IV Notes 💉

Aisha 58 year old female patient underwent total abdominal hysterectomy for uterine fibroids with general anesthesial Complaint: Pain and swelling in the left leg on postoperative day 5. History of Present Illness: Mrs. Aisha reports increasing calf pain and swelling over the past two days. The pain worsens when she walks and improves slightly with leg elevation. She also feels her leg is “heavier and tighter”. No chest pain or dyspnea. She has mostly been bed-bound since surgery, getting up only to use the bathroom. Past Medical History: Obesity Varicose veins in both legs Hypertension controlled with amlodipine No diabetes or prior thrombotic episodes Medications Amlodipine 5 mg daily Paracetamol and tramadol for postoperative pain No pharmacological DVT prophylaxis was given (only compression stockings) Examination Findings General: Alert, no respiratory distress, afebrile Vitals: BP 132/80, HR 96, RR 18, Temp 37.2, SpO₂ 97% on room air Left leg: Swollen and tender calf - Pitting edema up to mid-calf - Skin warm but not red Right leg: Normal Chest and heart: Normal

هنعرض قصة جديدة دلوقتي Be ready 🔥

1- هو بيبقى فيه باسوردات بتنزل بتفضل شغالة كدة كام اسبوع وتتقفل .. اخر حاجة كانت نازلة اتقفلت للأسف فلسة في انتظار باسورد جديد فعال 2- شكرا جدا والله 🙏🏻🙏🏻 اللي بعده مش كورس ده ترم دراسي 😅 neurological emergencies وهنبدأ في شهر يناير ان شاء الله بعد ما نخلص الكورس ده مباشرة .. أول ما نقفل اللي بنعمله دلوقتي هعلن عن تفاصيل الجديد مع بداية السنة ان شاء الله 3- موجودة هنا كلها https://quizlet.com/join/JneqxWbud?i=6xsdyx&x=1bqt 4- وإن شاء الله لما نحضر ونتذوق الموضوع هيكون أجمل بإذن الله 🤌🏻🙈 (دي من فورم برنامج النيورو القادم)

Saeed 60 year old male patient Procedure: Emergency laparotomy for small bowel obstruction Anesthesia: General anesthesia Mr. Saeed develops shortness of breath and fever on postoperative day 2 following emergency laparotomy. History of Present Illness The patient vomited bilious material in the recovery room shortly after extubation. He developed mild hypoxia (SpO₂ 88%) that improved with oxygen. Over the next 24 hours, he developed fever (38.6), productive cough, and increasing respiratory distress. Sputum is foul-smelling and yellow-green. No chest pain or hemoptysis. Past Medical History Long-standing GERD Obesity Hiatal hernia (diagnosed previously) No diabetes, no COPD Non-smoker Medications Omeprazole 20 mg daily Perioperative antibiotics: ceftriaxone and metronidazole (for bowel surgery prophylaxis) Examination Findings General: Dyspneic, sitting upright, using accessory muscles of respiration Vitals: Temp 38.6, HR 108, BP 126/78, RR 28, SpO₂ 88% on room air Chest: Dullness to percussion and coarse crackles in right lower lung zone Decreased air entry at right base Cardiovascular: Normal S1, S2 Abdomen: Post-op midline incision clean, non-tender, no distension Extremities: No edema or DVT signs Investigations WBC 16,200 (Neutrophils 88%) CRP 92 ABG on 2L O₂ pH 7.44, pCO₂ 32 mmHg, pO₂ 68 mmHg Chest X-ray Right lower lobe consolidation with air bronchograms Sputum culture Growth of Klebsiella pneumoniae and anaerobes Blood culture Negative