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Classify the following medical document.
TITLE: CCU Progress Note Chief Complaint: 24 Hour Events: - No overnight events - Comfortable on room air. - Requesting to go home Allergies: No Known Drug Allergies Last dose of Antibiotics: Infusions: Other ICU medications: Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2124-3-9**] 07:11 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.9 C (98.4 Tcurrent: 36.8 C (98.2 HR: 75 (75 - 93) bpm BP: 96/46(58) {84/44(55) - 103/58(69)} mmHg RR: 22 (17 - 34) insp/min SpO2: 98% Heart rhythm: SR (Sinus Rhythm) Total In: PO: TF: IVF: Blood products: Total out: 530 mL 295 mL Urine: 530 mL 295 mL NG: Stool: Drains: Balance: -530 mL -295 mL Respiratory support O2 Delivery Device: Nasal cannula SpO2: 98% ABG: ///31/ Physical Examination Gen: WDWN elderly male in NAD, appears younger than stated age. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. Neck: Supple with JVP elevated to earlobe CV: RR, 3/6 systolic murmur LUSB raditaing to carotids. No thrills, lifts. No S3 or S4. Chest: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. Crackles to halfway B/L. Speaking in full sentences. Abd: Soft, NTND. No HSM or tenderness. Ext: 2 pitting edema B/L. Skin: No stasis dermatitis, ulcers, scars, or xanthomas. . Pulses: Right: Carotid 2+ Femoral 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ DP 2+ PT 2+ Labs / Radiology 1.3 mg/dL 31 mEq/L 3.9 mEq/L 34 mg/dL 100 mEq/L 139 mEq/L [image002.jpg] [**2124-3-8**] 10:33 PM Cr 1.3 TropT 0.02 Other labs: CK / CKMB / Troponin-T:31//0.02, Mg++:2.0 mg/dL Assessment and Plan The patient is a [**Age over 90 **] year-old male with a PMH of CAD, moderate AS, and COPD admitted with acute onset dyspnea. . #. Acute on Chronic Systolic and Diastolic CHF - The patient presents with acute onset dyspnea, similar to prior admissions, differential diagnosis includes acute diastolic CHF vs COPD exacerbation. Patients symptoms most likely secondary to CHF exacerbation given evidence of volume overload on exam and CXR. BNP elevated though decreased from prior. The patient has no evidence of CE elevation or new ischemic ECG changes. He likley has episodes of transient ischemia leading to acute-on-chronic diastolic dysfunction and pulmonary edema as described prior. The patient also reports brief feeling of "chest spasm" relieved with neb in ED, suggests possible component of reactive airway disease. No wheezing on exam currently. - Trend CE, negative x2 so far - Continue lasix IV, goal 1L negative today - Continue lisinopril and metoprolol - Continue nebs PRN - Hold on further abx/steroids for now. There appears to be a possible RLL infiltrate that we will followup with PA and lateral chest xray. . #. Coronary Artery Disease - s/p BMS to OM2, D1, Left circumflex in [**2122-11-16**] for unstable angina - pt has declined further attempts at revascularization. No current acute ischemic changes on ECG - Trend CE, negative x2 so far - Continue ASA, metoprolol and lisinopril - Goal HCT ~30 given history of ischemia . #. Moderate Aortic Stenosis - careful diuresis given increased preload dependence - BB and ACE-I as above . # Gout: On allopurinol. Started cholchicine at home dose as needed #. COPD Will start tiotropium for likely COPD. Outpatient PFTs . #. Chronic GI Bleeds - Pt has had GIB in past on plavix, monitor HCT . #. FEN - cardiac diet, replete lytes PRN . #. Access: PIV . #. PPx: heparin SC . #. Code: FULL . #. Dispo: Floor today ICU Care Nutrition: Glycemic Control: Lines: 18 Gauge - [**2124-3-8**] 06:50 PM Prophylaxis: DVT: Heparin SQ Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition: ------ Protected Section ------ Cardiology Teaching Physician Note On this day I saw, examined and was physically present with the resident / fellow for the key portions of the services provided. I agree with the above note and plans. I would add the following remarks: History Nothing to add, agree with above Physical Examination Nothing to add, agree with above Medical Decision Making Nothing to add, agree with above Total time spent on patient care: 30 minutes. ------ Protected Section Addendum Entered By:[**Name (NI) 4646**] [**Name (NI) **] on:[**2124-3-11**] 08:28 ------
Physician
Classify the following medical document.
Admission Date: [**2178-10-24**] Discharge Date: [**2178-10-30**] Date of Birth: [**2135-7-24**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 106**] Chief Complaint: chest pain Major Surgical or Invasive Procedure: Cardiac catheterization with drug-eluting stent placement in LAD x 2 History of Present Illness: Patient is a 43 year-old male with HTN, Family Hx of CAD, and Tobacco use who had episode of persistent chest pain after work 2 days PTA. States sharp substernal chest pressure going from throat to the esophagus. no radiation, no associated sob, denies n/v/d. Pain constant never relieved and pt came to the ED ~ 36 hours after the onset of pain. . In the [**Name (NI) **] pt noted to have ST elevations anterolaterally and tachycardic, given IV lopressor and sent to cath lab. . On cath found to have proximal occlusion of LAD ->[**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] 2, CI 1.86 -> IABP placed and pt transferred to CCU. Pain free post cath. On admission to CCU pt had no complaints. ROS: +some doe for months, denies pnd/orthopnea/syncope. +Palpitations. Past Medical History: 1. HTN 2. Anxiety 3. Psoriasis Social History: Smoker 15 pack year history. Lives in [**Location **], social etOH, programmer at [**Hospital1 112**]. Family History: Mother died of MI at 69, Father - CVA, 2 sisters with MI, DM, 2 brother with DM. Physical Exam: GEN: Middle aged man in NAD HEENT: PERRL, MMM, JVP ~9cm at 30degrees. CHEST: CTAB anteriorly and laterally. CVR: RRR, nl s1, s2, no r/m/g ABD: Soft, nt, nd EXT: no edema, 2+ dp/pt pulses bilaterally. Groin site with soft hematoma, arterial line in place. Neuro: CNI-XII intact, A&O X 3. Skin: bilateral white plaques on forarms consistent with psoriasis. Pertinent Results: CBC: 15.3/44.2/331 Diff, N:79.6 L:15.0 M:4.5 E:0.5 Bas:0.5 Chemistry: 137/3.8/97/25/14/1.0/174 CK: 287 MB: 7 Trop-*T*: 2.43 PT: 13.2 PTT: 25.1 INR: 1.2 . DATA: ECG presentation: ST at 142, [**Apartment Address(1) 25947**],L, V1-V5. (V2-V4 >5mm). ECG post cath: ST at 100, ST normalized in 1,l,v1. STE V2 2mm, v3-V4 3mm. Cath - CO 3.24, CI 1.83, PCW 21, RA 10, PA 32/17, RV 32/8. LMCA - nl, LAD occluded at its origin, diag with thrombus and stenosis at its origin. dilation and [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 5303**]. residual 80% with normal flow. LCX - normal. RCA - normal . ECHO The left ventricular cavity size is top normal/borderline dilated. There is moderate regional left ventricular systolic dysfunction. Overall left ventricular systolic function is moderately depressed. Resting regional wall motion abnormalities include anteroseptal, anterior hypokinesis/akinesis and apical akinesis/dyskinesis. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. No apical thrombus seen (cannot exclude). . CATH Initial angiography showed a proximally occluded LAD. We planned to recanalize the vessel. Eptifibatide was continued. A 6 French XBLAD3.5 guide provided good support. The lesion was crossed with great difficulties using a Choice PT wire, which was then exchanged for a Prowater wire. Thrombectomy was performed using an Export catheter. The lesion was then pre-dilated with a 2.0 mm balloon at 8 atm. Next, two overlapping 3.0x3 mm and 3.0x28 mm Cypher DES were deployed in the mid and proximal LAD at 14 atm. Post-dilation was performed with a 3.25x23 mm Highsail balloon at 16 atm. Angiography showed slow flow in D1, which was rescued with a 2.0 mm ACE balloon at 8 atm. Final angiography showed no residual stenosis in the LAD, some thrombus in D1 with an 80% resdual stenosis, no dissection and TIMI 3 flow in both vessels. The patient left the lab in stable condition. * COMMENTS: 1. Selective coronary angiography in this right dominant patient revealed severe single vessel CAD. The RCA was angiographically normal. The Left Main and LCX were also both angiographically normal. The LAD was completely occluded at its origin. The D1 also had thrombus and stenosis at its origin 2. Resting hemodynamics revealed mild RA pressure elevation of 10mmHG. The pulmonary pressures were slightly elevated at 32/17 and the PCWP was moderately elevated to 21mmHG consistent with abnormal diastolic function. The cardiac index was depressed at 1.83 l/min/m2. 3. Successful stenting of the LAD with two 3.0 mm Cypher drug-eluting stents, which were post-dilated to 3.25 mm. 4. Successful insertion of a 40 cc IABP with good diastolic augmentation. Brief Hospital Course: Patient is a 43 year-old male with HTN, smoking history, Family Hx of CAD who presented with anterolateral ST elevations and found to have proximal occlusion of LAD in the cath lab. The following issues were addressed during his hospital stay: 1. Cardiovascular A. Coronary Artery Disease: Given complete proximal LAD occlusion in cath lab, 2 DES were placed in the artery with significant improvement in blood flow. Patient tolerated procedure well. An intra-aortic balloon pump was also placed in the cath lab with good diastolic augmentation. Patient received integrillin drip for 18 hours post-cath. Also started on ASA/Plavix/Statin/ACEI. BB was started prior to discharge, and medications were titrated up as tolerated. Patient was evaluated by Physical Therapy and cleared for discharge home with recommendations for cardiac rehabilitation. B. Pump: At cath, CO 3.24, CI 1.86. An IABP was placed at cath for afterload reduction and better coronary perfusion. This was discontinued the following day. LVEDP was 21 on cath, however post-cath patient voided 450cc without any lasix. ECHO showed EF 35%, anterospetal, anterior hypokinesis/akinesis, apical akinesis/dyskinesis, with no overt apical thrombus visualized. Given apical akinesis, patient was started on Coumadin and bridged with heparin until therapeutic INR was achieved. C. Rhythm: Patient in sinus rhythm, with initial tachycardia of multifactorial etiology: fever, acute coronary syndrome, dehydration, and poor EF with compensatory tachycardia to maintain cardiac output. Patient's HR began to decrease gradually post-MI, with fever resolution and improved cardiac function. No significant events were noted on telemetry. Patient to follow-up with Electrophysiology in 1 month for ICD placement evaluation. 2. FEVER Patient developed fever of unclear etiology post-MI; UA, CXR negative. 1 set blood cultures with gram positive cocci clusters/pairs, coagulase negative, likley contaminant given clinical picture. Other work-up was negative, and fever curve trended down without antibiotic therapy. Impression was fever secondary to acute myocardial infarction and cytokine release. Patient was without evidence of leukocytosis, and was afebrile x 48h prior to discharge without Tylenol administration. . 3. HTN Patient initially with asymptomatic relative hypotension initially, which resolved with cardiac revascularization and gentle fluid boluses. Patient discharged on Toprol XL 50 and Lisinopril 5, to follow-up in [**Hospital 191**] clinic for further control. . 4. PSORIASIS Patient with bilateral psoriatic plaques over arms, back, legs. No acute issues as inpatient, to be followed as outpatient. . 5. HEME Blood bank contact[**Name (NI) **] team as patient with [**Name (NI) 25948**] antibody on Type and Screen, usually seen in patients with history of transfusion. Patient denies any history of blood product transfusion. Labs not consistent with hemolysis; haptoglobin 350s, adjusted retic count WNL (LDH cannot be used as marker given recent infarction) Patient reportedly with sickle cell trait, nothing to work-up further as inpatient. . 6. Prophylaxis Patient on heparin gtt while being bridged to Coumadin. Patient ambulating, had BM while inpatient. Medications on Admission: Paxil 10mg qd. Discharge Medications: 1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*6* 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*3* 3. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*4* 4. Paroxetine HCl 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 5. Warfarin 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Please have your INR checked; dose may be adjusted accordingly. Disp:*30 Tablet(s)* Refills:*0* 6. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO at bedtime. Disp:*30 Tablet(s)* Refills:*6* 7. Metoprolol Succinate 50 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*6* 8. Warfarin 2 mg Tablet Sig: One (1) Tablet PO As directed by a physician: [**Name10 (NameIs) **] is an extra prescription to be used pending any changes in your Coumadin dosage. . Disp:*60 Tablet(s)* Refills:*0* 9. Outpatient Lab Work Please have your INR drawn by VNA on Saturday and have results called to Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) **] at [**Hospital3 **] on [**11-2**] - Monday A.M. -- [**Telephone/Fax (1) 250**] (INR does not need require f/u over weekend) Discharge Disposition: Home With Service Facility: [**Location (un) 86**] VNA Discharge Diagnosis: Primary 1. Acute ST Elevation MI s/p 2 DES to LAD Secondary 1. HTN 2. Hyperlipidemia 3. Tobacco use Discharge Condition: chest-pain free, hemodynamically stable, afebrile Discharge Instructions: 1. Please take all medications as prescribed -- Aspirin and Plavix MUST be taken daily. 2. Among your new medications, you have been started on Coumadin. This requires frequent visits for lab draws. Please make sure the results are sent to your PCP so that necessary dose adjustments can be made. 3. Please make all follow-up appointments. 4. Please refrain from any strenuous activity including heavy lifting for the next few weeks and until cleared by a cardiologist. 5. Please stop smoking 6. You will need to begin cardiac rehabilitation in 1 month - please arrange this with your PCP [**Name Initial (PRE) **]/or cardiologist. Followup Instructions: The following appointments have been schedule for you: 1. Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) **], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2178-11-2**] 11:30 (To have your INR checked) -- [**Hospital Ward Name 23**] Clinical Center, [**Location (un) 895**], North Suite 2. Provider: [**Name10 (NameIs) 640**] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2178-11-11**] 2:30 (To establish new PCP) - [**Hospital Ward Name 23**] Clinical Center, [**Location (un) 895**] 3. Cardiology: Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], [**Name Initial (NameIs) **].D. Phone:[**Telephone/Fax (1) 5003**] Date/Time:[**2178-11-17**] 1:00, [**Hospital Ward Name 23**] Clinical Center, [**Location (un) **] 4. Electrophysiology (evaluation for ICD placement). Dr. [**Last Name (STitle) **], Friday, [**2184-12-3**]:00 AM. [**Hospital Ward Name 23**] Clinical Center, [**Location (un) 3971**] Completed by:[**2178-11-2**]
Discharge summary
Classify the following medical document.
micu npn 1900-0700 patient received at 1900 from am shift. micu team had finished putting in r subclavian quad lumen. cxr showing that it was not in the correct position. dr [**Last Name (STitle) **] coming down to assist in rewiring line. cxr done and line ok per resident samone [**Doctor Last Name **]. r ij line pulled and i sent the tip for culture and switched over his lines to the new subclavian. within a half an hour dr [**Last Name (STitle) **] informed me that his line needed to be rewired again d/t incorrect positioning. i accessed his groin dialysis line fro propofol and the ambisone that he had begun to receive. dr. [**Last Name (STitle) **] and dr. [**Last Name (STitle) **] placed a new quad lumen in the r ij that has been confirmed by cxr to be in the correcr position. his line have been switched back over to this new line. systenms review- neuro- patient remains sedated on 30 mcg/kg/[**Last Name (STitle) 217**] of propofol. he opens eyes and awakens to voivem inconsistantly follows some simple commands, not able to get him to nod his head to yes/no q's though. cv- vasopressin off ~12am with last line change, bp had been in the 120 sys map 70's range. within a half hour, the intern, dr [**Last Name (STitle) **], pulled the subclavian line and pt's bp began to fall to the mid 80 sys range maps 50-60. vasopressin restarted at previous dose of 0.04 u/[**Last Name (STitle) 217**]. also within this time. pt had previously not had any ectopy, he began to have 4-7 beat runs of vtach, which all spontaneously resoved. after the line was placed a chem 10 was sent off revealing a K of 2.9 and mg of 1.6. the pt received 40 meq kcl and 3 amps mg. am labs to be drawn shortlky will reflect this. hr 60-70's o/n, sbp remains 95-100 on vasopressin. resp- remains on a/c .4 fio2 peep 10 750x14, occ breathing 1-2 breaths above, sats 98-100%, no abg's ordered this shift. suctioning tan thick sputum via ett q4-5 hrs. gi/gu- tube feeds (deliver 2.0( continue at 30 cc/hr, to up rate to 40 at 6am, [**Last Name (STitle) **] to advance SLOWLY -- q12 hrs to goal of 50cc/hr. viokase begun to assist in absorbtion of tube feeds d/t pt's hx of pancreatic insufficiency. pt conts w/large amts of stool (1300cc) o/n to mushroom catheter, slightly ob+ this am. sm amts brown urine to foley. endo- insulin gtt off xseveral hrs while access was an issue. [**Last Name (STitle) **] titrating blood sugars q1-2 hrs, currently at 0.5 u/hr bs in the 80;'s. id- a febrile o/n. vasopressin back on ?volume depletion w/lg stool losses and dialysis x2 days in a row w/good fluid removal both days. vs. new sepsis s/p pulling line out.. conts on ambisone q24 hrs for yeast n blood cultures from [**2163-8-31**]. heme- conts to have [**Last Name (un) 374**] low platelets, hit+, now pt w/new lij, subclavian clots, pt written to begin on lipirudin for anticoagulation, held o/n d/t r dialysis line needing to be pulled tonight or more likely in the am.. skin- multiple issues,, see flowsheet for details. much improved rash from uremia of last week. now pt w/yeast to groin, back, arm pits.. treating w/miconizole powder. [**Last Name (un) **] to support on vent until ms [**First Name (Titles) 7959**] [**Last Name (Titles) **] ready to begin weaning.. vasopressin for maps >60, attempt to turn off a
Nursing/other
Classify the following medical document.
Admission Date: [**2159-9-18**] Discharge Date: [**2159-9-20**] Date of Birth: [**2084-12-10**] Sex: M Service: MEDICINE Allergies: Enalapril Attending:[**First Name3 (LF) 106**] Chief Complaint: s/p right carotid angiography and stenting Major Surgical or Invasive Procedure: Right carotid angiography and stenting History of Present Illness: 74M hx of L ICA stenosis (s/p CEA [**2159-6-26**]), 80% R ICA stenosis, CAD s/p CABG ([**2154**], anatomy unavailable), EF 60%, prior CVA (no residual deficits), PAF (On Coumadin), HTN, HL, DMII, Moderate to Severe PVD, that presents to CCU following right carotid angiography and stenting. . The pt was referred to Dr. [**Last Name (STitle) **] on [**2159-4-28**] for evaluation of PVD. The pt subsequently underwent stress nuclear perfusion (no anginal symptoms or ischemic EKG changes). Non-Invasive vascular studies revealed non-compressible vessels and moderate to moderately severe peripheral vascular disease at rest based on Doppler waveforms and PVR??????s. ABI??????s invalid due to non compressibility of vessels. Given the pts known carotid bruits, the pt underwent Carotid U/S that showed significant bilateral carotid stenosis, L>R. Angiography ([**2159-6-25**]) revealed an 80% stenosis of the [**Country **] (which supplies the left ACA) and a 99% [**Doctor First Name 3098**] stenosis. Cerebral angiography further revealed patent right ACA and MCA and patent left ACA and left MCA. He did have a recent event when he was unable to move his left leg for a couple of days, but slowly regained function. . Thus the pt underwent L CEA on [**2159-6-26**]. Of note during the admission for ([**2159-6-25**] thru [**2159-6-28**]) the pt tolerated the procedure well. On POD 1 he experienced a severe headache that did resolve and was consistent with symptoms of reperfusion postop. The pt was kept in the VICU overnight for observation. The pt also experienced increased neck stiffness at that time. The pt also had LE swelling US without DVT. Subsequent Carotid U/S ([**2159-7-19**]) revealed stable R ICA stensosis 70-79% (unchanged). Left side without residual stenosis at CEA site. . Upon further review of symptoms the pt reports + Occasional dizziness, no prior syncope, occasional HA, Denies CP/SOB. No sensory or motor defects. The pt also noted a history of "ill defined feeling" in both legs with exercise that occasionaly occurs with rest. The pt previously attributed this to prior SVG harvest. He recalls that he might have had a stroke 10-15 years ago (unclear) without any residual deficit. Prior to CABG, he only had diaphoresis. . Further review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, palpitations, syncope or presyncope. . In general, the patient tolerated the procedure well. He had a vagal reaction during the procedure which required atropine. His SBP then went up to the 200s requiring a nitro drip. Access was first attempted in the right arm, but was unsuccessful. Therefore a right femoral approach as used. He was transferred to the CCU with an SBP of 100 off of the nitro drip for close monitoring of his blood pressures with a goal SBP between 90 and 120. He had a headache after the procedure which resolved by the time he was transferred to the CCU. Past Medical History: Paroxysmal atrial fibrillation CAD s/p CABG in [**2154**] ([**Hospital1 112**]) Prior CVA Bilateral carotid artery disease Anemia PVD Hypertension Diabetes c/b retinopathy and peripheral neuropathy Cataracts s/p surgery Thyroid nodule Colon polyps s/p resection Intermittent Lower back pain Proteinuria s/p right elbow fracture as a child Arthritis Social History: Patient is married with two children Lives with: Wife Occupation: previously worked as a printer ETOH: none Family History: No family history of premature CAD Physical Exam: VS: T=36.4 BP=91/44 HR=51 RR=14 O2 sat=100% RA GENERAL: pleasant male in NAD. Alert and oriented x3. Mood, affect appropriate. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 8 cm. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. Left> right crackles at the bases. No wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. RUE bandage is c/d/i. RLE has some oozing at the cath site, no hematoma. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. Warm and well perfused with normal capillary refill time. 1+ Left and trace right lower leg edema. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 1+ DP, PT [**Name (NI) **] [**Name (NI) 2325**]: Carotid 2+ Femoral 2+ Popliteal 1+ DP, PT [**Name (NI) **] Pertinent Results: Cardiac Cath ([**9-18**])- 1. Access was initially obtained at the right brachial artery. Due to anatomic tortuosity, we changed our approach and obtained access from the right femoral artery. 2. Selective angiography of the right carotid artery showed an 80% stenosis at the bifurcation of the ICA and ECA extending distally into the proximal segment of the ICA. 3. Successful PTA and placement of an 8.0x29mm self-expanding Carotid Wallstent were performed. The stent was post-dilated using a 5.0mm balloon. (See PTA comments.) 4. The right common femoral arteriotomy was successfully closed using a Perclose Proglide device. . FINAL DIAGNOSIS: 1. Right carotid artery disease. 2. Successful placement of a stent in the CCA-ICA. 3. The primary operator for this procedure was Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. The primary assistant was Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. . [**2159-9-19**] 06:40AM BLOOD WBC-8.1 RBC-2.95* Hgb-8.2* Hct-25.5* MCV-87 MCH-27.7 MCHC-32.0 RDW-15.0 Plt Ct-220 [**2159-9-19**] 02:05PM BLOOD WBC-8.0 RBC-2.81* Hgb-8.0* Hct-24.5* MCV-87 MCH-28.4 MCHC-32.5 RDW-14.3 Plt Ct-185 [**2159-9-18**] 09:00AM BLOOD PT-14.1* PTT-33.6 INR(PT)-1.2* [**2159-9-19**] 06:40AM BLOOD PT-13.4 PTT-31.1 INR(PT)-1.1 [**2159-9-19**] 06:40AM BLOOD Glucose-58* UreaN-32* Creat-2.0* Na-134 K-4.3 Cl-100 HCO3-24 AnGap-14 [**2159-9-19**] 02:05PM BLOOD Glucose-215* UreaN-32* Creat-2.1* Na-130* K-4.5 Cl-98 HCO3-23 AnGap-14 [**2159-9-19**] 02:05PM BLOOD Calcium-8.7 Phos-3.8 Mg-1.9 Brief Hospital Course: 74 y/o male with severe PVD, CABG in [**2154**], CVA with no residual effect, and bilateral carotid artery disease s/p left CEA [**7-3**] presenting for right carotid stenting. . # s/p RCA Stenting: Pt enrolled in [**Last Name (un) 81078**] study, underwent RCA stenting. Patient had a vagal reaction during the procedure which required atropine. His SBP then went up to the 200s requiring a nitro drip. Otherwise he tolerated the procedure well and was transferred to the CCU with an SBP of 100 off the nitro drip. While in the CCU, our goal remained SBP 90-120. Patient stayed in the 100s-120s. Neuro exam performed q1h for 2 hours, q2h for 2 checks, and then q6h after the procedure - all were within normal limits. Post-cath check at 2:30PM showed some R femoral oozing, but no hematoma or bruit. Patient's heart rate was 40s-50s s/p procedure, asymptomatic. His beta blocker was held in this setting; resumption will be addressed by his PCP. [**Name10 (NameIs) **] will go home on [**Doctor Last Name **] of Hearts monitor to continually monitor heart rate for 2 weeks. Patient's home dose of ASA 325mg and Plavix 75mg continued after procedure. Coumadin 5mg resumed after the procedure and lovenox administered twice daily dosing until INR became therapeutic. Patient will go home with 5 days of lovenox as bridge. INR will be checked on [**9-24**]. . # CORONARIES: previous CABG. Last stress-MIBI without concerning ECG changes. Continued home ASA, Plavix, Statin, Beta-Blocker, [**Last Name (un) **]. Patient denied any chest pain while in hospital. No EKG changes noted. . # PUMP: Last EF 60%. Initially had elevated BP's post-procedure. Trended down to SBP 100s-120s. Switched home atenolol 150mg daily to metoprolol 75mg [**Hospital1 **] for rate control given slightly increased creatinine. Upon discharge, BP was 110s-120s and HR was 50s, 60s with ambulation. Patient stable. . # RHYTHM: Pt with hx of PAF, currently bradycardic sinus rhythm. Continued to stay in bradycardic rhythm at HR 45-50s. Discharged on [**Doctor Last Name **] of Hearts monitor for 2 weeks, as noted above. Will transmit 2-3 times daily. . # DMII: Patient not on insulin as outpatient. HbA1C 7.3 ([**4-2**]). Gave home dose of glipizide and then covered to Humalog SS while in house. Held home metformin while in-hospital. Restarted upon discharge. . # Anemia: Unclear etiology. There is a longstanding history from prior records. Previous ferritin was normal. No microcytosis. Mildly elevated creatinine. Hemoglobin Electropheresis WNL (+FM hx for anemia). Hct baseline ranges from 25-30. Ranged between 24.5-31.5 while in hospital. Consider outpatient work-up. . Medications on Admission: Aspirin 325mg daily Plavix 75mg daily Simvastatin 40mg Daily Atenolol 150mg PO Daily Irbesartan 300mg daily Coumadin 2mg daily, 2 tablets as directed, last dose [**2159-9-13**] Lovenox b.i.d. on [**2159-9-16**] and [**2159-9-17**] Furosemide 40mg daily Glipizide 10mg twice a day Metformin 850mg three times a day Iron-Docusate Sodium 150mg-100mg one tablet twice a day Milk of Magnesia PRN Foltx one tablet daily Discharge Medications: 1. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Glipizide 10 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Irbesartan 300 mg Tablet Sig: One (1) Tablet PO once a day. Tablet(s) 7. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. 8. Metformin 850 mg Tablet Sig: One (1) Tablet PO three times a day. 9. Iron with Stool Softener 150 (50)-100 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO twice a day. 10. Foltx 2.5-25-2 mg Tablet Sig: One (1) Tablet PO once a day. 11. Enoxaparin 100 mg/mL Syringe Sig: One (1) injection Subcutaneous Q24H (every 24 hours) for 5 doses. Disp:*5 syringes* Refills:*0* 12. Warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM for 5 doses. Disp:*5 Tablet(s)* Refills:*0* 13. Warfarin 2 mg Tablet Sig: One (1) Tablet PO once a day: start once your INR is between [**2-27**]. Tablet(s) Discharge Disposition: Home Discharge Diagnosis: right sided carotid stenosis s/p stent placement . Secondary diagnoses: - s/p CABG - HTN - dyslipidemia - PAF (On Coumadin) - Prior CVA [**60**]-15 years ago (No residual defects) - Bilateral carotid artery disease s/p left CEA [**2159-6-26**] - Anemia (Unknown Etiology) - PVD - DMII c/b retinopathy and peripheral neuropathy - Cataracts s/p surgery - Thyroid nodule - Colon polyps s/p resection - Intermittent Lower Back Pain - Proteinuria - s/p right elbow fracture as a child - Arthritis Discharge Condition: Good, vital signs stable, ambulatory Discharge Instructions: You were admitted to the hospital to undergo a carotid stent placement to relieve a blockage in your carotid vessel. The procedure went well however you developed a low heart rate afterwards. Because of this you were admitted to the CCU for close monitoring. While you were in the CCU, your heart rate remained stable and you were asymptomatic. You will go home with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] of Hearts monitor to continually monitor your heart rate at home. . The following medication changes were made: 1. Stop your beta-blocker (atenolol 150mg). 2. Take lovenox 100mg daily for 5 days (day 1- [**9-20**]) or at least until your Coumadin level (INR) is between [**2-27**]. 3. Take Coumadin 5mg daily for 5 doses or until your INR is between [**2-27**] and then you can go back to your home dose of Coumadin 2mg daily. 4. You need to get your INR levels checked on [**9-22**] to monitor your blood thinning levels. . Please follow-up with all of your outpatient medical appointments listed below. . Please seek medical care if you experience any concerning symptoms such as headache, dizziness, lightheadedness, decreased muscle strength, chest pain, or increased shortness of breath. Followup Instructions: Please follow-up with all of your outpatient medical appointments listed below. 1. Follow-up with your [**Hospital 263**] clinic ([**Hospital1 **]-[**Location (un) **]) for INR check on Saturday, [**9-22**] (If your INR is between [**2-27**] then you can stop Lovenox, if it is below 2, continue with Lovenox). 2. Provider: [**First Name4 (NamePattern1) 1575**] [**Last Name (NamePattern1) 1576**], MD Phone:[**Telephone/Fax (1) 1579**] Date/Time:[**2159-10-2**] 10:10 3. Provider: [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2159-10-19**] 2:20 4. Provider: [**Last Name (NamePattern4) **]. [**First Name (STitle) **] [**Doctor Last Name **] Phone:[**Telephone/Fax (1) 1142**] Date/Time:[**2159-11-7**] 11:15 Completed by:[**2159-9-20**]
Discharge summary
Classify the following medical document.
TITLE: [**Hospital Unit Name 10**] Resident Progress Note Chief Complaint: 24 Hour Events: - off neosynephrine, only on levophed - checking daily LFTs and amylase/lipase as is s/p ERCP - Echo results [**8-22**] showed hyperdynamic LV, EF >75%, mild LVH, no focal wall motion abnormality - CVP was 22 based on femoral line - [**Hospital1 966**] accepted her for transfer - Got CVVH in preparation for transfer and for afternoon K of 6.1, decreased to 4.9 after CVVH - [**Hospital1 966**] decided they don't have space for her until [**1-10**], but they did tell us that she has antiphospholipid sydrome and she was started on heparin gtt Allergies: Ace Inhibitors Unknown; Levaquin (Oral) (Levofloxacin) Unknown; Cephalosporins Unknown; Oxycodone Unknown; Percocet (Oral) (Oxycodone Hcl/Acetaminophen) Unknown; Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2194-1-8**] 06:00 AM Meropenem - [**2194-1-9**] 03:43 PM Linezolid - [**2194-1-9**] 10:03 PM Gentamicin - [**2194-1-10**] 06:31 AM Infusions: Fentanyl - 25 mcg/hour Norepinephrine - 0.03 mcg/Kg/min Midazolam (Versed) - 1 mg/hour Heparin Sodium - 1,050 units/hour Other ICU medications: Heparin Sodium (Prophylaxis) - [**2194-1-9**] 03:42 PM Pantoprazole (Protonix) - [**2194-1-9**] 04:24 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2194-1-10**] 07:26 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.7 C (98 Tcurrent: 36.5 C (97.7 HR: 75 (62 - 85) bpm BP: 107/65(79) {91/54(66) - 117/78(89)} mmHg RR: 19 (15 - 33) insp/min SpO2: 98% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 84.4 kg (admission): 74 kg Height: 67 Inch CVP: 24 (20 - 34)mmHg Total In: 3,877 mL 312 mL PO: TF: IVF: 3,737 mL 312 mL Blood products: Total out: 1,026 mL 104 mL Urine: NG: 500 mL Stool: Drains: Balance: 2,851 mL 208 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 360 (360 - 360) mL Vt (Spontaneous): 153 (153 - 153) mL RR (Set): 16 RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 40% RSBI: 74 PIP: 22 cmH2O Plateau: 22 cmH2O Compliance: 21.2 cmH2O/mL SpO2: 98% ABG: 7.32/43/164/24/-3 Ve: 5.7 L/min PaO2 / FiO2: 410 Physical Examination GENERAL: cushingoid AAF, intubated and sedated HEENT: b/l injected conjunctiva, b/l chemosis. No scleral icterus. MM lubricated. Neck: unable to assess JVP 2/2 habitus. tunneled line in place CARDIAC: Regular tachycardia, 2/6 systolic murmur across precordium LUNGS: coarse breath sounds, no crackles or wheezes ABDOMEN: obese and surgically scarred abdomen. Minimal BS. NABS. EXTREMITIES: cool, no edema, dopplerable dorsalis pedis/ posterior tibial pulses. RUE old AV fistula without thrill/bruit SKIN: No rashes/lesions, ecchymoses. Labs / Radiology 105 K/uL 12.7 g/dL 126 mg/dL 5.0 mg/dL 24 mEq/L 4.9 mEq/L 37 mg/dL 109 mEq/L 147 mEq/L 41.7 % 8.4 K/uL [image002.jpg] [**2194-1-9**] 02:29 AM [**2194-1-9**] 05:53 AM [**2194-1-9**] 12:29 PM [**2194-1-9**] 12:42 PM [**2194-1-9**] 03:19 PM [**2194-1-9**] 05:44 PM [**2194-1-9**] 06:22 PM [**2194-1-10**] 12:00 AM [**2194-1-10**] 12:07 AM [**2194-1-10**] 02:29 AM WBC 8.3 8.4 Hct 41.5 41.7 Plt 110 105 Cr 6.5 6.7 5.0 5.0 TCO2 22 21 19 23 23 Glucose 198 144 119 126 Other labs: PT / PTT / INR:14.7/150.0/1.3, CK / CKMB / Troponin-T:/8/0.45, ALT / AST:227/51, Alk Phos / T Bili:162/0.4, Amylase / Lipase:53/32, Differential-Neuts:94.2 %, Lymph:3.6 %, Mono:2.1 %, Eos:0.1 %, Lactic Acid:2.0 mmol/L, Albumin:3.3 g/dL, LDH:212 IU/L, Ca++:8.3 mg/dL, Mg++:1.9 mg/dL, PO4:5.9 mg/dL Blood cultures 11/25 and [**1-9**] NGTD Sputum [**1-8**] GRAM STAIN (Final [**2194-1-8**]): >25 PMNs and <10 epithelial cells/100X field. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Preliminary): RARE GROWTH Commensal Respiratory Flora. YEAST. SPARSE GROWTH. Assessment and Plan 49F with SLE on chronic steroids, ESRD on HD, ERCP earlier today for choledocholithiasis, who presented with sepsis and pancreatitis. . #. Sepsis - probable biliary source but DDX includes line infection. Has h/o multidrug resistant organisms at [**Hospital1 966**]. -- f/u blood cultures (and those from [**Hospital1 1504**] ER) -- continue meropenem/getamicin/linezolid for broad coverage -- prn fluid for CVP goal [**9-25**], will check femoral line CVP, will also check delta pulse pressure -- wean vasopressors for MAP > 65 -- continue stress dose steroids for now -- f/u ERCP c/s recs -- f/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] c/s recs -- will get echo to assess heart function with all these fluids, check OSH records for any previous TTe . #. Resp Failure - Was intubated for airway protection, never dropped saturations or demonstrated problems with oxygenation. She has evidence of volume overload on CXR, will need aggressive IVF for sepsis and pancreatitis management, so this will be a barrier to extubation in the future. -- wean FiO2 as tolerated, keep on AC for now -- ultimately, volume management will be via HD/CVVH -- send sputum cultures -- fent/midaz for sedation . #. Pancreatitis s/p ERCP - no evidence of persistent obstruction or free air on CT scan. However, pancreatic enzymes are elevated, and HCT acutely elevated c/w pancreatitis. -- aggressive IVF -- NPO with bowel rest for now -- pain control with IV fentanyl -- trend LFTs and panc enzymes daily -- ERCP to follow . #. ESRD -- should be dialyzed today, will touch base with renal team -- can likely do hemodialysis but if BP drops, may need CVVH -- renally dose all medications . #. SLE -- currently on stress dose steroids, replacing her home dose -- continue Plaquenil 200mg daily -- continue Bactrim SS daily for prophylaxis . # h/o PE - on despite ESRD [**3-18**] "coumadin resistence" -- holding lovenox for now, will clarify coagulation needs by getting OSH records ICU Care Nutrition: NPO for now given pancreatitis, but prefer early intiation of TF's via OGT when possible, will obtain nutrition c/s Glycemic Control: Added ISS Lines: Dialysis Catheter - [**2194-1-8**] 05:42 AM Arterial Line - [**2194-1-8**] 06:33 AM Multi Lumen - [**2194-1-8**] 03:18 PM Prophylaxis: DVT: Sc heparin/pneumoboots Stress ulcer: VAP: Comments: Bowel regimen colace/senna Communication: Comments: Code status: Full code Disposition: [**Hospital Unit Name 10**]
Physician
Classify the following medical document.
