27 Oct Lab result all abrivation

Can you identify the lab result if it is normal or not and all of the things that you think i need to know about the lab result all abrivation please state the complete name thanks 

Chief Complaint

“I’ve been having increasing stomach pain.”

HPI

Myrna Cook is a 54-year-old woman who presents to the ED

complaining of increasing abdominal cramping for several days.

Her last bowel movement was 6 days ago. She began “not feeling

well” 4 days ago, with some mild chills, bloating, decreased appetite,

and fatigue. She reports no fever, N/V, CP, or SOB. She reports that

yesterday, when her cramping was at its worst, she used magnesium

citrate, Miralax, and Fleet enema but still had no bowel movement.

She states that she typically has daily bowel movements, with no

straining, and spends less than 10 minutes, with little effort, having

 

a bowel movement. She reports having a similar episode approxi-

mately 1 year ago; however, at that time her symptoms responded

 

to magnesium citrate and Miralax. She does not use stool softeners

 

111CHAPTER 38 Constipation

 

on a regular basis. She reports drinking approximately 1 gallon of

 

water daily, even before her constipation began. Her last colonos-

copy, performed 6 years ago, was unremarkable.

 

PMH

Asthma

Obstructive sleep apnea

HTN

Mitral valve stenosis

Atrial fibrillation

Depression

Hypothyroidism

Iron deficiency anemia

GERD

FH

Her mother is in her 70’s and is healthy. Her father died in his 50’s

from lung cancer. She has three brothers and three sisters; one

brother has viral hepatitis. She has two sons who are healthy.

SH

She is married and works as a social worker. She quit smoking 20+

years ago. She does not drink alcohol and does not use illicit drugs.

ROS

(+) for constipation, lower abdominal fullness, and fatigue after not

using her CPAP machine for the past two nights; (-) for N/V, SOB,

CP, and fever/chills

Meds

Diltiazem CR 240 mg po daily

Digoxin 0.25 mg po daily

Flecainide 100 mg po BID

Atenolol 25 mg po daily

Buspirone 10 mg po BID

Duloxetine 60 mg po daily

Lansoprazole 30 mg po daily

Warfarin 2.5 mg po daily

Fluticasone/salmeterol 500/50 1 puff BID

Albuterol inhaler 90 mcg 2 puffs Q 4 h PRN

Levothyroxine 50 mcg po daily

Multivitamin 1 tablet po daily

Ferrous gluconate 324 mg po TID

All

NKDA

Physical Examination

Gen

Pleasant woman in mild distress; appears tired

VS

BP 122/60, P 57, RR 16, T 36.2°C; Wt 112.4 kg, Ht 5’5”

Skin

Normal skin turgor and color

HEENT

PERRLA and EOM full without nystagmus; no scleral icterus; oral

mucosa moist; no ulcerations noted

Neck/Lymph Nodes

Supple, no lymphadenopathy or JVD; no thyromegaly or bruits

CV

Regular, S1 and S2 without murmur

Lungs

Normal breath sounds; no crackles, rales, or wheezes

Abd

Soft, obese, tender; decreased bowel sounds; stool palpable on left

side

Rectal

External hemorrhoids noted; no stool in rectal vault; no masses felt;

tone fair; push strength fair; nontender

MS/Ext

No tenderness; strength good; sensation intact; no edema

Neuro

A & O × 3; CNs II-XII symmetric and intact; DTRs 2+

 

 

LAB

 

Na 138 mEq/L 

 

Glu 133 mg/dL

 

 RBC 6.05 × 106/mm3 

 

RDW 15.4%

 

K 4.7 mEq/L 

 

Ca 9.3 mg/dL 

 

Hgb 15.5 g/dL

Cl 101 mEq/L 

 

TSH 2.70 mIU/mL 

 

Hct 48%

CO2 30 mEq/L 

 

Free T4 1.2 ng/dL

 

 MCV 79 fl

BUN 14 mg/dL 

 

TIBC 251 mcg/dL 

 

MCH 26 pg

SCr 0.8 mg/dL 

 

Ferritin 85.4 ng/mL 

 

MCHC 33%

 

Assessment

Constipation with secondary symptoms of abdominal discomfort,

etiology unknown

Plan

Obtain abdominal x-ray and CT scan to evaluate potential causes of

the constipation; consult GI service

Clinical Course

A plain x-ray of the abdomen showed gas-dilated loops in the colon.

An abdominal CT scan was then performed and showed a large

amount of stool in the colon. The GI service was consulted, and the

recommendation was made to hold warfarin for colonoscopy. The

 

laxative regimen used for colonoscopy bowel preparation was suc-

cessful in clearing her bowel for the procedure and also in relieving

 

the patient’s abdominal pain. Colonoscopy was unremarkable, and

 

she was discharged with directions to