TY - CHAP M1 - Book, Section TI - 10 Real Cases on Electrolyte Management and Miscellaneous Cases on Telemetry A1 - Shah, Niel A1 - Ali, Nisha A1 - Miranda, Jeirym A1 - Saad, Muhammad A2 - Saad, Muhammad A2 - Bhandari, Manoj A2 - Vittorio, Timothy J. Y1 - 2020 N1 - T2 - Patient Management in the Telemetry/Cardiac Step-Down Unit: A Case-Based Approach AB - A 68-year-old male nursing home resident was brought to the emergency department by emergency medical services for altered mental status since early morning. As per nursing home staff, the patient had been experiencing poor oral intake and had been noted to be withdrawn from social activities over the past few days. Review of system was negative for nausea, vomiting, diarrhea, or fever. His medical history included hypertension, hyperlipidemia, osteoarthritis, and dementia. His medications included amlodipine, simvastatin, and multivitamins. Physical examination showed stable vital signs. However, the patient was cachectic, had dry mucous membranes, was alert and awake, and was able to follow commands but was confused. The rest of the examination was completely unremarkable. Significant laboratory data showed sodium of 167 mmol/L, chloride of 125 mmol/L, potassium of 4.0 mmol/L, and creatinine of 1.8 mg/dL (137.25 µmol/L). His cell count was normal. CT of the head showed no acute infarct, mass, or hemorrhages as well as no chronic microvascular changes. He was started on intravenous fluid and was transferred to the telemetry unit for electrolyte monitoring. How would you manage this case? SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1166697568 ER -