TITLE: Chief Complaint: Hypoxia HPI: This is a 45 year old Armenian female transferred from the BMT service with worsening hypoxia. She was in her usual state of health until mid [**Month (only) 93**], she began to have fevers, chills, nightsweats. This was accompanied by a non-productive cough, nasal congestion, and fevers to 104. She was seen at [**Hospital3 **] ED and was found to have a WBC of 115 with 7% blasts, 45% bands, 15% neutrophils, 5% lymphs, 3% promyelocytes, 14% myelocytes with LDH 1661, uric acid 4.2, Hct 23.3, plat 28,000. She had O2 sats in the 80s on RA and was given CTX and levaquin. She had a BM biopsy at the time the results for which were inconclusive and she was transferred to the [**Hospital1 1**] for possible leukopharesis. She was started empirically on vancomycin, cefepime, levofloxacin and tamiflu. She had a CT chest that showed diffuse ground glass opacities with airspace opacification in RML and bilateral bases, as well as central lymph node enlargement and splenomegaly. She was started on hydroxyurea for her initial WBC 120,000 and her WBC has improved today to 32,000. Bone marrow bx here suggestive of acute myeloid leukemia, cytogenetics pending. Despite broad antibiotic coverage, her O2 requirement began to increase and micafungin was added empirically yesterday for fungal coverage. This afternoon MICU evaluation was requested due to worsening hypoxia with O2 sat 90% on 50% FM. She was given lasix 10 mg IV with ~1.5L urine output. ABG revealed respiratory alakalosis with concomittant metabolic alkalosis. Bicarb gtt was discontinued to improve metabolic alkalosis. She was noted to have a temperature of 104 and standing tylenol was ordered. She underwent a repeat CT thorax that revealed worsening widespread ground glass opacities in the lungs bilaterally, with airspace opacities in the lung bases, right middle lobe, and lingula. Due to lack of improvement in respiratory status, and also with plans to initiate chemotherapy for presumed component of infiltrative leukemia adding to worsening respiratory status, she was transferred to the [**Hospital Unit Name 10**]. . In the [**Hospital Unit Name 10**], she reports a productive cough with yellow sputum with blood streaks. She reports that her breathing has been gradually worse over the last few days. Allergies: No Known Drug Allergies Last dose of Antibiotics: Vancomycin - [**2153-8-11**] 07:38 PM Levofloxacin - [**2153-8-11**] 09:52 PM Cefipime - [**2153-8-11**] 11:34 PM Infusions: Other ICU medications: Other medications: Medications at time of transfer: Atrovent 1 neb Q6H Albuterol 1 neb Q6H Tylenol 650 mg Q6H Allopurinol 300 daily Micafungin 100 mg Cefepime 2 gm Q8h Vancomycin 1 gm Q12H Levofloxacin 750 mg IV daily Tamiflu 75 PO BID Past medical history: Family history: Social History: Rheumatic fever c/b arthralgias Mother with history of breast cancer, father with history of throat cancer. She moved to US from [**Country 7525**] 7 years ago. Russian is her native language. She also speaks English. Married. 2 sons, age 15 and 20, works as a health aid. 25 pack year smoking history, quit 9 days ago. Review of systems: Flowsheet Data as of [**2153-8-12**] 12:07 AM Vital Signs Hemodynamic monitoring Fluid Balance 24 hours Since 12 AM Tmax: 39.2 C (102.6 Tcurrent: 37 C (98.6 HR: 99 (99 - 137) bpm BP: 116/63(81) {116/63(81) - 122/67(84)} mmHg RR: 24 (24 - 40) insp/min SpO2: 97% Heart rhythm: SR (Sinus Rhythm) Height: 62 Inch CVP: 8 (8 - 12)mmHg Total In: 1,060 mL 27 mL PO: TF: IVF: 780 mL 15 mL Blood products: 280 mL 13 mL Total out: 1,410 mL 160 mL Urine: 1,410 mL 160 mL NG: Stool: Drains: Balance: -350 mL -133 mL Respiratory O2 Delivery Device: Aerosol-cool SpO2: 97% ABG: 7.46/43/92.[**Numeric Identifier 641**]/24/5 PaO2 / FiO2: 93 Physical Examination Vitals: T: 102.6 BP:122/60 P: 75 R: 38 O2: 92% 100% FM General: Sleeping but arousable, shallow breathing, oriented x 3 HEENT: Sclera anicteric, dry MM Neck: supple, JVP ~12 cm, no LAD Lungs: Diffuse crackles R>L CV: Tachycardic, nl s1 s2, [**2-16**] non-radiating soft systolic murmur Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Labs / Radiology 32 K/uL 6.8 g/dL 123 mg/dL 0.8 mg/dL 11 mg/dL 24 mEq/L 100 mEq/L 3.9 mEq/L 137 mEq/L 20.8 % 42.7 K/uL [image002.jpg] [**2150-1-12**] 2:33 A8/1/[**2153**] 07:48 PM [**2150-1-16**] 10:20 P8/1/[**2153**] 10:21 PM [**2150-1-17**] 1:20 P8/1/[**2153**] 11:35 PM [**2150-1-18**] 11:50 P [**2150-1-19**] 1:20 A [**2150-1-20**] 7:20 P 1//11/006 1:23 P [**2150-2-12**] 1:20 P [**2150-2-12**] 11:20 P [**2150-2-12**] 4:20 P WBC 42.7 Hct 20.8 Plt 13 32 Cr 0.8 TC02 32 Glucose 123 Other labs: PT / PTT / INR:16.2/31.5/1.4, ALT / AST:34/25, Alk Phos / T Bili:263/0.8, D-dimer:4687 ng/mL, Fibrinogen:541 mg/dL, Lactic Acid:1.2 mmol/L, Albumin:3.2 g/dL, LDH:559 IU/L, Ca++:8.2 mg/dL, Mg++:2.0 mg/dL, PO4:3.5 mg/dL Assessment and Plan This is a 45 year old female presenting with new diagnosis of likely AML now with worsening hypoxia, fever and diffuse interstitial infiltrates on CT. . # Hypoxemic respiratory distress: Pt with underlying emphysema compounding current picture. With interval progression of intersitial pattern on CT scan and worsening O2 requirement. Differential includes infectious etiologies (viral/bacterial including superimposing nosocomial infection given that she is now day #4 of hospitalization). Given progression despite broad spectrum coverage, infiltrative leukemia is also on differential. - Trial of diuresis with CVP goal < 10 - Check BNP, consider repeat ECHO if elevated - Continue broad spectrum coverage including vanc, cefepime, levoflox, micafungin and tamiflu. - Will add empiric anaerobic coverage with flagyl given recent emesis and worsening respiratory status - Follow up culture data - Frequent ABGs, trial of non-invasive ventilation if persistent O2 requirement/evidence of CO2 retention [**2-12**] fatigue - Chemotherapy per oncology - Nebs prn . # Fever: Currently meets SIRS criteria with temperature, HR, RR, and WBC. Remains hemodynamically stable, cultures negative to date. Clinical picture is compounded leukemia which may be responsible for the above. - f/u culture data - Antibiotics as above - Chemotherapy per oncology - ATC tylenol for fever given tachycardia, increase in metabolic demand . # Leukemia: With likely AML, awaiting cytogentics. Plan to start idarubacin and cytarabine tonight. - Dexamethasone, idarubacin, cytarabine per heme onc - TLS, DIC labs q6 hours - Transfuse to hct >24, plt> 15K - IVF with NS . # FEN: No IVF, replete electrolytes, regular diet . # Prophylaxis: p-boots . # Access: peripherals, RIJ, a-line . # Code: full . # Communication: Patient . # Disposition: pending above . ICU Care Nutrition:NPO Glycemic Control: n/a Lines: Multi Lumen - [**2153-8-11**] 05:46 PM Arterial Line - [**2153-8-11**] 11:13 PM Prophylaxis: DVT: p-boots Stress ulcer: n/a VAP: n/a Comments: Communication: Comments: Code status: Full code Disposition: pending improvement
Physician
Classify the following medical document.
Mr. [**Known firstname 20**] [**Known lastname **] is a 86 yo man with h/o CAD s/p MI and CABG in [**2136**], chronic AFib with V-pacing, chronic systolic CHF with EF 20%, multiple recent admission to the CCU for ICD firing, readmitted from [**Hospital **] rehab for left sided chest pain. He reports that he had severe left sided chest pain, worse with inspiration and palpation. He denies any dyspnea, nausea, vomiting, abdominal pain, diaphoresis, left arm or jaw pain or any other complaints. He does not know if his ICD fired. Of note he has been admitted numerous times recently for VT and ICD firing due to sustained VT. During his recent admission from [**9-19**] -[**9-21**] he was bolused with IV amiodarone twice for episodes of VT during the admission. During that admission he continued to refuse VT ablation and turning off ICD. This admission pt again had VT and this time agreed to go for VT ablation, dtr was on vacation and not reachable. Pt tolerated procedure well, sheaths pulled last night at 8 PM, area of right groin is slightly eccyhmotic in the inguinal area, and he also has bruises on the ABD area. Distal pulses palpable. Ventricular tachycardia, sustained Assessment: s/p ablation [**9-22**] remains, AV-paced w occasional to rare PVC s noted. Hr 50-60earlier then MD [**First Name (Titles) 9311**] [**Last Name (Titles) 4129**] rate to 70 for improved cardiac output. NO further runs of VT Post ablation. Lido off yesterday. Cont on PO amiodarone. SBP 100-110 w map s > 60 . PT does complain of off and on Chest pain or burning and stomach upset. Team aware and they believe pain to be R/T procedure and pt was given one percocet with good effect. Pt, per family somewhat confused after percocet, because he forgot that his niece was here earlier. However He can be difficult to assess as he speaks mostly Russian and translating by family. Later seemed more oriented, pt requested that I talk to the doctors at the rehab, because he was not sleeping well there and maybe I could get a sleeping pill ordered. Action: Monitored groin, site stable . Response: Remains hemodynamically stable post ablation Plan: Continue to follow. Heart failure (CHF), Systolic, Chronic Assessment: Received lasix in lab yesterday and again this AM 120 mg IV. Action: Received lasix in lab and again this AM 120 mg IV. Response: Good diuresis after lasix putting out one liter so far today Plan: Cont per order, of note Mag was 6 this AM spoke to team we will redraw, likely that Level is due to labs being drawn from IV where Mag was running. We will recheck at one thirty with next lab draw Impaired Skin Integrity Assessment: Pt bruises easily, eccymotic areas on belly from Sub Cut heparin shots and the area around procedure site ( right inguinal area, ) also bruise on left wrist, ? old inflate on last admission , area 2x2 and pink. Marked. Also left wrist bruise ? from A line attempt Action: All areas cleaned with soap and water, LOTA, marked Response: No advancement of bruises and areas skin remains intact Plan: Turn frequently lotion to all areas . RISK for fall Assessment: Pt at times confused, language barrier, BKA , has not tried to get out of bed today. Action: Exit alarm on, interpreter family members have reiterated that pt will stay in bed and not get OOB without assistance, check on pt frequently, offer water and toileting. Response: Pt did not try to get OOB today. Plan: Exit alarm on, interpreter family members have reiterated that pt will stay in bed and not get OOB without assistance, check on pt frequently, offer water and toileting. Demographics Attending MD: [**Doctor Last Name **] [**Doctor Last Name 2562**] I. Admit diagnosis: VTACH Code status: DNR / DNI Height: Admission weight: 78 kg Daily weight: 78.7 kg Allergies/Reactions: Morphine Nausea/Vomiting Mirtazapine Unknown; Ambien (Oral) (Zolpidem Tartrate) nightmares; Precautions: PMH: CV-PMH: Angina, Arrhythmias, CAD, MI, Pacemaker Additional history: MI X2 (inferior and anteroseptal) - CABG: LIMA to LAD, SVG to OM/PDA ([**Hospital1 609**] [**2136**]) - Afib w/o anticoag (fall risk) - Sustained VTach in [**2146**] s/p admission - PACING/ICD: BiV ICD ([**2122**]?). ICD generator changed to [**Company 1994**] Concerto in [**2145**]. - legally blind secondary to glaucoma - Hiatal hernia - Hepatic cysts/hemangioma and lipoma in hepatic flexure - s/p Lt BKA (WWII trauma [**2078**]) - BPH s/p suprapubic prostatectomy ([**2131**]) - s/p cholecystectomy ([**2110**]) - Chronic low back pain - Osteoarthritis - Positive PPD in past - Depression and anxiety **former oncology md-[**Country **]. Surgery / Procedure and date: s/p cabg Latest Vital Signs and I/O Non-invasive BP: S:109 D:59 Temperature: 98.6 Arterial BP: S:132 D:56 Respiratory rate: 21 insp/min Heart Rate: 72 bpm Heart rhythm: AV Paced O2 delivery device: Nasal cannula O2 saturation: 97% % O2 flow: 2 L/min FiO2 set: 24h total in: 956 mL 24h total out: 2,760 mL Pertinent Lab Results: Sodium: 133 mEq/L [**2147-9-23**] 06:07 AM Potassium: 4.5 mEq/L [**2147-9-23**] 02:03 PM Chloride: 100 mEq/L [**2147-9-23**] 06:07 AM CO2: 25 mEq/L [**2147-9-23**] 06:07 AM BUN: 18 mg/dL [**2147-9-23**] 06:07 AM Creatinine: 1.0 mg/dL [**2147-9-23**] 06:07 AM Glucose: 90 mg/dL [**2147-9-23**] 06:07 AM Hematocrit: 38.9 % [**2147-9-23**] 06:07 AM Finger Stick Glucose: 177 [**2147-9-23**] 04:30 PM Valuables / Signature Patient valuables: teeth in moth dentures- eye drops Other valuables: Clothes: Sent home with: Wallet / Money: No money / wallet Cash / Credit cards sent home with: Jewelry: Transferred from: ccu Transferred to: [**Hospital Ward Name **] 3 Date & time of Transfer:
Nursing
Classify the following medical document.
Admission Date: [**2137-9-11**] Discharge Date: [**2137-9-14**] Date of Birth: [**2062-9-1**] Sex: M Service: MED Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 689**] Chief Complaint: Melena Major Surgical or Invasive Procedure: Esophagoduodenoscopy with cauterization of duodenal ulcer History of Present Illness: 75 year old man on ASA and Plavix for history of CVA, hx of tobacco and EtOH abuse presented to his PCP with one week of melena and increased stool output. He has had small dark stools, epigastric discomfort, and decreased appetite for ~1 week. His stool output had increased from 1 BD /day to [**1-22**] then several days PTA had constipation. He also endorsed LH, denied N/V, CP/SOB. Later that night, lab called PCP that pt had hct 20. Pt was sent to [**Hospital1 18**] ED where he had negative NG lavage. EGD showed an actively oozing duodenal ulcera in posterior bulb. It was injected with epinephrine and cauterized. Upon arrival at ED, his hematocrit was 19.3. He received 2 liters of NS and total 6 units of PRBC with increased in hct to 33. He was initially admitted to the MICU for observation overnight then transferred to the floor with stable HCT. Past Medical History: CVA x 3 with blindness in right eye Hypercholesterolemia Heavy alcohol use Social History: Drinks 3-4 glasses of wine or beer per day and quit smoking 4 days ago. 60 pack year history. Lives with wife and is a retired shoemaker who once worked in [**Country 651**]. Originally from Stuttgard. Has one daughter. Physical Exam: T98.1 BP 123/76 (107-150/70-81) HR 80 (80-90) 16 98%RA GEN WDWN elderly man, lying flat in bed, comfortable HEENT [**Last Name (LF) 12476**], [**First Name3 (LF) 13775**], EOMI, 2+carotid, R bruit, JVP ~[**10-1**] @45' o/p clear, MM dry CV faint heart sounds, nl S1 + S2, no M/R/G noted Pulm bibasilar crackles L>R, ~[**Date range (1) 23119**] from base Abd +BS, mild distension, mild tenderness in hypogastrum, no rebound tenderness EXT No edema, 2+DP Neuro CN2-12 grossly intact Pertinent Results: [**2137-9-11**] 05:00AM WBC-17.3* HCT-19.3* MCV-97 MCH-32.8* MCHC-33.9 RDW-17.2* PLT COUNT-246 NEUTS-81.2* LYMPHS-13.6* MONOS-4.1 EOS-0.6 BASOS-0.5 [**2137-9-11**] 05:00AM CK(CPK)-77 CK-MB-3 cTropnT-<0.01 [**2137-9-11**] 07:18PM CK(CPK)-71 CK-MB-NotDone cTropnT-<0.01 [**2137-9-11**] 01:50PM HCT-21.7* [**2137-9-11**] 07:18PM HCT-22.5* [**2137-9-11**] 09:28PM HCT-23.4* Brief Hospital Course: 1. Duodenal ulcer After cauterization by EGD and transfusion of 6u PRBC, his hct remained stable at 33 and he had no further episodes of melena or frequent BM. Serology for H. pylori was positive and he was started on clarithromycin and amoxicillin x 14 days in addition to protonix [**Hospital1 **]. His ASA and plavix were discontinued and the patient was asked to address with his primary care doctor when he should begin taking these. 2. Anemia Iron studies were consistent with iron deficiency anemia. He was started on iron daily. In addition he was given B12, folate, and MVI though these levels were normal, given his alcoholism. 3. EtOH use He was placed on CIWA scale with Diazepam, which he did not require. He was given MVI, thiamine, and folate as mentioned. 4. h/o CVA He has had 3 strokes in the past, but per patient he had a negative work up. He continued statin. While the ASA and plavix were held, it is likely he needs to be placed back on these medications for this significant CVA history; this will be determined by his PCP as an outpatient. Medications on Admission: ASA 325 mg po qd Plavix 75 mg po qd Atorvastatin 10 mg po qd Discharge Medications: 1. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*30 Tablet(s)* Refills:*2* 2. Multivitamin Capsule Sig: One (1) Cap PO QD (once a day). Disp:*30 Cap(s)* Refills:*2* 3. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO QD (once a day) as needed for constipation. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 4. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*30 Tablet(s)* Refills:*2* 5. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO once a day. 6. Clarithromycin 500 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 14 days. Disp:*28 Tablet(s)* Refills:*0* 7. Amoxicillin 500 mg Capsule Sig: Two (2) Capsule PO Q12H (every 12 hours) for 14 days. Disp:*56 Capsule(s)* Refills:*0* 8. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*60 Tablet, Delayed Release (E.C.)(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Duodenal ulcer Upper gastrointestinal bleed Blood loss anemia Helicobacter Pylori infection History of stroke x 3 Discharge Condition: Stable Discharge Instructions: You have a duodenal ulcer. You are being given medicine to help reduce your gastric secretions to allow this to heal. You have also tested positive for H. Pylori, a bacteria that can contribute to ulcers, and will need to take a course of antibiotics to treat this. Call your doctor for any new blood in your stool, diarrhea, dark black stools, lightheadedness, or fatigue. Followup Instructions: Please call your primary care doctor, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2903**] [**Telephone/Fax (1) 2936**], to make a follow up appointment within the next 1-2 weeks. He should discuss with you the risks and benefits of restarting aspirin and plavix to prevent further strokes given your ulcer and gastrointestinal bleeding.
Discharge summary
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TSICU HPI: 66F with hx of [**Hospital 1571**] transferred from [**Location (un) 78**] after having worst HA of life at 4p while at church. She denied N/V, CP, SOB, LOC. Was found to have SAH at OSH, Dilantin loaded and started on Nimodipine. She was then transferred here for further evaluation. Chief complaint: SAH W/ ANEURYSM PMHx: HTN, GERD Current medications: 1. 2. 3. 1000 mL NS 4. Acetaminophen 5. Acetaminophen-Caff-Butalbital 6. Bisacodyl 7. Calcium Gluconate 8. Docusate Sodium 9. HYDROmorphone (Dilaudid) 10. Heparin 11. HydrALAzine 12. Insulin 13. Magnesium Sulfate 14. Metoprolol Tartrate 15. Neutra-Phos 16. Nimodipine 17. Omeprazole 18. Ondansetron 19. OxycoDONE (Immediate Release) 20. Oxycodone-Acetaminophen 21. Phenytoin 22. Pneumococcal Vac Polyvalent 23. Potassium Chloride 24. Senna 25. Sodium Chloride 0.9% Flush 26. Sodium Chloride 0.9% Flush 27. Valsartan 24 Hour Events: [**5-10**]: complaints of headache, dilaudid dose increased, recieved dose of lopressor x1 Post operative day: POD#4 - IR- Coiling x 3 Allergies: No Known Drug Allergies Last dose of Antibiotics: Infusions: Other ICU medications: Hydralazine - [**2175-5-10**] 05:09 PM Hydromorphone (Dilaudid) - [**2175-5-10**] 05:30 PM Metoprolol - [**2175-5-10**] 05:40 PM Heparin Sodium (Prophylaxis) - [**2175-5-10**] 08:17 PM Other medications: Flowsheet Data as of [**2175-5-11**] 05:56 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**77**] a.m. Tmax: 37.9 C (100.3 T current: 37.5 C (99.5 HR: 81 (65 - 92) bpm BP: 171/67(94) {141/40(60) - 209/90(116)} mmHg RR: 17 (11 - 21) insp/min SPO2: 95% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 126 kg (admission): 125.9 kg Height: 67 Inch Total In: 1,400 mL PO: 1,400 mL Tube feeding: IV Fluid: Blood products: Total out: 5,420 mL 450 mL Urine: 5,420 mL 450 mL NG: Stool: Drains: Balance: -4,020 mL -450 mL Respiratory support O2 Delivery Device: None SPO2: 95% ABG: ///25/ Physical Examination General Appearance: No acute distress HEENT: PERRL Cardiovascular: (Rhythm: Regular) Respiratory / Chest: (Breath Sounds: CTA bilateral : ) Abdominal: Soft, Non-distended, Non-tender, Obese Left Extremities: (Edema: Absent), (Temperature: Warm) Right Extremities: (Edema: Absent), (Temperature: Warm) Neurologic: (Awake / Alert / Oriented: x 3), Follows simple commands, Moves all extremities Labs / Radiology 336 K/uL 11.8 g/dL 133 mg/dL 0.5 mg/dL 25 mEq/L 3.2 mEq/L 9 mg/dL 100 mEq/L 135 mEq/L 34.0 % 13.7 K/uL [image002.jpg] [**2175-5-6**] 11:57 PM [**2175-5-7**] 02:00 AM [**2175-5-8**] 01:37 AM [**2175-5-9**] 02:13 AM [**2175-5-9**] 02:07 PM [**2175-5-10**] 01:49 AM [**2175-5-11**] 03:40 AM WBC 7.8 9.9 10.9 18.8 12.4 13.6 13.7 Hct 36.9 33.0 32.9 33.7 33.8 32.3 34.0 Plt [**Telephone/Fax (3) 6029**]35 293 287 336 Creatinine 0.7 0.7 0.7 0.5 0.6 0.5 0.5 Troponin T <0.01 Glucose 172 160 146 131 179 146 133 Other labs: PT / PTT / INR:12.6/23.2/1.1, CK / CK-MB / Troponin T:32/2/<0.01, Differential-Neuts:82.8 %, Lymph:13.5 %, Mono:3.5 %, Eos:0.0 %, Albumin:4.0 g/dL, Ca:8.3 mg/dL, Mg:2.2 mg/dL, PO4:2.1 mg/dL Assessment and Plan AEROBIC CAPACITY / ENDURANCE, IMPAIRED, BALANCE, IMPAIRED, HYPERTENSION, BENIGN, PAIN CONTROL (ACUTE PAIN, CHRONIC PAIN), ANEURYSM, OTHER Assessment and Plan: 66F with SAH s/p coiling of AComm aneurysm Neurologic: Neuro checks Q: 2 hr, SAH, POD 2 s/p coiling. On dilantin 100 mg po tid. Low level, received additional bolus last pm, currently 8.9. Vasospasm prophylaxis with nimodipine. Repeat head CT unchanged. Monitor for total 7 days in ICU Pain:controlled with dilaudid prn, Fiorocet, oxycodone. Cardiovascular: hx of HTN, goal SBP 100-200 per neurosurg. BP control w/ hydralazine, metoprolol and nimodipine, otherwise allow to autoregulate Pulmonary: stable on 2L NC, encourage IS, PT consult to get pt OOB. Gastrointestinal / Abdomen: regular diet. on bowel regimen colace, dulcolax, senna prn. Nutrition: Regular diet Renal: Monitor UOP and Daily Cr Hematology:HCT stable, check daily Endocrine: RISS, BG<150 Infectious Disease: low grade Temp, wbc stable 13.7, we will monitor fever curve no antibiotics for now Lines / Tubes / Drains: PIV Wounds: none Imaging: none Fluids: KVO Consults: Neuro surgery Billing Diagnosis: (Hemorrhage, NOS: Sub-arachnoid) ICU Care Nutrition: regular diet Glycemic Control: Regular insulin sliding scale Lines: 20 Gauge - [**2175-5-8**] 12:39 PM Prophylaxis: DVT: Boots, SQ Heparin Stress ulcer: H2 blocker VAP bundle: Comments: Communication: Patient discussed on interdisciplinary rounds , ICU Code status: Full code Disposition: ICU Total time spent: 21 minutes Patient is critically ill
Physician
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Chief Complaint: I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 58 yo man with with h/o ETOH abuse. Quit drinking on [**5-27**]. Had some gait difficulty, slurred speech, confusion after that which continued. Was to get MRI but it wasn't done. Went to [**Hospital3 **] for vacation. Yesterday morning had very poor mental status - [**Hospital 3296**] Hospital. Negative head CT. in ED BP 170/100, tach. labs sign for plts in 90s, NH4 141. Intubated to protect airway. Got treated for ?meningitis, but no tap. 24 Hour Events: INVASIVE VENTILATION - START [**2137-7-12**] 07:17 PM actual start of veentilation in MICU6 was ~ 1830 Allergies: Last dose of Antibiotics: Vancomycin - [**2137-7-12**] 08:00 PM Infusions: Propofol - 30 mcg/Kg/min Other ICU medications: Other medications: Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2137-7-13**] 09:37 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.8 C (98.3 Tcurrent: 36.8 C (98.3 HR: 92 (69 - 95) bpm BP: 153/80(98) {113/59(75) - 161/97(111)} mmHg RR: 24 (10 - 24) insp/min SpO2: 100% Heart rhythm: SR (Sinus Rhythm) Height: 74 Inch Total In: 1,039 mL 1,249 mL PO: TF: IVF: 979 mL 1,219 mL Blood products: Total out: 1,240 mL 625 mL Urine: 1,240 mL 625 mL NG: Stool: Drains: Balance: -201 mL 624 mL Respiratory support Ventilator mode: CMV/ASSIST Vt (Set): 600 (600 - 600) mL RR (Set): 12 PEEP: 5 cmH2O FiO2: 40% RSBI: 25 PIP: 16 cmH2O Plateau: 11 cmH2O SpO2: 100% ABG: 7.44/37/160/25/ Ve: 12.2 L/min PaO2 / FiO2: 400 Physical Examination General Appearance: Well nourished, No acute distress Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Normocephalic Cardiovascular: (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Breath Sounds: Clear : ) Abdominal: Soft, Non-tender Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 11.4 g/dL 53 K/uL 131 mg/dL 1.0 mg/dL 25 mEq/L 3.3 mEq/L 14 mg/dL 113 mEq/L 142 mEq/L 31.7 % 5.9 K/uL [image002.jpg] [**2137-7-12**] 09:15 PM [**2137-7-13**] 04:15 AM WBC 5.6 5.9 Hct 33.1 31.7 Plt 57 53 Cr 1.0 1.0 TropT 0.02 Glucose 154 131 Other labs: PT / PTT / INR:16.7/37.6/1.5, CK / CKMB / Troponin-T:449/7/0.02, ALT / AST:35/56, Alk Phos / T Bili:92/2.7, Amylase / Lipase:45/61, Differential-Neuts:58.3 %, Lymph:31.6 %, Mono:6.2 %, Eos:3.4 %, Lactic Acid:1.2 mmol/L, Albumin:2.7 g/dL, LDH:180 IU/L, Ca++:9.4 mg/dL, Mg++:1.7 mg/dL, PO4:3.6 mg/dL Assessment and Plan Delirium/poor MS: Most likely hepatic encephalopathy. Reported has not drank since [**5-27**], so ETOH withdrawl unlikely. Continue with lactulose. doubt meningitis with two weeks of altered MS and no fever. Also consider Wernicke's - tx with thiamine. alchoholic hepatitis: discriminate score about 29. will ask hepatology if they feel treatment is warranted. respiratory failure: will try to extubate once stooling and MS better. ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2137-7-13**] 12:00 AM 16 Gauge - [**2137-7-13**] 12:00 AM Prophylaxis: DVT: SQ UF Heparin Stress ulcer: PPI VAP: Comments: Communication: Comments: Code status: Full code Disposition :ICU Total time spent: 40 minutes Patient is critically ill
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TITLE: Chief Complaint: 24 Hour Events: Echo - Left ventricular cavity enlargement with extensive regional systolic dysfunction c/w CAD (mid-LAD distribution, LVEF = 25-30). Mild aortic regurgitation. Pulmonary artery systolic hypertension. Mild mitral regurgitation. CT surgery, will likely get CABG Wed/[**Doctor First Name **], started heparin gtt w/o bolus. Lipids at goal, A1C 5.4. Guiac pos stool. CXR - ? R hilar mass, ordered CT chest. U/S -L ICA mod/severe stenosis 60-69% w/ interval progression; R no sign stenosis. Wound cons. Pend, CK trending down, [**2116**]. Febrile o/n. BCx and UCx sent. Had episode of hypxia/SOB, mild CP in HD, CXR unchanged, ECT STe in same leads as STEMI. Given IV morphine, nebs, Nitro and back to HD. Allergies: No Known Drug Allergies Last dose of Antibiotics: Infusions: Heparin Sodium - 1,200 units/hour Other ICU medications: Morphine Sulfate - [**2110-11-10**] 07:35 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2110-11-11**] 06:09 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 38.4 C (101.1 Tcurrent: 37.8 C (100.1 HR: 76 (63 - 104) bpm BP: 97/47(58) {56/33(40) - 143/125(128)} mmHg RR: 22 (13 - 35) insp/min SpO2: 92% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 98.5 kg (admission): 100 kg Height: 27 Inch Total In: 927 mL 74 mL PO: 660 mL TF: IVF: 267 mL 74 mL Blood products: Total out: 0 mL 0 mL Urine: NG: Stool: Drains: Balance: 927 mL 74 mL Respiratory support O2 Delivery Device: Nasal cannula SpO2: 92% ABG: ///31/ Physical Examination GENERAL: Somnlent but otherwise well-appering man in NAD. Oriented to person, month and year. HEENT: Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. NECK: Supple with no appreciable JVP. CARDIAC: PMI located in 5th intercostal space, midclavicular line. Distant heart sounds RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. Lower left-midline scar s/p appendectomy per pt. EXTREMITIES: No femoral bruits. L arm AV fistula, + palpable thrill and audible bruit. R femoral area soft without ecchymosis or hematoma, no bruits, 2+ femoral pulses bilaterally. 1+ DP and PT pulses SKIN: Ulceration on L anterior skin with eschar and granulation tissue. Chronic skin changes of bilateral lower extremities c/w statis dermatitis. Labs / Radiology 170 K/uL 10.2 g/dL 99 mg/dL 8.0 mg/dL 31 mEq/L 4.1 mEq/L 36 mg/dL 92 mEq/L 138 mEq/L 30.4 % 9.6 K/uL [image002.jpg] [**2110-11-9**] 05:42 PM [**2110-11-10**] 02:30 AM [**2110-11-10**] 01:53 PM [**2110-11-11**] 03:53 AM WBC 8.3 7.6 9.6 Hct 30.1 30.3 30.4 Plt 160 205 170 Cr 9.4 9.8 8.0 TropT 12.68 16.03 17.03 19.10 Glucose 102 181 99 Other labs: PT / PTT / INR:15.7/61.9/1.4, CK / CKMB / Troponin-T:1216/50/19.10, ALT / AST:30/151, Alk Phos / T Bili:348/0.4, Albumin:3.9 g/dL, LDH:849 IU/L, Ca++:8.1 mg/dL, Mg++:1.8 mg/dL, PO4:5.5 mg/dL Assessment and Plan 64yo M with hx of ESRD on HD, CAD, hypercholesterolemia, CVA p/w chest pain and STEMI, v. fib X 3 at OSH, resolved with shock, transferred from OSH for cardiac cath, now s/p LAD BMS stent with 3v disease. . # CORONARIES: Pt with hx of CAD, p/w STEMI and cath showing 3v disease, s/p BMS stent to LAD. Now chest pain free. ECG showed anterior ischemic changes. Pt received [**Last Name (LF) **], [**First Name3 (LF) 119**], aggrastat at OSH. - discuss with CT surgery regarding plans for CABG; if going to be done this week, will start heparin for anticoagulation in the setting of a BMS and will hold on [**First Name3 (LF) **]. If not done this week, will restart [**First Name3 (LF) **]. - continue aspirin - bblocker, statin - check lipid panel, HBA1C, fasting glucose in AM . # PUMP: No prior echos to compare. Does not appear in heart failure clinically. - TTE . # RHYTHM: S/P v. fib X 3 at OSH with shock X 3. Has been in NSR since with some non-sustained VT 6-9 beats on tele overnight. V fib secondary to ischemia and now reperfusion. - stop amiodarone today. - continue to monitor on tele . # ESRD on HD: unclear origin of disease. Pt dialyzed M, W, F and last dialysis was friday per patient. Pt received aggrastat which is renally cleared and is likely having lasting effects on clotting time. Sheath pulled and no evidence of bleeding or hematoma. - pt to have dialysis today - continue Sevelamer, Nephrocaps, Sensipar - check platelet agglutination study today . # COPD: not contributing factor at this time and pt on no medications - continue to monitor . # Weight Loss: Due to poor PO intake per daughter. [**Name (NI) **] etiologies may be malignancy (lung, colon cancer), metabolic (hyperthyroidism). TSH normal. CXR done this morning. - guiac stool, pt will need outpatient colonscopy - f/u CXR for lung cancer screening . # Left leg ulcer: appears chronic - wound care consult . # Hx of CVA: - continue [**Last Name (LF) 119**], [**First Name3 (LF) 124**] give [**First Name3 (LF) 120**] or heparin as per above . # FEN: cardiac, renal diet, replete lytes as needed . # Prophylaxis: no SC heparin for now given bleeding risk, PPI as per home tx, bowel regimen . # Access: 2 PIV on right arm, fistula left arm . # Code Status: FULL, confirmed with patient and daughter . # Contact: Daughter [**First Name4 (NamePattern1) 532**] [**Last Name (NamePattern1) **] [**Telephone/Fax (1) 2967**] . # Dispo: call out to floor today ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2110-11-10**] 08:30 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition:
Physician
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Chief Complaint: 24 Hour Events: EKG - At [**2148-12-2**] 08:50 AM History obtained from Medical records Patient unable to provide history: Sedated Allergies: Ace Inhibitors Cough; Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2148-12-2**] 02:00 PM Vancomycin - [**2148-12-2**] 04:28 PM Piperacillin - [**2148-12-3**] 06:00 AM Infusions: Fentanyl - 50 mcg/hour Midazolam (Versed) - 1 mg/hour Other ICU medications: Heparin Sodium (Prophylaxis) - [**2148-12-2**] 02:00 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2148-12-3**] 08:09 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.6 C (99.6 Tcurrent: 37.5 C (99.5 HR: 93 (64 - 97) bpm BP: 128/48(73) {86/37(54) - 171/57(90)} mmHg RR: 20 (17 - 22) insp/min SpO2: 100% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 56.6 kg (admission): 56 kg Total In: 4,082 mL 1,645 mL PO: TF: IVF: 3,912 mL 1,645 mL Blood products: Total out: 1,307 mL 275 mL Urine: 638 mL 275 mL NG: Stool: Drains: Balance: 2,775 mL 1,370 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST Vt (Set): 400 (400 - 400) mL Vt (Spontaneous): 165 (165 - 165) mL PS : 0 cmH2O RR (Set): 20 RR (Spontaneous): 9 PEEP: 5 cmH2O FiO2: 40% RSBI: 13 PIP: 20 cmH2O Plateau: 15 cmH2O Compliance: 40 cmH2O/mL SpO2: 100% ABG: 7.34/52/127/25/1 Ve: 6.9 L/min PaO2 / FiO2: 318 Physical Examination General Appearance: No acute distress Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Normocephalic, Endotracheal tube Cardiovascular: (S1: Normal), (S2: Normal), No(t) S3, No(t) S4, No(t) Rub Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Clear : , No(t) Crackles : , No(t) Bronchial: , No(t) Wheezes : ) Abdominal: Soft, Non-tender, Bowel sounds present, No(t) Distended Extremities: Right: Absent, Left: Absent, No(t) Cyanosis, No(t) Clubbing Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Sedated, Tone: Not assessed Labs / Radiology 155 K/uL 7.9 g/dL 67 mg/dL 2.9 mg/dL 25 mEq/L 4.6 mEq/L 46 mg/dL 110 mEq/L 144 mEq/L 23.0 % 10.4 K/uL [image002.jpg] [**2148-12-2**] 08:49 AM [**2148-12-2**] 12:06 PM [**2148-12-2**] 12:09 PM [**2148-12-2**] 03:44 PM [**2148-12-2**] 07:02 PM [**2148-12-2**] 07:27 PM [**2148-12-2**] 10:28 PM [**2148-12-2**] 10:50 PM [**2148-12-3**] 04:40 AM [**2148-12-3**] 04:51 AM WBC 10.4 Hct 29 25.0 27 23.0 Plt 155 Cr 3.2 3.0 2.8 2.8 2.9 TCO2 24 26 28 27 29 Glucose 146 73 159 137 67 Other labs: PT / PTT / INR:14.7/49.9/1.3, ALT / AST:164/102, Alk Phos / T Bili:32/0.5, Amylase / Lipase:1485/68, Differential-Neuts:82.4 %, Lymph:10.7 %, Mono:5.3 %, Eos:0.9 %, Lactic Acid:2.1 mmol/L, Albumin:4.1 g/dL, LDH:254 IU/L, Ca++:9.2 mg/dL, Mg++:1.6 mg/dL, PO4:5.2 mg/dL Assessment and Plan PAIN CONTROL (ACUTE PAIN, CHRONIC PAIN) PANCREATITIS, ACUTE RENAL FAILURE, CHRONIC (CHRONIC RENAL FAILURE, CRF, CHRONIC KIDNEY DISEASE) HYPOTENSION (NOT SHOCK) ICU Care Nutrition: Glycemic Control: Lines: Multi Lumen - [**2148-12-2**] 03:20 AM Arterial Line - [**2148-12-2**] 03:20 AM Dialysis Catheter - [**2148-12-2**] 05:32 AM Prophylaxis: DVT: SQ UF Heparin Stress ulcer: VAP: HOB elevation, Mouth care, Daily wake up, RSBI Comments: Communication: Patient discussed on interdisciplinary rounds Comments: Code status: Disposition:
Physician
Classify the following medical document.
