NRNP 6550
iHuman Ken
Fowler: Week 7
- CONDITIONS OF
THE RENAL &
GENITOURINARY
SYSTEMS
,NRNP 6550 - iHuman Ken Fowler: Week 7 - Conditions of the
Renal and GenitourinarySystems
NRNP 6550: Advanced Care of Adults in Acute
Settings IIi-Human: Ken Fowler V5
FILL OUT THIS TEMPLET AS YOU GO THROUGH THE I-HUMAN PATIENT
MODULE SO YOU KNOW WHAT YOU ARE DOING AS YOU GO.
YOU ARE ALL WELCOME!!!
Name: Ken Fowler
Age: 70 years
Sex: M
Ht: 5'10" (178.0 cm)
Wgt: 190 lb (86.0 kg) (BMI 27.3)
NOTES FROM i-HUMAN ASSESSMENT:
1) Observations: warm and sweaty
2) Chief complaint: Nausea and fatigue
QUESTIONS: (ask the patient up to 100 questions)
1) How can I help you today? "I went to see my doctor this morning because I
have been feeling bad for the past few days. I'm tired, with nausea &
vomiting. Well, he examined me and ordered some labs, and then told me
that "kidneys are failing," something about a big change in my creatinine
and that I needed to come to the emergency department. He told me to
bring the test results here with me. [Test resultstoday: creatinine 3.2
mg/dL; 1 month ago Test results 1.1 mg/dL; urine protein = 400 mg
microalbuminuria] Do you understand what all that means? I sure don't!"
2) Do you have any other symptoms or concerns we should discuss? I
also feelexhausted, probably from all the vomiting and not eating.
3) When did your nausea start? It started three days ago, I woke up feeling
nauseousand started throwing up everything I ate.
4) What are the events surrounding this start of your nausea and vomiting?
Nothingreally happened that I can think of.
5) Do you have difficulty breathing? Uh… no.
6) When do you fatigue start? Just the last few days.
7) Do you have a problem with fatigue/tiredness? Yup
8) Does your fatigue come and go? No.
9) Have you gained or lost weight or intentionally, despite normal
appetite andexercise? Uh… no.
10) Have you gained weight? No.
,11) Has there been a change in your urination frequency? Actually, I have
been peeningless recently.
12) What is the color of urine, has it changed recently? It's usually fine, but I
have beenpeeing less recently
13) Does anything make your fatigue/tiredness better or worse? No.
14) Do you have pain anywhere? If so where? I hurt my back last week, but
that's finenow.
15) Have you noticed swelling in any part of your body? No
16) Can you tell me about any current or past medical problems she had? I
have high blood pressure. I take medications for that. I was told last
month my blood pressure has caused some kidney damage. Something
about my protein in my urine. Oh, abouta week ago I pulled my back
lifting a heavy carton when I was cleaning out my garage. It was pretty
painful so I took something for the pain. My back is really prettygood right
now, but then this nausea vomiting began.
17) Any previous medical, surgical, or dental procedures? Yes. I had my
tonsils out as akid and then my appendix out about 35 years ago now.
18) What treatments have you had for the pain in your back? Just Naproxen.
19) Are you taking any prescription medications? I take lisinopril, metoprolol,
and hydrochlorothiazide for BP. I have not taken anything for the last 24
hours because Ifeel so sick, can’t keep the pills down.
20) Do you have any pain in your back? Not anymore
21) When you urinate, have you noticed any pain, burning, blood, difficulty
starting orstopping, dribbling, incontinence, urgency during day or night,
or any changes in frequency? Uh, no. In fact, I am barely peeing at all.
22) When are the events surrounding the start of your difficulty urinating? That’s not
a
problem for me.
23) When you pee, is a stream or flow of urine weak or do you dribble? No
24) Do you have problems with nausea, vomiting, constipation, diarrhea,
coffee grounds in your vomit, dark tarry stool, bright red blood in your
bowel movements,early satiety or bloating? Yes, I have already told you
about my nausea and vomiting.But none of the other stuff. My poop is
normal
25) How severe is your nausea and/or vomiting? I have not eaten much of
anything inthe last three days, so I am not sure how to answer that
question. Vomiting is and miserable business so for me it is bad.
26) Does anything make your nausea and/or vomiting better or worse? It
does getworse when I eat, that's why I haven't eaten much.
27) What treatments have you had for nausea and/or vomiting? Nothing
28) Do you have any problems with fatigue, difficulty sleeping, or intentional
weight loss or gain, fevers, or night sweats? Yeah I feel exhausted, but I
, think it is because ofmy nausea… just keeps me up at night. No fevers
29) Does your fatigue/tiredness improve after a good night's rest? No
30) What does your vomit look like? Clear or residual food particles, but I
haven't eatenfor over 24 hours
31) When do you nausea and/or vomiting start? It started 3 days ago, I woke
up feelingnauseous and started throwing up everything I ate.
