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

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