TITLE: Chief Complaint: 56 year old woman with metastatic breast cancer to bone, lung and brain, presenting with worsening lower extremity edema, found to be hypoxic and with new large right pleural effusion. 24 Hour Events: THORACENTESIS - At [**2162-5-2**] 02:11 PM Allergies: Taxol (Intraven.) (Paclitaxel Semi-Synthetic) Anaphylaxis; Last dose of Antibiotics: Levofloxacin - [**2162-5-2**] 08:53 PM Infusions: Other ICU medications: Pantoprazole (Protonix) - [**2162-5-2**] 08:28 AM Morphine Sulfate - [**2162-5-2**] 05:52 PM Heparin Sodium (Prophylaxis) - [**2162-5-2**] 10:28 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2162-5-3**] 07:39 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.6 C (97.9 Tcurrent: 35.7 C (96.2 HR: 95 (95 - 119) bpm BP: 115/74(84) {115/54(84) - 154/94(104)} mmHg RR: 15 (15 - 27) insp/min SpO2: 98% Heart rhythm: SR (Sinus Rhythm) Total In: 2,605 mL 76 mL PO: 690 mL TF: IVF: 855 mL 76 mL Blood products: 560 mL Total out: 697 mL 245 mL Urine: 697 mL 245 mL NG: Stool: Drains: Balance: 1,908 mL -169 mL Respiratory support O2 Delivery Device: Nasal cannula SpO2: 98% ABG: ///24/ Physical Examination Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 120 K/uL 8.7 g/dL 115 mg/dL 0.5 mg/dL 24 mEq/L 4.1 mEq/L 17 mg/dL 106 mEq/L 139 mEq/L 26.3 % 10.3 K/uL [image002.jpg] [**2162-5-2**] 09:41 AM [**2162-5-3**] 05:02 AM WBC 9.7 10.3 Hct 31.2 26.3 Plt 118 120 Cr 0.5 0.5 Glucose 88 115 Other labs: PT / PTT / INR:16.7/70.0/1.5, Differential-Neuts:86.0 %, Band:6.0 %, Lymph:2.0 %, Mono:4.0 %, Eos:0.0 %, Lactic Acid:2.6 mmol/L, Albumin:2.4 g/dL, LDH:830 IU/L, Ca++:8.3 mg/dL, Mg++:2.7 mg/dL, PO4:2.3 mg/dL Fluid analysis / Other labs: Pleural Fluid Chemistry Protein 2.4 Glucose 105 Creat: 0.4 LD(LDH): 428 Albumin: 1.7 Pleural Fluid WBC 225 RBC 315 Poly 7 Lymph 37 Mono 7 EOs Meso: 2 Macro: 43 Other: 4 Imaging: CTA 1. No definite evidence of pulmonary emboli. 2. Extensive lung masses and nodules involving both lungs, which appears to have increased when compared to prior exam. Some of these masses appear to encase the distal segmental pulmonary arteries. 3. Extensive ground-glass opacity and septal thickening. This could represent lymphangitic spread or edema. 4. Hypodense lesions in the liver concerning for metastasis and fluid within the perihepatic space. 5. Sclerotic lesions in the lower thoracic vertebral bodies with compression deformities. 6. Large left pleural effusion and small right pleural effusion. LENI IMPRESSION: No evidence of DVT. The study and the report were reviewed by the staff radiologist. Assessment and Plan RASH RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name 76**]) RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name 76**]) 56 year old woman with metastatic breast cancer to bone, lung and brain, presenting with worsening lower extremity edema, found to be hypoxic and with new large right pleural effusion. #. RESPIRATORY DISTRESS: Currently on 4L O2, at baseline is 100%RA. As the pt has mets in lung and unclear history of sarciod it is difficult to discern whether the pt has pneumonia as well. No fever, minimal cough and nl WBC (although pt does have bands, and normal WBC may be elevated in the setting of recent Avastin and possible myelosuppression). Suspect effusion is most likely secondary to malignancy. -- Levaquin for CAP -- S/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] -- Supplemental oxygen. #. LOWER EXTREMITY EDEMA: Concerning for venous obstruction. -- Final LENI s negative for DVT -- Consider imaging of abd/pelvis (CT v MRI) -- Elevation of LE -- F/u final echo #. BREAST CANCER: No plans for inpatient therapy #. BRAIN METASTASIS: CT stable, no significant change in cerebellar lesions #. URINARY TRACT INFECTION: Levaquin for now. X3d -- F/U Culture FEN: Regular diet PPX: -DVT ppx with SQ Heparin and Pneumoboots -Bowel regimen -Pain management with Tylenol ACCESS: PIV's CODE STATUS: full -- Plan for family meeting today DISPOSITION: transfer to OMED ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2162-5-2**] 02:48 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition:
Physician
Classify the following medical document.
Admission Date: [**2120-8-28**] Discharge Date: [**2120-9-6**] Date of Birth: [**2043-6-19**] Sex: M Service: ORTHOPAEDICS Allergies: Penicillins / Sulfa (Sulfonamides) / Iodine Attending:[**First Name3 (LF) 3190**] Chief Complaint: Pt presented s/p fall w/bilaterall lower ext weakness w/parasthesias and difficulty handeling secretions. Major Surgical or Invasive Procedure: Cervical stabilization anterior partial vertebrectomies c4-5,c6-7 [**2120-8-30**] Past Medical History: Past Medical History: diabetes type II mild asthma [**Doctor Last Name 3271**]-[**Doctor Last Name **] virus lower extremity edema newly diagnosed T3N1 poorly differentiated esophageal cancer PAST SURGICAL HISTORY: Significant for inguinal hernia repair in [**2082**] and status post exploratory laparotomy in [**2098**] for abdominal pain at which they performed an incidental cholecystectomy and appendectomy. Social History: He lives in [**Location (un) 3844**] where he has lived for the past 40 years with his partner. [**Name (NI) **] works as a cashier at a bookstore. He smoked 50-pack year quitting 15 years ago. He does not drink any alcohol. He has no children. Family History: His mother died at age of 87 from gastric cancer and his father died at age of 70 from cirrhosis. He has a sister who is 81 years old and has no cancer. His brother is 66 and healthy. Physical Exam: NAD, A&Ox3 Echymosis bilateral orbits PERRLA RRR Course BS bilat Abdomen soft, NT/ND Neuro: +[**12-23**] left bicep, +[**1-20**] left tricep, [**2-20**] bilateral hand grips, [**1-20**] right bicep and tricep, [**12-22**] DTR LUE, [**11-21**] LUE, 0/4 Bilat LE, bilat downgoing toes, sensation intact but describes as "pins and needles sensation" on bilateral UE. Pertinent Results: [**2120-8-28**] 12:20AM GLUCOSE-95 UREA N-9 CREAT-0.7 SODIUM-138 POTASSIUM-4.0 CHLORIDE-102 TOTAL CO2-30 ANION GAP-10 [**2120-8-28**] 12:20AM WBC-3.7*# RBC-3.68* HGB-11.5* HCT-35.2* MCV-96# MCH-31.4 MCHC-32.8 RDW-21.2* [**2120-8-28**] 12:20AM NEUTS-64.2 LYMPHS-29.5 MONOS-5.9 EOS-0.3 BASOS-0.1 [**2120-8-28**] 12:20AM HYPOCHROM-1+ ANISOCYT-2+ MACROCYT-3+ [**2120-8-28**] 12:20AM PLT COUNT-148* [**2120-8-28**] 12:20AM PT-13.5* PTT-26.5 INR(PT)-1.2 [**2120-8-28**] 12:20AM BLOOD WBC-3.7*# RBC-3.68* Hgb-11.5* Hct-35.2* MCV-96# MCH-31.4 MCHC-32.8 RDW-21.2* Plt Ct-148* [**2120-8-28**] 12:20AM BLOOD Neuts-64.2 Lymphs-29.5 Monos-5.9 Eos-0.3 Baso-0.1 [**2120-8-28**] 12:20AM BLOOD PT-13.5* PTT-26.5 INR(PT)-1.2 [**2120-8-28**] 12:20AM BLOOD Glucose-95 UreaN-9 Creat-0.7 Na-138 K-4.0 Cl-102 HCO3-30 AnGap-10 Brief Hospital Course: [**2120-8-28**]: Admited to TSICU after transfer from NEH on steroid gtt. Made NPO for spinal intervention. Admited TSICU for increased secretions. [**2120-8-29**]: OR delayed secondary to increased secretions [**2120-8-30**]: OR for Anterior fusion from C4-C7. Anterior partial vertebrectomy of C5, C6, C7. Anterior discectomies C4-5, C5-6, C6-7 Anterior instrumentation C4-C7. Structural allograft. Stable postoperatively. Right groin line placed after failed attempt on right subclavian w/small right apical pneumothorax. Episode of hypotension w/position change requiring neosynephrine and fluid boluses. [**2120-8-31**]: Hematocrit drop from 33 to 26. Transfused. [**2120-9-1**]: OR for: Total laminectomy of C3, C4, C5, C6. Fusion C4-C7. Autograft. Excision of soft tissue mass in the posterior cervical region. On CPAP/PS post op w/occasional desats and increased secretions. [**2120-9-2**]: Sputum returns w/gram neg rods w/levofloxacin started. Attempted placement of dobhoff tube unsuccesfully. [**2120-9-3**]: Patient extubated sucessfully. [**2120-9-4**]: Patient failed swallow study w/frank aspiration. Feeding tube by IR. [**2120-9-5**]: Tube feeds started after placement of feeding tube by IR. A-Line removed, femoral line removed w/mild hemorrhage (approx 200cc blood loss) stopped w/direct pressure. Hct and coags normal. Droping urine output responsive to fluid boluses. RADIOLOGY Final Report CT RECONSTRUCTION [**2120-8-28**] 4:02 AM CT C-SPINE W/O CONTRAST; CT RECONSTRUCTION Reason: eval for [**Hospital **] [**Hospital 93**] MEDICAL CONDITION: 77 year old man with fall and head trauma, ? C-spine injury REASON FOR THIS EXAMINATION: eval for fx CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: Fall and head trauma and C-spine injury on outside CT and MRI, evaluate fracture. COMPARISON: None available at the time of dictation. TECHNIQUE: Axial MDCT images were obtained through the cervical spine without intravenous contrast. Additional coronal and sagittal reformations are provided. CT OF THE CERVICAL SPINE WITHOUT INTRAVENOUS CONTRAST: The cervical spine is imaged from C1 through T3. There is a minimally displaced fracture through the spinous process of C4 extending to the posterior arch of C4. Minimally displaced fractures of the tips of the spinous processes of C5. Mildly displaced fracture of the spinous process of C7. There is malalignment of the component vertebrae at C4-5, with grade 1 retrolisthesis of C4 on C5 and with marked widening of the intervertebral disc space anteriorly. There is additional widening of the intervertebral disc space anteriorly at C6-7. There is marked narrowing of the spinal canal at C4-5 due to retrolisthesis of C4 on C5 and angulation of the spine at this level. The prevertebral soft tissues are widened diffusely. In addition, there is a suggestion of hyperdensity within the widened intervertebral disc spaces at C4-5 and C6-7 as well as within the prevertebral soft tissues, possibly representing hematoma. There is an additional questionable linear lucency within the anterior inferior aspect of the C2 vertebra on the sagittal views only without clear correlate on the axial views, finding that could represent artifact Vs. a nondisplaced fracture. The visualized portions of the lung apices appear unremarkable. IMPRESSION: 1. Fractures of the spinous processes at C4, C5, and C7. 2. Cervical spine malalignment of C4-5 and C6-7, with retrolisthesis and intervertebral disc space widening at C4-5 and disc space widening at C6-7, and spinal stenosis. The findings are highly suggestive of ligamentous injury at these locations. MRI should be considered for assessment of the spinal cord as well as soft tissues. 3. Marked expansion of the prevertebral soft tissues consistent with hematoma and edema. 4. Questionable artifact Vs. nondisplaced fracture of the anterior inferior corner of C2 vertebra, seen on the sagittal reconstructions only. Results were discussed with the orthopedic resident at the time of interpretation (4:45 a.m.). The study and the report were reviewed by the staff radiologist. DR. [**First Name (STitle) 8913**] R.M. SUN DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 21104**] Approved: WED [**2120-8-28**] 8:58 AM Medications on Admission: Actose 30 QD, Glucophage 250 QD, Methadone Discharge Medications: 1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 2. Albuterol Sulfate 0.083 % Solution Sig: [**11-19**] Inhalation Q4H (every 4 hours). 3. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4-6H (every 4 to 6 hours) as needed. 4. Magnesium Oxide 400 mg Tablet Sig: One (1) Tablet PO PRN (as needed) as needed for Mg<2. 5. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 6. Potassium Chloride 20 mEq Packet Sig: Two (2) Packet PO PRN (as needed) as needed for K<4. 7. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours). 8. Lansoprazole 30 mg Susp,Delayed Release for Recon Sig: One (1) PO DAILY (Daily). 9. Olanzapine 5 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO ONCE (once) for 1 doses. 10. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. Insulin Regular Human 100 unit/mL Solution Sig: Sliding Scale Injection ASDIR (AS DIRECTED). 12. Heparin Lock Flush (Porcine) 100 unit/mL Syringe Sig: One (1) ML Intravenous DAILY (Daily) as needed. 13. Magnesium Sulfate 50 % Solution Sig: One (1) Injection ONCE (once) for 1 doses. Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: Cervical subluxation C4-5 Central cord syndrome Discharge Condition: good Discharge Instructions: keep collar on when out of bed. Keep incision clean and dry. Daily dressing changes to surgical incisions. Physical Therapy: Activity: Bedrest with bed position Pneumatic boots Cervical collar: At all times may elevate HOB No heavy lifting (no lifting>10lbs) Treatments Frequency: Site: ant/post cervical Type: Surgical Dressing: Gauze - dry Change dressing: qd Site: Healing incision to ant, neck Description: Incision Care: dry sterile dressing Followup Instructions: 10 days from date of discharge with Dr [**Last Name (STitle) 363**] [**Telephone/Fax (1) 3573**] Completed by:[**2120-9-6**]
Discharge summary
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Chief Complaint: Acute respiratory failure, pneumonia I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 24 Hour Events: PICC LINE - START [**2105-12-10**] 10:15 AM MULTI LUMEN - STOP [**2105-12-10**] 04:05 PM Trial of diuresis yesterday Hypotensive SBP - 60's overnight, given 250 cc IV NS and increased neo with BP increase to 90's. Upper airway secretions reduced with scopolamine patch Patient unable to provide history: Sedated, intubated Allergies: No Known Drug Allergies Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2105-12-11**] 07:55 AM Vancomycin - [**2105-12-11**] 07:55 AM Infusions: Phenylephrine - 1.2 mcg/Kg/min Midazolam (Versed) - 2 mg/hour Fentanyl - 50 mcg/hour Other ICU medications: Furosemide (Lasix) - [**2105-12-10**] 12:12 PM Famotidine (Pepcid) - [**2105-12-10**] 08:45 PM Heparin Sodium (Prophylaxis) - [**2105-12-11**] 07:55 AM Other medications: Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Pain: No pain / appears comfortable Flowsheet Data as of [**2105-12-11**] 10:13 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.4 C (99.3 Tcurrent: 36.8 C (98.2 HR: 69 (63 - 80) bpm BP: 104/46(66) {76/37(51) - 160/64(96)} mmHg RR: 18 (13 - 22) insp/min SpO2: 98% Heart rhythm: SR (Sinus Rhythm) Height: 62 Inch Total In: 3,082 mL 1,484 mL PO: TF: 1,148 mL 352 mL IVF: 1,534 mL 982 mL Blood products: Total out: 1,420 mL 490 mL Urine: 1,420 mL 490 mL NG: Stool: Drains: Balance: 1,662 mL 994 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CPAP/PSV Vt (Set): 450 (450 - 450) mL Vt (Spontaneous): 365 (365 - 450) mL PS : 10 cmH2O RR (Set): 8 RR (Spontaneous): 31 PEEP: 5 cmH2O FiO2: 40% RSBI: 81 PIP: 15 cmH2O Plateau: 17 cmH2O SpO2: 98% ABG: 7.37/44/96.[**Numeric Identifier 7**]/23/0 Ve: 12.1 L/min PaO2 / FiO2: 242 Physical Examination Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Normocephalic, Endotracheal tube Lymphatic: Cervical WNL, Supraclavicular WNL Cardiovascular: (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Breath Sounds: Rhonchorous: bilaterally ) Abdominal: Soft, Bowel sounds present Extremities: Right: 1+, Left: 1+ Skin: Warm Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 9.7 g/dL 421 K/uL 125 mg/dL 0.6 mg/dL 23 mEq/L 3.8 mEq/L 16 mg/dL 104 mEq/L 137 mEq/L 28.0 % 25.0 K/uL [image002.jpg] [**2105-12-8**] 04:50 AM [**2105-12-8**] 12:46 PM [**2105-12-8**] 08:33 PM [**2105-12-9**] 03:29 AM [**2105-12-9**] 03:48 AM [**2105-12-9**] 02:28 PM [**2105-12-9**] 08:34 PM [**2105-12-10**] 01:56 AM [**2105-12-11**] 03:56 AM [**2105-12-11**] 06:15 AM WBC 27.6 23.3 25.0 Hct 30.3 30.0 27.6 28.0 Plt [**Telephone/Fax (3) 2259**] Cr 0.6 0.6 0.5 0.5 0.6 TCO2 21 23 22 26 Glucose [**Telephone/Fax (3) 2260**]38 125 Other labs: PT / PTT / INR:16.9/41.3/1.5, CK / CKMB / Troponin-T:228/7/0.06, D-dimer:1665 ng/mL, Lactic Acid:1.7 mmol/L, Ca++:7.3 mg/dL, Mg++:1.7 mg/dL, PO4:2.9 mg/dL Microbiology: C. Diff negative x 1 Assessment and Plan ACUTE HYPOXIC RESPIRATORY FAILURE secondary to pneumonia. Secretions are unchanged, thick tan. Concerning that WBC going back up. Having diarrhea, sending stool for C. Diff. CXR suggests possible pleural effusion, concerned for complicated parapneumonic effusion vs. empyema. Will obtain CT chest today. Repeat sputum gram stain, C+S, blood and urine cultures. Continue vanco/zosyn. ATRIAL FIBRILLATION (AFIB): Remains in SR on amiodarone. HYPOTENSION secondary to hypovolemia in setting of diuresis. Improved with fluids albeit also required increased neo, now being weaned back down. ICU Care Nutrition: Comments: Tube feeds at goal. Glycemic Control: Lines: Arterial Line - [**2105-12-8**] 07:00 AM 20 Gauge - [**2105-12-8**] 07:00 AM PICC Line - [**2105-12-10**] 10:15 AM Prophylaxis: DVT: Boots Stress ulcer: PPI VAP: Need for restraints reviewed Comments: Communication: Comments: Code status: Full code Disposition :ICU Total time spent: 55 minutes Patient is critically ill ------ Protected Section ------ CT chest shows dense consolidation on the left, mulitlobar involvement, areas of external compression with obstruction of bronchus vs. endobronchial obstruction. Bronched through ETT with the pulmonary fellow, moderate amounts of purulent secretions, suctioned for mucus plugs. Edematous ariways thorughout with external compression. Washings sent for gram stain, C+S. Chest CT also shows pleural efffusion. If elevated WBC persists, will need to tap. ------ Protected Section Addendum Entered By:[**Name (NI) 2140**] [**Last Name (NamePattern1) 2141**], MD on:[**2105-12-11**] 18:29 ------
Physician
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TITLE: Chief Complaint: 24 Hour Events: Extubated yesterday, required racemic epi for upper airway sounds, briefly without gag reflex following extubation. T max of 100.1. Amio 400 TID started. Tele: 3 short runs of NSVT. Allergies: No Known Drug Allergies Last dose of Antibiotics: Bactrim (SMX/TMP) - [**2121-11-18**] 09:30 PM Infusions: Heparin Sodium - 1,350 units/hour Amiodarone - 0.5 mg/min Other ICU medications: Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2121-11-20**] 07:44 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.8 C (100.1 Tcurrent: 37.3 C (99.2 HR: 64 (59 - 83) bpm BP: 98/45(65) {93/45(65) - 146/98(328)} mmHg RR: 18 (14 - 31) insp/min SpO2: 96% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 107 kg (admission): 104.5 kg Height: 65 Inch Total In: 1,308 mL 401 mL PO: 270 mL 200 mL TF: IVF: 978 mL 201 mL Blood products: Total out: 3,270 mL 920 mL Urine: 3,270 mL 920 mL NG: Stool: Drains: Balance: -1,962 mL -519 mL Respiratory support O2 Delivery Device: Nasal cannula Ventilator mode: CPAP/PSV Vt (Set): 550 (550 - 550) mL Vt (Spontaneous): 473 (325 - 552) mL PS : 5 cmH2O RR (Set): 14 RR (Spontaneous): 23 PEEP: 5 cmH2O FiO2: 50% PIP: 11 cmH2O SpO2: 96% ABG: 7.41/32/89.[**Numeric Identifier 433**]/28/-2 Ve: 10.8 L/min PaO2 / FiO2: 178 Physical Examination Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 202 K/uL 12.5 g/dL 120 mg/dL 0.6 mg/dL 28 mEq/L 4.2 mEq/L 7 mg/dL 102 mEq/L 139 mEq/L 35.0 % 8.1 K/uL [image002.jpg] [**2121-11-17**] 05:08 PM [**2121-11-17**] 06:54 PM [**2121-11-18**] 05:15 AM [**2121-11-18**] 05:26 AM [**2121-11-18**] 09:37 PM [**2121-11-19**] 02:28 AM [**2121-11-19**] 04:55 AM [**2121-11-19**] 11:00 AM [**2121-11-19**] 02:48 PM [**2121-11-20**] 05:40 AM WBC 11.4 9.8 8.1 Hct 37.7 38.0 35.0 Plt 249 223 202 Cr 0.7 0.7 0.6 TCO2 30 30 31 26 30 31 21 Glucose 126 111 120 Other labs: PT / PTT / INR:13.1/60.2/1.1, Lactic Acid:0.8 mmol/L, Ca++:8.6 mg/dL, Mg++:1.8 mg/dL, PO4:3.1 mg/dL Assessment and Plan URINARY TRACT INFECTION (UTI) VENTRICULAR TACHYCARDIA, NON-SUSTAINED (NSVT) CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD, BRONCHITIS, EMPHYSEMA) WITH ACUTE EXACERBATION ICU Care Nutrition: Glycemic Control: Lines: Arterial Line - [**2121-11-17**] 05:00 PM 20 Gauge - [**2121-11-19**] 07:00 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition:
Physician
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Admission Date: [**2135-7-30**] Discharge Date: [**2135-8-6**] Date of Birth: [**2082-12-21**] Sex: M Service: [**Hospital1 212**] HISTORY OF PRESENT ILLNESS: Patient is a 52-year-old man with a history of HIV, now viral counts are undetectable, and 350 CD4 count who presents with bloody diarrhea three times over a 24 hour period. Patient has felt dizzy on the day prior to admission and collapsed on the way to the bathroom. Patient lost consciousness for an unknown period of time. Patient stated that after this and after walking to his apartment, he collapsed again. Patient visited [**Hospital1 778**] office where he regularly gets his medical care. He was seen in the afternoon and told he was dehydrated and sent home. That same night, when the patient was at home and was on the way to the bathroom, he had collapsed again. Patient has had black tarry diarrhea and some episodes of bright red blood per rectum in medium to large amounts. Patient denied having fevers or chills. There was no change in his urine color. There was no nausea, vomiting or abdominal pain. Patient did not ingest any unusual food and has no recent history of travel. Patient denied taking over the counter medications including aspirin, Motrin and others. Patient's colonoscopy nine months ago was negative. Patient had colonoscopy as a screening test due to his family history of colon cancer. PAST MEDICAL HISTORY: CMV retinitis, PCP, [**Name10 (NameIs) 10619**] sarcoma, all HIV related, neuropathy, depression and hypertension. SOCIAL HISTORY: No tobacco, alcohol or drug use. MEDICATIONS ON ADMISSION: Zestril, Lipitor, Wellbutrin, amitriptyline and HIV medications were: Zerit 20 mg po b.i.d., lamivudine 150 mg po b.i.d. and Sustiva 600 mg po q.h.s. ALLERGIES: To sulfa. Patient becomes anaphylactic. PHYSICAL EXAMINATION: Revealed a 52-year-old man in no acute distress, appearing comfortable, sitting in a hospital bed. Vital signs on admission were 97. Heart rate 82. Respiratory rate 19. Blood pressure 104/54 and 100% on room air. Head, eyes, ears, nose and throat exam revealed no lymphadenopathy, no jugular venous distention. Oropharynx was clear with no blood in the oral cavity. Dentition was normal. Lungs were clear to auscultation bilaterally. No crackles. Heart: Regular rate and rhythm, no murmurs, rubs or gallops, S1, S2 normal. Abdomen: Soft, nontender, nondistended, positive bowel sounds, it was grossly guaiac positive. There was blood evident on the rectal exam. Extremities were within normal limits. There was no cyanosis, clubbing or edema. There was no costovertebral angle tenderness. Skin revealed no rashes and neurological exam was nonfocal. Strength was [**5-7**] in upper and lower extremities and sensation was grossly intact. LABS ON ADMISSION: White blood cells were 12.4, hematocrit 22.6, platelets 212,000. Sodium 138, potassium 4.8, chloride 102, bicarbonate 22, BUN 40, creatinine 1.0, glucose 126. His urinalysis was negative. His electrocardiogram showed diffuse T wave flattening in I, III and aVF leads, as well as biphasic T waves in V4 through V6. There was no findings suggestive of acute ischemia. HOSPITAL COURSE: During the course of his hospitalization, Mr. [**Known lastname 10620**] has had some active bleeding and has required a transfusion of a total of 11 units of packed red blood cells over the course of his hospitalization. He has undergone extensive work-up which has been unrevealing. His tests included: Esophagogastroduodenoscopy, colonoscopy, enteroscopy, small bowel follow through and tagged red blood cells scan. All of these tests, again, were negative. The patient was maintained on intravenous Protonix and was aggressively resuscitated with fluids in addition to packed red blood cells as mentioned. The patient was also transferred to the Medical Intensive Care Unit for a period of two days during his hospitalization. Over the course of the last 72 hours, patient's hematocrit has remained stable. Therefore, patient will be discharged home today. He will live with his friend for two weeks. Therefore, patient will be monitored if he has any recurrent episodes of collapse. No follow-up with Gastroenterologist has been recommended by the Gastrointestinal Service. The patient, however, will follow-up with his primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 9625**]. Per Gastrointestinal Service, if the patient rebleeds, immediate CT angiogram would be recommended. HIV. During the hospital course patient was continued on his regular outpatient HIV management. Depression: Patient also continued on his outpatient management consisting of Wellbutrin and amitriptyline. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 10621**], M.D. [**MD Number(1) 10622**] Dictated By:[**Last Name (NamePattern4) 10623**] MEDQUIST36 D: [**2135-8-9**] 20:02 T: [**2135-8-9**] 20:02 JOB#: [**Job Number 10624**]
Discharge summary
Classify the following medical document.
Admission Date: [**2120-8-16**] Discharge Date: [**2120-8-20**] Date of Birth: [**2067-7-3**] Sex: M Service: MEDICINE Allergies: Tetracycline / Clarithromycin Attending:[**First Name3 (LF) 2901**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: Cardiac catheterization [**2120-8-16**] with DES to LAD. History of Present Illness: The patient is a 53 yo man with h/o HTN and gout, who presented with acute onset chest pain. The patient states that he was in his normal state of health until approximately 8 PM last night, when he developed acute onset chest pain in the setting of moving a mattress. The patient states that the pain was [**9-16**], "pressure," located substernally and radiating to his left shoulder and back. He had associated diaphoresis. His wife, who was a RN in [**Country 532**], convinced him to come to the ED, where he presented at approximately 1:30 am. In the ED, the patient's VS were T 97.9, BP 126/87, P 82, R 20, O2 97% on RA. A Code STEMI was called, and the patient was taken emergently to the cath lab at 3 am. He was given ASA 325 mg, O2, NTG SL, Plavix 600 mg, Morphine, and he was started on a heparin gtt. In the cath lab, the patient was found to have a 100% occlusion of the proximal LAD. A thrombectomy was performed, and a DES was placed in the LAD. He was then admitted to the CCU for further observation. On arrival to the floor, the patient states that he is no longer experiencing chest pain. He has stomach pain which began shortly after the procedure, but he states that this is markedly different from the pain which brought him into the hospital. On review of systems, he denies any prior history of stroke, TIA, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. He denies recent fevers, chills or rigors. He denies exertional buttock or calf pain. All of the other review of systems were negative. Cardiac review of systems is notable for absence of dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. Past Medical History: 1. CARDIAC RISK FACTORS: (-) Diabetes, (+) Dyslipidemia, (+) Hypertension 2. CARDIAC HISTORY: -CABG: -PERCUTANEOUS CORONARY INTERVENTIONS: -PACING/ICD: 3. OTHER PAST MEDICAL HISTORY: GERD IBS PUD with negative H.pylori h/o NASH B12 deficiency Vitamin D deficiency Nephrolithiasis Gout Seasonal allergies s/p cholecystectomy in [**2113**] Social History: The patient is married and lives with his wife. [**Name (NI) **] currently drives a taxi for a living and has one son who lives in the [**Name (NI) 86**] area. Son is alive and well, w/ active lifestyle. -Tobacco history: The patient previously smoked for 30 years and quit in [**2106**] -ETOH: Only on holidays -Illicit drugs: None. Family History: The patient's mother passed away from pancreatic cancer. His father died when the patient was 10 in [**Country 532**]. No known family history of early MI, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. Physical Exam: VS: T 98.8, BP 114/70, HR 91, RR 18, O2 sat 94% on 4L GENERAL: Middle aged man, pleasant, anxious and emotional, in NAD. Oriented x 3 HEENT: PERRL, EOMI, Oropharynx clear and without exudate. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. NECK: Supple with JVP of 8 cm. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. Abd aorta not enlarged by palpation. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. Femoral catheter site c/d/i. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: DP 2+ PT 2+ Left: DP 2+ PT 2+ Pertinent Results: ADMISSION LABS: [**2120-8-16**] 02:30AM WBC-14.2 Hct-45.1 Plt Ct-217 Neuts-80.9* Lymphs-15.6* Monos-2.9 Eos-0.2 Baso-0.4 COAGs: PT-14.3* PTT-99.4* INR(PT)-1.2* 144 | 105 | 18 /114 4.1 | 20 | 1.4 \ Calcium-9.3 Phos-4.5 Mg-1.8 LFT's: ALT-72* AST-91* LD(LDH)-352* CK(CPK)-755* AlkPhos-93 TotBili-0.5 Cardiac Enzymes [**2120-8-16**] 02:30AM CK 755 CKMB 32 MBindex 4.2 cTropnT-0.31* [**2120-8-16**] 10:00AM CK-MB-189* MB INDX-2.9 cTropnT-13.33* CK(CPK)-6439* [**2120-8-16**] 03:05PM CK-MB-107* MB INDX-2.2 cTropnT-8.67* CK(CPK)-4791* [**2120-8-16**] 07:00PM CK-MB-74* MB INDX-1.8 CK(CPK)-4013* [**2120-8-16**] 12:05PM BLOOD Type-ART pO2-66* pCO2-31* pH-7.50* [**2120-8-16**] 12:05PM BLOOD Lactate-1.8 PERTINENT LABS/STUDIES: EKG ([**8-16**]): NSR at 77 bpm. Q waves in V1-V5. 3mm ST elevation in V2-V4. No R wave progression in precordial leads. ETT ([**2115-5-8**]): The patient exercised for 6.5 minutes of [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] protocol and was stopped for fatigue. Fair functional capacity. The patient was asymptomatic throughout. The rhythm was sinus with no ectopy. No significant ST segment changes. Appropriate hemodynamic response to imposed demands. IMPRESSION: No objective evidence of myocardial ischemia by EKG or anginal symptoms at the achieved level of work. 1) Normal myocardial perfusion. 2) Normal left ventricular cavity size and systolic function CARDIAC CATH: - LAD: 100% occlusion with thrombus, now s/p thrombectomy and [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] placement - LCx: 30% diffuse mid - RCA: 30% mid HEMODYNAMICS: RA 11 (mean), RV: 49/11, PCWP: 25, PA: 42/23, LABORATORY DATA: Troponin: 0.31 CK 755, MB 32, MBI 4.2 BMP: Na 144, K 4.1, Cl 105, HCO3 20, BUN 18, Cr 1.4 (baseline 1.2-1.3), Glucose 109 CBC: WBC 14.2, Hct 45.1, Plt 217 PT 14.3, PTT 99.4, INR 1.2 Cholesterol Panel ([**5-16**]): Total cholesterol 191, Triglycerides 235, HDL 37, LDL 107 ECHO [**2120-8-16**] The left atrium is mildly dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size. There is moderate to severe regional left ventricular systolic dysfunction with akinesis of the anterior wall, septum and the apex. The remaining segments exhibit compensatory hypERkinesis (LVEF = 30%). There is spontaneous echo contrast at the LV apex, but no formed thrombus at this time. Moderate to severe left ventricular systolic dysfunction, c/w proximal LAD infarction. No significant valvular disease. Mild pulmonary hypertension. Findings discussed with Dr. [**Last Name (STitle) **] at 11a on the day of the study. DISCHARGE LABS: [**2120-8-20**] 05:40AM BLOOD WBC-10.0 RBC-4.12* Hgb-13.0* Hct-37.4* MCV-91 MCH-31.5 MCHC-34.6 RDW-14.4 Plt Ct-242 [**2120-8-20**] 05:40AM BLOOD PT-14.9* PTT-30.3 INR(PT)-1.3* [**2120-8-20**] 05:40AM BLOOD Glucose-94 UreaN-22* Creat-1.4* Na-142 K-4.5 Cl-106 HCO3-23 AnGap-18 Brief Hospital Course: # STEMI: The patient was found to have ST elevations in V2-V4, and elevated cardiac biomarkers on admission (Troponin: 0.31 CK 755, MB 32, MBI 4.2). Code STEMI was called and patient was taken to the cath lab. There patient was found to have a 100% occlusion and thrombus of the proximal LAD, underwent thrombectomy and [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 5175**]. EKG showed improvement of ST elevations, and chest pain resolved. The patient was started on ASA 325 mg daily, Plavix 75 mg daily. Integrilin gtt was continued for total duration of 18 hours. Metoprolol was started and uptitrated gradually to 50 mg TID as tolerated. Captopril was initially started, but was held when creatinine became elevated in the setting of IV contrast for CT (see below). It was restarted when creatinine returned to baseline on [**2120-8-18**]. Of note, patient has a history of erectile dysfunction on ACEi. Home Diovan was held. The patient had a previous history of fatty liver on Tricor. Baseline LFTs were normal and it was decided that statin would be started and LFT's monitored carefully. Home Prilosec was changed to Ranitidine [**Hospital1 **] in the setting of starting Plavix. TTE done in the morning following cath showed moderate to severe left ventricular systolic dysfunction, c/w proximal LAD infarction. No significant valvular disease. Mild pulmonary hypertension. There was spontaneous echo contrast at the LV apex, but no formed thrombus at this time. That morning ([**2120-8-16**]), patient c/o headache, epigastric pain, appeared diaphoretic. Repeat EKGs showed no significant change from post-cath EKG. Patient received Tylenol, morphine and pain improved. Given apical akinesis and pooling of blood seen on TTE, there was concern for embolization to intestinal vasculature. CTA of the abdomen showed no SMA/[**Female First Name (un) 899**] thrombus or GI bleed. Patient received Mucomyst and hydration prior to CTA. In the setting of poor LV dysfunction/apical stasis and high risk for thrombus/emboli, patient was started on heparin gtt, with goal 60-80. Coumadin was started [**2120-8-17**]. Patient had no further chest or epigastric pain during hospital course. Cardiac biomarkers trended down, and patient remained hemodynamicaly stable. He was discharged on Metoprolol, Aspirin, Plavix, Atorvastatin and Lisinopril. For his anticoagulation, he was discharged on Lovenox SC injection and Warfarin with plan to have INR checked 3 days post-discharge and discontinue Lovenox as able. # Congestive Heart Failure: Acute systolic and diastolic CHF. The patient had elevated RVEDP on cardiac catheterization (24). TTE (see above) showed LVEF 30% with apical akinesis. The patient received Lasix prn. #. Hyperlipidemia: The patient has a history of hyperlipidemia, though he reportedly developed NASH in the setting of TriCor. He was started on 80 mg atorvastatin during admission since he is now post-STEMI. Baseline LFTs were normal, and LFT's should be monitored carefully as an outpatient. # Acute Kidney Injury: Patient's creatinine bumped from baseline 1.2 to 1.7 after receiving contrast both in the cath lab and for CTA, despite pre-treatment with mucomyst and IVF. Medications were renally dosed and ACEi was held. Creatinine trended down to baseline and captopril restarted on [**2120-8-18**]. #. Gout: Patient had no evidence of acute gout flare-up, he was continued home Allopurinol, but the dose was decreased to 150 mg daily given creatinine clearance. #. GERD: The patient was taking Omeprazole for his GERD at home. This was changed to Ranitidine in the setting of Plavix use. Medications on Admission: Amlodipine 5 mg daily Hydrochlorothiazide 25 mg daily - Stopped Atenolol 50 mg daily - Stopped Diovan 160 mg daily - Stopped Allopurinol 300 mg daily Prilosec 40 mg daily Clobetasol 0.05% ointment [**Hospital1 **] Vitamin B12 1000 mcg injections monthly Discharge Medications: 1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Take every day for one year. Disp:*30 Tablet(s)* Refills:*11* 3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Allopurinol 300 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 5. Clobetasol 0.05 % Ointment Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed for rash. 6. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 7. Outpatient Lab Work Please check PT/INR on Thursday [**2120-8-20**] and call results to Dr. [**Last Name (STitle) **]. 8. Enoxaparin 80 mg/0.8 mL Syringe Sig: One (1) syringe Subcutaneous twice a day: Take until INR > 2.0. Disp:*6 syringes* Refills:*2* 9. Warfarin 2 mg Tablet Sig: 3.5 Tablets PO once a day. Disp:*105 Tablet(s)* Refills:*2* 10. Metoprolol Succinate 100 mg Tablet Sustained Release 24 hr Sig: 1.5 Tablet Sustained Release 24 hrs PO DAILY (Daily). Disp:*45 Tablet Sustained Release 24 hr(s)* Refills:*2* 11. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 12. Furosemide 20 mg Tablet Sig: 0.5 Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: ST Elevation Myocardial Infarction with Apical Akinesis Hyperlipidemia Hypertension Acute Systolic Congestive Heart Failure Discharge Condition: Improved. Vital signs have been stable, patient ambulating without issues. Discharge Instructions: -You were admitted with sudden onset chest pain and diagnosed as having a heart attack. You were taken to the cardiac catheterization lab where a blood vessel supplying the heart was found to be blocked. The blockage was cleared and a stent placed in the vessel to keep it open. Since coming to the Cardiac unit, you have been started and continued on medications to maximize your heart function and recovery. -It is important that you continue to take your medications as directed. We made the following changes to your medications during this admission: --> START Warfarin 7 mg daily for prevention of blood clots. You will need regular INR checks at the coumadin clinic at [**Company 191**]. --> START Lovenox injections twice daily in place of the heparin drip to prevent blood clots. Stop taking Lovenox when your INR is greater than 2.0. --> START full-strength aspirin 325 mg daily to keep the stent open --> START Plavix 75mg daily. It is important that you continue this medication (at least for a year) as it keeps the new stent in your heart clear. Do not stop taking Plavix unless Dr. [**Last Name (STitle) **] tells you to. --> START Atorvastatin 80mg daily for your cholesterol --> START Toprol XL 150mg daily for your blood pressure. --> START Lasix (Furosemide) 10 mg daily to prevent fluid buildup -->STOP your atenolol 50mg daily. -->STOP your Amlodipine 5mg daily. --> START Ranitidine 150mg twice a day for your GERD/reflux. It is important that you do not resume your Prilosec (omeprazole); Prilosec and other proton pump inhibitors have been found to decrease the effectiveness of Plavix on keeping stents clear --> CONTINUE your Allopurinol 300mg daily, Clobetasol Propionate 0.05% Ointment twice daily, Vitamin B12 injections. -Contact your doctor or come to the Emergency Room should your symptoms return. Also seek medical attention if you develop any new fever, chills, trouble breathing, chest pain, nausea, vomiting or unusual stools. You should weigh yourself every morning and call your PCP if your weight increases by more than 3 lbs within one day on 6 pounds within 3 days. Also try to adhere to a low salt (2 gram), low fat diet. Followup Instructions: Primary Care: [**First Name11 (Name Pattern1) 1980**] [**Last Name (NamePattern4) 1981**], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2120-8-22**] 2:30 Cardiology: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]. Phone: [**Telephone/Fax (1) 62**]. Date/time: [**10-8**] at 2:40pm. Dermatology: Provider: [**Name10 (NameIs) **] [**Name8 (MD) **], MD Phone:[**Telephone/Fax (1) 1971**] Date/Time:[**2120-9-13**] 11:15 Rheumatology: Provider: [**First Name8 (NamePattern2) 11595**] [**Last Name (NamePattern1) 11596**], MD Phone:[**Telephone/Fax (1) 2226**] Date/Time:[**2120-9-18**] 2:00 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**]
Discharge summary
Classify the following medical document.
