Dialysis

8/June/2022

General medicine elog2


 Hi,I’m A Naga pravallika 3rd semester medical student.This is an online e log book to discuss our patients health data.This also reflect my patient centered online learning portfolio.



An 27 year old man student,resident of suryapet came  to hospital for dialysis.


3years ago he had frequent vomitings upto 45 days  and went to hospital and treated with medication.From then he started going for dialysis.


He had a difficulty in breathing and has hypertension.His heamohlobin levels was very low (7.6).


Since 2days he was having a stomach pain and no appetite.





Personal History 

Diet-vegetarian

Appetite- normal 

Bowels-regular 

Addictions-no 

Family History 

Hypertension-yes 

Diabetes-no 

Heart disease-no 

Stroke -no 

Asthma-no

SYSTEMIC EXAMINATION 

CVS

thrills-no 

Cardiac sounds -s1,s2,+

Cardiac murmurs-no

RESPIRATORY 

Dyspnoea-no

Wheez -no

Position of trachea-central

Breath sounds -vesicular

CNS

conscious 

Speech-normal

Neck stiffness-no


General Examination 

Moderately built 

Moderately nourished

Conscious 

No pallor 

No icterus 

No clubbing of fingers 

No cyanosis 

No lymphadenopathy 

Oedema of feet -yes

His vital signs are normal 


Diagnosis - chronic kidney disease 

Maintenance hemodialysis 


Plan to care - hemodialysis 

TREATMENT 

tab nicardia 20mg po/bd

Nodisis500mg po/od

Tab orofer XT po/bd

Tab shel cal CT po/od

Inj.epo 4000IU weekly twice

Tab lasix 40mg 








 



10/June/2022

Where is the anatomical location of patient?(related to macro anatomy )

Location is kidney is retroperitoneally on the posterior abdominal wall at level of T12 to L3.

Why is the patient having this problem?(related to micro anatomical pathogensis as well as macro-social environment events influencing it)

He is having histological leisions in the kidney.father is having hypertension.

What are we doing about it ?(pharmacological and non pharmacological interventions)

Pharmacological interventions:

Nicardia 20 mg

Nodosis 

Orofer 

Shelcal 

Inj.epo 

Arkamine 

Non pharmacological interventions:

Fluid intake should be less than 1.5 lit/day 

Salt inatake should be less 

Maintenance of adequate cardiac output and blood pressure.

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