65 yrs old male patient came to casualty with complaints of no urine output and shortness of breath
GENERAL MEDICINE CASE
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Patient came with cheif complaints of decreased urine output since 1 week and complete stoppage since yesterday and bilateral lower limb swelling and cough with sputum.
Patient was apparently asymptomatic 1 week back and then he developed decreased urine output since 2 days and no urine output since 2 days and shortness of breath since 3days and pedal edema since 1 week.
Past history:-Patient had H/o of CKD since 2 year and H/o 3 dialysis sessions done in 2020 followed by since then on medical management.
H/o COPD since 3 years.
O/E:- pt is c/c/c.
BP-90/60 mmHg
PR- 80 bpm
RR- 22cpm
Spo2-98%on 6L o2.
CVS-S1S2 +
RS- BAE+
CNS- NAD.
P/A - soft ,non tender
Investigations:-
Provisional diagnosis:-
Chronic kidney disease with COPD.
Treatment:-
Inj lasix 20 mg IV BD.
Inj NORAD 20ml/hr
Inj Dobutamine 7.2ml/hr
IV fluids NS @ uo+ 50ml/hr.
Nebulization with Ipravent and budecort.
Inj optineuron 1amp in 100 ml NS IV OD.
Tab pulmoclear 100mg po BD
Tab orofer XT po OD
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