A.B is a 62-year-old male who was admitted to the hospital this afternoon with
complaints of shooting pain in his left leg. The patient is allergic to penicillin. He is recovering
post-op from a recent left knee replacement. The patient has not left the house recently, and has
developed leg pain and a productive cough. He has a chronic history of hypertension and
hypercholesterolemia. Family history of Type I Diabetes (brother), CAD (father), and HTN
(father). Patient is experiencing an acute pain level of 9, edema, and erythema. Blood pressure is
elevated at 149/89 and temperature is at 38.3 C (100.94 F). His glucose, cholesterol, and
triglyceride levels are elevated above normal, while the patient is a prediabetic. His Fibrin
D-dimer is severely elevated at 4000, normal range being <5. Chest x-ray was ordered and
results indicated small pleural effusions consistent with pneumonia. A lower extremity doppler
report of the lower left extremity was conducted and decreased blood flow of 50% in the
popliteal vein was indicated.
He has a history of chronic hypertension, and would benefit from taking Furosemide
(Lasix). This medication should assist in lowering his elevated blood pressure (most recent was
149/89) by reducing excess fluid and salt in the body and increasing the amount of urine
excreted. I would explain to him why it is being prescribed and let him know that this is
commonly known as a “water pill”. This medication should also help with the acute edema that
he is experiencing, however, edema is often seen with knee replacement surgeries. I would
recommend alongside the Furosemide, icing his knee to reduce the acute erythema and edema
that he is experiencing. I would encourage this patient in eating more potassium rich foods and
limiting his salt intake, as this medication may deplete potassium levels. I would inform him
common side effects are increased urination, constipation, vertigo, and nausea.