Chief Complaint: 24 Hour Events: BLOOD CULTURED - At [**2119-6-27**] 12:26 AM FEVER - 102.8 F - [**2119-6-27**] 12:24 AM - Conjugated hyperbilirubinemia - Vitamin K 5mg PO x1 - ID - Continue antibiotics, continue surveillance cultures. Persistent fevers not concerning at this point. If continues, consider CT chest to reassess for abscess. - Pulmonary - Cautious fluid resuscitation, no plan for bronchoscopy - [**Doctor First Name **], ANCA pending - 2:00PM - LFTs, hyperbilirubinemia, platelet count, coagulopathy, fibrinogen, FDP stable - Levophed stopped at 2:30pm, restarted at 6:00pm - 6pm: 7.36/34/83, Lactate 1.3 - No new culture data (as of 10:30pm) - 12am: Spiked to 102.8 (rectal); hypertensive, and Levophed was weaned; blood cultures sent; blood pressure slowly came down, MAPs remained over 55 Allergies: Morphine Unknown; Amlodipine Unknown; Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2119-6-24**] 02:00 PM Levofloxacin - [**2119-6-26**] 04:21 PM Nafcillin - [**2119-6-27**] 04:00 AM Infusions: Fentanyl - 100 mcg/hour Midazolam (Versed) - 4 mg/hour Norepinephrine - 0.06 mcg/Kg/min Other ICU medications: Famotidine (Pepcid) - [**2119-6-26**] 08:00 AM Heparin Sodium (Prophylaxis) - [**2119-6-27**] 12:00 AM Other medications: Changes to medical and family history: None Review of systems is unchanged from admission except as noted below Review of systems: Intubated, sedated Flowsheet Data as of [**2119-6-27**] 06:34 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 39.3 C (102.8 Tcurrent: 38.2 C (100.8 HR: 86 (71 - 105) bpm BP: 109/51(70) {82/44(55) - 134/63(84)} mmHg RR: 22 (16 - 24) insp/min SpO2: 96% Heart rhythm: SR (Sinus Rhythm) Height: 72 Inch CVP: 11 (9 - 13)mmHg Total In: 4,733 mL 777 mL PO: TF: 350 mL 223 mL IVF: 3,914 mL 425 mL Blood products: Total out: 1,310 mL 260 mL Urine: 1,310 mL 260 mL NG: Stool: Drains: Balance: 3,423 mL 517 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST Vt (Set): 500 (500 - 500) mL RR (Set): 20 RR (Spontaneous): 5 PEEP: 8 cmH2O FiO2: 50% RSBI: 58 PIP: 16 cmH2O Plateau: 17 cmH2O Compliance: 55.6 cmH2O/mL SpO2: 96% ABG: 7.36/36/116/18/-4 Ve: 10.9 L/min PaO2 / FiO2: 232 Physical Examination Labs / Radiology 294 K/uL 10.5 g/dL 119 mg/dL 2.5 mg/dL 18 mEq/L 3.6 mEq/L 40 mg/dL 110 mEq/L 139 mEq/L 32.3 % 9.8 K/uL [image002.jpg] [**2119-6-25**] 04:51 AM [**2119-6-25**] 03:52 PM [**2119-6-25**] 06:39 PM [**2119-6-25**] 08:48 PM [**2119-6-26**] 04:24 AM [**2119-6-26**] 05:32 AM [**2119-6-26**] 02:37 PM [**2119-6-26**] 06:05 PM [**2119-6-27**] 05:25 AM [**2119-6-27**] 05:39 AM WBC 10.2 9.8 Hct 33.1 35.0 32.3 Plt [**Telephone/Fax (3) 6197**] Cr 2.0 2.1 2.5 TCO2 25 19 19 20 20 21 Glucose 106 112 119 Other labs: PT / PTT / INR:24.7/36.0/2.4, CK / CKMB / Troponin-T:339/6/0.51, ALT / AST:59/106, Alk Phos / T Bili:59/4.7, Differential-Neuts:70.0 %, Band:1.0 %, Lymph:14.0 %, Mono:13.0 %, Eos:0.0 %, Fibrinogen:620 mg/dL, Lactic Acid:1.3 mmol/L, Albumin:2.6 g/dL, LDH:366 IU/L, Ca++:6.6 mg/dL, Mg++:2.1 mg/dL, PO4:3.2 mg/dL Assessment and Plan 82M with hypertension, essential tremor admitted with NSTEMI, now with MSSA pneumonia complicated by sepsis, enlarging right sided infiltrate 1. Hypoxic respiratory failure: Tolerated pressure support briefly yesterday. Now currently on assist control. Large A-a gradient by blood gas. Patient with component of respiratory alkalosis, although this may be compensatory given metabolic acidosis. - Pneumonia treatment as below - Vent parameters per ARDSnet protocol - Pulmonary recs 2. Pneumonia/sepsis: MSSA pneumonia. Patient with persistent fevers, although lower grade. ID involved. - Discuss with ID given persistent fevers, should we expand coverage for anaerobes? - Continue Nafcillin for total 3 week course through [**2119-7-11**] (start date [**6-21**], Vancomycin initiation date) and levofloxacin for total 8 day course ([**2119-6-24**] through [**2119-7-2**]) - Follow culture data - Maintain CVP 8-12, MAP>60; if falls below this, bolus IVF (LR given non-anion gap metabolic acidosis potentially secondary to NS); wean Levophed as tolerated - CIS 3. Coagulopathy: INR elevated to 2.4, confirmed on recheck. Differential includes DIC (FDP 10-40, although elevated fibrinogen and PTT normal), shock liver (LFTs improved since admission). Could also be nutritional deficiency. - Vitamin K PO x1 - Recheck coags, FDP, fibrinogen this afternoon 4. s/p NSTEMI: Cath showed clean coronaries, NSTEMI possibly caused by thrombus that had since resolved with medical therapy. Likely demand ischemia in the setting of pneumonia. - Continue ASA - Hold beta-blocker in the setting of sepsis - Hold Plavix at this time given concern for PAH (very low likelihood) - Continue statin 5. PUMP: TTE with newly depressed EF 35-40% with inferolateral and apical hypokinesis - Beta-blocker on hold as above - Would benefit from ACE inhibitor once over acute illness - Hold Plavix and heparin given mention of potential PAH, although this is unlikely; will likely restart heparin in next 1-2 days given concern for thrombus formation at site of hypokinesis 6. ACUTE RENAL FAILURE: Baseline 1.0. Creatinine slowly trending up, likely prerenal given sepsis. - Renally dose meds ICU Care Nutrition: Nutren Pulmonary (Full) - [**2119-6-27**] 12:00 AM 40 mL/hour Glycemic Control: Lines: 20 Gauge - [**2119-6-24**] 10:14 PM Arterial Line - [**2119-6-24**] 11:29 PM Multi Lumen - [**2119-6-25**] 02:49 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition:
Physician
Classify the following medical document.
55 y.o. male with PMHx of DM, HTN, CAD s/p IMI with 3 stents to RCA and recently diagnosed RCC who was transferred from [**Hospital3 **]for ongoing work-up of acute renal failure and change in mental status. . Patient was admitted to [**Hospital3 **]Hospital on [**2165-4-16**] for chest and abdominal pain. He ruled out for an MI with cardiac biomarkers and was felt to be constipated (on CT) due to chronic narcotic use for lower back pain and right hip pain (awaiting hip replacement). His constipation was treated aggressively with medications and disimpaction with minimal effect. On day 4 of his hospitalization, he was febrile to 104 with a leukocytosis to 14 and was pan-cultured while Vancomycin and Zosyn were started empirically with specific concern for a PIV infection suggested by surrounding erythema and edema. Blood cultures later grew GPCs in [**2-23**] bottles and chronic foot ulcers were swabbed and reportedly grew staph aureus with pending sensitivities. Zosyn was thus discontinued. In the setting of infection, patient became delirious, noted to be attempting to grab things from the air and talking to people in the room. Of note, patient was continued on narcotics, reportedly at the wife's insistence given concern for narcotic withdrawal. Neurology was consulted and recommended a head CT which was unremarkable, leaving them to conclude that the mental status was toxic/metabolic in the setting of infection and narcotic use. He was started on Ceftriaxone 2 grams daily for CNS coverage though no LP was performed. On day 5, patient was noted to develop acute renal failure with a creatinine of 3, up from 1.3 and was also anuric. CKs were checked to evaluate renal failure from rhabdomyolysis and were not likely contributing at a level of 361. He was transferred [**4-21**] to [**Hospital1 1**] for concern of his renal failure progressing to the point of needing HD, since [**Hospital3 6341**] no HD facilities. . Upon arrival, patient was noted to vomit and had reportedly vomited en route to [**Hospital1 1**]. He additionally started experiencing low-amplitude, rhythmic clonus of his hands and legs, became transiently hypoxic and was not verbally responsive. There was concern for seizing and patient was urgently intubated to protect his airway. Discussion with the patient's wife, [**Name8 (MD) **] RN, revealed that the patient has never had a seizure disorder and does not drink alcohol. Additionally, he had a CT scan with contrast at [**Hospital1 49**] 3 days prior to his admission to [**Hospital 6342**]as a part of his RCC work-up and the wife expressed concern for contrast-induced nephropathy. Patient was then ordered for a stat head CT given the mental status and neurology was consulted for further assistance with management. LP [**4-23**] + for meningitis, TEE neg for vegetation. Meningitis, bacterial Assessment: Pt O X 1, following commands with encouragement. Speech normal, but saying random words. MAE, PEARL @ 3mm/brisk bilat. [**Month/Day (2) 6643**] restless. Pt had rec d Haldol 2mg IM overnight for yelling/verbal abuse with good results. VSS with HR 71-87SR with occas PVC s, BP 152/51-165/56. Low-grade temp persists, presently 99.6ax. Lung snds clear, diminished in bases with non-productive cough. O2 sat 93-96% on 4l NC with RR 21-26 and regular. Action: Soft wrist restraints remain in place bilat for pt safety. Pt freq reoriented. Pt rec d Vancomycin with HD. Response: MS [**Month/Day (2) **] to slowly improve. Plan: [**Month/Day (2) **] freq orientation, monitoring for change in MS. [**First Name (Titles) **] [**Last Name (Titles) 6636**] tx. Follow-up cx results. Renal failure, acute (Acute renal failure, ARF) Assessment: AM BUN/creat 54/5.8. Pt had rec d Lasix 120mg X 1 yesterday with 1 liter diuresis resulting. Urine yellow/clear, draining @ 20-45ml/hr. LOS fluid balance +4.8liters. Action: Pt rec d HD today, removing 3liters over 4hrs. Response: HD tolerated well, no change in BP. Plan: [**Last Name (Titles) **] to monitor fluid balance, BUN/creat. Impaired Skin Integrity Assessment: Pt has 3 dry ulcers on L foot. Two ulcers on bottom of foot (2cmX2cmX3cm deep, and 1cmX1cm), and there is a small ulcer on top of foot (3cmX1cm). Pt had amputated toes and the foot is very dry. Podiatry dresses ulcers with WTD dsgs daily. Also, coccyx is red, yeast infection around coccyx/periarea. Action: Pt repositioned Q2hrs. Miconazole powder to yeasty areas. Foot dsg changed/reinforced as it comes off with pt s restlessness. Response: No change. Plan: [**Last Name (Titles) **] present WTD dsg, podiatry to follow. Hyperglycemia Assessment: FSG 218, 255. Action: Pt [**Last Name (Titles) **] to receive TF @ goal via NGT with no residuals. Abd soft/obese with + BS. Flexiseal draining mod amts brown loose stool. Pt rec Insulin per sliding scale and fixed dose. Response: FSG @ 1600 247. Pt rec d 8units Humalog per sliding scale. Plan: Tighten sliding scale, as FSG consistently in 200 s. [**Last Name (Titles) **] Q4hr fingersticks to check glucose. Pain control (acute pain, chronic pain) Assessment: Pt denied pain in am but is poor historian at the moment. [**Name2 (NI) 6643**] groaning, trying to reposition self in bed. Pt with PMH R hip pain. At one point yelling for Dr [**First Name (STitle) 1071**] , saying he needed $50 worth of MS Contin Action: Pt with Lidocaine patch on R hip, 37.5mcg patch Fentanyl. He also rec PRN Fentnayl 50mcg IVP @ 1500. Response: Pt states pain ins @ 1600. Plan: [**First Name (STitle) **] to freq reposition pt. Pain meds per above, with PRN Fentanyl IVP.
Nursing
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[**2156-2-6**] 5:37 PM IVC GRAM/FILTER Clip # [**0-0-**] Reason: High clinical suspicion PEpersitent hypoxia of sudden onsetP Contrast: OPTIRAY Amt: 40 ********************************* CPT Codes ******************************** * [**Numeric Identifier 1623**] INTERUP IVC [**Numeric Identifier 1624**] INTRO CATH SVC/IVC * * -51 MULTI-PROCEDURE SAME DAY [**Numeric Identifier 1625**] PERC PLCMT IVC FILTER * * [**Numeric Identifier 3895**] IVC GRAM C1769 GUID WIRES INCL INF * * C1880 VENA CAVA FILTER * **************************************************************************** ______________________________________________________________________________ [**Hospital 4**] MEDICAL CONDITION: 67 year old man with REASON FOR THIS EXAMINATION: High clinical suspicion PEpersitent hypoxia of sudden onsetPt cannot be anticoagulated secondary to head bleedWOuld require filter in PE present ______________________________________________________________________________ FINAL REPORT HISTORY: 67 y/o man with intracranial injury and hypoxia. RADIOLOGISTS: The procedure was performed by Drs. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] and [**First Name4 (NamePattern1) 134**] [**Last Name (NamePattern1) 135**], with the attending radiologist Dr. [**First Name (STitle) 135**] being present during the entire procedure. PROCEDURE AND FINDINGS: The risks and benefits were explained to the patient's family and consent was obtained. The patient was placed supine on the angiographic table and the right groin was prepped and draped in sterile fashion. Under local anesthesia using 1% Lidocaine, the right common femoral vein was accessed with a 19 gauge needle and 0.035 [**Last Name (un) 414**] wire was advanced into the inferior vena cava. The needle was exchanged for a 4 FR Omniflush catheter with its tip just above the IVC bifurcation. Inferior vena cavogram was performed with injection of nonionic contrast diluted to half which demonstrated patent bilateral common iliac veins and IVC with no filling defect or anomalies visualized. Both renal vein openings were identified bilaterally. The catheter was removed and the venous entry site was dilated over a .035 wire with increasing sized dilators sequentially. A 15 FR long sheath was advanced over the wire into the upper inferior vena cava. Then, [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 16915**] filter was deployed with tip at the level of bilateral renal vein openings. The final X-ray demonstrated the filter is in proper position. The sheath was removed and local hemostasis was achieved by manual compression. The patient tolerated the procedure well with no complications. IMPRESSION: Successful placement of a infrarenal [**Location (un) 16915**] IVC filter. Patent inferior vena cava. Reflux into the left common iliac vein compatible with increased right atrial pressure. (Over) [**2156-2-6**] 5:37 PM IVC GRAM/FILTER Clip # [**0-0-**] Reason: High clinical suspicion PEpersitent hypoxia of sudden onsetP Contrast: OPTIRAY Amt: 40 ______________________________________________________________________________ FINAL REPORT (Cont)
Radiology
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65 yo M without medical history presenting for evaluation of shortness of breath, nausea and vomiting. 5-6 days prior to admission he developed paroxysmal cough. He obtained Tessalon Perles and an antibiotic from a local allergist. Over the weekend, he developed prominent GI symptoms w/ persistent nausea, forced dry heaves/wretching and some vomiting. He noted shortness of breath and came to the ED for evaluation on [**7-21**]. CXR demonstrated RUL PNA w/ LLL nodular density and he was dc d on Levofloxacin, Albuterol and Prednisone. He went home but his GI symptoms progressed and returned to the ED. Hospital course complicated by H1N1 diagnosis, ARDS- placed on Rotoprone bed on [**7-24**]- tolerating 3.15hrs of being prone and 45 min being supine. CRRT started [**7-24**]. Transitioned to HD. Pt had been in Afib- cardioverted on [**7-24**] back to NSR. Now aflutter/ST-NSR. + C-Diff colitis tx vanco via NGT [**8-1**] noted diffuse drug rash which does not appear any worse. Acute Respiratory Distress Syndrome (ARDS, Acute Lung Injury, [**Doctor Last Name 11**]) Influenza A+ HINI Assessment: Received pt off both fent/versed gtts. Had been dc d right before shift change at 1830. Pt had been started on methadone [**8-1**] to help transition off fent/vers. Did require bolus dose of each x 1 overnight for tachypnea up to 40 s and apparent resp distress with increased WOB. Bolus effective. At other times, pt becomes tachypneic, high minute volumes and high pressures but then settles back out on own without intervention. Vent mode PSV 7/5 60% RR 18-38 TV >400. Sats 90-96% transient episodes Desats with turning; however, does do well with max rotation on triadyne. Lungs dimished throughout, slight rhonchi to bases. None to scant tan secretion. HR 85-110 s, NSR-ST with pac s and pvc s. MAPS>60. Responsive to verbal and painful stimulation as evidenced by opening eyes. Noted to have movement in upper ext s-not purposeful at this time. Moves left arm > right. Does not follow any commands. No movement from LE s. Grimaces with pain and opens eyes. Illiciting strong cough. Opens eyes spont with vigorous stimulation not tracking surroundings pupils 2mm equal react brisk. T max 102.5. WBC 8.9 (up from 7.6) , +diffuse drug rash. S/p HD on [**8-2**] with 3.2 L off (did transiently drop bp during HD and required getting a little fluid back but still total of 3.2 off) Peep weaned from 12 to 7 yesterday. Sats 90-95%. Action: methadone dose cut in half as ordered by MD. Seraquel dose PRN if needed. Peep weaned from 12 to 8 on days and weaned from 8 to 7 this shift. VBG done as pt without aline. Tylenol given. PO abx as ordered. Response: Maintaining sats with peep wean with exception of turn/stimulation in which case placed on 100% o2 suction. Cont to spike temps. No culture growth to date. Plan: Wean Peep as tol Cont sedation with methadone. Plan fent/versed bolus PRN Cont PO vanco x 14 days. Renal failure, acute (Acute renal failure, ARF) Assessment: Anuric u/o tol 7cc this shift. Foley dc d yesterday due to persistent fevers. BUN/Creat 62/9.0 (from 66/9.8). Received HD with Fluid removal 3.2L transient hypotension. Action: Urine spec sent tor easoniphils. Response: unchanged. Plan: Straight cath q12hrs. HD for ARF and fluid removal; next HD Monday C. difficile infection (C Diff, Cdiff Colitis, Clostridium Difficile) Assessment: Flexiseal in place. Action: PO vanco x 14 day course (to end [**8-11**]) Response: cont with loose stool per flexiseal Plan: [**Month (only) 51**] decrease po dose of vanco ** Spouse [**Name (NI) **] visited at bedside and phoned for updates; with good understanding of pt s status and plan of care. Will be in today to visit.
Nursing
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Admission Date: [**2144-7-1**] Discharge Date: [**2144-7-6**] Service: NEUROSURGERY Allergies: Sulfa (Sulfonamide Antibiotics) / aspirin Attending:[**First Name3 (LF) 1835**] Chief Complaint: s/p fall Major Surgical or Invasive Procedure: None History of Present Illness: The patient is an 88 year old woman with a history of aortic valvular repair/replacement, DM2, HTN, vertigo here s/p unwitnessed fall with head injury and loss of consciousness. She has no memory of the event or antecedent symptoms and appears emotionally distressed by the event; she answered most questions regarding the event with "I don't know." She has a posterior headache with some abdominal upse, but no vomiting, visual disturbances, or lethargy/ inability to stay awake. She denies any other neurologic symptoms. She was found on imaging to have small bifrontal SAH and small subcentimeter R frontal SDH. Past Medical History: Aortic valve repair/replacement (not known, [**12/2143**]) HTN HL DM2 Vertigo ?Arrhythmia Social History: No tobacco, ETOH, or illicits endorsed. Family History: NC Physical Exam: VS HR: 82 BP: 108/73 General: Awake, NAD, lying in bed comfortably. Head: NC, superficial bleeding on posterior occiput, no scleral icterus, no oropharyngeal lesions Neck: Supple, no nuchal rigidity Extremities: Warm, well perfused Skin: No rashes or lesions Neurologic Examination: - Mental Status - Awake, alert, oriented x name, month, birth date, place. Does not recall the event. Attention easily attained and maintained. Follows two step commands, midline and appendicular. Language fluent with intact repetition and verbal comprehension. Normal prosody. No paraphasic errors. No dysarthria. No neglect. - Cranial Nerves - [II] PERRL 3->2 brisk. VF full to confrontation. Funduscopy shows crisp disc margins, no papilledema. [III, IV, VI] EOMI, no nystagmus. [V] V1-V3 without deficits to light touch bilaterally. [VII] No facial asymmetry. [VIII] Hearing intact to finger rub bilaterally. [IX, X] Palate elevation symmetric. [[**Doctor First Name 81**]] SCM/Trapezius strength 5/5 bilaterally. [XII] Tongue midline. - Motor - Normal bulk and tone. No pronation, no drift. No tremor or asterixis. =[Delt] [Bic] [Tri] [ExD] [IO] [IP] [Quad] [Ham] [TA] [Gas] [[**Last Name (un) 938**]] L 5 5 5 5 5 5 5 5 5 5 5 R 5 5 5 5 5 5 5 5 5 5 5 - Sensory - No deficits to light touch bilaterally. - Reflexes =[Bic] [Tri] [[**Last Name (un) 1035**]] [Quad] [Gastroc] L 2 2 2 2 0 R 2 2 2 2 0 Plantar response silent bilaterally. - Coordination - No dysmetria with finger/foot mirrored movements. - Gait - Not safe to assess. Pertinent Results: CT C-Spine [**7-1**] IMPRESSION: No acute fracture or dislocation of the cervical spine. CT Head [**7-1**] 1. Bilateral subarachnoid hemorrhage. 2. 4-mm right frontal subdural hematoma without midline shift. CT Abd/pelvis No acute visceral injury in the abdomen or pelvis. Mild anterolithesis of L4 over L5 of indeterinate age, but may be degenerative. Multi-level adjacent degenerative changes seen. Cholelithiasis without CT findings of acute cholecystitis. Apparent urinary bladder wall thickening, could relate to underdistention, but recommend correlation with urine analysis. CT head [**7-2**] 1. Thin right subdural hematoma, re-distributed posteriorly, though unchanged in size with no significant mass effect. 2. Unchanged bifrontal subarachnoid hemorrhage. 3. Small focus of likely hemorrhagic contusion in the right frontal region inferiorly, which appears new from one day prior. 4. Newly noted layering of blood products within the occipital horns of the lateral ventricles, likely reflecting re-distribution. No hydrocephalus. [**2144-7-3**] 08:40AM BLOOD TSH-5.7* [**2144-7-4**] 02:35PM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.012 Blood-MOD Nitrite-NEG Protein-30 Glucose-300 Ketone-10 Bilirub-NEG Urobiln-NEG pH-7.0 Leuks-SM RBC-42* WBC-11* Bacteri-NONE Yeast-NONE Epi-<1 Brief Hospital Course: Patient preented to [**Hospital1 18**] ER on [**7-1**] for eval after having a witnessed syncopal episode in which she struck her head. Imaging revealed a right frontal SDH and bifrontal contsuions. She was on coumadin prior to admit so she was reversed with vitamin K, factor 9, and FFP and admitted to the ICU for further observation. She remained stable voernight in the ICU into [**7-2**] and on the morning her INR was 1.5 for which she recieved a single dose of Vitamin K PO in addition to her normal dosing, she was also started on Dilantin for antiseizure prophylaxis. She underwent a repeate head CT which showed normal evolution of her bifrontal contusions as well as a new small amount of blood in her occpital horns most likely due to redistribution of blood. She was deemed fit for transfer to the floor and a medicine consult was called to aid in a syncopal workup. A follow-up INR was done which was 1.3 and after he tranfer to the floor the medicine team saw her. They felt that she did not require a TTE as she had one recently and given her lack of symptoms pointing to a recurrent aortic stenosis as a culprit they did not feel a new echo was warranted. She remained stable on the floor on [**7-2**] and then in the evenign had a few episodes of emesis which did not initially respond to zofran so phenergan was added with good efect. On the morning of [**7-3**] medicine gave further recs including orthostatic vital signs, medication changes including adding evening lantus dosing for blood sugar management, and IV fluids. She remained stable into the evening of [**7-3**] with goals of mobilizing her and encouraging PO intake. On [**7-4**] the patient was noted to be sundowning and to be delerious. The medicine team made further recommendations in regards to medications to avoid and started her on ceftriaxone for a suspected UTI. A TSH was checked and was 5.6. On [**7-5**] the patient was neurologically stable. Orthostatic VS's were checked again and negative. The medicine team signed off suggesting cefpodox for the UTI treatment x 10 days. On [**7-6**] she was screened for rehab facilities. Her urine culture resulted in no growth therefore her antibiotics were discontinued. Now, DOD she is set for d/c to rehab and will followup accordingly. Medications on Admission: Warfarin 10 on Thursday/Sunday and 7.5 other days, Metoprolol 25 [**Hospital1 **], Pravastatin 20, Ranitidine 150 [**Hospital1 **], Glargine (unknown dose), Lispro (unknown dose), Meclizine PRN Discharge Medications: 1. pravastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. phenytoin sodium extended 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 3. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. insulin glargine 100 unit/mL Solution Subcutaneous 7. insulin lispro Subcutaneous 8. meclizine 12.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for dizzy. 9. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 10. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 11. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for Constipation. Discharge Disposition: Extended Care Facility: [**Location (un) 582**] of [**Location (un) 583**] Discharge Diagnosis: Right Subdural Hematoma Bifrontal contusions Syncope Urinary tract infection hyperglycemia Elevated TSH Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: ACCORDING TO YOUR CARDIOLOGIST YOU NO LONGER NEED TO TAKE COUMADIN ?????? Take your pain medicine as prescribed. ?????? Exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? Increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. We generally recommend taking an over the counter stool softener, such as Docusate (Colace) while taking narcotic pain medication. ?????? Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, Aspirin, Advil, or Ibuprofen etc. - You are on dilantin and we recommend that you continue for until your scheduled follow-up with Neurosurgery. This will need to be monitored with blood work from your PCP or rehab center. ?????? CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING ?????? New onset of tremors or seizures. ?????? Any confusion, lethargy or change in mental status. ?????? Any numbness, tingling, weakness in your extremities. ?????? Pain or headache that is continually increasing, or not relieved by pain medication. ?????? New onset of the loss of function, or decrease of function on one whole side of your body. Followup Instructions: ??????Please call ([**Telephone/Fax (1) 88**] to schedule an appointment with Dr. [**Last Name (STitle) **], to be seen in 4 weeks. ??????You will need a CT scan of the brain without contrast prior to your appointment. This can be scheduled when you call to make your office visit appointment. ?????? You should follow up with your PCP upon discharge. It has been recommended that you get a repeat TSH in [**3-25**] weeks. Completed by:[**2144-7-6**]
Discharge summary
