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Posted

Sounds like the classic dementia where patients do normal tasks repeatly to act like they are ok.

Vitals?

Any stroke indication?

Meds?

Allergies?

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Posted

You said she thinks it's 1978. She didn't used to be a maid did she? Also, I've heard of a type of amnesia caused by certain brain accidents that will cause a person to repeat the past x amount of time over and over. Could that be it? Also, this is kinda out there, but does she wear glasses? And if so, are they dirty? Does she have cataracts or anything else with her vision that may be leading her to think the floor is dirty when she looks at it?

Posted

BP: 86/40

HR: 52, weak, irregular radial

RR: 18 (good TV, regular, non-labored)

O2 Sat: 95%

Skin: Dry, pale, cool

LS: Clear bilaterally

Pupils: PEARLA

Meds in cabinet: Lisinopril, Digoxin, Aspirin, Exelon, Cognex, HZTC, Magnesium Supplement

Allergies: None family knows off. She says no.

All negative findings on the Cincinnati Stroke Scale.

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Some good points Jessi. She did not used to be a maid, but she was always super clean and kept the house-hold tidy.

She doesn't wear glasses and not known vision problems, but you're getting warmer in this direction of thinking. It's not the answer, but will lead to more s/s that will lead to answer.

Posted

Okay. So I am looking at a couple things. I did quite a bit of research so I may have over thought this. So far I'm looking at digoxin toxicity, potassium deficiency, and dehydration, in that order. Am I on the right track? Any of these could account for her symptoms but the digoxin looks the most suspicious because of it's own side effects(including double vision, hallucinations, confusion) and it's high potential for toxicity when combined with diuretics(HZTC). HZTC can also cause blurred vision on it's own. Do we know if these were all prescribed by the same doctor? Is she using prune juice, bran cereal, or a high fiber diet to maintain gi regularity, which is common in the elderly? All of these can increase the effects of digitalis as can a salt-restricted diet that she may be on for the hypertension. I haven't listed all of my reasons for looking at these disorders as to not waste your time if I'm wrong, but if you have any questions as to my reasons, feel free to ask. Oh, and please let me know if I'm over thinking this. I tend to do that.

By the way, my drug info is from The Complete Guide to Prescription and Non-Prescription Drugs(2005 edition) originally published by H. Winter Griffith, M.D. and revised by Stephen Moore, M.D. in case you were wondering.

Posted
Okay. So I am looking at a couple things. I did quite a bit of research so I may have over thought this. So far I'm looking at digoxin toxicity, potassium deficiency, and dehydration, in that order. Am I on the right track?

Yes, you are. Now what are you going to do to help you narrow in on your suspected cause before initiating a treatment.

Posted

can we have a blood sugar please and a expanded medical history directed towards mental health also do we have a track record for her BP and a last oral intake? also any signs of dehydration.

Posted

Oxygen 3L Nasal Cannula, transport in a flat position, keep warm, still, call medic, drive toward medic, while taking to hospital. :P

Posted
can we have a blood sugar please and a expanded medical history directed towards mental health also do we have a track record for her BP and a last oral intake? also any signs of dehydration.

BGL=80

Only mental health hx consist of early stage Alzheimer's which she last saw her doctor for three weeks ago.

Hx of HTN, but no prior episodes of hypotension.

Says she ate breakfast when sun came up (it's a little after noon).

What signs of dehydration are you looking for?

4cmk6, you're partnered with a medic. He's stuck, so up to you to save..errr help him out ;)


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