NR 576 Week 6 iHuman Virtual Patient Encounter Attempt 3813948 - Bertie Bridges

History Notecard by Nada Issa on case Bertie Bridges Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = Sx = Sx = Sx = Sx = Sx = Onset Location Duration Characteristics Aggravating Relieving Timing / Treatments Severity Attempt: 3813948 Report generated on 2/9/2026, 12:21:36 PM America/Denver Management Plan by Nada Issa on case Bertie Bridges Diagnostics: CBC, serum iron, TIBC, serum ferritin, TSH, T4 serum, CT abdomen without contrast chest Xray, Troponin, BNP, transferrin saturation Medications: START ferrous sulfate 325mg daily PO with vitamin C #90 tablets 0 refills CONTINUE Metoprolol 100g PO daily # 90 tab 0 refills, Aspirin 81mg PO daily #90 tablets 0 refills Atorvastatin 20mg PO daily 90 tab 0 refills, Nexium 40mg PO daily #30 tablets 0 refills OTC Ibuprofen 400mg as needed Referral: Refer to GI to further evaluate anemia with iron deficiency Education: 1. What iron deficiency anemia is: Your body needs iron to make healthy red blood cells that carry oxygen. When iron is too low, you can feel tired, short of breath, and weak. This is a very common cause of fatigue in older adults (Abou Baker & Davis, 2026). 2. Importance of iron supplements: Taking iron pills as prescribed helps build up your iron stores and improve your symptoms, but it can take weeks to feel better. Adding vitamin C (like orange juice) with your iron can help your body absorb it better (DeLoughery et al., 2024). 3. Diet tips: Eating iron-rich foods such as lean meats, beans, and fortified cereals can support treatment, but diet alone is usually not enough when anemia is significant. 4. Constipation and iron: Iron supplements can cause constipation; drinking plenty of water and eating fiber can help, and your provider can suggest stool softeners if needed. 5. Symptom monitoring: If you have new or worsening symptoms like chest pain, dizziness, or fainting, contact your provider right away as these could mean your heart is affected by low blood levels. 6. Need for GI evaluation: Because iron deficiency anemia in older adults can be caused by hidden bleeding in the digestive tract, your provider may recommend both an upper and lower scope (EGD and colonoscopy) to look for a source, even if you do not have obvious symptoms like blood in the stool (Abou Baker & Davis, 2026). In older adults with confirmed iron deficiency anemia and no clear explanation, guidelines recommend evaluation of the gastrointestinal (GI) tract to look for sources of