text:  ON ADMISSION  Physical examination at the time of admission revealed she was in no acute distress . Blood pressure was 150  79   a pulse of 81 . She is legally blind . She was without any adenopathy . Her chest was clear to auscultation . Heart had a normal S1 and S2   with no murmurs   gallops or rubs . Her abdomen was soft with well-healed incisions . There was no organomegaly . Extremities were without edema . She had a functioning arteriovenous fistula with a thrill and a bruit in her left arm .