Walter Reeves is a 65-year-old man recently diagnosed with m…
Walter Reeves is a 65-year-old man recently diagnosed with multiple myeloma. Mr. Reeves presents with severe back pain that has progressively worsened over the past month, along with new onset of debilitating pain radiating down both legs. He has a history of COPD and mentions developing cold symptoms including nasal congestion over the past week. Upon examination, he is expectorating thick green sputum with occasional blood streaking. He appears disoriented, unable to recall what month it is, and has difficulty following multi-step instructions. Mr. Reeves appears visibly pale with notable weakness when attempting to stand, requiring assistance with ambulation. The healthcare team has implemented fall precautions and ordered assistance for all out-of-bed activities. Vital Signs: Temperature: 39.0°C Pulse: 106 RR: 26 BP: 152/94 O2 Sat: 89% on room air Pain: 9/10 Laboratory Results: Electrolytes Values Arterial Blood Gas Values Sputum Culture Na 128 mEq/L PaO2 59 mm Hg Preliminary Cl 91 mEq/L PaCO2 60 mm Hg Gram Stain = Gram+ Cocci K 5.9 mEq/L pH 7.31 Culture = Pending BUN 42 mg/dl HCO3 37 mmol/L Sensitivity = Pending Creat. 2.6 mg/dl SaO2 88% CO2 37 mmol/L Ca 12.3 mg/dl Mag 1.8 mEq/L Phos 2.4 mg/dl Glucose 142 mg/dl Albumin 3.5 g/dl
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