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SICU HPI: 70yo M w/ persistent abd pain, poor po intake, w/ gallstone pancreatitis, complicated by abdominal compartment syndrome following ERCP, ARDS, septic vasodilatory shock, Cdiff, and ARF. Now with necrotizing pancreatitis s/p drain placement and multiple necrosectomies. . SURGERIES: ex lap ([**7-3**], [**7-3**]) partial abd closure ([**7-8**]) abd closure, GJ placement ([**7-13**]) vaccuum dressing ([**7-19**]) trach ([**7-24**]) vicryl closure ([**7-29**]) I&D retroperitoneal abscess ([**8-18**]) Minimally-invasive pancreatic necrosectomy ([**8-22**], [**8-28**], [**9-4**]) . MICRO: [**2113-7-3**]: Sputum: RARE YEAST [**2113-7-8**] Sputcx: yeast w/ aspergillus [**2113-7-8**] peritoneal: yeast 2+, [**Female First Name (un) **] [**2113-7-11**] BAL: yeast, aspergillus Cdiff: + [**2113-7-19**] BALx2- prelim aspergillus [**2113-7-25**] stool - guaic + [**2113-7-31**] [**2113-7-25**] sputum: E.coli+yeast [**2113-7-27**] Blood - GRAM POSITIVE COCCUS(COCCI)IN PAIRS AND CLUSTERS [**2113-7-28**] BAL- Pan-S pseudomonas, cipro-R e.coli [**2113-7-31**] sputum: pseudomonas + ecoli [**2113-8-10**] cdiff neg x 3 [**2113-8-12**] blood cx P [**2113-8-13**] pancreatic fluid culture: Pseudomanas and [**Female First Name (un) **] albicans [**2113-9-4**]:[**Female First Name (un) 1354**]. Variable rods and gram positive cocci in chains and clusters. [**2113-9-5**] cdiff neg [**2113-9-7**] BCx=coag neg staph and UCx Neg, L flank drainage - pseudomonas, cipro and pip [**Last Name (un) 270**]. [**2113-9-7**] Wound Cx pseudomonas/ cipro-sensitive [**2113-9-7**] Sputum +Pseudomonas and rare GNR [**2113-9-9**] SputumCx: 4+(>10 per 1000X FIELD): GNR; 1+ Budding Yeast [**2113-9-10**] UrineCx no growth [**2113-9-11**] SputumCx: 4+ GNR, 2+ yeast [**2113-9-12**] Picc Cath tip IMAGING: [**2113-7-1**]: RUQ US: limited study, gallbladder wall thickening, nl CBD, no stones [**2113-7-1**]: OSH CT abd/pelvis: thickened GB with stone in neck, can not assess CBD, marked pancreatitis [**2113-7-2**]: TTE and TEE ([**2113-7-2**]) showing hypovolemia, no wall motion abnormalities. [**2113-7-14**]: VUS: Non-obstructive clot in the left lower internal jugular vein. [**2113-7-14**]: Non-obstructive clot in the left lower internal jugular vein [**2113-7-17**]: Liver U/S Cholelithiasis. Gallbladder wall thickening not significantly changed. Small pericholecystic same as CT ([**2113-7-1**]). No definite evidence cholecystitis. [**2113-7-19**]: CT head/torso extensive pancreatic necrosis. No focal abscess. Mild chronic sinusitis. R lobe PNA [**2113-8-12**]: CT Torso necrotizing pancreatitis per [**Doctor First Name 213**] read [**2113-8-21**]: Thrombosis L >RIJ, neither completely occluded. Complete thrombosis R basilic vein which neither compresses nor augments. [**2113-9-6**]: KUB paucity of abdominal gas. Residual barium throughout small bowel, colon,rectum [**2113-9-7**] CT abd: Interval decrease peripancreatic collection. Ascites, unchanged. Small bilateral pleural effusions, atelectasis. [**2113-9-8**]: CXR stable bibasilar atelectasis, effusions [**2113-9-10**]: KUB = Contrast is seen in the transverse and descending colon. hazy opacity projecting above the transverse colon ?extrav. [**2113-9-10**] IJ Ultrasound = Small non-occlusive thrombosis in the distal left IJ, smaller in size from prior. No new DVT. [**2113-9-11**] CXR Moderate right pleural effusion, small left pleural effusion and mild-to-moderate bibasilar atelectasis unchanged. Mediastinal vascular congestion slightly improved. [**2113-9-11**] KUB Contrast in transverse and descending colon [**2113-9-12**] Renal US no hydronephrosis, stones or masses, arterial flow documented bilaterally, limited exam cannot r/o R renal artery stenosis, L kidney Doppler waveforms demonstrate good upstrokes however lack of diastolic flow in the intraparenchymal arteries may be due to technical limitations [**2113-9-12**] KUB p [**2113-9-12**] CXR p . EVENTS: [**2113-7-2**]: ERCP, aspiration mid-procedure so intubated. Unsuccessful ERCP, difficulty passing NG tube. Excessive air causing compartment syndrome of abdomen. Taken to OR for Abd compartment syndrome from air insufflation. [**2113-7-3**]: Ex-lap, enterotomy for abd decompression. Due to worsening [**Last Name (un) **] distension, hemodynamic instabilty the [**Last Name (un) **] wound was extended in the ICU by the surgical team and packed. . [**2113-7-8**]: to OR for washout + dressing change + partial closure, ABD still open [**2113-7-8**] Sputcx: yeast w/ aspergillus [**2113-7-12**]: cdiff+, started po vanco, flagyl, dc vanco, zosyn. [**2113-7-13**]: closed in OR [**2113-7-17**]: Upper GI bleed, S/P Upper GI scope by GI and clipping of bleeding vessel. Likely Dieulafoy's lesion. [**2113-7-19**]: Head to pelvis CT - pancreatic necrosis, no evidence of large hematoma or abscess. Developed hemoptysis w/ increased Gtube output -> GI scoped - lots of debris in stomach, no evidence acute bleeding. TEE - showing low svr state, hypovolemia, empty hyperdynamic ventricles. Bronch showing erythematous trachea, bal for clot, thick secretions, no plugs. Increasing abd distention with increased bladder pressures (28) - OR for decompressive laporatomy. Vanco and zosyn for PNA. [**2113-7-24**]: washout of abd wound and trach in OR [**2113-7-28**]: Worsening infiltrates on CXR, bronch showing purulent fluid. BAL sent. GPC to R SVC CVL. E.coli in sputum (pan-sensi). Lines replaced w/ tips cultured. Vanco, zosyn, cipro added. Flagyl also added for empiric C.diff. OR for closure w/ mesh. Trach with cuff leak, not changed in OR. [**2113-9-4**]: to OR for repeat necrosectomy, started levophed gtt, on CMV. Left flank drain O/P bloody. [**2113-9-5**]: 2 units PRBC, G/J changed in IR (tube was leaking), trach collar trial [**2113-9-6**]: Out of bed to chair, tube feeds re-started at 10 but bilious vomiting several hours later, KUB ruled out obstruction, TF re-started again [**2113-9-7**]: TM trialx7h, CT A/P with PO unchanged per surgery, methadone 10 [**Hospital1 7**], started lopressor. T spike 101.6 ON--panCx and CXR. [**2113-9-8**]: Bowel contents draining from wound around pancreatic drain. Pt made NPO, TPN started. V/C/F started empirically. [**2113-9-9**]: SputumCx 4+ GNR, 1+ yeast. Pancreatic drain dressing? [**2113-9-10**]: Zosyn for ?pseudomonas, resent ET aspirate per ID as they did not trust initial sputum/contam. KUB=+contrast still. Surgery wants wet-dry [**Hospital1 7**] dressings, res and att aware of local breakdown [**2-6**] fistula. IJ thrombi largely resolved on U/S. heparin gtt d/c'd. [**2113-9-11**]: VAC change, Cr increasing to 3.3, Renal Reconsulted. [**2113-9-12**]: New CVL, PICC pulled and sent for culture, A line placed. Abg with 7.08 PCo2 81 HCO3 26 Lactate 1.2. Methadone held and placed on rate - repeat gas 2 hrs later 7.08/81/153/23. Assessment: 70M w/ gallstone pancreatitis s/p failed ERCP and abdominal compartment syndrome([**2113-7-2**]) c/b vasodilatory SIRS shock w/subsequent decompressive exploratory laparotomy ([**2113-7-3**]) w/ persistent open abdomen, expansion of wound ([**2113-7-3**]) bleeding Dieulafoy's s/p clipping ([**2113-7-17**]) ARF, s/p episode ARDS and c.diff, s/p abd closure and repeat decompressive ex lap ([**2113-7-19**]), now trached ([**2113-7-24**]), Partial closure with mesh ([**2113-7-29**]) and wound Vac ([**2113-8-1**]). Repeatedly febrile, repeat abd CT shows air in pancreas. now s/p drainage of pancreatic collection by IR ([**2113-8-13**]) upsizing of drain ([**2113-8-18**]), laproscopic minimally invasive pancreatic necrosectomy ([**2113-8-22**], [**2113-8-28**], [**2113-9-4**]). . PLAN: Neuro: Methadone careful titration. Tylenol, Fentanyl prn pain. CVS: Lopressor 5 IV Q6h as BP tolerates Pulm: Follow CXRs. Changed to CMV for hypercabia. GI: Significant drainage around pancreatic drain w. skin breakdown, decreased since TF stopped. No drainage of perihep/gutter since not loculated/acute. Per primary team low threshold for CT abdomen. KUB [**9-12**] + barium sigmoid. Small bowel follow through on hold. [**Doctor First Name **] wound care plan is wet-dry [**Hospital1 7**] (too large for ostomy and aware of breakdown). Renal: ARF, Cr 3.0 wtih FENA suggestive of primary renal etiology. Renal Ultrasound limited Bl flow norm. FEN: TF stopped [**2113-9-8**], TPN started (1.25g/kg prot; total [**Numeric Identifier **]). TPN + LR IVF = 150. HyperP, hypoCa. No TPN phos. Corrected calcium normal. Heme: Off heparin gtt for cleared neck U/S, on SCH. *PT REQUIRES ~8HRS NOTICE FOR ANY BLOOD PRODUCTS [**2-6**] UNUSUAL ABS. Endo: 20units regular in TPN. RISS.(normal [**Last Name (un) **] stim test [**2113-8-14**]). PTH 22 ID: V/C/Z for sensitive Pseudomonas+ pancreatic drainage. [**2113-9-7**] BCx=coag neg staph and UCx Neg, L flank drainage - pseudomonas, cipro and pip [**Last Name (un) 270**]. F/u PICC tip. Consider fungal coverage. Wounds: Abdomen wound vac (changed [**9-11**]). Left flank wound around panc tube. Wet->dry [**Hospital1 7**] per [**Doctor First Name 213**] att/res. Prophylaxis: SCDs, H2B, SQH Consults: West 2, ID, PT/OT, renal. Code: Full Disposition: SICU Chief complaint: Necrotizing pancreatitis PMHx: asthma, HTN, basal cell CA Current medications: Acetaminophen prn, Albuterol prn, Bisacodyl, Colace, Epoetin, Fentanyl prn, Haloperidol prn, RISS, atrovent prn, Lorazepam prn, Protonix, Elecrolyte SS, metoprolol 37.5mg po bid, methadone holding 24 Hour Events: New CVL, PICC pulled and sent for culture, A line placed. Abg with 7.08 PCo2 81 HCO3 26 Lactate 1.2. Methadone held and placed on rate - repeat gas 2 hrs later 7.08/81/153/23. Post operative day: POD#72 - ex lap for compartment syndrome. 2 drains to wall suction. exam otherwise unchanged from previous. POD#67 - s/p abdominal partial closure and dressing change POD#61 - abdominal wound closure; insertion of g-j tube POD#56 - ex lap POD#51 - trach and abd washout POD#46 - ex-lap and mesh closure of abdomen POD#26 - Replacement of pancreatic drain for abscess including irrigation port POD#22 - laparoscopic pancreatic necrosectomy POD#9 - washout of peripancreatic space. Allergies: Aspirin Unknown; Sulfa (Sulfonamide Antibiotics) Rash; Last dose of Antibiotics: Vancomycin - [**2113-9-10**] 04:00 PM Ciprofloxacin - [**2113-9-12**] 06:12 PM Piperacillin/Tazobactam (Zosyn) - [**2113-9-12**] 11:45 PM Infusions: Other ICU medications: Methadone Hydrochloride - [**2113-9-12**] 10:08 AM Heparin Sodium (Prophylaxis) - [**2113-9-12**] 10:05 PM Metoprolol - [**2113-9-12**] 10:05 PM Fentanyl - [**2113-9-12**] 11:45 PM Other medications: Flowsheet Data as of [**2113-9-13**] 01:08 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**16**] a.m. Tmax: 36.9 C (98.5 T current: 36.9 C (98.5 HR: 82 (71 - 96) bpm BP: 118/59(78) {116/55(75) - 133/66(87)} mmHg RR: 20 (12 - 25) insp/min SPO2: 100% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 90.7 kg (admission): 108.3 kg Height: 64 Inch CVP: 14 (7 - 14) mmHg Total In: 6,570 mL 238 mL PO: Tube feeding: IV Fluid: 4,770 mL 166 mL Blood products: Total out: 2,974 mL 30 mL Urine: 494 mL 30 mL NG: 800 mL Stool: Drains: 1,680 mL Balance: 3,596 mL 208 mL Respiratory support O2 Delivery Device: Tracheostomy tube Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 500 (500 - 500) mL Vt (Spontaneous): 312 (312 - 412) mL PS : 0 cmH2O RR (Set): 18 RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 40% RSBI: 43 PIP: 31 cmH2O Plateau: 24 cmH2O SPO2: 100% ABG: 7.26/50/153/22/-4 Ve: 10.5 L/min PaO2 / FiO2: 383 Physical Examination Labs / Radiology 337 K/uL 8.1 g/dL 143 mg/dL 3.9 mg/dL 22 mEq/L 3.8 mEq/L 85 mg/dL 104 mEq/L 135 mEq/L 28.8 % 13.6 K/uL [image002.jpg] [**2113-9-7**] 03:18 AM [**2113-9-8**] 04:25 AM [**2113-9-9**] 03:00 AM [**2113-9-10**] 03:09 AM [**2113-9-11**] 03:00 AM [**2113-9-11**] 05:25 PM [**2113-9-12**] 02:25 AM [**2113-9-12**] 07:20 PM [**2113-9-12**] 08:12 PM [**2113-9-12**] 10:04 PM WBC 7.6 8.2 7.8 11.7 13.3 13.6 Hct 28.4 28.6 28.7 29.7 29.6 28.8 Plt [**Telephone/Fax (3) **]94 358 337 Creatinine 2.0 2.0 2.1 2.2 2.9 3.3 3.5 3.9 TCO2 26 23 Glucose 237 143 93 159 146 133 174 143 Other labs: PT / PTT / INR:19.7/117.8/1.8, CK / CK-MB / Troponin T:57/5/0.38, ALT / AST:[**10-20**], Alk-Phos / T bili:86/0.9, Amylase / Lipase:51/16, Differential-Neuts:72.0 %, Band:6.0 %, Lymph:11.0 %, Mono:5.0 %, Eos:1.0 %, Fibrinogen:738 mg/dL, Lactic Acid:1.2 mmol/L, Albumin:1.7 g/dL, LDH:151 IU/L, Ca:9.0 mg/dL, Mg:1.9 mg/dL, PO4:6.0 mg/dL Assessment and Plan RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name 11**]), AIRWAY, INABILITY TO PROTECT (RISK FOR ASPIRATION, ALTERED GAG, AIRWAY CLEARANCE, COUGH), [**Last Name 12**] PROBLEM - ENTER DESCRIPTION IN COMMENTS, IMPAIRED SKIN INTEGRITY, RENAL FAILURE, ACUTE (ACUTE RENAL FAILURE, ARF), VASCULAR DEVICE INFECTION (NOT CENTRAL OR ARTERIAL LINE, INCLUDING GRAFT, FISTULA), SHOCK, SEPTIC, ELECTROLYTE & FLUID DISORDER, OTHER, ANXIETY, .H/O DIARRHEA, PANCREATIC PSEUDOCYST, AROUSAL, ATTENTION, AND COGNITION, IMPAIRED, GAIT, IMPAIRED, KNOWLEDGE, IMPAIRED, TRANSFERS, IMPAIRED, ALTERATION IN NUTRITION, SEPSIS, SEVERE (WITH ORGAN DYSFUNCTION), .H/O FEVER (HYPERTHERMIA, PYREXIA, NOT FEVER OF UNKNOWN ORIGIN), PAIN CONTROL (ACUTE PAIN, CHRONIC PAIN) Assessment and Plan: Neuro: Methadone careful titration. Tylenol, Fentanyl prn pain. CVS: Lopressor 5 IV Q6h as BP tolerates Pulm: Follow CXRs. Changed to CMV for hypercabia. GI: Significant drainage around pancreatic drain w. skin breakdown, decreased since TF stopped. No drainage of perihep/gutter since not loculated/acute. Per primary team low threshold for CT abdomen. KUB [**9-12**] + barium sigmoid. Small bowel follow through on hold. [**Doctor First Name **] wound care plan is wet-dry [**Hospital1 7**] (too large for ostomy and aware of breakdown). Renal: ARF, Cr 3.0 wtih FENA suggestive of primary renal etiology. Renal Ultrasound limited Bl flow norm. FEN: TF stopped [**2113-9-8**], TPN started (1.25g/kg prot; total [**Numeric Identifier **]). TPN + LR IVF = 150. HyperP, hypoCa. No TPN phos. Corrected calcium normal. Heme: Off heparin gtt for cleared neck U/S, on SCH. *PT REQUIRES ~8HRS NOTICE FOR ANY BLOOD PRODUCTS [**2-6**] UNUSUAL ABS. Endo: 20units regular in TPN. RISS.(normal [**Last Name (un) **] stim test [**2113-8-14**]). PTH 22 ID: V/C/Z for sensitive Pseudomonas+ pancreatic drainage. [**2113-9-7**] BCx=coag neg staph and UCx Neg, L flank drainage - pseudomonas, cipro and pip [**Last Name (un) 270**]. F/u PICC tip. Consider fungal coverage. Wounds: Abdomen wound vac (changed [**9-11**]). Left flank wound around panc tube. Wet->dry [**Hospital1 7**] per [**Doctor First Name 213**] att/res. Neurologic: Cardiovascular: Beta-blocker Pulmonary: (Ventilator mode: CMV), PS trial Gastrointestinal / Abdomen: Nutrition: TPN Renal: Foley, Poor UOP, RUS with normal renal artery flow bilaterally, Rising Creatinine Hematology: Endocrine: RISS Infectious Disease: Check cultures Lines / Tubes / Drains: Foley, Trach, Surgical drains (hemovac, JP) Wounds: Wound vacuum Imaging: KUB today Fluids: LR Consults: General surgery, ID dept, Nephrology Billing Diagnosis: Pancreatitis, Acute renal failure ICU Care Nutrition: TPN w/ Lipids - [**2113-9-12**] 09:51 PM 75 mL/hour Glycemic Control: Regular insulin sliding scale Lines: 18 Gauge - [**2113-9-8**] 04:19 PM Multi Lumen - [**2113-9-12**] 03:43 PM Arterial Line - [**2113-9-12**] 08:45 PM Prophylaxis: DVT: Boots, SQ UF Heparin Stress ulcer: H2 blocker VAP bundle: Comments: Communication: Comments: Code status: Full code Disposition: ICU Total time spent: Patient is critically ill
Physician
Classify the following medical document.
Chief Complaint: septic shock I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 42 y/o F w/CVID, Hep C cirrhosis, adm with C.diff sepsis. 24 Hour Events: -head CT yest normal -abd CT with ascites, edematous bowel but no pneumatosis -tube feeds held due to worsening abd distention -lactate normal History obtained from Medical records Patient unable to provide history: Sedated Allergies: Aspirin rectal bleeding Penicillins Rash; Hives; Sulfonamides aseptic menigi Biaxin (Oral) (Clarithromycin) Diarrhea; Levaquin (Oral) (Levofloxacin) Rash; Cefzil (Oral) (Cefprozil) Rash; Motrin (Oral) (Ibuprofen) aseptic meningi Erythromycin Base Rash; Last dose of Antibiotics: Vancomycin - [**2189-3-19**] 06:33 AM Metronidazole - [**2189-3-19**] 08:25 AM Infusions: Other ICU medications: Hydromorphone (Dilaudid) - [**2189-3-18**] 03:57 PM Dextrose 50% - [**2189-3-19**] 06:33 AM Pantoprazole (Protonix) - [**2189-3-19**] 08:00 AM Other medications: vanco po, peridex, sodium chloride nasal spray, protonix, reglan, insulin sliding scale, flagyl Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2189-3-19**] 10:22 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.6 C (97.8 Tcurrent: 36.2 C (97.1 HR: 94 (84 - 99) bpm BP: 94/34(48) {85/30(46) - 114/51(64)} mmHg RR: 23 (9 - 31) insp/min SpO2: 96% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 59.9 kg (admission): 64 kg Height: 64 Inch CVP: 14 (8 - 16)mmHg Bladder pressure: 18 (18 - 18) mmHg Total In: 2,881 mL 839 mL PO: TF: 453 mL IVF: 806 mL 311 mL Blood products: Total out: 2,290 mL 535 mL Urine: 2,290 mL 535 mL NG: Stool: Drains: Balance: 591 mL 305 mL Respiratory support O2 Delivery Device: Tracheostomy tube Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 350 (350 - 350) mL Vt (Spontaneous): 113 (113 - 113) mL RR (Set): 18 RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 40% RSBI Deferred: RR >35 PIP: 11 cmH2O SpO2: 96% Ve: 10.8 L/min Physical Examination General Appearance: opens eyes to voice but doesn't follow commands Eyes / Conjunctiva: icteric Head, Ears, Nose, Throat: Normocephalic, trach in place Cardiovascular: (S1: Normal), (S2: Normal), (Murmur: No(t) Systolic) Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Rhonchorous: diffusely), tachypneic Abdominal: Distended, doesn't appear tender but limited exam given mental status Extremities: Right: 3+, Left: 3+ Skin: Not assessed, Jaundice Neurologic: No(t) Follows simple commands, Responds to: Verbal stimuli, Movement: No spontaneous movement, Tone: Not assessed Labs / Radiology 9.0 g/dL 228 K/uL 42 mg/dL 2.0 mg/dL 22 mEq/L 3.8 mEq/L 125 mg/dL 103 mEq/L 137 mEq/L 25.7 % 34.2 K/uL [image002.jpg] [**2189-3-15**] 04:21 AM [**2189-3-15**] 05:01 PM [**2189-3-16**] 03:43 AM [**2189-3-16**] 03:16 PM [**2189-3-17**] 04:53 AM [**2189-3-17**] 03:37 PM [**2189-3-18**] 05:00 AM [**2189-3-18**] 07:43 AM [**2189-3-18**] 05:17 PM [**2189-3-19**] 05:40 AM WBC 15.9 14.7 17.6 15.3 19.7 22.3 34.2 Hct 23.7 20.9 24.6 22.1 24.7 25.4 25.7 Plt 257 211 234 [**Telephone/Fax (3) 5338**] 228 Cr 1.8 1.2 1.5 2.6 1.5 1.6 1.6 2.0 2.0 TCO2 23 Glucose 76 60 50 66 199 186 185 163 42 Other labs: PT / PTT / INR:31.7/76.7/3.3, Differential-Neuts:87.0 %, Band:2.0 %, Lymph:4.0 %, Mono:7.0 %, Eos:0.0 %, D-dimer:6342 ng/mL, Fibrinogen:260 mg/dL, Lactic Acid:1.2 mmol/L, Albumin:2.6 g/dL, LDH:339 IU/L, Ca++:8.7 mg/dL, Mg++:2.7 mg/dL, PO4:4.4 mg/dL Imaging: CXR: diffuse multifocal infiltrates, R hemidiaphragm more clear today than yesterday Microbiology: Sputum yest: abundant PMNs, no organisms on gram stain Blood cx pending Urine cx pending Assessment and Plan 42 y/o F with multiple medical problems, critically ill for the past month, now with worsening tachypnea, leukocytosis, abdominal distention. # Likely sepsis: Most likely source is abdomen given her physical exam findings. No clear cause elucidated on abd CT yesterday but didn't have contrast so wasn't a great study. -add back antibiotics today (vanc/[**Last Name (un) **]) -repeat cx -paracentesis -check bladder pressure pre- and post-paracentesis - concern for abd compartment syndrome; she certainly has intra abdominal hypertension and would see if her BP and renal perfusion improves with paracentesis -check LFTs, pancreatic enzymes # Resp failure: Due to ARDS, likely component of volume overload. Would hold on diuresis given what appears to be evolving sepsis. # [**Last Name (un) **]: Unclear etiology, likely combination of ATN vs AIN. Will follow. Creatinine was improving with diuresis suggesting some improvement of her stroke volume with decreased R sided filling pressures, but at this point would hold on diuresis as above. Could also have worsening creatinine from vascular effects of high abdominal pressures. # Coagulopathy: Likely due to underlying liver disease and chronic illness. No evidence of DIC. ICU Care Nutrition: TPN w/ Lipids - [**2189-3-18**] 07:35 PM 50 mL/hour Glycemic Control: Insulin in TPN, Comments: Decrease insulin in TPN Lines: PICC Line - [**2189-3-4**] 03:00 PM Multi Lumen - [**2189-3-10**] 03:35 PM Prophylaxis: DVT: Boots Stress ulcer: PPI VAP: HOB elevation, Mouth care, Daily wake up, RSBI Comments: Communication: ICU consent signed Comments: Code status: Full code Disposition :ICU Total time spent: 35 minutes Patient is critically ill ------ Protected Section ------ I saw and examined this pt, and was present with the ICU team for the key portions of services provided. I agree with Dr. [**First Name (STitle) **] s note as outlined above, and would add: Abd and Head CT negative yesterday. Pt remains less responsive with worsening renal function (despite holding of diuretics) and worsening leukocytosis. Remain concerned for sepsis with abdomen the most likely source- back on Vanco/Merepenem while we await pan-cultures. Bladder pressures somewhat high (18-19) and will proceed with paracentesis today. Pt is critically ill. Total time spent: 40 minutes. ------ Protected Section Addendum Entered By:[**Name (NI) 1174**] [**Last Name (NamePattern1) **], MD on:[**2189-3-19**] 14:30 ------
Physician
Classify the following medical document.
TITLE: MICU Progress Note Chief Complaint: 24 Hour Events: Pt remained intubated. Spoke w/ son who says that goal is for family meeting on Tuesday at [**Hospital3 **] where family will discuss goals of care with [**Hospital3 **] staff. Indicated that they may move towards do not hospitalize, CMO. Did well on SBT but remained intubated through the day for concern of need for re-intubation. Transfused 1 unit PRBCs. INR reversed w/ Vitamin K. Hct stable throughout the day. CT scan abd obtained for concern of RP bleed, did not show evidence of RP bleed, but did show anasarca, pleural effusions. Allergies: No Known Drug Allergies Last dose of Antibiotics: Cefipime - [**2190-3-20**] 03:14 PM Metronidazole - [**2190-3-21**] 04:06 PM Vancomycin - [**2190-3-21**] 08:00 PM Meropenem - [**2190-3-22**] 04:05 AM Infusions: Propofol - 15 mcg/Kg/min Norepinephrine - 0.03 mcg/Kg/min Other ICU medications: Lansoprazole (Prevacid) - [**2190-3-21**] 08:07 AM Furosemide (Lasix) - [**2190-3-22**] 02:41 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2190-3-22**] 06:57 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**91**] AM Tmax: 37.1 C (98.8 Tcurrent: 37.1 C (98.8 HR: 81 (68 - 89) bpm BP: 98/39(53) {87/25(41) - 161/71(90)} mmHg RR: 24 (13 - 27) insp/min SpO2: 100% Heart rhythm: SR (Sinus Rhythm) Total In: 2,956 mL 552 mL PO: TF: IVF: 1,707 mL 522 mL Blood products: 639 mL Total out: 795 mL 215 mL Urine: 795 mL 215 mL NG: Stool: Drains: Balance: 2,161 mL 337 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CPAP/PSV Vt (Spontaneous): 499 (317 - 499) mL PS : 5 cmH2O RR (Spontaneous): 24 PEEP: 5 cmH2O FiO2: 40% RSBI: 80 PIP: 11 cmH2O SpO2: 100% ABG: 7.37/38/66/20/-2 Ve: 11.9 L/min PaO2 / FiO2: 165 Physical Examination GEN: Intubated and sedated HEENT: NC/AT. PULM: Bilateral inspiratory rhonchi, left greater than right. Decreased breath sounds right base. CVS: RRR with normal S1+S2 ABD: Hypoactive BS, soft, non-distended. Neurologic: sedated Labs / Radiology 208 K/uL 9.1 g/dL 100 mg/dL 1.5 mg/dL 20 mEq/L 3.6 mEq/L 58 mg/dL 117 mEq/L 145 mEq/L 28.4 % 10.6 K/uL [image002.jpg] [**2190-3-20**] 05:30 PM [**2190-3-20**] 08:56 PM [**2190-3-20**] 10:15 PM [**2190-3-20**] 10:41 PM [**2190-3-21**] 02:28 AM [**2190-3-21**] 12:40 PM [**2190-3-21**] 03:50 PM [**2190-3-21**] 05:50 PM [**2190-3-21**] 11:19 PM [**2190-3-22**] 02:24 AM WBC 11.4 10.6 Hct 26.1 24.3 26.5 26.7 28.1 28.4 Plt 255 208 Cr 1.4 1.4 1.5 1.5 TropT 1.38 1.39 1.28 1.26 1.28 TCO2 18 20 23 Glucose 135 92 111 100 Other labs: PT / PTT / INR:20.0/36.6/1.8, CK / CKMB / Troponin-T:132/22/1.28, Differential-Neuts:84.3 %, Lymph:10.4 %, Mono:3.5 %, Eos:1.7 %, Lactic Acid:1.7 mmol/L, Ca++:7.9 mg/dL, Mg++:2.0 mg/dL, PO4:3.8 mg/dL CT Abdomen/Pelvis without Contrast: 1. No definite evidence of retroperitoneal bleeding. 2. Hyperdense fluid within the sigmoid colon. Correlation with Hemoccult is recommended to exclude blood within the colon. Alternately, this may represent oral contrast. Correlation with clinical history is recommended. 3. Large bilateral pleural effusions, slightly increased when compared to prior exam. 4. Vascular calcifications. 5. Diffuse anasarca. Assessment and Plan 78 y/o M with multiple medical problems including healthcare associated pneumonia, chronic aspiration, afib on coumadin, CVAs, and CAD who presents with hypoxia, consistent with pulmonary edema. # Acute hypercarbic respiratory failure: CXR with increased volume and patient did not improve with Bipap in the ED. Now intubated with improved ventilation on ABG. BNP greater than assay is markedly consistent with CHF. Put out well in the ED. Anticoagulated, so PE seems less likely. Mucous plugging seems like a likely component as well. Already on HAP treatment, and schedule to complete course today. Worsening leukocytosis and fever concerning for possible resistant organism. - Continue Ventilation now and talk with family about possible extubation (family meeting scheduled for Tuesday) - Pressure support trial on 0/0 - Continuing [**Last Name (un) 350**]/Vanco/Flagyl would have DC d today, but will keep him on these for now - Repeat TTE # Hypotension: pt. intermittently hypotensive with diuresis, continues on levophed - consider CVL - attempt to wean pressor # Pneumonia: Initially the pt was on vanc/pip-tazo for HCAP on admission on [**3-11**]. Piperacillin-tazobactam was changed to cefepime on [**3-13**]. Metronidazole was added on [**3-13**] due to persistent fevers. - broaden as above - follow cultures - repeat sputum # Hypernatremia: [**Month (only) 8**] be do to poor po intake, but patient total body overloaded. 2.5 L deficit at this time. Do not want to fluid bolus given CHF as above. Na 145 this AM. FWD about 2L - Continue FW flushes through tube 250cc x4 # NSTEMI: Troponin elevated but flat CK, could be consistent with resolving infarct on last admission. EKG with signs of demand in lateral leads. Troponin now trending down - cycle enzymes to peak - asa 325 mg daily - high dose statin - Betablocker with holding parameters - hold ace-i in setting of acute CHF # Afib: Sinus tachycardia has resolved, was previously in Afib in ED. Pt has been on anticoagulation for afib but Hct trending down. - restart coumadin - Rate control as above - Repeat EKG this morning # Anemia: HCT appears stable after transfusion of 1 unit pRBCs. - continue PPI - T and S - Maintain 2 PIVs , PICC # Dm: ISS # Dementia: Continue mirtazapine # FEN: Gentle D5 IVF, replete electrolytes, NPO for now # Prophylaxis: restart coumadin, PPI # Access: peripheral PICC Line - [**2190-3-20**] 01:45 PM 18 Gauge - [**2190-3-20**] 01:45 PM # Communication: has two daughters and son; [**Doctor Last Name **] is HCP, work no: [**Telephone/Fax (1) 12228**]. Email: [**Company 12171**]. [**Doctor First Name 792**], daughter [**Telephone/Fax (1) 12035**]. # Code: Full (discussed with HCP) # Disposition: ICU pending clinical improvement I ICU Care Nutrition: Glycemic Control: Lines: PICC Line - [**2190-3-20**] 01:45 PM 18 Gauge - [**2190-3-20**] 01:45 PM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Disposition:
Physician
Classify the following medical document.