32) Do you have diabetes? Uh… no.
iHuman Ken
Fowler: Week 7
- CONDITIONS OF
THE RENAL &
GENITOURINARY
SYSTEMS
,NRNP 6550 - iHuman Ken Fowler: Week 7 - Conditions of the
Renal and GenitourinarySystems
NRNP 6550: Advanced Care of Adults in Acute
Settings IIi-Human: Ken Fowler V5
FILL OUT THIS TEMPLET AS YOU GO THROUGH THE I-HUMAN PATIENT
MODULE SO YOU KNOW WHAT YOU ARE DOING AS YOU GO.
YOU ARE ALL WELCOME!!!
Name: Ken Fowler
Age: 70 years
Sex: M
Ht: 5'10" (178.0 cm)
Wgt: 190 lb (86.0 kg) (BMI 27.3)
NOTES FROM i-HUMAN ASSESSMENT:
1) Observations: warm and sweaty
2) Chief complaint: Nausea and fatigue
QUESTIONS: (ask the patient up to 100 questions)
1) How can I help you today? "I went to see my doctor this morning because I
have been feeling bad for the past few days. I'm tired, with nausea &
vomiting. Well, he examined me and ordered some labs, and then told me
that "kidneys are failing," something about a big change in my creatinine
and that I needed to come to the emergency department. He told me to
bring the test results here with me. [Test resultstoday: creatinine 3.2
mg/dL; 1 month ago Test results 1.1 mg/dL; urine protein = 400 mg
microalbuminuria] Do you understand what all that means? I sure don't!"
2) Do you have any other symptoms or concerns we should discuss? I
also feelexhausted, probably from all the vomiting and not eating.
3) When did your nausea start? It started three days ago, I woke up feeling
nauseousand started throwing up everything I ate.
4) What are the events surrounding this start of your nausea and vomiting?
Nothingreally happened that I can think of.
5) Do you have difficulty breathing? Uh… no.
6) When do you fatigue start? Just the last few days.
7) Do you have a problem with fatigue/tiredness? Yup
8) Does your fatigue come and go? No.
9) Have you gained or lost weight or intentionally, despite normal
appetite andexercise? Uh… no.
10) Have you gained weight? No.
,11) Has there been a change in your urination frequency? Actually, I have
been peeningless recently.
12) What is the color of urine, has it changed recently? It's usually fine, but I
have beenpeeing less recently
13) Does anything make your fatigue/tiredness better or worse? No.
14) Do you have pain anywhere? If so where? I hurt my back last week, but
that's finenow.
15) Have you noticed swelling in any part of your body? No
16) Can you tell me about any current or past medical problems she had? I
have high blood pressure. I take medications for that. I was told last
month my blood pressure has caused some kidney damage. Something
about my protein in my urine. Oh, abouta week ago I pulled my back
lifting a heavy carton when I was cleaning out my garage. It was pretty
painful so I took something for the pain. My back is really prettygood right
now, but then this nausea vomiting began.
17) Any previous medical, surgical, or dental procedures? Yes. I had my
tonsils out as akid and then my appendix out about 35 years ago now.
18) What treatments have you had for the pain in your back? Just Naproxen.
19) Are you taking any prescription medications? I take lisinopril, metoprolol,
and hydrochlorothiazide for BP. I have not taken anything for the last 24
hours because Ifeel so sick, can’t keep the pills down.
20) Do you have any pain in your back? Not anymore
21) When you urinate, have you noticed any pain, burning, blood, difficulty
starting orstopping, dribbling, incontinence, urgency during day or night,
or any changes in frequency? Uh, no. In fact, I am barely peeing at all.
22) When are the events surrounding the start of your difficulty urinating? That’s not
a
problem for me.
23) When you pee, is a stream or flow of urine weak or do you dribble? No
24) Do you have problems with nausea, vomiting, constipation, diarrhea,
coffee grounds in your vomit, dark tarry stool, bright red blood in your
bowel movements,early satiety or bloating? Yes, I have already told you
about my nausea and vomiting.But none of the other stuff. My poop is
normal
25) How severe is your nausea and/or vomiting? I have not eaten much of
anything inthe last three days, so I am not sure how to answer that
question. Vomiting is and miserable business so for me it is bad.
26) Does anything make your nausea and/or vomiting better or worse? It
does getworse when I eat, that's why I haven't eaten much.
27) What treatments have you had for nausea and/or vomiting? Nothing
28) Do you have any problems with fatigue, difficulty sleeping, or intentional
weight loss or gain, fevers, or night sweats? Yeah I feel exhausted, but I
, think it is because ofmy nausea… just keeps me up at night. No fevers
29) Does your fatigue/tiredness improve after a good night's rest? No
30) What does your vomit look like? Clear or residual food particles, but I
haven't eatenfor over 24 hours
31) When do you nausea and/or vomiting start? It started 3 days ago, I woke
up feelingnauseous and started throwing up everything I ate.
32) Do you have diabetes? Uh… no.
