Please progress in order:
Introduction
Pre-Test
Case 1: Mrs. Parker
Case 2: Mrs. Nguyen
Case 3: Mr. Gomez
Learning Objectives
Case Presentation
On the Floor, Part 1
Hospital Policies and Documentation
On The Floor, Part 2
HDS and Surgery
Discharge and Medical Reconciliation
Conclusion
Case 4: Mr. Watson
Post-Test

Case 3: Mr. Gomez

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Case Presentation

A. History

Mr. Gomez, a 50 year-old Hispanic male, presents to the Emergency Room with abdominal pain. You are paged by the nurse to assess him.

Upon arrival, you read in his file that Mr. Gomez has a past medical history of hypertension, history of an MI, and constipation. He currently presents with right upper-quadrant pain. For the past few weeks, he noticed that there is always pain "in his belly" after he eats a fatty meal. On his way home from a fast food place today, the sensation of really bad abdominal pain came back so he drove directly to the ER. In the ER, his temp is 98.6 F; pulse 92; and blood pressure is 150/100.

Past Medical History
Hypertension - poorly controlled
High cholesterol
Myocardial infarction in 2005
Depression
Constipation

Family History
Came to US as child
No cancer, diabetes, no asthma, or pulmonary disease; no allergic conditions

Medications
Lisinopril 40mg daily
Atenolol  50 mg daily
ASA 81 mg daily

Social History
High school teacher
Married
3 Children and his mother lives with him
Occasional alcohol (1-2 beers/night)
No drugs, no cigarettes
Attends Hispanic church regularly

 
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Copyright 2011 Department of Family Medicine at Boston University School of Medicine.