Chief Complaint: I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 24 Hour Events: PEEP weaned to 8. FiO2 down to 40%. Was 9L neg on CVVH. CVVH taken off this am. Switched insulin to TPN. Off vasopressin. Allergies: Aspirin rectal bleeding Penicillins Rash; Hives; Sulfonamides aseptic menigi Biaxin (Oral) (Clarithromycin) Diarrhea; Levaquin (Oral) (Levofloxacin) Rash; Cefzil (Oral) (Cefprozil) Rash; Motrin (Oral) (Ibuprofen) aseptic meningi Erythromycin Base Rash; Last dose of Antibiotics: Vancomycin - [**2189-2-24**] 09:00 AM Meropenem - [**2189-2-24**] 06:00 PM Metronidazole - [**2189-2-26**] 06:03 AM Infusions: Insulin - Regular - 5 units/hour Fentanyl - 275 mcg/hour Midazolam (Versed) - 8 mg/hour Other ICU medications: Other medications: Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2189-2-26**] 11:35 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.2 C (99 Tcurrent: 36.3 C (97.4 HR: 102 (74 - 103) bpm BP: 109/44(64) {109/43(64) - 139/63(89)} mmHg RR: 25 (24 - 48) insp/min SpO2: 100% Heart rhythm: ST (Sinus Tachycardia) Height: 64 Inch CVP: 13 (-5 - 13)mmHg Total In: 9,720 mL 3,929 mL PO: TF: IVF: 8,259 mL 3,210 mL Blood products: Total out: 19,098 mL 6,714 mL Urine: 691 mL 198 mL NG: 200 mL Stool: Drains: Balance: -9,378 mL -2,785 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: PCV+Assist RR (Set): 24 RR (Spontaneous): 0 PEEP: 8 cmH2O FiO2: 40% RSBI Deferred: Hemodynamic Instability PIP: 33 cmH2O Plateau: 27 cmH2O SpO2: 100% ABG: 7.46/34/110/21/0 Ve: 9.6 L/min PaO2 / FiO2: 275 Physical Examination General Appearance: Well nourished Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Normocephalic Lymphatic: Cervical WNL Cardiovascular: (PMI Normal), (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Crackles : diffuse, Wheezes : diffuse) Abdominal: Soft, Distended, Tender: diffuse Extremities: Right: 3+, Left: 3+ Skin: Warm Neurologic: Responds to: Not assessed, Movement: Not assessed, Sedated, Tone: Not assessed Labs / Radiology 11.2 g/dL 144 K/uL 209 0.4 mg/dL 21 mEq/L 4.5 mEq/L 17 mg/dL 106 mEq/L 137 mEq/L 32.8 % 11.5 K/uL [image002.jpg] [**2189-2-25**] 09:55 AM [**2189-2-25**] 03:38 PM [**2189-2-25**] 03:54 PM [**2189-2-25**] 10:17 PM [**2189-2-25**] 10:21 PM [**2189-2-26**] 04:43 AM [**2189-2-26**] 04:54 AM [**2189-2-26**] 06:00 AM [**2189-2-26**] 09:00 AM [**2189-2-26**] 11:00 AM WBC 11.5 Hct 32.8 Plt 144 Cr 0.4 0.4 TCO2 25 28 26 25 Glucose 124 146 137 96 173 186 196 209 Other labs: PT / PTT / INR:20.9/41.3/2.0, ALT / AST:45/96, Alk Phos / T Bili:140/16.8, Amylase / Lipase:[**10-30**], Differential-Neuts:68.0 %, Band:4.0 %, Lymph:14.0 %, Mono:11.0 %, Eos:0.0 %, D-dimer:6342 ng/mL, Fibrinogen:202 mg/dL, Lactic Acid:1.1 mmol/L, Albumin:2.8 g/dL, LDH:445 IU/L, Ca++:9.3 mg/dL, Mg++:1.9 mg/dL, PO4:3.6 mg/dL Assessment and Plan ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS, ACUTE LUNG INJURY, [**Doctor Last Name 76**]) RENAL FAILURE, ACUTE (ACUTE RENAL FAILURE, ARF) 1. C. Diff sepsis: Cont. po vanco/pr vanco/ IV flagyl -off pressors -IVIG weekly, due tomorrow possibly -trophic TF at 10/h if CT OK -CT abd without contrast today to rule out free air 2. ARDS: Decrease PEEP to 5 and 0.4, could try PS if she starts over breathing -fentanyl [**Month (only) 453**] to 200, versed 4 today, turn off briefly for daily wake up -trach tomorrow 3. ARF: CVVH off -I/O goal neg -follow uop -renal recs 4. DIC: Resolved 5. DM1, on TPN with insulin, SSI 6. Leukocytosis: pancx 7. Cirrhosis: LFts improved -liver following 8. Pull L SCL today if enough access ICU Care Nutrition: TPN without Lipids - [**2189-2-25**] 10:17 PM 62.5 mL/hour Glycemic Control: Insulin in TPN Lines: Multi Lumen - [**2189-2-13**] 12:05 AM Dialysis Catheter - [**2189-2-17**] 07:22 PM PICC Line - [**2189-2-20**] 09:27 AM Arterial Line - [**2189-2-24**] 09:29 PM Prophylaxis: DVT: Boots Stress ulcer: H2 blocker VAP: HOB elevation, Mouth care, Daily wake up, RSBI Need for restraints reviewed Comments: Communication: Patient discussed on interdisciplinary rounds Comments: Code status: Full code Disposition :ICU Total time spent: Patient is critically ill
Physician
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Admission Date: [**2138-9-29**] Discharge Date: [**2138-10-4**] Date of Birth: [**2138-9-29**] Sex: M Service: NB [**Known lastname **] [**Known lastname 61773**] [**Known lastname 60891**] was born at 36-4/7 weeks gestation by spontaneous vaginal delivery after induction for pregnancy induced hypertension. This mother is a 36-year-old gravida 2, para 1, now 2 woman. Her prenatal screens are blood type O+, antibody negative, rubella immune, RPR nonreactive, hepatitis surface antigen negative and Group B strep unknown. Rupture of membranes occurred six hours prior to delivery. The mother did receive intrapartum antibiotics for GBS prophylaxis. The infant emerged with decreased respiratory effort requiring bag and mask ventilation, his Apgar's were 6 at one minute and 8 at five minutes. Of note is that the infant also had a true knot in his umbilical cord. The birth weight was 3395 grams, the birth length 19-1/2 cm. And the head circumference was 34.5 cm. PHYSICAL EXAMINATION: On admission revealed a full term non- dysmorphic infant anterior fontanel open and flat, bruised faced due to rapid second phase of labor. Positive bilateral red reflex, intact palate, mild subcostal retractions, positive grunting, breath sounds were equal. Heart was regular rate and rhythm. No murmur. Abdomen soft, nontender, nondistended. Extremities well perfused, stable hips, spine intact, bilateral descended testes and age appropriate tone and reflexes. NICU COURSE BY SYSTEMS: He continued to have respiratory distress after admission to the NICU requiring nasopharyngeal continuous positive airway pressure. He weaned from that to nasal cannula oxygen on day of life #2 and then to room air also later on day of life #2 where he has remained. He continues to breath comfortably. Lung sounds are clear and equal. He has had no apnea or bradycardia. Cardiovascular status: He has remained normotensive throughout his NICU stay. His heart has regular rate and rhythm and no murmur. Fluid, electrolyte and nutrition status: At the time of discharge his weight is 3,175 grams. Enteral feeds were begun on day of life #2 and advanced without difficulty to full volume feeding by day of life #4. At the time of discharge he is breast feeding or taking 20 calorie per ounce formula on an ad lib schedule. He has remained U-glycemic throughout his NICU stay. Gastrointestinal status: He was treated with phototherapy from day of life 3 until day of life 4. His peak bilirubin on day of life 3 was total 15.5, direct 0.4. A rebound Bili is pending. Hematology: The infant has never received any blood product transfusions during his NICU stay. His hematocrit at the time of admission was 50.3. The infant is blood type O+, direct Coombs' negative. Infectious Disease: Ampicillin and gentamicin was started at the time of admission for sepsis risk factors. The antibiotics were discontinued after 48 hours and the blood cultures were negative and the infant was clinically well. Sensory Audiology: Hearing screening was performed with automated auditory brain stem responses and the infant passed in both ears. Psychosocial: The parents have been very involved in the infants care throughout his NICU stay. Genitourinary: A circumcision is planned prior to discharge. The infant is discharged in good condition. He is discharged home with his parents. His primary pediatric care provider will be Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 7363**] of [**Location (un) 1439**], MA. RECOMMENDATIONS AFTER DISCHARGE: Feeding: Formula, breast feeding with appropriate support as needed. The infant is discharged on no medications. A State newborn screen was sent on [**2138-10-2**]. The infant has not yet received his first hepatitis B vaccine. Recommended immunizations: 1. Synagis RSV prophylaxis to be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following three criteria: Born at less then 32 weeks. Born between 32 and 35 weeks with two of the following: Day care during the RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings or with chronic lung disease. 2. Influenza immunization is recommended annually in the Fall for all infants once they reach 6 months of age. Before this and for the first 24 months of the childs life immunization against influenza is recommended for household contacts and out of home caregivers. FOLLOW UP: Includes follow-up with his primary pediatric care provider and lactation support as needed. DISCHARGE DIAGNOSIS: 1. Prematurity at 36-4/7 weeks. 2. Status post transitional respiratory distress. 3. Sepsis ruled out. 4. Status post hyperbilirubinemia of prematurity. [**First Name11 (Name Pattern1) 449**] [**Last Name (NamePattern1) **], [**MD Number(1) 54604**] Dictated By:[**Last Name (NamePattern1) 56577**] MEDQUIST36 D: [**2138-10-4**] 06:26:40 T: [**2138-10-4**] 08:31:29 Job#: [**Job Number 62998**]
Discharge summary
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48 yo m w/ HTN, OSA, etoh abuse, s/p total hip revision with hardware removal course c/b post-op resp failure, asp pna, and L lung collapse, arf,, a-fib / flutter, and etoh withdrawal, extubated [**8-22**] Hypernatremia (high sodium) Assessment: Sodium level =142 this am Action: Pt given 250cc s free water boluses via ngt as ordered and electrolytes checked as ordered Response: Sodium level on the decline Plan: Continue to check lytes as ordered and adjust free water boluses as needed Arousal, Attention, and Cognition, Impaired Assessment: Pt experienced etoh withdrawal post op requiring large amts of iv valium. Pt s girlfriend very supportive to pt but questioning all sedatives given to pt. states that pt is not to receive any haldol because it drops hr . pt is avbel to state his name, name of the hospital and street name but then becomes extremely agitated stating he s getting out of here and going home. Pt has self d/c d the condom cath and once foley cath was reinserted he also disconnected the foley. Pt becomes verbally abusive using foul language and then falls off to sleep Action: Safe environment maintained. Bed alarm activated and bed locked and in low position. All rails up to prevent pt from climbing oob. Pt offered emotional support and told frequently the plan of care and that pt is not safe or ready to go home. Response: Episodes of agitation continue but pt has not received any valium since Monday. Pt s girlfriend at times able to quiet pt down. Plan: Continue to reorient pt to plan of care and treatment plan. Maintain safe pt environment and avoid medicating with haldol. Allow [**Doctor First Name 7312**] to remain at bedside when possible to help quiet pt and support him Alteration in Nutrition Assessment: Pt s/p extubation on [**8-22**] with altered ms and s/p 3 failed extubations. Immedicately following extubation pt with impaired gag reflex. Failed 1^st speech and swallow study and was scheduled to have video speech and swallow study today but because of pt s body habitus study could not be done. Bedside eval done at bedside. After 1 st failed study pt had ngt placed via left nare and tube fdgs were started. Na today=142. pt passed 2 lg brown softs tools that were heme neg. Action: Bedside speech and swallow study done. Tube fdgs of replete with fiber continue at pt s goal rate of 80cc s/hr. electrolytes followed as ordered. [**Name (NI) 7413**] pt was receiving 250cc s free water boluses via ngt q 4 hrs but that was dropped down to 100cc s q 4hrs b/cause na level is on the decline Response: Tolerated bedside speech and swallow study without any evidence of aspiration. Plan: Po diet: nectar thick liqs and moist puree consistencies. 1:1 supervision. Alternate bites with sips. Continue tube fdgs as primary means of nutrition,hydration and meds. Please wait to remove tube fdgs until pt is seen again by speech and swallow consult team. Maintain aspiratipn precautions. Refer to social workers progress note from [**8-29**] regarding conversations with pt s [**Initials (NamePattern5) **] [**Last Name (NamePattern5) 7312**] Demographics Attending MD: [**Doctor Last Name **] [**Doctor First Name 5409**] Admit diagnosis: RIGHT HIP OA/SDA Code status: Full code Height: 72 Inch Admission weight: 118 kg Daily weight: 126 kg Allergies/Reactions: No Known Drug Allergies Precautions: PMH: ETOH, Smoker CV-PMH: Hypertension Additional history: Pt. is s/p FALL from roof in [**2178**] >>> severe right femur fracture. Pt. developed avascular and osteo necrosis of femur head, and chronic pain of right hip/groin, revised today. Surgery / Procedure and date: '[**78**] IM nailing s/p femur fracture Latest Vital Signs and I/O Non-invasive BP: S:181 D:78 Temperature: 98.6 Arterial BP: S:145 D:72 Respiratory rate: 22 insp/min Heart Rate: 84 bpm Heart rhythm: SR (Sinus Rhythm) O2 delivery device: None O2 saturation: 96% % O2 flow: 10 L/min FiO2 set: 35% % 24h total in: 2,639 mL 24h total out: 1,700 mL Pertinent Lab Results: Sodium: 142 mEq/L [**2182-8-29**] 04:24 AM Potassium: 3.5 mEq/L [**2182-8-29**] 04:24 AM Chloride: 109 mEq/L [**2182-8-29**] 04:24 AM CO2: 28 mEq/L [**2182-8-29**] 04:24 AM BUN: 21 mg/dL [**2182-8-29**] 04:24 AM Creatinine: 0.8 mg/dL [**2182-8-29**] 04:24 AM Glucose: 143 mg/dL [**2182-8-29**] 04:24 AM Hematocrit: 28.1 % [**2182-8-29**] 04:24 AM Valuables / Signature Patient valuables: transferred with pt [**Name (NI) 19**] valuables: cell phone Clothes: Sent home with: Wallet / Money: No money / wallet Cash / Credit cards sent home with: Jewelry: none Transferred from: [**Hospital Ward Name **] 402 Transferred to: 1164 Date & time of Transfer: [**2182-8-29**] 1815
Nursing
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CVICU HPI: 53 y.o. M POD # 7 from CABGx1(SVG to PLB)/AVR (porcine), complicated by respiratory failure (significant smoking history) and pneumonia. In addition, post-op EtOH withdrawal. Chief complaint: PMHx: PMH: Biscuspid AV with AS and AI, Sleep apnea (Did not tolerate CPAP), HTN, Hyperlipidemia, LE claudication, Seasonal allergies, GERD Hx of left forearm, right collar bone fractures without [**Doctor First Name 213**]. Cervical disc disease, on Percocet, Anxiety Age 6 MVA with head injury H/o Pericarditis early [**2141**], s/pTonsillectomy, s/p neck lymph node removal [**Last Name (un) **]: Atenolol 50', Lipitor 20', Nexium 40', Fluoxetine 40', HCTZ 25', Lisinopril 5', Oxybutynin Chloride 10', Percocet 5mg-325mg 1.5 in afternoon, Aspirin 81', MVI Tobacco + ETOH + 4-5 beers a day Current medications: 24 Hour Events: URINE CULTURE - At [**2161-10-28**] 12:48 PM ARTERIAL LINE - STOP [**2161-10-28**] 06:02 PM EKG - At [**2161-10-28**] 09:00 PM Post operative day: POD#8 - avr & cabg x1 Allergies: Shellfish Derived Nausea/Vomiting Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2161-10-27**] 04:03 AM Ciprofloxacin - [**2161-10-29**] 11:14 AM Infusions: Other ICU medications: Other medications: Flowsheet Data as of [**2161-10-29**] 11:34 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**63**] a.m. Tmax: 36.2 C (97.2 T current: 35.9 C (96.7 HR: 75 (65 - 86) bpm BP: 100/57(67) {93/54(65) - 121/70(82)} mmHg RR: 19 (16 - 30) insp/min SPO2: 97% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 96.3 kg (admission): 102 kg Height: 68 Inch Total In: 2,435 mL 870 mL PO: 1,640 mL 620 mL Tube feeding: IV Fluid: 695 mL 250 mL Blood products: Total out: 1,010 mL 200 mL Urine: 1,010 mL 200 mL NG: Stool: Drains: Balance: 1,425 mL 670 mL Respiratory support O2 Delivery Device: None SPO2: 97% ABG: ///28/ Physical Examination General Appearance: No acute distress HEENT: PERRL Cardiovascular: (Rhythm: Regular), (Murmur: No(t) Systolic, No(t) Diastolic) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: CTA bilateral : ) Abdominal: Soft, Non-distended, Bowel sounds present Left Extremities: (Edema: Trace), (Temperature: Warm), (Pulse - Dorsalis pedis: Present), (Pulse - Posterior tibial: Present) Right Extremities: (Edema: Trace), (Temperature: Warm), (Pulse - Dorsalis pedis: Present), (Pulse - Posterior tibial: Present) Neurologic: (Awake / Alert / Oriented: x 2), Follows simple commands, (Responds to: Verbal stimuli), Moves all extremities Labs / Radiology 530 K/uL 10.3 g/dL 195 mg/dL 0.5 mg/dL 28 mEq/L 3.7 mEq/L 19 mg/dL 100 mEq/L 135 mEq/L 29.9 % 16.7 K/uL [image002.jpg] [**2161-10-26**] 06:00 PM [**2161-10-26**] 08:53 PM [**2161-10-27**] 03:45 AM [**2161-10-27**] 03:51 AM [**2161-10-27**] 07:38 AM [**2161-10-27**] 09:56 PM [**2161-10-28**] 03:35 AM [**2161-10-28**] 11:00 AM [**2161-10-28**] 05:49 PM [**2161-10-29**] 02:28 AM WBC 11.5 15.3 16.7 Hct 27.9 31.5 29.9 Plt 335 455 530 Creatinine 0.8 0.6 0.6 0.5 TCO2 37 32 33 Glucose 103 114 131 102 128 130 110 195 Other labs: PT / PTT / INR:13.7/26.7/1.2, ALT / AST:33/59, Alk-Phos / T bili:109/1.7, Amylase / Lipase:63/52, Differential-Neuts:90.0 %, Lymph:7.9 %, Mono:1.3 %, Eos:0.6 %, Fibrinogen:352 mg/dL, Lactic Acid:1.6 mmol/L, Albumin:3.1 g/dL, LDH:708 IU/L, Ca:9.1 mg/dL, Mg:2.4 mg/dL, PO4:4.4 mg/dL Assessment and Plan ALCOHOL WITHDRAWAL (INCLUDING DELIRIUM TREMENS, DTS, SEIZURES), VALVE REPLACEMENT, AORTIC BIOPROSTHETIC (AVR), HYPOXEMIA, CORONARY ARTERY BYPASS GRAFT (CABG) Assessment and Plan: 53 y.o. M POD # 7 from CABGx1(SVG to PLB)/AVR (porcine), complicated by respiratory failure (significant smoking history) and pneumonia. In addition, post-op EtOH withdrawal. Neurologic: Neuro checks Q: 4 hr, Pain controlled, MS slightly improved. Off midaz gtt. Valium 5 mg [**Hospital1 **], methadone 10 mg [**Hospital1 **] with much improvement. In addition, clonidine patch and oral PO until tomorrow. Welbutrine started for smoking craving. Still disoriented, but slightly better Cardiovascular: Aspirin, Beta-blocker, Statins, HD stable Pulmonary: IS, OOB --> walking. Not compliant with IS Gastrointestinal / Abdomen: BM yesterday and today. On bowel regimen Nutrition: Regular diet Renal: Adequate UO Hematology: Serial Hct, Stable anemia. Monitor for now Endocrine: RISS, BG well controlled. Keep < 150 Infectious Disease: Check cultures, H flue in sputum and enterobacter. On cipro. Follow sensitivities. WBC continue to increase. CXR today Lines / Tubes / Drains: Wounds: Dry dressings Imaging: CXR today Fluids: KVO Consults: CT surgery Billing Diagnosis: Post-op complication ICU Care Nutrition: Glycemic Control: Regular insulin sliding scale Lines: PICC Line - [**2161-10-26**] 06:14 PM Prophylaxis: DVT: Boots, SQ UF Heparin Stress ulcer: PPI VAP bundle: Comments: Communication: Patient discussed on interdisciplinary rounds , ICU Code status: Disposition: ICU Total time spent: 20 minutes
Physician
Classify the following medical document.
Unit No: [**Numeric Identifier 67488**] Admission Date: [**2156-8-16**] Discharge Date: [**2156-8-23**] Date of Birth: [**2082-9-9**] Sex: M Service: GU CHIEF COMPLAINT: Bladder cancer. HISTORY OF PRESENT ILLNESS: Mr. [**Known lastname 67489**] is a 73-year-old man with known bladder cancer diagnosed on [**2156-7-15**]. He is here for a cystectomy and stoma scheduled for [**2156-8-17**]. ALLERGIES: No known drug allergies. OUTPATIENT MEDICATIONS: Atenolol. PAST MEDICAL HISTORY: Prostate cancer, radical resection of the prostate in [**2148**], severe gunshot wound to the abdomen, 3 to 4 exploratory laparoscopies for pus and adhesions secondary to these gunshot wounds. The gunshot wounds were a result of injuries in hunting accidents. PAST SURGICAL HISTORY: RRP [**2148**], abdominal ex-laps. FAMILY HISTORY: There is a questionable history of prostate cancer in his father. SOCIAL HISTORY: He quit smoking 30 years ago and prior to that smoked one pack per day for 20 years. INPATIENT MEDICATIONS: 1. Acetaminophen. 2. Atenolol 25 mg PO once daily. 3. Diphenhydramine 25 PO q6 hours. 4. Dolasetron mesylate. 5. Docusate sodium. 6. Famotidine 20 b.i.d. 7. Oxycodone-acetaminophen 1 to 2 tablets PO q.4 to 6 hours. 8. Phenaseptic throat spray. 9. Sarna lotion. PHYSICAL EXAMINATION: Temperature Max. 97.6, heart rate 46, BP 154/80, respiratory rate 18, oxygen saturations 99% on room air. Chest clear to auscultation bilaterally. CARDIOVASCULAR: Regular rate and rhythm. ABDOMEN: With urostomy in place and stents draining into urostomy. No erythema or exudate or other sign of infection. Abdomen is nontender, nondistended, and soft. Extremities warm and well perfused. No clubbing, cyanosis or edema. BRIEF HOSPITAL COURSE: Mr. [**Known lastname 67489**] was admitted on [**2156-8-16**]. His preoperative labs were all within normal limits. He was typed and crossed for 4 units of blood. On [**8-17**], postoperative day 1, he did well and was kept in the SICU overnight for monitoring. He was also started on Ancef and clindamycin for a total of 3 doses. On postoperative day 2, Dr. [**Last Name (STitle) 9125**] discussed the results of the surgery with him. Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **], oncology, and Dr. [**First Name11 (Name Pattern1) 11312**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 656**], radiation oncology, were consulted. On postoperative day 3, the NG tube and the JP drain were discontinued secondary to little output. The patient tolerated PO intakes very well and was ambulating very well and was tolerating oral pain medications with Percocet. On hospital day 5, CT scan for staging was obtained. The CT scan showed a moderate bilateral hydronephrosis, hydroureter and on one side the stent located on the left within the ureter and the other stent was located in the ileal conduit. The patient continued to drain and complained of no pain or dysuria or discomfort in the area of the stent and therefore they were left as is. The patient was discharged home the following day with Percocet for pain as well as Colace to soften his stools. He was also given a witch [**Female First Name (un) **] type of cream for his hemorrhoids. A followup appointment with Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] has been arranged. The patient was instructed to call Dr.[**Name (NI) 15380**] office to confirm that appointment and also a followup appointment with Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 365**] was made. The patient was given instructions and was discharged in good condition. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 13269**] Dictated By:[**Name8 (MD) 560**] MEDQUIST36 D: [**2156-8-24**] 03:49:52 T: [**2156-8-24**] 08:12:45 Job#: [**Job Number 67490**]
Discharge summary
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Admission Date: [**2165-8-19**] Discharge Date: [**2165-8-24**] Date of Birth: [**2088-8-5**] Sex: M Service: HISTORY OF PRESENT ILLNESS: Briefly, this is a 74-year-old male with a past medical history of hypertension and type 2 diabetes who felt chest discomfort and increasing pounding in his chest. He went to the hospital and was found to have had a myocardial infarction. He was taken to the catheterization laboratory which was positive for multivessel disease. PAST MEDICAL HISTORY: (Past medical history is significant for) 1. Hypertension. 2. Diabetes. 3. Transient ischemic attacks. 4. Bilateral carotid disease. MEDICATIONS ON ADMISSION: His medications on admission were Glucotrol, glyburide, Zestril, Zocor, aspirin, and Timolol. ALLERGIES: He has no known drug allergies. PHYSICAL EXAMINATION ON PRESENTATION: On physical examination, he was afebrile. His vital signs were stable. His pupils were equal, round, and reactive to light. His extraocular muscles were intact. His neck was supple with no jugular venous distention, and no bruits. His chest examination revealed he had small crackles at the bases; otherwise, lungs were clear to auscultation bilaterally. His heart was regular in rate and rhythm with no murmurs, rubs, or gallops. His abdomen was soft, nontender, and nondistended. Bowel sounds were present. His extremities were warm and well perfused with just trace edema. HOSPITAL COURSE: The patient was taken to the operating room on [**2165-8-20**] where a coronary artery bypass graft times three was performed; left internal mammary artery to the left anterior descending artery, saphenous vein graft to RPL, saphenous vein graft to right posterior descending artery. The patient was transferred to the Postanesthesia Care Unit postoperatively, where he was slowly weaned from his ventilator and extubated. He had labile blood pressures which responded to volume; but otherwise he continued to do well. He diet was advanced, and he was started on beta blocker at that time. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] Diabetes consultation was obtained at that time to help control his blood pressures. He continued to have labile blood pressures; however, he continued to improve with aggressive fluid management. The patient was transferred to the floor postoperatively where he did well. Physical Therapy was consulted to assess his ambulation, and they felt at that time he would do quite well at home. It was planned by the family that he would have to come stay with him 24 hours a day. A cane was given to assist him in his walking; however, home Physical Therapy was also planned in order to help him to increase his ability to ambulate. Postoperatively, his chest tubes were removed. His Foley catheter was removed, and his wires were removed, and he did well. Aggressive pulmonary toilet and diuresis was continued. The patient's blood sugars also improved with better control. DISCHARGE DISPOSITION: The patient continued to improve, and on postoperative day four, he was discharged to home in stable condition. MEDICATIONS ON DISCHARGE: (His discharge medications included) 1. Lopressor 25 mg p.o. b.i.d. 2. Lipitor 10 mg p.o. q.d. 3. Timolol 0.25% one drop b.i.d. to effected eye. 4. Glipizide-XL 10 mg p.o. q.d. 5. Percocet one to two tablets p.o. q.4h. as needed. 6. Enteric-coated aspirin 325 mg p.o. q.d. 7. Zantac 150 mg p.o. b.i.d. 8. Colace 100 mg p.o. b.i.d. 9. Potassium chloride 20 mEq p.o. b.i.d. 10. Lasix 20 mg p.o. b.i.d. DISCHARGE DIAGNOSES: (The patient's discharge diagnoses included) 1. Coronary artery disease; status post coronary artery bypass graft. 2. Hypertension. 3. Diabetes. 4. Glaucoma. 5. Transient ischemic attacks. 6. Bilateral carotid disease. DISCHARGE STATUS: The patient was discharged to home. CONDITION AT DISCHARGE: Condition on discharge was stable. DISCHARGE FOLLOWUP: The patient was instructed to follow up with Dr. [**Last Name (STitle) 1537**] in four to six weeks, and with his primary care physician in one to two weeks, and with Cardiology in two to four weeks. [**First Name11 (Name Pattern1) 275**] [**Last Name (NamePattern4) 1539**], M.D. [**MD Number(1) 1540**] Dictated By:[**Last Name (NamePattern4) **] MEDQUIST36 D: [**2165-8-23**] 21:19 T: [**2165-8-29**] 09:00 JOB#: [**Job Number **]
Discharge summary
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34yo F G8P6 at 8weeks gestation admitted with uterine bleeding s/p Bakri balloon placement now admitted to [**Hospital Unit Name 4**] for closer monitoring. BRIEF HISTORY : 34yo G8P6 admitted with vaginal bleeding. The patient was diagnosed with non-viable pregnancy in [**Month (only) 2877**] with bleeding off and on since then. Last week she went into her OB for a check up and was still having uterine bleeding with a positive HCG. Her OB said she needed a D+C but she wanted to wait until after passover to have this done and since she was having only minimal bleeding it was agreed that she could wait. However, overnight she had heavier bleeding including clots from her vagina. She tried to stay at home to manage it but this morning her husband convinced her to come to the OB/GYN. . In the OB/GYN triage unit she started passing large clots in toilet this am and then, while the OB/GYN resident was standing with her, she syncopized but didnt hit anything. Therefore she was taken back to the OR for urgent D+C. D+C didnt show retained products but continued to bleed afterward to the point that they were thinking of doing emergent hysterectomy (lost 2 liters). At that point she then got a foley balloon placed in uterus to tamponade (Bakri balloon). This was attached to a urimeter to monitor bleeding - will see it in bag or on her pad. Hct on admission was 29, intra op it was 20, received 3units pRBCs in OR and near end of case was 28. INR 1.3 intraop. Fibrinopgen 190. Has 2 pivs in place. Actiev T+S and aline. VSS currently. Cramping from uterus and LH after dilaudid but otherwise not symptomatic. . Also a type one diabetic but took it off when she got here but initial FSBS was 300 - received 10units reg insulin in OR and now written for a drip. . She was transferred to the [**Hospital Unit Name 4**] for monitoring overnight. Uterine bleeding Assessment: s/p D &C and Bakri balloon placement [**4-27**] following LOC and 2L blood loss. Pt with small amt of output from balloon. Dark red in color. 15 CC TODAY. No other signs of bleeding. Morning crit 21. MINIMAL BROWN/PINK DRAINAGE ON PERI PAD CHANGED Q4 HR. Bakri balloon defalted at 11:00 with no bleeding noted. Fully removed at 13:30 by ob and few small dark [**Doctor Last Name **] clots noted with removal. Pt oob to chair 30 min after balloon out with 1 3-4 cm brown/pink clot. 1 pad with pink brown serous drainage thus far noted. Minimal dizziness, bp 98/64.. hr up to 100 from 80 2 with standing. Recovered bp and pulse upon sitting Action: Drit repeted at 13:30 and up to 22.4 oob to chair a line d/ced Response: Pt A&O x 3 and appropriate. No s/s of sever bleeding noted. Hemodynamically stable. Plan: Cont to monitor for s/s bleeding. Will start po intake if no bleeding 3-4 hr after balloon removed at 1700. Diabetes Mellitus (DM), Type I Assessment: Received pt on insulin gtt at 0.5 units/hr. Blood sugars in the 100 throughout night. Since 0700 glucone in 90-84 range. Action: Insulin gtt stopped at 13:30 and started on sub cutaneous humalog insulin pump per pt own device . dose is .45 units/hr SC. Blood glucose q 3-4 hr. Response: Ongoing. Good glucose control but pt is po. 2 PIV lines if needs glucose rescue. Plan: Plan to start feeding pt if no bleeding occurs and will not need [**Doctor First Name 91**] transfer to OB floor and prob discharge in am if no further bleeding. Educate pt to diet intake for iron and volume for low crit. Hypotension (not Shock) Assessment: UOP down at 0500-0600. bp 83/60 . pt c/o slight dizziness . Action: 1000 cc ns bolus over 1 hr given Response: Bp 95-110 sys withmap > 60. hr 80 s nsr. Slight tachy to 100 with exertion of OOB. Urine output this shift thus far is 1200 cc. minimal dizziness with standing. Improving crit Plan: Conts to monitor. Send to ob floor
Nursing
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Chief Complaint: subdural hematoma, respiratory failure I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 82 y/o M w/afib, s/p AVR, diastolic CHF, admitted with subdural hematoma s/p fall now s/p craniotomy and evacuation, with persistent respiratory failure. 24 Hour Events: FEVER - 102.2 F - [**2135-9-27**] 12:00 AM Became hypoxic to the 90s last night and peep was increased to 10. CXR with worsening RLL infiltrate. Antibiotics broadened to cover hospital-acquired organisms. [**Name8 (MD) 54**] RN, left arm and left leg shook for a couple of seconds both yesterday and this morning. Allergies: Procainamide Arthralgia/Arth Morphine Confusion/Delir Last dose of Antibiotics: Cefipime - [**2135-9-27**] 04:00 AM Infusions: Other ICU medications: Fentanyl - [**2135-9-27**] 04:00 AM Famotidine (Pepcid) - [**2135-9-27**] 08:00 AM Other medications: D5NS at 125 cc/hr, peridex, multivitamin, folate, colace, atrovent, dilantin, finasteride, atorvastatin, flomax, allopurinol, insulin sliding scale, hydral, lopressor 25 [**Hospital1 **], amiodarone 200 [**Hospital1 **], levothyroxine 75 mcg daily, imdur 20 [**Hospital1 **], vancomycin, tylenol prn, fentanyl prn Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2135-9-27**] 09:44 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 39 C (102.2 Tcurrent: 38.3 C (101 HR: 60 (55 - 61) bpm BP: 125/57(77) {107/46(63) - 158/70(96)} mmHg RR: 17 (16 - 30) insp/min SpO2: 98% Heart rhythm: AV Paced Wgt (current): 94.7 kg (admission): 68 kg Height: 70 Inch Total In: 2,137 mL 1,480 mL PO: TF: 1,440 mL IVF: 347 mL 790 mL Blood products: Total out: 1,695 mL 465 mL Urine: 1,695 mL 465 mL NG: Stool: Drains: Balance: 442 mL 1,015 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 500 (500 - 600) mL RR (Set): 12 RR (Spontaneous): 25 PEEP: 8 cmH2O FiO2: 50% RSBI Deferred: PEEP > 10 PIP: 25 cmH2O Plateau: 22 cmH2O SpO2: 98% ABG: 7.52/36/87 Ve: 10.9 L/min PaO2 / FiO2: 282 Physical Examination General Appearance: No acute distress Eyes / Conjunctiva: left pupil remains greater than right but both reactive Head, Ears, Nose, Throat: Normocephalic, Endotracheal tube, NG tube Cardiovascular: (S1: Normal), (Murmur: Systolic), Mechanical S2, II/VI HSM at apex Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Clear : ) Abdominal: Soft, Non-tender, Bowel sounds present Extremities: Right: Absent, Left: Absent Skin: Warm Neurologic: Responds to: Unresponsive, Movement: Non -purposeful, Tone: Not assessed Labs / Radiology 9.0 g/dL 163 K/uL 200 mg/dL 2.1 mg/dL 27 mEq/L 3.3 mEq/L 52 mg/dL 122 mEq/L 157 mEq/L 26.9 % 8.5 K/uL [image002.jpg] [**2135-9-25**] 09:06 AM [**2135-9-25**] 05:30 PM [**2135-9-26**] 04:20 AM [**2135-9-26**] 04:35 AM [**2135-9-26**] 06:09 PM [**2135-9-26**] 10:27 PM [**2135-9-27**] 01:44 AM [**2135-9-27**] 02:38 AM [**2135-9-27**] 03:01 AM [**2135-9-27**] 07:44 AM WBC 7.8 6.0 7.0 8.5 Hct 23.2 20.9 27.2 26.8 26.9 Plt 120 126 136 163 Cr 2.3 2.2 2.1 TCO2 29 29 29 30 30 Glucose 195 246 200 Other labs: PT / PTT / INR:25.9/53.7/2.6, CK / CKMB / Troponin-T:154/13/0.07, ALT / AST:134/102, Alk Phos / T Bili:179/1.2, Fibrinogen:300 mg/dL, Lactic Acid:1.6 mmol/L, Albumin:2.9 g/dL, LDH:407 IU/L, Ca++:8.6 mg/dL, Mg++:2.6 mg/dL, PO4:1.2 mg/dL Fluid analysis / Other labs: LFTs decreased slightly from yesterday Reticulocyte count 0.6% Hapto 110 FDP 10-40 Iron 39 TIBC 186 Ferritin 616 TG 84 Folate, B12 normal Imaging: CXR today with worsened RLL infiltrate Microbiology: Sputum [**9-26**]: 3+ GPC in prs and clusters Blood cx [**9-26**] pending Assessment and Plan A/P: 82 y/o M w/afib, s/p AVR, diastolic CHF, admitted with bilateral subdural hematoma and intraparenchymal bleed s/p fall now one week s/p evacuation, course complicated by reintubation. 1. Respiratory failure: Persistent hypoxemia requiring increased peep, with worsening infiltrate on CXR. Likely due to VAP. - treating with vanco and cefepime - has a respiratory alkalosis which is likely due to his CNS process - decreased tidal volume but still has a high Ve - extubation limited by mental status and hypoxemia 2. Subdural hematoma: s/p craniotomy and evacuation. Head CTs have been stable despite what effectively is systemic anticoagulation (elevated INR and PTT). Now with ? of seizure activity. - continue dilantin - discuss seizures with neurosurgery; dilantin dose appears to be therapeutic - discuss prognosis with neurosurgery 3. Diastolic CHF: s/p multiple admissions for this in past. Appears relatively euvolemic and pulmonary infiltrates likely pneumonia/aspiration as opposed to CHF. - cont metoprolol 4. s/p AVR: Not on anticoagulation due to subdural, but PT & PTT both elevated today. Continue to hold anticoagulation for now. 5. Coagulopathy: Both INR and PTT are elevated, despite having been given multiple units of FFP during his hospital course. DIC panel negative with normal fibrinogen and FDP. Held SQ heparin although unlikely that he is systemically absorbing this. - DIC panel negative - restart SQ heparin 6. Anemia: Hct now stable. Anemia labs c/w ACD, has hx of abnl bone marrow biopsy. Hemolysis labs negative. - check Hct [**Hospital1 **] - guaiac stools 7. CKD: baseline creatinine is 2.3-2.8. currently 2.2. BUN higher than baseline, likely due to diuresis, now trending down. - renally dose meds 8. Hypertension: Given bleed, goal SBP <160 - increase hydralazine to 37.5 mg TID - Imdur 20 [**Hospital1 **] - metoprolol 25mg [**Hospital1 7**] 9. Atrial fibrillation: Amiodarone 200 [**Hospital1 7**] 10. Hypothyroidism: On levothyroxine. 11. Altered mental status: Is unresponsive off of sedation. Likely due to subdural with contributions from hypernatremia, uremia, and infection. As above, will discuss with neurosurgery to assess trend of his exam over hospital course. - ? need for EEG given question of seizure activity this morning 12. Hyperlipidemia: continue statin 13. Hypernatremia: has been trending up, likely contributing to mental status. Will start on D5W (was inadvertently on D5NS overnight.) - free water boluses 300q4 14. Elevated LFTs: Now slightly improved. Unclear etiology; no clear medications that should be causing this other than amiodarone but has been on this for quite some time and statin. - RUQ u/s - hepatitis serologies - d/c statin ICU Care Nutrition: Comments: tube feeds Glycemic Control: Blood sugar well controlled Lines: Arterial Line - [**2135-9-19**] 10:14 AM 20 Gauge - [**2135-9-25**] 04:30 PM Prophylaxis: DVT: SQ UF Heparin Stress ulcer: H2 blocker VAP: HOB elevation, Mouth care, Daily wake up, RSBI Comments: Communication: Comments: Code status: DNR (do not resuscitate) Disposition :ICU Total time spent: Patient is critically ill
Physician
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TITLE: Physician Resident Progress Note Chief Complaint: 24 Hour Events: -started meropenem and discontinued ceftriaxone -consulted EP, will check ICD tomorrow -6 p.m., noted to be more hypoxemic, blood gas 7.50/37/50 -gave Lasix and placed on non-rebreather without improvement -7 p.m. intubated for hypoxemic respiratory failure -8 p.m. A-line placed -febrile, pan-cultured -9 p.m. bolused 500 cc NS for SBP 70s -10 p.m. started levophed for SBP 70s -11 p.m. bolused additional 500 cc NS for SBP 70s -2 a.m. ET tube advanced 2 cm. -4 a.m. bolused with 500 cc NS for low urine output Allergies: Penicillins Hives; Rash; Ambien (Oral) (Zolpidem Tartrate) Lightheadedness Last dose of Antibiotics: Cefipime - [**2141-3-3**] 08:15 PM Azithromycin - [**2141-3-4**] 09:30 AM Ceftriaxone - [**2141-3-4**] 03:00 PM Vancomycin - [**2141-3-4**] 11:16 PM Meropenem - [**2141-3-5**] 12:44 AM Infusions: Midazolam (Versed) - 2 mg/hour Fentanyl - 50 mcg/hour Norepinephrine - 0.08 mcg/Kg/min Other ICU medications: Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2141-3-5**] 05:58 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**42**] AM Tmax: 38.2 C (100.7 Tcurrent: 37.8 C (100 HR: 60 (60 - 103) bpm BP: 76/47(53) {76/47(53) - 124/83(96)} mmHg RR: 22 (16 - 25) insp/min SpO2: 97% Heart rhythm: V Paced Wgt (current): 104 kg (admission): 105 kg Height: 72 Inch Total In: 2,049 mL 712 mL PO: 560 mL TF: IVF: 1,489 mL 712 mL Blood products: Total out: 1,610 mL 145 mL Urine: 1,610 mL 145 mL NG: Stool: Drains: Balance: 439 mL 567 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 500 (500 - 500) mL Vt (Spontaneous): 0 (0 - 0) mL RR (Set): 22 RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 70% RSBI Deferred: FiO2 > 60%, Hemodynamic Instability PIP: 20 cmH2O Plateau: 15 cmH2O Compliance: 51.5 cmH2O/mL SpO2: 97% ABG: 7.42/44/117/27/3 Ve: 10.7 L/min PaO2 / FiO2: 167 Physical Examination GENERAL: Alert; Oriented x3. Uncomfortable; fidgety. Diaphoretic. High-flow O2 mask on. HEENT: NC/AT. NECK: Supple. Unable to appreciate JVP. CARDIAC: Difficult to hear over breath sounds; No m/r/g appreciated. LUNGS: Resp slightly labored; bilateral crackles and coarse breath sounds. ABDOMEN: Obese, Soft, NTND. No HSM or tenderness noted. Ventral hernia present. EXTREMITIES: No significant LE edema noted. No calf pain. Labs / Radiology 172 K/uL 10.6 g/dL 134 mg/dL 0.9 mg/dL 27 mEq/L 3.7 mEq/L 29 mg/dL 105 mEq/L 139 mEq/L 31.5 % 7.5 K/uL [image002.jpg] [**2141-3-3**] 05:38 PM [**2141-3-3**] 08:15 PM [**2141-3-4**] 04:30 AM [**2141-3-4**] 10:00 AM [**2141-3-4**] 03:08 PM [**2141-3-4**] 06:29 PM [**2141-3-4**] 09:17 PM [**2141-3-4**] 11:16 PM [**2141-3-5**] 04:44 AM [**2141-3-5**] 04:55 AM WBC 7.4 7.5 Hct 33.9 31.5 Plt 174 172 Cr 1.2 1.1 0.9 TropT <0.01 <0.01 <0.01 TCO2 28 30 30 27 26 30 Glucose 134 131 140 134 Other labs: PT / PTT / INR:24.2/34.4/2.3, CK / CKMB / Troponin-T:374/4/<0.01, Lactic Acid:0.9 mmol/L, Ca++:7.7 mg/dL, Mg++:2.1 mg/dL, PO4:2.1 mg/dL Assessment and Plan 71 y/o M with PMHx significant for systolic HF (EF 20-25%), MI in '[**26**], paroxysmal AV block, atrial fibrillation, h/o v.tach and v.fib s/p ICD implantation, who presented to the ED with a chief complaint of dyspnea, initially thought to be due to CHF exacerbation but now suspicious for pneumonia. . # Dyspnea: Overnight, the patient had recurrent of dyspnea. Repeat CXR showed a more clear left-sided infiltrate. Also, of note, pt had fevers overnight. This presentation now more consistent with pneumonia, with a possible superimposed CHF component. Pt given vanc/cefepime/levofloxacin yesterday evening. - vanc/cefepime/azithromycin for broad coverage for pneumonia at this point - attempt to get sputum cultures - restarting Lasix 60 mg PO daily to prevent CHF exacerbation on top of PNA - continue metoprolol 12.5 mg daily, per home med list . # CORONARIES: Pt has a history of an anterior wall MI in [**2126**]. Pt denies any current chest pain, and the first 2 sets of CE's was negative. Of note, the patient did report some chest pressure previously, but this has since resolved. - will continue to rule out MI with 3 sets of CE's - continue to monitor for any chest pain . # RHYTHM: Pt with a history of a.fib, for which he is on coumadin. His INR is currently therapeutic at 2.3 on presentation. Telemetry currently showing v-paced rhythm. - continue coumadin, with goal INR of [**1-25**] - need to closely monitor INR, as it may change with pt on abx . # Hypertension: Normotensive at this time. - continue metoprolol tartrate - lasix as above . # Hypothyroidism: - continue levothyroxine 50 mcg daily . # Anemia: Pt with a history of anemia, baseline Hct of approx. 33-35. Pt currently near his baseline. - continue iron supplementation - continue to trend hct - bowel regimen with colace/senna . # ID: Per o/p ID notes, the patient is on chornic cefpodoxime for ongoing suppression after high-grade viridans streptococcal bacteremia in the setting of pacer/defibrillator wires and to continue intended life-long suppression for suspected Klebsiella pneumoniae lead endocarditis during a prior bacteremia. - holding cefpodoxime while on broad spectrum abx as above - touch base with outpt ID doc . # S/p Whipple: - continue pancreatic enzyme repletion ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2141-3-5**] 12:58 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition: ICU
