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A 64 year old gentleman came to the hospital with Shortness of breath and abdominal pain. Patient just had a PCI placed a couple weeks prior and a biliary stent placed around the same time. He presented to the hospital with chest pain abdominal pain, nausea, and fatigue and shortness of breathe. T-99 p-117 with sinus tach on the monitor with PVC’s, r-24 and 02 96% b/p 99/67. He also had some edema to his BLE The patient had moderately increased work of breathing and diffuse coarse crackles at the lung bases Patient was placed on 2L to give comfort, Zofran, and a one time dose of dilaudid. Patient was given small boluses of NS due to hx of heart failure, IV Lasix TID, and IV ATB. A echocardiogram was also done which showed a decreased Cardiac output. Labs showed a increase in patients Cr of 1.8 prior to 2.6 the next day and then was trending up over days. BUN was noted to be 54. Patient’s urine output over 24 hours was only 250 ml. Patient was placed on Dobutamine 5mcg/kg/min. Lasix was decreased to BID at a lower dose Patient’s labs showed the next day patient’s serum CR
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