Monique Kennard, A 17-Year-Old Female, Came Into Our Office Today. She Is Accompanied By…

Monique Kennard, A 17-Year-Old Female, Came Into Our Office Today. She Is Accompanied By Her Mother, Who Is Very Worried About Her Daughter. Patient States She Has Been Experiencing Wheezing × 10 Days. She States The Symptoms Are Worse At Night. She Was Seen A Week Ago At This Clinic And Started On A 5-Day Course Of Azithromycin Without Improvement.
4. Monique Kennard, a 17-year-old female, came into our office today. She is accompanied by her mother, who is very worried about her daughter. Patient states she has been experiencing wheezing × 10 days. She states the symptoms are worse at night. She was seen a week ago at this clinic and started on a 5-day course of azithromycin without improvement. Yesterday she was seen at an urgent care clinic and prescribed an albuterol inhaler, amoxicillin/clavulonic acid, and methylprednisolone. Symptoms continued to worsen throughout the day. Patient reports chest pain attempting to swallow the amoxicillin/clavulonic acid tablets. Chest pain involves her left upper chest; it does not radiate. The quality is “heavy.” VS: 97.9°F, HR 85, RR 25, BP 144/101, SaO2 97% HEAD/NECK: She is awake and alert, NAD (no apparent distress), HEENT (head, eyes, ears, nose, throat), NC/AT (normocephalic and atraumatic), EOMI (extraocular movements intact). Left EAC (external auditory canal) is swollen shut; right is occluded with cerumen. Oropharynx is pink and moist. HEART: RRR (regular rate and rhythm) LUNGS: No wheezing, but patient is stridorous ABDOMEN: Benign/unremarkable EXTREMITIES: Normal pulses × 4 CN II–XII grossly intact INTEGUMENTARY: Dermatologic tests reveals no rash ALLERGIES: NKDA (no known drug allergies) PMHx (Past Medical History): Unremarkable SocHx (Social History): Patient denies EtOH (ethanol, alcohol). Denies smoking but states positive for secondhand tobacco exposure PLAN: Orders written for CXR (chest x-ray) to be done at imaging center across the road. Nurse to perform venipuncture for specimens for comprehensive metabolic panel; CBC complete, automated; and automated differential WBC count. Patient to return once results are in.
CODE IT?