Physician
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Admission Date: [**2195-12-8**] Discharge Date: [**2195-12-16**] Date of Birth: [**2143-6-4**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 348**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: intubation [**Date range (3) 63639**] right internal jugular central venous line [**Date range (3) 63640**] History of Present Illness: MR. [**Known lastname 10794**] is a 52 year-old man with NICM ([**10/2195**]-LVEF 20% and 1+ MR), and type 1 diabetes mellitus who presented to ED with SOB. Patient reports running out of lasix 4 days PTA. He further described cough, SOB, orthopnea and slightly worse LE edema 2 days PTA. And presented to the ED on [**12-7**] with worsened SOB at rest. In the ED, initial vitals 130/91 139 36 99% CPAP. His exam notable for 2 sentence dyspnea, crackles to BL mid-lung fields. Labs notable for WBC count of 11.3 w/ 85% PMNs, HCT 32.1, BNP 2361, creatinine 0.9, trop 0.02. ABG: 7.43 pCO2 34 pO2 324 on BiPap. CXR with diffuse bilateral airspace opacities initally though to be asymetric pulmonary edema. The patient was started on nitro gtt and given lasix 80IV. He was then admitted to the CCU. In the CCU, he was continued on lasix IV in the CCU and achieved 1L liter length of stay fluid balance without significant improvement in respirtory status. A CTA Chest was performed that identified bilateral parenchymal opacities consistent with multifocal PNA and inconsistent with pulmonary edema. The patient was started on Cefepime, Azithromycin, Vancomycin and Bactrim. The patient was febrile to 101.2 on [**12-9**] and the decision was then made to transfer the patient to the MIUC. Vitals on transfer were 100.0 103 82/51 96% 6L NC. Past Medical History: 1. CARDIAC RISK FACTORS: Type I Diabetes, Hyperlipidemia, HTN 2. CARDIAC HISTORY: 3. OTHER PAST MEDICAL HISTORY: - Nonischemic dilated cardiomyopathy ([**10/2195**]-LVEF 20%, LVD 6.4 cm, mild RV dilation, borderline function, 1+ MR) - hepatitis C antibody positive - MRSA pneumonia (requiring trach) - COPD - Substance abuse (cocaine) - Tobacco abuse - schizophrenia Social History: - history of multiple incarcerations (>6 months in [**2193**]) - lives with sister - walks w/ cane due to right sided foot drop - Tobacco history: current smoker, 1 cig per day - ETOH: denies - Illicit drugs: crack cocaine three days ago Family History: - Father: pacemaker, deceased Physical Exam: ADMISSION EXAM: VS: 115/81 119 22 92% 4L NC GENERAL: NAD. Oriented x3. Mood, affect appropriate. Frequent yawns. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. No xanthalesma. Poor dentition NECK: Supple with JVP of 7 cm. CARDIAC: tachycardia, normal S1, S2. No m/r/g. No thrills, lifts. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. No HSM or tenderness. No abdominial bruits. EXTREMITIES: No c/c/e. No femoral bruits. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Neuro: strength 5/5 bilaterally UE and LE except R foot: [**2-21**] strength in dorsiflexion. CN II-XII intact. DISCHARGE EXAM: VS: Tm 98 / Tc 98, BP (105-130)/(65-85), HR 75 (75-95), RR 18, POx 97%RA FS glucose 172-300 GENERAL: NAD. Oriented to self, hospital name, year, month. CARDIAC: S1 and S2, no murmur. LUNGS: Clear to auscultation throughout all fields bilaterally NEURO: chronic right-sided foot drop; gait stable with cane Pertinent Results: ADMISSION LABS [**2195-12-8**] 02:35AM BLOOD WBC-11.3* RBC-3.95* Hgb-10.4* Hct-32.1* MCV-81* MCH-26.5* MCHC-32.5 RDW-13.7 Plt Ct-286 [**2195-12-8**] 02:35AM BLOOD Neuts-85.6* Lymphs-9.5* Monos-3.4 Eos-1.2 Baso-0.4 [**2195-12-9**] 04:15AM BLOOD PT-13.8* PTT-38.7* INR(PT)-1.3* [**2195-12-8**] 01:58AM BLOOD Glucose-256* UreaN-8 Creat-0.9 Na-139 K-3.3 Cl-105 HCO3-20* AnGap-17 [**2195-12-8**] 01:58AM BLOOD ALT-20 AST-27 LD(LDH)-299* CK(CPK)-249 AlkPhos-54 TotBili-0.2 [**2195-12-8**] 01:58AM BLOOD Calcium-8.3* Phos-4.1 Mg-1.4* [**2195-12-8**] 02:37AM BLOOD Type-ART pO2-324* pCO2-34* pH-7.43 calTCO2-23 Base XS-0 PERTINENT LABS [**2195-12-12**] 08:36PM BLOOD calTIBC-203* Ferritn-679* TRF-156* [**2195-12-14**] 08:49PM BLOOD TSH-3.2 [**2195-12-9**] 04:15AM BLOOD HIV Ab-NEGATIVE [**2195-12-8**] 02:45AM URINE bnzodzp-NEG barbitr-NEG opiates-NEG cocaine-POS amphetm-NEG mthdone-NEG MICRO DATA [**2195-12-8**] 02:45AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.009 [**2195-12-8**] 02:45AM URINE Blood-TR Nitrite-NEG Protein-100 Glucose-300 Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.5 Leuks-NEG [**2195-12-8**] 02:45AM URINE RBC-1 WBC-2 Bacteri-FEW Yeast-NONE Epi-<1 [**2195-12-8**] 02:45AM URINE CastHy-1* [**2195-12-8**] 02:45AM URINE Mucous-RARE [**2195-12-9**] 8:30 am BLOOD CULTURE x2 **FINAL REPORT [**2195-12-15**]** Blood Culture, Routine (Final [**2195-12-15**]): NO GROWTH. [**2195-12-9**] 6:55 pm BRONCHOALVEOLAR LAVAGE LEFT UPPER BAL. GRAM STAIN (Final [**2195-12-9**]): 1+ (<1 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Final [**2195-12-11**]): NO GROWTH, <1000 CFU/ml. LEGIONELLA CULTURE (Final [**2195-12-16**]): NO LEGIONELLA ISOLATED. POTASSIUM HYDROXIDE PREPARATION (Final [**2195-12-9**]): This is a low yield procedure based on our in-house studies. if pulmonary Histoplasmosis, Coccidioidomycosis, Blastomycosis, Aspergillosis or Mucormycosis is strongly suspected, contact the Microbiology Laboratory (7-2306). NO FUNGAL ELEMENTS SEEN TEST REQUESTED PER DR.[**Known lastname **] [**Known firstname **] [**2195-12-10**]. Immunoflourescent test for Pneumocystis jirovecii (carinii) (Final [**2195-12-10**]): SPECIMEN COMBINED. PLEASE REFER TO SPECIMEN #337-2463B [**2195-12-9**]. PATIENT CREDITED. FUNGAL CULTURE (Preliminary): NO FUNGUS ISOLATED. ACID FAST SMEAR (Final [**2195-12-10**]): NO ACID FAST BACILLI SEEN ON CONCENTRATED SMEAR. ACID FAST CULTURE (Preliminary): NO MYCOBACTERIA ISOLATED. VIRAL CULTURE: R/O CYTOMEGALOVIRUS (Preliminary): No Cytomegalovirus (CMV) isolated. CYTOMEGALOVIRUS EARLY ANTIGEN TEST (SHELL VIAL METHOD) (Final [**2195-12-14**]): Negative for Cytomegalovirus early antigen by immunofluorescence. Refer to culture results for further information. [**2195-12-9**] 6:55 pm Rapid Respiratory Viral Screen & Culture BAL. **FINAL REPORT [**2195-12-12**]** Respiratory Viral Culture (Final [**2195-12-12**]): No respiratory viruses isolated. [**2195-12-10**] 5:58 am URINE Source: Catheter. **FINAL REPORT [**2195-12-11**]** URINE CULTURE (Final [**2195-12-11**]): NO GROWTH. [**2195-12-9**] 10:05PM BLOOD ASPERGILLUS GALACTOMANNAN ANTIGEN-Negative [**2195-12-9**] 10:05PM BLOOD B-GLUCAN-Negative Brief Hospital Course: Mr. [**Known lastname 10794**] is a 52y/o gentleman with nonischemic cardiomyopathy who presented from home with progressively worsening shortness of breath for two days and was found to be in hypoxic respiratory distress due to multifocal PNA. He was intubated, stabilized in the MICU with antibiotics, and was transitioned to the medical floor where he was weaned to room air and was discharged home. ACTIVE ISSUES #. Acute respiratory failure: due to multifocal PNA. He was intubated and at first his presentation was concerning for CHF exacerbation. Was initially admitted to the Cardiac ICU and was diuresed, but when he spiked a fever and became tachycardic in the setting of leukocytosis as well, a CTA was performed which ruled out PE but showed multifocal PNA so diuresis was stopped and he was started on antibiotics and transferred to the MICU for further management (see below). #. Multifocal pneumonia: Clinically resolved by discharge. He has a history of MRSA pneumonia requiring tracheostomy during prior admission to OSH in summer [**2194**]. Here, he was started on Vanc/Cefepime/Cipro/Azithro as well as Bactrim given concern for potential PCP (he has been in prison and has a h/o IVDU). His HIV test was negative. PPD was placed and was negative. Bronchoscopy was done and he was ruled out for TB and PCP so his [**Name9 (PRE) **] were changed to Vanc/Cefepime/Cipro. Was extubated without complication. Was transitioned to the medical floor where he remained afebrile, hemodynamically stable, with leukocytosis resolved. He was weaned to room air and ambulated without desaturating. He completed an 8 day regimen ([**Date range (3) 63640**]) and was discharged home. #. Non-ischemic cardiomyopathy: euvolemic. LVEF 20%, mild RV dilation, 1+ MR. As discussed above, he was initially diuresed due to concern for CHF exacerbation, but he was euvolemic. He was transitioned back to his home dose of lasix 40mg PO daily. He was also continued on his home ACE inhibitor and beta-blocker. #. Elevated troponin: possibly represented demand ischemia. Troponin was mildly elevated with peak of 0.05 which was thought to be related to demand from his persistent tachycardia. He ruled out for MI with declining troponins. No EKG changes. #. Acute kidney injury: likely prerenal; resolved. Creatinine baseline is 0.9 but peaked at 2 on [**11-19**]. Was likely [**1-21**] to spesis and over-diuresis. Also, possibly related to brief Rx with treatment-dose Bactrim. His Cr then trended down and was back to baseline at 0.9 upon discharge. #. DM2: stable at the time of discharge. He was initially continued on glargine and ISS. On [**12-10**] he required insulin drip for FS persistently in the 400s despite SC insulin, but this quickly resolved. He was discharged on his home dose of medications and will follow up with his PCP. #. Schizophrenia/Depression: with depressed mood/affect and hallucinations this admission. After he was stabilized and extubated, he was noted to respond to questions with single-word answers, with flat affect and poor eye contact. CT head was negative. However, after a visit from his sister and sister's boyfriend, he tearfully admitted that he had been lonely and felt that nobody was visiting him (especially since he had been in the ICU on [**Holiday **]). After this, he was alert/interactive and was fully conversant. He admitted that while he was in the ICU he saw a tiger in his room. It is unclear if this was related to intubation/sedation or his untreated schizophrenia. No further hallucinations. At the time of discharge, he denied SI/HI and desired follow-up with a mental health provider so an appointment was made for him. #. Substance abuse: UTox positive for cocaine. He was counseled on the importance of abstinence from drugs. INACTIVE ISSUES #. Hyperlipidemia: stable. He was continued on home Atorvastatin. #. COPD: stable. He was continued on home Albuterol, Ipratropium. TRANSITIONAL ISSUES #. Emergency Contact: [**Name (NI) 4944**] ([**Telephone/Fax (1) 63641**]) #. Code Status: Full Code Medications on Admission: - lasix 40 daily - metoprolol succinate 100mg daily - lisinopril 5mg daily - lipitor 20mg daily - aspirin 81mg daily - seroquel 25m QHS - insulin 40u lantus QHS, 12u novolug AM - atrovent 250/50 [**Hospital1 **] - ipratropium Q6 PRN SOB - albuterol PRN SOB - doxepin 20mg QHS (not taking) Discharge Medications: 1. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day. 2. metoprolol succinate 100 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. 3. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Lipitor 20 mg Tablet Sig: One (1) Tablet PO once a day. 5. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 6. Seroquel 25 mg Tablet Sig: One (1) Tablet PO at bedtime. 7. Lantus 100 unit/mL Solution Sig: Forty (40) units Subcutaneous at bedtime: please use 1/2 dose if not eating well; call your doctor for any blood sugars less than 80. 8. Novolog 100 unit/mL Solution Sig: Twelve (12) units Subcutaneous every morning: please use 1/2 dose if not eating well; call your doctor for any blood sugars less than 80. 9. Advair Diskus 250-50 mcg/dose Disk with Device Sig: One (1) puff Inhalation twice a day. 10. ipratropium bromide 17 mcg/Actuation HFA Aerosol Inhaler Sig: 1-2 puffs Inhalation every six (6) hours as needed for shortness of breath or wheezing. 11. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: 1-2 puffs Inhalation every 4-6 hours as needed for shortness of breath or wheezing. Discharge Disposition: Home Discharge Diagnosis: multifocal pneumonia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You presented with shortness of breath and cough, and were admitted to the ICU where you required intubation (breathing tube) for pneumonia. You were treated with antibiotics and were able to be extubated and transferred to the medical floor to complete your antibiotics. Now you are stable for discharge home with Primary Care follow-up. While you were here, you were depressed and had a hallucination. You did not feel that you were a harm to yourself or others. We made you an appointment with a mental health provider (please see appointment below). We did not make any changes to your medications. Followup Instructions: PRIMARY CARE Department: [**Hospital1 7975**] INTERNAL MEDICINE When: WEDNESDAY [**2195-12-23**] at 10:30 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 63642**], MD [**Telephone/Fax (1) 7976**] Building: [**Hospital1 7977**] ([**Location (un) 686**], MA) [**Location (un) **] Campus: OFF CAMPUS Best Parking: Free Parking on Site PSYCHIATRY/SOCIAL WORK Department: [**Hospital 7975**] [**Hospital **] HEALTH CENTER When: THURSDAY [**2196-1-7**] at 10:30 AM With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 63643**], LICSW [**Telephone/Fax (1) 7976**] Building: [**Hospital1 7977**] ([**Location (un) 686**], MA) [**Location (un) **] Campus: OFF CAMPUS Best Parking: Free Parking on Site
Discharge summary
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Chief Complaint: Hypotension, suspected pneumonia HPI: Mrs. [**Known lastname 10048**] is a 71 year old female with past medical history of congestive heart failure, back pain, psychotic depression, and GERD who presented from her nursing home with fevers and change in mental status. Per report from ED and review of paperwork, at baseline she is alert and oriented, though has some paranoia. Today her nursing facility noted an acute change in mental status with hallucinations, accompanied by a fever to 101. She was also noted to be hypoxic with oxygen saturation of 88% on room air, improved on 2L nasal cannula. She was brought to the [**Hospital1 19**] ED. . In the ED, initial vital signs were: temperature of 100.6, blood pressure of 114/54, heart rate of 72, oxygen saturation of 95% on room air. Patient was given 1 gram of vancomycin of which 500 mg was received, 750 mg of levofloxacin, and 4.5 grams of Zosyn. She also received 650 mg of Tylenol. She was given about 3500 mL of IVF for borderline low blood pressure with systolic ranging 85-101. A chest x-ray was notable for bilateral patchy opacities, retro-cardiac air bronchograms, and mild cardiomegaly. An ABG was obtained which demonstrated: 7.32/53/98/29. . Upon arrival to the ICU, she reports that she feels "lousy all over." She states her breathing is "okay" as long as she is not turned on her side or laying flat. She reports chronic back pain. She is oriented to self and place. She reports that she thought she was coming down with a cold, as everyone at her rehab has had cough and congestion. Allergies: Last dose of Antibiotics: Infusions: Other ICU medications: Home medications: - Lidoderm 5% patch - Levothyroxine 25 mcg - Prilosec 20 mg - Cymbalta 60 mg - Colace 100 mg [**Hospital1 7**] - Labetalol 200 mg [**Hospital1 7**] - Oxycontin 30 mg [**Hospital1 7**] - Senna 1 tablet [**Hospital1 7**] - Diazepam 5 mg Q6H PRN - Oxycodone 10 mg Q6H PRN - Multivitamin daily - Lyrica 50 mg daily 9 AM for two weeks, plan to increase to 50 mg [**Hospital1 7**] on [**2121-8-27**] - Robitussin 10 mL Q4H PRN Past medical history: Family history: Social History: - Congestive heart failure - GERD - Psychotic depression - Infrarenal abdominal aortic aneurysm - Degenerative joint disease/osteoarthritis - Hypothyroidism - Thyroid cancer - Osteoporosis - ICU stay with intubation (further details unknown) at [**Hospital3 4050**] [**2119**] - Status-post Ceasarin section - Status-post cystectomy - Status-post cholecystectomy - Status-post hysterectomy - Lower back pain with surgery, discetomy in [**5-/2121**] Unable to obtain. Patient lives at [**Hospital 1833**] Rehabilitation and Nursing Center. She is a former nursing health aide. She has four sons. She states her husband died from sepsis. She smoked, however quit 30 years ago. She denies any alcohol use. Review of systems: (+) Per HPI (-) Denies fever, chills, night sweats, recent weight loss or gain. Denies headache, rhinorrhea or congestion. Denied cough. Denied chest pain or tightness, palpitations. Denied nausea, vomiting, diarrhea, constipation or abdominal pain. No recent change in bowel or bladder habits. No dysuria. Denied arthralgias or myalgias. Flowsheet Data as of [**2121-8-21**] 12:02 AM Vital Signs Hemodynamic monitoring Fluid Balance 24 hours Since 12 AM Tmax: 35.4 C (95.7 Tcurrent: 35.4 C (95.7 HR: 73 (68 - 73) bpm BP: 129/99(106) {99/39(55) - 133/99(112)} mmHg RR: 22 (12 - 22) insp/min SpO2: 93% Heart rhythm: SR (Sinus Rhythm) Height: 61 Inch Total In: 70 mL PO: 70 mL TF: IVF: Blood products: Total out: 100 mL 0 mL Urine: 100 mL NG: Stool: Drains: Balance: -30 mL 0 mL Respiratory O2 Delivery Device: Nasal cannula SpO2: 93% Physical Examination Vitals: T: 95.7 BP: 126/57 P: 74 R: 20 O2: 96% on 4L General: Oriented to self, place--"[**Location (un) 23**], [**Hospital1 19**]," month, and year. No acute distress; unable to articulate whether her husband is alive or dead, however answers some questions appropriate. Awake and alert. No accessory muscle use. HEENT: Sclera anicteric, oropharynx clear with very dry mucous membranes, PERRL Neck: supple, JVP difficult to assess, no LAD Lungs: Decreased breath sounds over the right side, left side with rales up 1/2 of the lung field, no dullness to percussion on the left side, some at the base on right, no wheezes, + ronchi and transmitted upper airway noise throughout. CV: Regular rate and rhythm, normal S1 + S2, with systolic murmur, no rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: Foley in place Ext: Warm, well perfused, 2+ pulses, bilateral trace edema, no asymetry, no cyanosis Labs / Radiology [image002.jpg] Micro: Blood cultures x2 from ED pending . Images: Chest x-ray: bilateral basilar infiltrate versus edema, slightly enlarged cardiac silhouette, blunting of left heart border . EKG: Sinus, rate of 78, poor baseline, normal intervals and axis, late R wave progression. No prior available for comparison. Assessment and Plan Mrs. [**Known lastname 10048**] is a 71 year old female with past medical history of congestive heart failure, GERD, back pain, and psychotic depression who presents with fevers, altered mental status, hypoxia, and hypotension. . #) Fevers, leukocytosis: Picture is most consistent with infectious etiology. Most likely is pneumonia given chest x-ray findings, hypoxia, and history of cough. Other potential source would be urinary tract given mildly positive urine analysis with WBC and trace positive leukesterase. No convincing story for GI source. Given question of change in mental status, must also consider CNS infection, though this appears less likely given hypoxia and cough, and improvement after fluid resuscitation in ED. - Continue broad coverage antibiotics: Vancomycin/Zosyn for hospital acquired pneoumonia (given she lives in health care facility), and levofloxacin to double cover gram negative pathogens as well as atypicals. Will consider narrowing coverage pending culture data. - Will send urinary legionella, sputum culture - Urine culture - Rapid respiratory panel, droplet precautions - Repeat CXR in AM . #) Altered mental status: Currently appears to be at baseline, per report from nursing facility. Suspect this was in the setting of fever, hypoxia. - Will continue to monitor respiratory status closely, should further mental status changes ensue, would consider head CT and/or lumbar puncture . #) Hypotension: Given above picture of fever and now relative hypothermia, leukocytosis, initial tachycardia, and tachypnea, patient fits criteria for SIRS/sepsis, given hypotension with possible end organ damage given elevated creatinine (baseline unknown). Currently BP improved after 3-4 liters of IVF. No known history of steroid use to suggest adrenal insufficiency, no evidence of ischemia on EKG. - Continue to monitor respiratory status closely, bolus for MAP >65 as permitted given history of CHF - Consider placement of CVL to obtain CVP, pressors if necessary - Antibiotics as discussed above . #) Hypoxia: Suspect secondary to infectious process as well as possible degree of CHF given CXR, however improvement in her symptoms after IVF would argue against this. Currently doing well on 4 L NC. Given bilateral infiltrates, must also be mindful of ARDS, though cannot entirely be sure this is not secondary to fluids. - BNP - Repeat CXR in AM . #) History of CHF: Unknown what her systolic and diastolic function are, currently feels better after IVF. As noted above, CXR could be consistent with CHF, though seems less likely in setting of leukocytosis and improvement in symptoms with hydration. - Added on BNP - Will attempt to get records from her PCP regarding status of her systolic and diastolic function - Will continue cautious IVF resuscitation given unknown cardiac function . #) Psycotic depression: Patient is followed by Dr. [**First Name5 (NamePattern1) 461**] [**Last Name (NamePattern1) 10049**] at [**Male First Name (un) 1833**] and Dr. [**Last Name (STitle) **] [**Last Name (NamePattern4) 1756**] [**Last Name (NamePattern1) 10050**]. - Continuing home medications . #) Renal insufficiency: Unknown baseline creatinine. Hydrating as noted above. - Renal lytes to check FeNa - PCP contact for baseline value . #) Hypothyroidism: Continue home medications . #) Anxiety, pain: Continue home medications . #) Hypertension: Holding home labetolol for now. . #) Intrarenal aortic anerusym: Further details unknown, pulses are bilaterally symmetric. . ICU Care Nutrition: as noted above, replete electrolytes, regular diet in AM if respiratory status more stable Glycemic Control: Lines: Currently with two peripherals, will pursue additional access if needed. 18 Gauge - [**2121-8-20**] 09:14 PM Prophylaxis: DVT: Subutaneous heparin, home PPI and bowel regimen Stress ulcer: VAP: Comments: Communication: Comments: Patient, Son [**Name (NI) 751**] [**Name (NI) 10048**] ([**Telephone/Fax (1) 10051**], ([**Telephone/Fax (1) 10052**] Code status: Full, per documentation from nursing home stating she wishes full resuscitation, also discussed with patient Disposition:
Physician
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TITLE: Chief Complaint: 24 Hour Events: -K improved by PM lytes -[**9-25**] f/u scheduled with heme/onc -touched base with SW and case manager-working on rehab vs home health nurse [**First Name (Titles) **] [**Last Name (Titles) **] anticipated monday. -will need to t/b with heme/onc in regards to final recs on dc. -started on topical miconazole out of concern for yeast infection. Allergies: Iodine; Iodine Containing Unknown; Last dose of Antibiotics: Infusions: Other ICU medications: Heparin Sodium (Prophylaxis) - [**2116-9-18**] 11:29 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2116-9-19**] 07:33 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.8 C (98.2 Tcurrent: 36.8 C (98.2 HR: 104 (95 - 114) bpm BP: 86/59(64) {86/11(22) - 125/93(100)} mmHg RR: 13 (12 - 24) insp/min SpO2: 95% Heart rhythm: SR (Sinus Rhythm) Height: 60 Inch Total In: 1,280 mL 300 mL PO: 830 mL 300 mL TF: IVF: 450 mL Blood products: Total out: 1,550 mL 1,115 mL Urine: 1,550 mL 1,100 mL NG: Stool: Drains: Balance: -270 mL -815 mL Respiratory support O2 Delivery Device: Nasal cannula SpO2: 95% ABG: ///28/ Physical Examination Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 281 K/uL 13.7 g/dL 140 mg/dL 0.7 mg/dL 28 mEq/L 4.4 mEq/L 22 mg/dL 104 mEq/L 140 mEq/L 41.3 % 7.9 K/uL [image002.jpg] [**2116-9-13**] 04:01 AM [**2116-9-14**] 04:43 AM [**2116-9-15**] 04:06 AM [**2116-9-16**] 05:52 AM [**2116-9-17**] 04:56 AM [**2116-9-18**] 04:50 AM [**2116-9-18**] 03:11 PM [**2116-9-19**] 04:13 AM WBC 7.0 5.1 5.4 7.1 8.2 8.8 9.5 7.9 Hct 48.6 43.7 41.4 45.9 40.3 39.3 42.5 41.3 Plt 247 254 265 [**Telephone/Fax (3) 8751**] 281 281 Cr 0.8 0.8 0.8 0.7 0.8 0.9 0.7 Glucose 122 112 124 125 117 130 140 Other labs: PT / PTT / INR:10.7/35.2/0.9, ALT / AST:16/24, Alk Phos / T Bili:83/0.3, LDH:127 IU/L, Ca++:8.7 mg/dL, Mg++:2.0 mg/dL, PO4:3.1 mg/dL Assessment and Plan 47 year old female PMH breast cancer who presents with bilateral lower extremity edema of 1 day duration, found to have pericardial effusion. . # Pericardial effusion: Drain placed on [**9-12**], fluid showed adenocarcinoma. The drain was pulled on [**9-17**] after output decreased. Pt went to CT [**Doctor First Name **] for window procedure yesterday. Pt has been in NSR since admission (with occ PVCs). Fluid overload has improved since draining of effusion. - continue pleural drains for 24-48 hrs per [**Doctor First Name **] recs - Continue Indomethacin/dilaudid PO for pain control . # CORONARIES: CAD risk factors of HTN and smoking. Pleuritic chest pain does not support angina or ACS. No prior history of CAD. Lisinopril restarted for hypertension at home dose. . # Breast Cancer: Pt has been non-compliant with onc f/u. Patient's last appointment [**2115-1-30**] reports she is to continue Aromasin (aromotase inhibitor) which she is currently not taking. We now have evidence of metastatic spread of her tumor with pleural effusion showing adenocarinoma and evidence of bony mets to the spine by CT. Also concern for malignant pleural effustions. Appreciate oncology consult. -will obtain bone scan non-urgently -f/u onc recs . # Asthma: Significant wheezing on exam on admission, but has since improved. CXR reports atelectasis vs early pneumonia in the right middle lobe, but no evidence of infection and afebrile. Also likely COPD given smoking history and lung volumes on CXR. - Continue Ipratropium NEBs standing; Albuterol NEBs prn - Continue outpatient singulair - If spikes or has leukocytosis consider CAP coverage, no antibiotics for now . # Depression/Insomnia: Continue outpatient trazadone 200 mg qhs. . # Constipation: bowel regimen uptitrated yesterday without effect. Will continue to to titrate to BM. . # Hyperkalemia: rising k, ? tumor lysis, will re-check K this afternoon. . # Social: Patient currently lives in rooming house. Reports stresses at home. Has not followed with medical care (multiple do not show appointments). Appreciate SW consult. Will f/u with social work today ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2116-9-17**] 02:11 PM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Disposition:
Physician
Classify the following medical document.
Admission Date: [**2189-12-24**] Discharge Date: [**2189-12-30**] Date of Birth: [**2124-7-15**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 922**] Chief Complaint: Scapular pain Major Surgical or Invasive Procedure: [**2189-12-24**] Redo-Sternotomy, Coronary Artery Bypass Graft x 3 (SVG to Diag to OM, SVG to PDA), Aortic Valve Replacement w/ 25mm CE Magna pericardial tissue valve History of Present Illness: 65 y/o male s/p CABG in [**2179**] now experiencing mild scapular back pain. Cardiac cath revealed severe native coronary artery disease with patent grafts. Echo performed showed severe aortic stenosis with a valve are of 0.7cm2. He was then referred for surgical intervention. Past Medical History: Coronary Artery Disease s/p Coronary Artery Bypass Graft [**2179**], s/p PTCA of RCA [**2178**], Hypertension, Hypercholesterolemia, Diabetes Mellitus, Chronic Obstructive Pulmonary Disease, Anemia, s/p Anal fistulotomy Social History: Patient smoked one ppd x 53 years, quit in [**2189-5-23**] Divorced and lives alone. He has four children. Retired, used to work as a cop. Family History: Father died at age 77 from an MI. Mother was diabetic and had an MI in her 70's. Physical Exam: VS: 70 14 140/80 5'9" 220# Skin: Unremarkable with well-healed MSI HEENT: EOMI, PERRL, NC/AT Neck: Supple, FROM, -JVD, -carotid bruit Chest: CTAB -w/r/r Heart: RRR, 4/6 SEM Abd: Soft, NT/ND, +BS Ext: Warm, well-perfused, 2+ pulses throughout, -edema or varicosities Neuro: A&O x 3, MAE, non-focal Pertinent Results: [**2189-12-24**] Echo: PRE-CPB: The left atrium is mildly dilated. There is severe symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Regional left ventricular wall motion is normal. Transmitral Doppler and tissue velocity imaging are consistent with normal LV diastolic function. Right ventricular chamber size and free wall motion are normal. Right ventricular chamber size is normal. Right ventricular systolic function is normal. There are simple atheroma in the aortic root. There are simple atheroma in the ascending aorta. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. There are three aortic valve leaflets. The aortic valve leaflets are severely thickened/deformed. No masses or vegetations are seen on the aortic valve. There is moderate aortic valve stenosis (area 0.8-1.19cm2) Moderate (2+) aortic regurgitation is seen. The mitral valve leaflets are moderately thickened. No mass or vegetation is seen on the mitral valve. There is a minimally increased gradient consistent with trivial mitral stenosis. Mild (1+) mitral regurgitation is seen. POST-CPB: On phenylephrine infusion. There is a well-seated bioprosthetic valve in the aortic position with no AI seen. Flow is seen in the LMCA. The measured gradient across the aortic valve is now 6 mmHg. There is preserved biventricular systolic function. LVEF 65%. There is no [**Male First Name (un) **]. MR is trace. The aortic contour is normal post decannulation. [**2189-12-29**] CXR: Bilateral pleural effusions have significantly decreased in size since prior exam. Small bilateral pleural effusions remain. The cardiac silhouette, mediastinal and hilar contours are stable in size status post CABG and AVR. The pulmonary vasculature is normal and there is no pneumothorax. No consolidations are seen bilaterally. [**2189-12-24**] 01:33PM BLOOD WBC-13.8*# RBC-3.33*# Hgb-7.3*# Hct-22.3*# MCV-67* MCH-21.9* MCHC-32.8 RDW-15.0 Plt Ct-65*# [**2189-12-26**] 05:10PM BLOOD WBC-8.2 RBC-2.90* Hgb-6.5* Hct-19.3* MCV-67* MCH-22.3* MCHC-33.6 RDW-15.5 Plt Ct-110* [**2189-12-30**] 05:50AM BLOOD WBC-7.4 RBC-3.51* Hgb-8.5* Hct-24.9* MCV-71* MCH-24.3* MCHC-34.3 RDW-18.7* Plt Ct-273# [**2189-12-24**] 01:33PM BLOOD PT-19.5* PTT-50.7* INR(PT)-1.9* [**2189-12-28**] 06:25AM BLOOD PT-16.0* INR(PT)-1.5* [**2189-12-29**] 06:10AM BLOOD PT-35.0* INR(PT)-3.8* [**2189-12-29**] 10:55AM BLOOD PT-43.4* INR(PT)-5.0* [**2189-12-30**] 05:50AM BLOOD PT-32.3* INR(PT)-3.5* [**2189-12-24**] 03:18PM BLOOD Glucose-93 UreaN-11 Creat-0.6 Cl-115* HCO3-28 [**2189-12-30**] 05:50AM BLOOD Glucose-113* UreaN-18 Creat-0.9 Na-139 K-4.1 Cl-100 HCO3-33* AnGap-10 Brief Hospital Course: Mr. [**Known lastname 80687**] was a same day admit (underwent pre-op work-up as on outpatient) and was brought directly to the operating room where he underwent a redo coronary artery bypass graft x 3 and aortic valve replacement. Please see operative report for surgical details. Following surgery he was transferred to the CSRU for invasive monitoring in stable condition. Later on op day he was weaned from sedation, awoke neurologically intact and extubated. Beta blockers and diuretics were initiated and he was gently diuresed towards his pre-op weight. He was then transferred to the telemetry floor. On post-op day three his chest tubes and epicardial pacing wires were removed. Post-op his HCT was low and on day three it was 19. He was therefore transfused with several units of blood. By discharge it was 24.9. Also on post-op day three he had an episode of atrial fibrillation. He was bolused with Amiodarone and given Lopressor. Lopressor was titrated, Amiodarone was eventually given PO and he was started on Heparin. Coumadin was started on post-op day four and titrated for goal INR between [**12-26**]. INR abruptly rose up to 5 by post-op day five and Coumadin was held and INR trended down towards therapeutic level by discharge. On post-op day five antibiotics were started d/t left arm phlebitis. Physical therapy followed patient during entire post-op course for strength and mobility. He appeared to be doing well on post-op day six and was discharged home with VNA services and the appropriate follow-up appointments. Dr. [**Last Name (STitle) **] was contact and will manage his Coumadin as an outpatient. Medications on Admission: Aspirin 325mg qd, Benicar 40mg qd, Avandamet 500mg qd, Ninpeolomine 3mg qd Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*1* 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 4. Rosuvastatin 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*60 Tablet(s)* Refills:*1* 5. Metoprolol Tartrate 50 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). Disp:*135 Tablet(s)* Refills:*1* 6. Ferrous Gluconate 300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*1* 7. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*1* 8. Metformin 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*1* 9. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*1* 10. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day): Take 400mg [**Hospital1 **] for 1 week. Then 200mg [**Hospital1 **] for 1 week. Then 200mg QD until stopped by your cardiologist. Disp:*60 Tablet(s)* Refills:*1* 11. Cephalexin 500 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours) for 10 days. Disp:*30 Capsule(s)* Refills:*0* 12. Furosemide 20 mg Tablet Sig: One (1) Tablet PO twice a day for 10 days. Disp:*20 Tablet(s)* Refills:*0* 13. Potassium Chloride 10 mEq Capsule, Sustained Release Sig: Two (2) Capsule, Sustained Release PO Q12H (every 12 hours) for 10 days. Disp:*40 Capsule, Sustained Release(s)* Refills:*0* 14. Nifedipine (Bulk) Powder Sig: One (1) Miscellaneous TID (3 times a day) as needed for anal fissures: 0.2% gel rectally for anal fissures. Disp:*30 1* Refills:*0* 15. Psyllium Packet Sig: One (1) Packet PO TID (3 times a day). Disp:*90 Packet(s)* Refills:*0* 16. Warfarin 1 mg Tablet Sig: One (1) Tablet PO once a day: Adust dosage according to Dr. [**Last Name (STitle) **]. Goal INR 2-3.0. Disp:*60 Tablet(s)* Refills:*1* Discharge Disposition: Home With Service Facility: Caregroup VNA Discharge Diagnosis: Coronary Artery Disease/Aortic Stenosis s/p Redo-Sternotomy, Coronary Artery Bypass Graft x 3, Aortic Valve Replacement PMH: s/p Coronary Artery Bypass Graft [**2179**], s/p PTCA of RCA [**2178**], Hypertension, Hypercholesterolemia, Diabetes Mellitus, Chronic Obstructive Pulmonary Disease, Anemia, s/p Anal fistulotomy Discharge Condition: Good Discharge Instructions: Patient may shower, no baths. No creams, lotions or ointments to incisions. No driving for at least one month. No lifting more than 10 lbs for at least 10 weeks from the date of surgery. Monitor wounds for signs of infection. Please call with any concerns or questions. Dr. [**Last Name (STitle) **] will manage your Coumadin. Followup Instructions: Dr. [**Last Name (STitle) 914**] in 4 weeks Dr. [**Last Name (STitle) **] in 2 weeksProvider: [**Name6 (MD) **] [**Last Name (NamePattern4) **], MD Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2190-1-29**] 12:00 Completed by:[**2189-12-30**]
Discharge summary
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TITLE: Chief Complaint: 24 Hour Events: -HD on [**5-21**] -pressures steady with one drop to systolic of 79, improved with 500 cc bolus -expect floor transfer on [**5-22**] if pressures remain stable Allergies: Penicillins swelling itchi Last dose of Antibiotics: Infusions: Other ICU medications: Dextrose 50% - [**2109-5-21**] 07:00 AM Morphine Sulfate - [**2109-5-21**] 09:50 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2109-5-22**] 05:54 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.8 C (98.3 Tcurrent: 36.8 C (98.2 HR: 86 (70 - 86) bpm BP: 113/23(45) {70/23(34) - 137/89(95)} mmHg RR: 15 (10 - 19) insp/min SpO2: 94% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 94.8 kg (admission): 92.7 kg Total In: 1,341 mL 30 mL PO: 480 mL TF: IVF: 836 mL 30 mL Blood products: Total out: 615 mL 0 mL Urine: 115 mL NG: Stool: Drains: Balance: 726 mL 30 mL Respiratory support O2 Delivery Device: None SpO2: 94% ABG: ///27/ Physical Examination General: A+O x3, NAD, sitting in bed with no discomfort HEENT: moist mucous membranes, oropharynx clear, left EJ peripheral line in place with no signs of infection. CV: RRR S1 S2, systolc [**2-1**] murmur Resp: CTAB, no wheezes or rhonchi, intermittant crackle in lower lung fields Abdomen: soft/NT/ND +BS Ext: Right AKA site C/D/I with no surrounding erythema. No edema or cyanosis in Left lower extremity, pulse felt in left lower extremity. Labs / Radiology 343 K/uL 8.1 g/dL 78 mg/dL 6.9 mg/dL 27 mEq/L 5.9 mEq/L 42 mg/dL 102 mEq/L 141 mEq/L 25.3 12.1 K/uL [image002.jpg] [**2109-5-20**] 11:46 PM [**2109-5-21**] 08:28 AM WBC 11.0 Hct 28 26.1 Plt 390 Cr 6.9 Glucose 78 Other labs: PT / PTT / INR:12.5/27.2/1.1, ALT / AST:[**8-17**], Alk Phos / T Bili:104/0.2, Lactic Acid:1.3 mmol/L, LDH:132 IU/L, Ca++:8.0 mg/dL, Mg++:2.0 mg/dL, PO4:5.9 mg/dL Assessment and Plan [**Last Name **] PROBLEM - ENTER DESCRIPTION IN COMMENTS s/p R AKA .H/O RENAL FAILURE, END STAGE (END STAGE RENAL DISEASE, ESRD) .H/O DIABETES MELLITUS (DM), TYPE II PAIN CONTROL (ACUTE PAIN, CHRONIC PAIN) Pt is 67 yo f with hx of DM, ESRD on HD, and leg fracture, now s/p AKA of right leg and transferred to [**Hospital Unit Name 10**] in setting of hypotension. . # Hypotension: BP was in upper 70s in OR, improved from high 80s to low 100s with 500ml bolus, bp improved to 90s-119 with bolus and stable since. [**Month (only) 11**] have been secondary to fluid loss during procedure combined with sedation medications. Per pt has baseline BP 90-100, likely in setting of being HD pt with fistula. - pt received HD on [**5-21**], with one episode SBP=70 afterwards, responded well to 500 cc bolus of fluids. Will monitor, continuous and/or bolus not needed at this time. - no need for pressors at this time - PICC to be placed for access. . # Hypoxia: New post-op O2 requirement noticed after surgery, not requiring O2 currently with good O2 sats. HD yesterday, planned for today to maintain volume status. Pt with no known OSA. - HD yesterday and planned for today, [**5-22**] - oxgygen as needed to keep sats >92% - incentive spirometry . # AKA: s/p surgery, had chonic fracture of femur with broken plate for last 3 year. Wheelchair bound. - ortho to review femur xray done [**5-21**]. Patient emotionally labile in regards to losing her right leg. - wound care - Coumadin 1.5 mg - 2 mg, 2-2.5, x 6 weeks - social work consult # Pain: Pt c/o leg pain and phantom foot pain. Pt states pain not controlled, but vitals within normal range. - increase gabapentin as needed within renal dosing guidelines. Consider supplemental dose after HD. - continue percocet - morphine IV PRN for breakthrough pain - heat packs/ice packs #Fever: up to 100.3 this am with moderate leukocytosis (12.1) - blood cx, urine cx -incentive spirometry for possible atelectasis- related fever . # ESRD on HD: Normal HD is MWF, missed regular HD today. Likely the reason potassium is elevated. Also would explain edema on CXR. Makes some urine output in urostomy bag. Nephro following - monitor UO - HD planned for today - renally dose meds . # DM on insulin: Long standing DM, complicated by nephropathy, neuropathy, and vascular disease - lantus (on 8 units), will increase dose as needed with increasing PO intake - SSI Q6H with humalong - gabapentin and ASA and statin - start diabetic renal diet today . # GERD: - continue PPI . # Peripherial vascular disease: has stenosis of right axillary artery, s/p 1 month tx of plavix - continue statin - may need futher plavix tx as out pt - continue ASA . # Hyperkalemia: K likely elevated in setting of renal failure - HD today - monitor on tele . # Anemia: hct of 26 today, likely secondary to surgical blood loss and baseline anemia secondary to renal failure - monitor hct - transfuse 1 unit PRBCs today prior to transfer . # Colostomy: - colostomy care . # Hyperlipidemia: - will continue home statin dose ICU Care Nutrition: normal renal diet Glycemic Control: SSI Lines: 18 Gauge - [**2109-5-20**] 09:39 PM Prophylaxis: DVT: coumadin Stress ulcer: PPI VAP: Comments: Communication: Comments: Code status: Full code Disposition: stable, can transfer to floor after transfusion
Physician
Classify the following medical document.
