HISTORY:
for
, episodes ,
, episodes ,
, , ,
, , , clots
, up to °, over
, , , ,
, over ,
Worsening factors:
Treatments tried: ,
Other elements:
EXAM:
General appearance:
Vital signs: , BP , HR , RR , SpO2 %, Temp °
Neck:
Heart: ,
Lungs: ,
Abdomen: , , ,
Skin:
Extremities: , , cap refill , pulses ,
ASSESSMENT:
DDx:
PLAN:
- Blood work: , , , ,
- Stools: , , ,
- Encourage oral rehydration
-
- if no fever or bloody diarrhea
- Dietary modifications:
- Referral to infectious disease specialist
- Follow-up in
- Return if symptoms worsen or if new symptoms develop such as recurrent vomiting, high fever, or black stools