Clinical Fluid Management and Focused Physical Examination in Patient Care

Questions

1. How much fluid intake is recommended for a healthy adult?  Do routine daily fluid needs change for the healthy elderly person? 

Need answer to this question?

2. Your patient has the following lab results:

        Serum studies

Sodium 126 mEq/L

Chloride 98 mEq/L    

Potassium 3.7 mEq/L

Bicarbonate 25 mEq/L 

Osmolality 260 mosmol/kg  

BUN 4 mg/dl

Creatinine .4 mg/dl

Glucose 129 mg/dl

         Urine studies

Specific gravity 1.025

Sodium 58 mEq/L

Osmolality  645 mosmol/kg

What are the main abnormalities? What could cause this? What are your next steps?

3. A 23-year-old Japanese American Buddhist woman came to your outpatient clinic for a routine gynecological exam. She explains she is having trouble urinating.

 Describe the focused physical exam you would perform with the rationale for each part. MLO8.6, CLO2

Instructional Materials – Required Textbook Readings-4

Edmunds: Section 9, pp. 306-323

Dains:  Chapters  5, 6, 7, 18, 27, 34, 35, 42

Cooper & Frain:  Chapter 7

Ball et al.:  Chapters 17, 19, 20, 21

Williamson & Snyder: Chapter 2

Course Materials:
Required Texts:
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination an interprofessional approach (10th ed.) Elsevier.

Cooper, N., & Frain, J. (Eds.). (2016). ABCs of clinical reasoning. Wiley.
Dains, J. E., Baumann, L.C., & Scheibel, P. (2020). Advanced health assessment and clinical diagnosis in primary
care (6th ed.). Elsevier.

Edmunds, M. W. (2017). Procedures for the primary care provider (3rd ed.). Elsevier.

Gunder, L. M. & Martin, S.A. (2011). Essentials of medical genetics for health professionals. Jones & Bartlett.

Pagana, K.D., Pagana, T.J. & Pagana T.N. (2022). Mosby’s manual of diagnostic and laboratory tests (7th ed.).
Elsevier.

Supplemental Course Materials:

Cohn, E.G. (2012). Flip & see ECG (4th ed.). W.B. Saunders.
Maldonado, D.C. & Ziniga, C. (2019). SOAP for family medicine (2nd ed.). Lippincott William

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