A 56 year old female presents to the emergency room complaining of nausea, vomiting and headaches x 3 days.

0700: Patient evaluated in emergency room. Patient complains of nausea, denies pain. Order for anti-emetic requested. IV initiated and labs sent as ordered. Educated patient on need for urine sample. Patient states, “I haven’t been using the bathroom much, even though I’ve been trying to drink a lot of water to make up for this stomach bug.” 

0800: Patient voided 50mL of concentrated, yellow urine. Sample sent to lab as ordered. Patient reports improvement in nausea since administration of ondansetron.

0630: A 56 year old female presents to the emergency room complaining of nausea, vomiting and headaches x 3 days. Medical history includes hypertension, type II diabetes, obesity and breast cancer. Physical exam reveals trace edema in bilateral ankles, lung sounds clear throughout all fields, bowel sounds hyperactive, pulses 2+ in all extremities. Patient denies pain but endorses marked fatigue over the past week.

• CMP
• Urinalysis
• CBC
• Ondanestron 4mg IV q8h PRN nausea 
• 0.9% NaCl IV continuous infusion at 100 ml/hr 
• Clear liquid diet

• Up with assistance