Elderly female with known metastatic CA of ? Gyn origine, bladder catherer dependent, presents with weakness, fell down, and mild anemia and presumed dehydration. I am not finding the vital…

signs in the data page but see this elderly lady with CAD was given a 500 cc bolus of NSS which would presumable drop her HgB from the initial 9.7 to a lower level. Rectal exam not done to r/o active bleeding and blood ordered. I am no finding vital signs so can’t comment if this is acute problem or an anemia of chronic disease and age. If chronic, component therapy not necessary now. Followup Hgb shows ? dilutional anemia versus either hemolysis of sepsis or dilutional. Blood given but time not recorded. It is disconcerting that the anemia has increased with two units PRBC and only 500 cc NSS. More information such as sequential vital signs and urine output would be helpful. If these are not available in the chart, this is a charting issue.

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