iHUMAN Case Study Sally Smith: Comprehensive for
Fatigue in a Middle-Aged Female | Expert Nursing
Assessment & Management
In-depth iHUMAN case study of Sally Smith presenting with fatigue. Includes a complete expert-level,
differential diagnosis, diagnostic interpretation, evidence-based treatment plan, and clinical reasoning
aligned with nursing education standards.
• iHUMAN case study Sally Smith
• Sally Smith fatigue
• iHUMAN example
• Nursing student iHUMAN fatigue case
Stuvia
,Patient Name: Sally Smith
Age: 45 years
Sex: Female
Chief Complaint (CC): “I feel tired all the time.”
S – Subjective
Chief Complaint (CC):
“I’ve been feeling extremely fatigued for the past few months.”
History of Present Illness (HPI):
Sally Smith is a 45-year-old female who presents with progressive fatigue for approximately 3 months.
She reports feeling constantly tired despite adequate sleep, with decreased energy levels affecting her
work and daily activities. Fatigue is worse in the afternoons and minimally relieved by rest.
She denies fever, recent illness, chest pain, shortness of breath, dizziness, syncope, or weight loss. She
reports poor concentration, mild headaches, and cold intolerance. She denies depressive symptoms but
admits to increased stress at work. No recent travel or sick contacts.
Associated Symptoms
• Decreased energy
• Cold intolerance
• Mild headaches
• Difficulty concentrating
Denies
• Fever or chills
• Dyspnea
• Palpitations
• GI bleeding
• Depression or anxiety
Past Medical History (PMH):
, • Hypertension
• Iron-deficiency anemia (history)
Past Surgical History (PSH):
• Cesarean section (2005)
Medications:
• Lisinopril 10 mg PO daily
• Multivitamin (intermittent)
Allergies:
• NKDA
Family History:
• Mother: Hypothyroidism
• Father: Type 2 diabetes
• No family history of cancer
Social History:
• Married, lives with spouse
• Works full-time as an administrative assistant
• Denies tobacco or illicit drug use
• Alcohol: Occasional
• Diet: Low red meat intake
• Exercise: Minimal
Review of Systems (ROS):
• General: Fatigue
• Skin: Dry skin
• HEENT: No visual changes
• Cardiac: No chest pain
Fatigue in a Middle-Aged Female | Expert Nursing
Assessment & Management
In-depth iHUMAN case study of Sally Smith presenting with fatigue. Includes a complete expert-level,
differential diagnosis, diagnostic interpretation, evidence-based treatment plan, and clinical reasoning
aligned with nursing education standards.
• iHUMAN case study Sally Smith
• Sally Smith fatigue
• iHUMAN example
• Nursing student iHUMAN fatigue case
Stuvia
,Patient Name: Sally Smith
Age: 45 years
Sex: Female
Chief Complaint (CC): “I feel tired all the time.”
S – Subjective
Chief Complaint (CC):
“I’ve been feeling extremely fatigued for the past few months.”
History of Present Illness (HPI):
Sally Smith is a 45-year-old female who presents with progressive fatigue for approximately 3 months.
She reports feeling constantly tired despite adequate sleep, with decreased energy levels affecting her
work and daily activities. Fatigue is worse in the afternoons and minimally relieved by rest.
She denies fever, recent illness, chest pain, shortness of breath, dizziness, syncope, or weight loss. She
reports poor concentration, mild headaches, and cold intolerance. She denies depressive symptoms but
admits to increased stress at work. No recent travel or sick contacts.
Associated Symptoms
• Decreased energy
• Cold intolerance
• Mild headaches
• Difficulty concentrating
Denies
• Fever or chills
• Dyspnea
• Palpitations
• GI bleeding
• Depression or anxiety
Past Medical History (PMH):
, • Hypertension
• Iron-deficiency anemia (history)
Past Surgical History (PSH):
• Cesarean section (2005)
Medications:
• Lisinopril 10 mg PO daily
• Multivitamin (intermittent)
Allergies:
• NKDA
Family History:
• Mother: Hypothyroidism
• Father: Type 2 diabetes
• No family history of cancer
Social History:
• Married, lives with spouse
• Works full-time as an administrative assistant
• Denies tobacco or illicit drug use
• Alcohol: Occasional
• Diet: Low red meat intake
• Exercise: Minimal
Review of Systems (ROS):
• General: Fatigue
• Skin: Dry skin
• HEENT: No visual changes
• Cardiac: No chest pain
