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History of present illness: This 72-year-old female presented to the ENT clinic complaining of her current epistaxis for 7 days prior to admission. The bleeding usually occurred from the right nostril. She had no prior history of epistaxis and denied any rhinorrhea. congestion, or anemia. On admission, she also complained of weakness. Four days prior to admission, her hematocrit level was 35, and the night before her admission, her hematocrit level was 29 when measured at an outside hospital. Her past medical history was significant for rheumatoid arthritis. Her past surgical history included status post bilateral knee replacement and right hip replacement. Medications at the time of admission included prednisone, 2 mg PO b.i.d.. and aspirin, six to eight per day for the past several months. Allergies: none. Physical examination: On physical examination at the time of her admission, she was afebrile. Her blood pressure was 114/70, and her pulse was 92. Examination of the head and neck was significant for nasal cavities, which were without lesions and without PhYSical bleeding Sites. the remainder of the head and neck examination was within normal limits. Her neck was normal with no jugular venous distention. The lungs were clear. The heart rate
SCIENCE
HEALTH SCIENCE
NURSING

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