55 year old man with pedal edema

55 year old man with c/o decreased urine output, pedal edema,sob since 1year.

Patient was apparently asymptomatic 1year back then he developed bilateral pedal oedema (pitting type). Gradually progressive a/w sob and h/o decreased urine output.no h/o palpitation,burning micturition.

K/c/o HTN ON tablet Nocardia 10mg

N/k/c/o DM,TB,ASTHAMA, EPILEPSY,CAD.

ON EXAMINATION_PATIENT IS CONSCIOUS,COHERENT , COOPERATIVE.

TEMP-AFEBRILE.

PR-83BPM

BP-120/80MMHG

RR-17CPM

SPO2-98

GRBS-121MG/DL

CVS-S1S2+

RS-BAE+,NVBS.

CNS-NAD

INVESTIGATIONS-

ON 22/12/2021

BLOOD UREA-79MG/DL

SERUM CREATININE-7.4MG/DL

SODIUM-148MEQ/L

POTASSIUM-3.9MEq/L

CHLORIDE-98mEq/L

SERUM IRON- 94ug/dl

HBsAg-negative

HIV-NON REACTIVE

HCV-NEGATIVE

BLOOD GROUP-O POSITIVE

Rx-

FLUID AND SALT RESTRICTION

T. LASIX 40MG PO/BD

T. NICARDIA 10MG PO/BD

INJ. ERYTHROPOIETIN 4000IU IV/SC WEEKLY ONCE

Ward D

55/M 

S- c/o decreased appetite since yesterday

O- 

C/c/c

Bp- 130/80mmHh

PR-92bpm

RR- 16cpm

CVS- S1 S2 heard

RS- BAE (+VE)

P/A- SOFT NON TENDER

A- 

Shortness of breath - ? Heart failure 

Decreased urine output - chronic renal failure

P- 

FLUID AND SALT RESTRICTION

T. LASIX 40MG PO/BD

T. NICARDIA 10MG PO/BD

INJ. ERYTHROPOIETIN 4000IU IV/SC WEEKLY ONCE