Ms. Smith is a 55 year old female with nausea and vomiting and I was consulted by (Doctor) for assisting with further management. She has been having nausea and vomiting since Monday and not able to keep anything down. She has a history of acid reflux on medication for that every other day. Denies of abd pn. She is on laxatives for constipation but still struggles to have bowl movement. Denies of diarrhea. She had left BKA 2 years ago for diabetes. she is also blind. History of chronic kidney disease on dialysis. she is morbid obese with BMI 41 and is bedridden.