- ↓ Urine Output (inquire); Urine specific gravity >1.030
- Postural Vital Signs (↑ pulse occurs before ↓ BP)
- Diarrhea [gastroenteritis]
- Fever [pneumonia, pyelo, other infection]
- Abdominal pain [use as key Sx for differential & W/U]
- Missed Menses [pregnancy]
- Melena [ulcer]
- Prominent “Other Sx” (e.g. HA, etc) [use it to structure Dif Dx]
- Day #1 of N/V: Staph Gastroenteritis
- Day #2 of N/V: Rotavirus / Norovirus Gastroenteritis
>2 Days of N/V (& no diarrhea): consider Basic Work-Up
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- Rx high-dose Proton Pump Inhibitor (presumed gastric cause)
- Follow-Up for results in 1-2 weeks
- If Sx better, lower PPI dose & Tx for 8 wks.
- If wt. loss: Abd. CT &/or Endoscopy
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Ongoing N/V and No Wt. Loss or other Dx: Functional
- Seek mood Sx
- Seek clues to Bulemia: erosion of tooth enamel, parotid enlargement, calluses on the back of the hand
* possible causes of isolated N/V identified by Chemistry Panel
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