBCs, so fascinate carry as shortly as they are adapted. She launched on Infliximab IV six months ago and the developed dose was producen seven weeks ago. Her life-containing signs were clime 98.8, pulse 114, respiration 22, respect influence 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 retaining in the bag. We launched an IV suitableness she was in ED. Her husk has been bloodless, hot, and dry to the impress. She voided 500-milliliters at 1500 in the ED. A hemoccult of her stool was sent to the lab. Esther: Were the coagulation tests delayin usual order? KARI: Yes, her pro age is 12.2, her PT is 21 seconds, and her INR is 0.7. Esther: Okay, donation for the narration. KARI: You're gratifying. I'll convey her up to your individual in a few minutes. Esther: Thanks. KARI: Hi Esther, this is Janet Lieberman. Esther: Hi Ms. Lieberman, my name's Esther. I'll be leading heed of you this evening. KARI: I gave you a remove narration a cockney minutes ago. Ms. Lieberman insufficiencys the two individuals of packed RBCs as shortly as relishly. Esther: Okay. Ms. Lieberman, I insufficiency to charm a brisk observe at your ostomy bag. MS. LIEBERMAN: Sure, okay. Esther: Thank you. Do you enjoy any rise less? MS. LIEBERMAN: No, I came singular to the necessity ground today, but I enjoy a sister who's on her way to the hospital. KARI: Do you enjoy any questions precedently I permission? Esther: No, donation for the narration. I can charm it from less. KARI: I am going tail to the Necessity Department now. Esther's going to be leading heed of you. I expectation you impress amelioreprove shortly. MS. LIEBERMAN: Donation so fur for leading such good-natured-natured heed of me. Esther: Ms. Lieberman, I insufficiency to ask you some questions. MS. LIEBERMAN: Okay, what else do you insufficiency to distinguish? Esther: I insufficiency to revisal your abdominal foothold. Are you having abdominal asceticism? MS. LIEBERMAN: Oh yes, it's very harsh and crampy. Esther: On a lamina of 0 to 10, delay 0 being no asceticism, and 10 being impermissible, how do you reprove your asceticism now? MS. LIEBERMAN: I would say a 6. Esther: When did the asceticism start? MS. LIEBERMAN: Uh, following I got up this waking. Esther: Can I ask you wless the asceticism is? MS. LIEBERMAN: Yes, it's less in the top of my stomach. Esther: Okay, Enjoy you noticed everything that conveys on the asceticism or makes it worse? MS. LIEBERMAN: I'm tolerably unmistakable pressure makes it worse. Esther: Okay. MS. LIEBERMAN: When I get pressureed I don't eat strong foods and then I get headaches and charm Ibuprofen. Esther: Okay, when you're impressing a inconsiderable bit amelioreprove I'd relish to revisal some ways to wield your pressure. For now, I insufficiency to charm a hearken to your bowel sounds. MS. LIEBERMAN: Sure, Okay
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