Patient presents with renal failure with uncertain cause but likely due to longstanding DM/HTN_. Patient not taking any nephrotoxic medications_. UA was remarkable for _. Renal ultrasound ordered_, urine lytes sent off_.  There is no indication for emergent dialysis as patient is mentating normally with normal electrolytes and no hypoxemia from pulmonary edema. Patient admitted to medicine for further work up and possible initiation of hemodialysis.
Patient presented with bleeding over their fistula site which was controlled with _. This patient’s fistula did not display overt characteristics of Infection, Aneurysm, Vascular Insufficiency, Outflow/Inflow Obstruction or other emergent problem.
Asymptomatic no ekg changes
Patient found to have asymptomatic hyperkalemia with no ecg changes likely secondary to ESRD_. Patient not taking ACE-I, ARBs, SGLT2 inhibitor, digoxin, no recent burns or trauma to explain hyperkalemia. Doubt drug induced, unlikely secondary to crush or thermal injury. Given CBC and BMP results doubt DKA or tumor lysis syndrome. Patient given temperazing measures of insulin, as well as lasix and lokelma_ to reduce potassium level. Patient has ESRD and spoke with nephrology with plan for emergent dialysis _.
Symptomatic, ekg changes
Patient found to have symptomatic hyperkalemia with ecg changes likely secondary to ESRD_. Patient not taking ACE-I, ARBs, SGLT2 inhibitor, digoxin, no recent burns or trauma to explain hyperkalemia, doubt drug induced, unlikely secondary to crush or thermal injury. Given CBC and BMP results doubt DKA or tumor lysis syndrome. Patient given temperazing measures of calcium gluconate, bicarb, insulin, as well as lasix and lokelma_ to reduce potassium level. Patient has ESRD and spoke with nephrology with plan for emergent dialysis _.
Patient found to be hyponatremic to _ Patient mentating normally. Patient not hypovolemic so doubt extra renal losses such as GI losses, burns, 3rd spacing, or diuretic use. Labs are not consistent with adrenal insufficiency. Patient euvolemic on exam so likely cause is SIADH. Patient not hypervolemic on exam with no history of CHF, cirrhosis, nephrotic syndrome, no acute renal failure.
MDM for different chief complaints
Critical care documentation
Combative patient
Wilderness preparedness
ACEP clinical policies
Expedited partner therapy
SCVMC:CUSTODY CARE
FALLS protocol