Admission Date: [**2108-7-10**] Discharge Date: [**2108-7-12**] Date of Birth: [**2025-11-24**] Sex: F Service: MEDICINE Allergies: Penicillins / Quinine / Latex Attending:[**First Name3 (LF) 7333**] Chief Complaint: Dyspnea on exertion Major Surgical or Invasive Procedure: Aortic valvuloplasty History of Present Illness: 82 y/o woman with a history of CHF, EF 20%, RV paced with DOE and worsening aortic stenosis was referred for aortic valvuloplasty and upgrade to [**Hospital1 **]-V pacer. Patient got IVF prior to procedure and desated to 80s post-procedure. Was 97% on 6L prior to transfer. Got 40 IV lasix and TTE which showed 3+ AR. Upon arival to ICU patient was not SOB and had no chest pain. Said she was feeling well. Prior to this admission was SOB with basic activities. Needed 1-2L NC prn. Past Medical History: 1. CARDIAC RISK FACTORS: no DM, no HTN, no documented HLD 2. CARDIAC HISTORY: -CABG: none -PERCUTANEOUS CORONARY INTERVENTIONS: none -PACING/ICD: none Atrial fibrillation, not on Coumadin s/p pacemaker approximately five years ago . 3. OTHER PAST MEDICAL HISTORY: Lung adenocarcinoma s/p right upper lobe lobectomy, s/p tracheostomy and percutaneous endoscopic gastrostomy placement COPD Hypothyroidism [**2103**] CVA versus TIA (no residual) Aortic stenosis Meniere's disease Restless leg syndrome History of left breast cancer s/p bilateral mastectomies Mildly hard of hearing (uses a left sided hearing aid) Remote ear surgery Resection of ovary d/t possible ovarian cyst Social History: Lives with husband, uses [**Name2 (NI) **] at baseline. Has O2 that she uses prn for dyspnea. Family History: Father had MI at 72 Physical Exam: GENERAL: NAD. NECK: Supple with no JVD CARDIAC: RRR, 3/6 SEM LUNGS: CTAB anteriorly ABDOMEN: Soft, NTND. EXTREMITIES: no edema, groin shows no hematoma Pules: 2+ DP pulses bilaterally Pertinent Results: [**2108-7-12**] 04:15AM BLOOD WBC-5.5 RBC-3.97* Hgb-11.5* Hct-34.6* MCV-87 MCH-28.9 MCHC-33.2 RDW-15.0 Plt Ct-179 [**2108-7-12**] 10:55AM BLOOD PTT-23.9 [**2108-7-12**] 04:15AM BLOOD Glucose-88 UreaN-13 Creat-0.8 Na-142 K-4.0 Cl-105 HCO3-26 AnGap-15 [**2108-7-12**] 04:15AM BLOOD CK(CPK)-509* [**2108-7-11**] 06:45PM BLOOD CK(CPK)-484* [**2108-7-12**] 04:15AM BLOOD CK-MB-70* MB Indx-13.8* cTropnT-1.15* [**2108-7-11**] 06:45PM BLOOD CK-MB-78* MB Indx-16.1* cTropnT-0.60* [**2108-7-11**] 11:50AM BLOOD CK-MB-9 cTropnT-0.19* [**2108-7-12**] 04:15AM BLOOD Calcium-9.3 Phos-3.9 Mg-2.0 [**2108-7-10**] 06:50PM BLOOD Type-ART O2 Flow-6 pO2-135* pCO2-40 pH-7.44 calTCO2-28 Base XS-3 Intubat-NOT INTUBA Comment-NC [**2108-7-10**] 06:08PM BLOOD Type-ART Rates-/18 pO2-107* pCO2-42 pH-7.43 calTCO2-29 Base XS-2 Intubat-NOT INTUBA Comment-2L NASAL C . ECHO [**7-10**]: The left atrium and right atrium are normal in cavity size. The estimated right atrial pressure is 0-5 mmHg. Left ventricular wall thicknesses and cavity size are normal. There is mild regional left ventricular systolic dysfunction with near akinesis of the basal half of the inferior and inferolateral walls. There is mild hypokinesis of the remaining segments (LVEF = 35 %). [Intrinsic left ventricular systolic function is likely more depressed given the severity of valvular regurgitation.] Right ventricular chamber size and free wall motion are normal. The diameters of aorta at the sinus, ascending and arch levels are normal. The aortic valve leaflets are severely thickened/deformed. A vegetation cannot be excluded if clinically suggested. There is mild aortic valve stenosis (valve area 1.2-1.9cm2). Severe (4+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is an anterior space which most likely represents a prominent fat pad. IMPRESSION: Thickened aortic valve leaflets with severe aortic regurgitation. Cannot excluded endocarditis if clinically suggested. Regional and global left ventricular systolic dysfunction. Mild aortic valve stenosis. . Cardiac catheterization [**7-10**]: COMMENTS: A transvenous temporary pacing wire was placed through the right CFV into the right ventricle and pacing capture was tested. The right CFA sheath was upsized to 8F. 3000u of Heparin was given prophylactically and a therapeutic ACT was confirmed. A straight wire was able to cross the aortic valve after much difficulty. This was then exchanged for an Amplatz super stiff wire over a Pigtail catheter. An 18x60mm Tyshek II balloon was advanced to the aortic valve. Rapid ventricular pacing was initiated at 180 bpm with successful reduction of BP to less than 50mmHg and the Tyshek II balloon was fully inflated across the aortic valve. This procedure was then repeated x 2. Subsequent echocardiography revealed significant aortic insufficiency and the procedure was terminated. Patient was given 40mg IV lasix as well as IV nitro drip for afterload reduction. The patient left the lab free of angina and in stable condition. FINAL DIAGNOSIS: 1. Coronary arteries are normal. 2. Successful aortic valvuloplasty. 3. Severe aortic insufficiency. Brief Hospital Course: #1 Aortic stenosis s/p Valvuloplasty: Pt underwent a valvuloplasty on [**2108-7-10**]. complicated by hypertension requiring nipride drip and low oxygen levels thought to be related to IVF during the procedure. The patient was transferred to the CCU for close monitoring. An ECHO after the procedure found that the EF had improved to 35% with the aortic valve area 1.6 and gradient 27. 3+ AR was noted and pt was started on Norvasc for prevention of progression. Aspirin was also increased to 325 mg daily. Pt had a CK leak with positive troponin after the procedure. This was thought to be due to the procedure itself. No EKG changes or ischemic symptoms. Pt did have some chest discomfort on [**7-11**] that was thought to be related to her constipation, relieved with bowel movement. Cardiac catheterization showed no significant CAD. . #2 Acute on Chronic Systolic Congestive Heart Failure: pt has a history of 2 recent hospital admissions for CHF. Appeared euvolemic during this hospital stay. Weight is 40.4kg here. No peripheral edema or lung crackles. Pt uses oxygen at home chronically. Continued on home dose of Lasix. No ACEi, [**Last Name (un) **] or beta blocker is indicated because of severe valve disease per Dr. [**Last Name (STitle) **]. Daily weights, symptoms of CHF and diet reviewed with pt and family before discharge. . #3 V- paced: EP saw patient and adjusted pacer settings and feels like patient does not need [**Hospital1 **]-V pacer this admission. Pt will f/u with Dr. [**Last Name (STitle) **] in [**Month (only) 205**] for further assessment. . #4 Hypothyroidism: Stable, continue synthroid . #5 History of Lung CA s/p right upper lobectomy: Resp status stable after initial desaturation after valvuloplasty. Pt was maintained on low flow oxygen which she uses at home. . #6 Restless leg: Continued carbidopa-levodopa . #7 dispo: VNA at discharge for PT and continued monitoring of BP, HR and fluid status. Medications on Admission: CARBIDOPA-LEVODOPA 50 mg-200 mg Tablet SR QHS FLUTICASONE 50 mcg Spray prn FUROSEMIDE 20 mg QAM LATANOPROST 0.005 % gtt- 1 drop to each eye every night LEVOTHYROXINE 100 mcg QAM LIDOCAINE 5 % Adhesive Patch daily PRN ONDANSETRON HCL 8 mg PRN nausea PANTOPRAZOLE 40 mg Tablet QAM POTASSIUM CHLORIDE 10 mEq Capsule, Sustained Release - 1 Capsule(s) by mouth three times a day PROPOXYPHENE N-ACETAMINOPHEN [DARVOCET-N 100] - (Prescribed by Other Provider) - 100 mg-650 mg Tablet - 1 Tablet(s) by mouth as needed for pain Medications - OTC ASPIRIN - (Prescribed by Other Provider) - 81 mg Tablet, Delayed Release (E.C.) - 1 Tablet(s) by mouth every morning CALCIUM POLYCARBOPHIL [FIBERCON] - (Prescribed by Other Provider) - 625 mg Tablet - 2 Tablet(s) by mouth every morning MULTIVITAMIN - (Prescribed by Other Provider) - Capsule - 1 Capsule(s) by mouth qam Discharge Medications: 1. Carbidopa-Levodopa 50-200 mg Tablet Sustained Release Sig: One (1) Tablet PO HS (at bedtime). 2. Fluticasone 50 mcg/Actuation Spray, Suspension Sig: One (1) Spray Nasal DAILY (Daily). 3. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime). 5. Levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 7. Ondansetron 8 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO three times a day as needed for nausea. 8. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 9. Potassium Chloride 10 mEq Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO TID (3 times a day). 10. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 11. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. FiberCon 625 mg Tablet Sig: Two (2) Tablet PO once a day. 13. Multiple Vitamin Tablet Sig: One (1) Tablet PO once a day. 14. Darvocet-N 100 100-650 mg Tablet Sig: One (1) Tablet PO every four (4) hours as needed for pain. Discharge Disposition: Home With Service Facility: [**Hospital1 8685**] home care Discharge Diagnosis: Aortic Stenosis Acute on Chronic systolic congestive Heart Failure Atrial Fibrillation Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid ([**Hospital1 **] or cane). Discharge Instructions: You had an aortic valvuloplasty and you were transferred to the CCU afterwards because of low blood pressure. Another Echocardiogram was done which showed that the aortic valve is not tight anymore but also does not close completely. Dr. [**Last Name (STitle) **] and Dr. [**First Name (STitle) 7756**] will follow this closely after you go home. Please check your oxygen level if you feel short of breath. It should be more than 92%. You blood pressure should also be about 110-130/ 50's-80's. If your blood pressure is lower or higher than this consistantly, please call Dr. [**Last Name (STitle) **]. The pacemaker settings were adjusted and Dr. [**Last Name (STitle) **] will decide in [**Month (only) 205**] if you need to have the pacemaker itself changed. We made the following changes to your medicines: 1. Start Norvasc to control your blood pressure 2. Increase your aspirin to 325 mg daily. . Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs in 1 day or 6 pounds in 3 days. Followup Instructions: Cardiology Appointment:Wednesday, [**7-25**] @2pm With: [**First Name8 (NamePattern2) 20**] [**Last Name (NamePattern1) **],MD Address: 131 ORNAC, JCB #650, [**Location (un) **],[**Numeric Identifier 17125**] Phone: [**Telephone/Fax (1) 71179**] PCP [**Name Initial (PRE) 648**]: [**Last Name (LF) 2974**], [**7-13**] @ 1:40pm With:[**Doctor First Name 6811**] E.[**Name8 (MD) **],MD Location: [**Location (un) 2274**]-CONCROD Address: [**Hospital Ward Name **], [**Location (un) **],[**Numeric Identifier 15215**] Phone: [**Telephone/Fax (1) 28262**] Department: CARDIOLOGY, DR [**Last Name (STitle) **] When: THURSDAY [**2108-8-9**] at 3:40 PM in the [**Location (un) 1514**] office. Please call to confirm this appt. Completed by:[**2108-7-12**]
Discharge summary
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Chief Complaint: HPI: 53yo male with esophageal ca s/p esophagogastrectomy in [**2184**] and s/p multiple stents (last one on [**2188-7-28**]) tx from OSH for management of food impaction. Pt has been vomnitting all his food and meds for 1 day. He was admitted to the ICU for elective intubation and EGD. EGD was successfully performed, food was removed and pushed through from the esophagus and the patient was extubated. Advanced endoscopy will be consulted tomorrow for a definite stricture/stent management Post operative day: Allergies: Trazodone Unknown; Sertraline Unknown; Last dose of Antibiotics: Infusions: Other ICU medications: Fentanyl - [**2188-8-13**] 10:00 PM Other medications: Past medical history: Family / Social history: PMH:Esophageal cancer s/p esophagogastrectomy in [**2184**] CAD s/p MI (pt denies but in OSH records) GERD s/p L colectomy (unclear why) hx of c.diff colitis ETOH abuse [**Last Name (un) 574**]: Omeprazole 20mg PO BID Seroquel 25mg PO QHS Vitamin B12 100mg PO daily Multivitamin Celexa 40mg PO daily Oxycodone 5/325mg PO Q6H PRN Flowsheet Data as of [**2188-8-14**] 12:02 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.7 C (98 Tcurrent: 36.7 C (98 HR: 67 (63 - 99) bpm BP: 119/63(78) {94/58(68) - 200/134(150)} mmHg RR: 24 (12 - 26) insp/min SpO2: 100% Heart rhythm: SR (Sinus Rhythm) Total In: 614 mL PO: TF: IVF: 614 mL Blood products: Total out: 0 mL 0 mL Urine: NG: Stool: Drains: Balance: 0 mL 614 mL Respiratory support O2 Delivery Device: Nasal cannula Ventilator mode: CMV/ASSIST Vt (Set): 350 (350 - 350) mL RR (Set): 14 PEEP: 5 cmH2O FiO2: 40% PIP: 25 cmH2O SpO2: 100% ABG: //// Ve: 5.2 L/min Physical Examination General Appearance: Thin, NAD Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Normocephalic Cardiovascular: (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Clear : ) Abdominal: Soft, Tender: in epigastric area Extremities: Right: Absent, Left: Absent Skin: Not assessed Neurologic: Attentive, Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology [image002.jpg] Assessment and Plan Assessment And Plan: 53yo male with esophageal ca s/p esophagogastrectomy in [**2184**] and s/p multiple stents (last one on [**2188-7-28**]) tx from OSH for management of food impaction. EGD performed, obstruction disimpacted. Neurologic: no issues, neurologically intact Pain: Fentanyl prn Cardiovascular: Stable. Rec ASA to discuss with primary care team Pulmonary: Extubated after procedure, stable Gastrointestinal: Advanced endoscopy consult in the morning, NPO for now Renal: no issues Hematology: stable Infectious Disease: no issues Endocrine: RISS no requirement Fluids: D5NS at 90 Electrolytes: Nutrition: NPO General: ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2188-8-13**] 09:00 PM Prophylaxis: DVT: Boots, SQ UF Heparin Stress ulcer: PPI VAP: Comments: Communication: Patient discussed on interdisciplinary rounds , ICU Code status: Full code Disposition: floor Total time spent: 35 minutes
Physician
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SICU HPI: 57M with h/o hep C cirrhosis s/p OLT [**12-31**] complicated by hepatic artery thrombosis and biliary ischemia, s/p ERCP/CBD stent [**10-2**], re-transplanted [**2124-10-25**] with subsequent hepaticojejunostomy for bile leak [**2124-11-5**], admitted for hypotension, WBC 32 likely from C-diff pan colitis. Chief complaint: PMHx: PMH/PSH: UGIB ([**2120**]), Hep C cirrhosis, s/p OLT [**12-31**], three Grade II varices with portal gastropathy s/p banding, L leg cellulitis, nec fasc, osteomyelitis and group A strep sepsis [**11/2123**] requiring skin graft, Chronic thrombocytopenia, Hypersplenism, MVA [**2101**], surgery to R leg, mult fx L leg, Failure to thrive after liver transplant, Mult ARF with unclear baseline creatinine (was as low as 0.8 in [**12-31**], range 0.8-4.5) Current medications: 24 Hour Events: Allergies: No Known Drug Allergies Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2124-12-14**] 01:13 PM Vancomycin - [**2124-12-15**] 02:56 AM Metronidazole - [**2124-12-16**] 06:15 PM Ciprofloxacin - [**2124-12-16**] 09:09 PM Infusions: Phenylephrine - 2 mcg/Kg/min Propofol - 10 mcg/Kg/min Other ICU medications: Pantoprazole (Protonix) - [**2124-12-16**] 09:09 PM Furosemide (Lasix) - [**2124-12-16**] 09:32 PM Sodium Bicarbonate 8.4% (Amp) - [**2124-12-16**] 09:36 PM Other medications: Flowsheet Data as of [**2124-12-17**] 03:41 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**27**] a.m. Tmax: 36.5 C (97.7 T current: 35.6 C (96 HR: 95 (95 - 120) bpm BP: 94/61(72) {82/49(59) - 127/75(90)} mmHg RR: 24 (11 - 28) insp/min SPO2: 100% Heart rhythm: ST (Sinus Tachycardia) Wgt (current): 62.3 kg (admission): 53.6 kg Height: 68 Inch CVP: 4 (3 - 16) mmHg Total In: 4,441 mL 362 mL PO: Tube feeding: IV Fluid: 2,429 mL 103 mL Blood products: 200 mL Total out: 948 mL 0 mL Urine: 98 mL NG: 250 mL Stool: 600 mL Drains: Balance: 3,493 mL 362 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 400 (400 - 400) mL RR (Set): 24 RR (Spontaneous): 0 PEEP: 8 cmH2O FiO2: 50% PIP: 33 cmH2O SPO2: 100% ABG: 7.35/35/168/20/-5 Ve: 9 L/min PaO2 / FiO2: 336 Physical Examination General Appearance: No acute distress HEENT: PERRL Cardiovascular: (Rhythm: Regular) Respiratory / Chest: (Breath Sounds: CTA bilateral : ) Abdominal: Soft, Non-tender, Distended Left Extremities: (Edema: Absent), (Temperature: Warm), (Pulse - Dorsalis pedis: Present) Right Extremities: (Edema: Absent), (Temperature: Warm), (Pulse - Dorsalis pedis: Present), (Pulse - Posterior tibial: Present) Neurologic: Moves all extremities, Sedated Labs / Radiology 85 K/uL 10.6 g/dL 224 mg/dL 3.9 mg/dL 20 mEq/L 4.0 mEq/L 117 mg/dL 107 mEq/L 138 mEq/L 30.6 % 14.1 K/uL [image002.jpg] [**2124-12-16**] 04:35 AM [**2124-12-16**] 06:20 PM [**2124-12-16**] 06:34 PM [**2124-12-16**] 07:56 PM [**2124-12-16**] 09:06 PM [**2124-12-16**] 09:57 PM [**2124-12-16**] 11:10 PM [**2124-12-17**] 12:17 AM [**2124-12-17**] 02:38 AM [**2124-12-17**] 02:48 AM WBC 13.0 14.1 Hct 29.4 30.6 Plt 61 85 Creatinine 3.9 3.9 TCO2 21 21 20 21 21 20 18 20 Glucose 203 224 Other labs: PT / PTT / INR:20.1/56.4/1.9, ALT / AST:13/16, Alk-Phos / T bili:86/0.3, Amylase / Lipase:44/, Fibrinogen:282 mg/dL, Lactic Acid:1.2 mmol/L, Albumin:1.9 g/dL, LDH:162 IU/L, Ca:8.5 mg/dL, Mg:2.5 mg/dL, PO4:5.5 mg/dL Assessment and Plan RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name **]), IMPAIRED SKIN INTEGRITY, DIARRHEA, OLIGURIA/ANURIA, SHOCK, HYPOVOLEMIC OR HEMORRHAGIC, HYPERKALEMIA (HIGH POTASSIUM, HYPERPOTASSEMIA), HYPOTENSION (NOT SHOCK), ACIDOSIS, METABOLIC, ALTERATION IN NUTRITION, ELECTROLYTE & FLUID DISORDER, OTHER, PAIN CONTROL (ACUTE PAIN, CHRONIC PAIN), SEPSIS WITHOUT ORGAN DYSFUNCTION Assessment and Plan: 57M with h/o hep C cirrhosis s/p OLT [**12-31**] complicated by hepatic artery thrombosis and biliary ischemia, s/p ERCP/CBD stent [**10-2**], re-transplanted [**2124-10-25**] with subsequent hepaticojejunostomy for bile leak [**2124-11-5**], admitted for hypotension, WBC 32 likely from C-diff pan colitis. Neurologic: no pain meds, minimize propofol Cardiovascular: wean Neo Pulmonary: intubated for resp distress Gastrointestinal / Abdomen: s/p OLT x 2, C.diff with pan colitis on PO vanc/flagyl, hold TF Nutrition: TPN, NPO Renal: ARF, Cr 3.9, oliguric despite 100 lasix Hematology: Hct stable at 30.6, INR down to 1.9 (home coumadin for OLT) Endocrine: RISS Infectious Disease: C.diff, PO vanc/IV flagyl/Cipro/Fluc/Bactrim/Valcyte, Nitazoxanide, transplant wants daily blood cx and fungal cx, vanc enemas stopped due to intolerance, IVIG Q3 days, cholestyramine to bind toxin Lines / Tubes / Drains: PIV, foley, rt IJ [**Last Name (LF) 2643**], [**First Name3 (LF) **], NGT, ETT Wounds: Imaging: Fluids: Consults: Transplant Billing Diagnosis: Acute renal failure, Other: c diff colitis ICU Care Nutrition: TPN w/ Lipids - [**2124-12-16**] 04:29 PM 74.[**Telephone/Fax (3) 1697**] mL/hour Glycemic Control: Regular insulin sliding scale Lines: Multi Lumen - [**2124-12-13**] 03:00 AM Arterial Line - [**2124-12-13**] 03:58 AM Prophylaxis: DVT: Boots Stress ulcer: PPI VAP bundle: Comments: Communication: Patient discussed on interdisciplinary rounds , ICU Code status: Full code Disposition: ICU Total time spent: 35 minutes
Physician
Classify the following medical document.
Admission Date: [**2140-10-17**] Discharge Date: [**2140-10-22**] Date of Birth: [**2084-5-2**] Sex: M Service: MEDICINE Allergies: Percocet Attending:[**First Name3 (LF) 1973**] Chief Complaint: GIB Major Surgical or Invasive Procedure: colonoscopy History of Present Illness: . HPI: Mr.[**Known lastname 25925**] is a 56 M with h/o multiple sclerosis and an upper GIB who presented to an OSH after an epsiode of BRBPR this morning. The patient is cared for during the week by a PCA who noted approximately 1 cup of BRBPR after a BM and in the shower the AM of admission. The PCA also noted that his stool was normal color and that the patient appeared pale and somnolent. At home, the patient's blood pressure was 71/42, then 79/47 after drinking Gatorade. At the OSH, the patient was hypotensive in the 70s and had a Hct of 24 for which he received 2U of PRBCs and 3L IVF. He underwent NGL at the OSH, which was negative. He was started on omeprazole and transferred to [**Hospital1 18**]. Also of note, he was intermittently hypoglycemic at OSH but here his glucose is 133. In the ED, he was hemodynamically stable with a repeat Hct of 35, he was found to have UTI and was hypothermic with a rectal temperature of 92. He was started on levofloxacin. The patient has never had a colonoscopy, but had a sigmoidoscopy in [**7-27**] after an episode of BRBPR and found to have hemorrhoids. Of note, the patient was discharged on [**10-9**] after ICU hospitalization for PNA which was treated with a course of vancomycin, zosyn, and levofloxacin. . ROS: +chronic constipation, +difficulty breathing x 1 episode today, + difficulty swallowing, + decreased PO intake; denied CP, palpitations, syncope, headache, change in vision, dizziness, lightheadedness, change in bowel or bladder function . PMH: progressive multiple sclerosis (followed by Dr. [**Last Name (STitle) 25923**] [**Name (STitle) 25924**]) neurogenic bladder (s/p suprapubic tube placement) h/o multiple UTI's h/o upper GIB (ulcerative esophagitis and gastritis [**12-24**] NSAIDS) GERD HTN CHF (unknown EF) h/o "sepsis" L eye blindness intrathecal baclofen pump (10 years) ??sleep apnea - sleep study scheduled for [**10-26**] . Social History: Retired college professor. Disabled, has personal care assistant. Married with 3 children. No smoking. No EtOH. . Family History: Father had CAD and CVA. Mother has [**Name (NI) 2481**] disease. Brother has diabetes. . Allergies: Percocet makes him sleepy . Medications: Lisinopril 20 mg PO BID Albuterol [**11-23**] PUFF IH Q4-6H:PRN Multivitamins 1 CAP PO DAILY Amlodipine 5 mg PO DAILY Oxybutynin 5 mg PO BID Brimonidine Tartrate 0.15% Ophth. 1 DROP OU Q8H Paroxetine HCl 40 mg PO DAILY Fentanyl Patch 25 mcg/hr TP Q72H Gabapentin 400 mg PO Q8H . Physical Exam: Vitals: T 95.0 BP 145/85 HR 88 RR 18 O2 96% on 2L NC Gen: NAD, lying on in bed on his side HEENT: sluggish pupils, dry MM. EOMI. Neck: Supple without LAD Cardio: RRR, nl s1/s2, no m/r/g Resp: mild rhonchi in L mid-lung field Abd: soft, nt, nd, +BS. No rebound/guarding. Suprapubic cath and baclofen pump in place. Ext: extreme spacicity LE > UE, 3+ symmetric pedal edema Neuro: A & O to person, place, month, year, day, but not date; able to recall recent holiday and president. CN II-XII grossly intact. Pt does not move LE. 3/5 strength UE BL (only with repeated prompting). . Asssesment: 56 M with lower GIB, likely hemorrhoids vs AVM vs polyp vs malignancy. . Plan: # GIB - continue carafate and PPI [**Hospital1 **] - Golytely prep - colonoscopy in AM or Wednesday - [**Hospital1 **] Hct - Transfuse for Hct < 26 . # UTI - Unclear whether this is a true infection or colonization [**12-24**] suprapubic catheter. - Will not continue levaquin at this time - F/u UCx, BCx - Restart abx if pt appears sick . # Elevated PTT: lab error vs drug effect vs lupus anticoagulant - repeat and if still high, check lupus anticoagulant . # Hyperglycemia: patient reported hypoglycemic at OSH but here he is mildly hyperglycemic. - follow fingersticks . # Prophylaxis: PPI, no heparin products given recent GI bleed, TEDs in place . # FEN: NPO after MN for procedure, maintenance IVF . # Access: R PICC, L PIV 22" x 2 - will replace 1 with larger bore . # Communication - Wife, [**Name (NI) 2048**] [**Name (NI) 25925**] - cell: [**Telephone/Fax (1) 25928**], work: [**Telephone/Fax (1) 25929**], home: [**Telephone/Fax (1) 25930**] . FULL CODE Past Medical History: progressive multiple sclerosis (followed by Dr. [**Last Name (STitle) 25923**] [**Name (STitle) 25924**]) neurogenic bladder (s/p suprapubic tube placement) h/o multiple UTI's h/o upper GIB (ulcerative esophagitis and gastritis [**12-24**] NSAIDS) GERD HTN CHF (unknown EF) h/o "sepsis" L eye blindness Social History: Retired college professor. Disabled, has personal care assistant. Married with 3 children. No smoking. No EtOH. Family History: Father had CAD and CVA. Mother has [**Name (NI) 2481**] disease. Brother has diabetes. Pertinent Results: [**2140-10-17**] 06:10PM GLUCOSE-128* UREA N-27* CREAT-0.9 SODIUM-136 POTASSIUM-4.9 CHLORIDE-104 TOTAL CO2-22 ANION GAP-15 [**2140-10-17**] 06:10PM ALT(SGPT)-30 AST(SGOT)-26 ALK PHOS-105 TOT BILI-0.4 [**2140-10-17**] 06:10PM CALCIUM-8.7 PHOSPHATE-4.5 MAGNESIUM-2.1 [**2140-10-17**] 06:10PM WBC-4.4 RBC-4.23* HGB-12.0* HCT-35.8* MCV-85 MCH-28.4 MCHC-33.6 RDW-16.4* [**2140-10-17**] 06:10PM NEUTS-59.6 LYMPHS-33.2 MONOS-4.9 EOS-1.1 BASOS-1.3 Brief Hospital Course: [**Hospital Unit Name 13533**]: Mr. [**Known lastname 25925**] was transfered to the [**Hospital Unit Name 153**] with concern of rapid GI bleeding. He was given fluids, but his hematocrit remained stable. GI was consulted and they will scope him in the morning. His prep will be started on transfer. Wife to find out names of "steroid" for MS as well as ?antibiotic for UTI ppx? Discharge Medications: 1. Paroxetine HCl 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 2. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Oxybutynin Chloride 5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 6. Fentanyl 25 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). 7. Gabapentin 400 mg Capsule Sig: One (1) Capsule PO Q8H (every 8 hours). 8. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q4-6H (every 4 to 6 hours) as needed. 9. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation Q8H (every 8 hours) as needed. 10. Brimonidine 0.15 % Drops Sig: One (1) Drop Ophthalmic Q8H (every 8 hours). 11. Sucralfate 1 g Tablet Sig: One (1) Tablet PO QID (4 times a day). 12. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. 13. Furosemide 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 14. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 15. Oxazepam 15 mg Capsule Sig: One (1) Capsule PO HS (at bedtime). 16. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 17. Nexium 40 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO twice a day. 18. Methylprednisolone Sodium Succ 1,000 mg/8 mL Recon Soln Sig: One (1) g Injection once a month: To be given by VNA, last given [**2140-10-21**]. Disp:*qs 3 months* Refills:*3* Discharge Disposition: Home With Service Facility: [**Hospital **] Home Health Care Discharge Diagnosis: Lower Gastrointestinal Bleeding Acute Blood Loss Anemia Multiple Sclerosis Discharge Condition: stable Discharge Instructions: Please take your medications as listed below. Please follow up with your PCP and your neurologist. Call your doctor if you experience recurrent bleeding or black stool, lightheadedness, shortness of breath, chest pain, or other concerning symptoms. Followup Instructions: 1. Provider: [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) 1575**] [**Last Name (NamePattern1) **], MD Phone:[**Telephone/Fax (1) 44**] Date/Time:[**2140-10-27**] 12:00 2. Please follow up with your PCP in the next week to have your blood counts checked, and to arrange for a surgical evaluation to have your hemorhoids treated 3. Please follow up with Dr. [**Last Name (STitle) **] to have your sleep study arranged at [**Location (un) 620**] (in a hospital setting). 4. Provider: [**Name10 (NameIs) 1571**] FUNCTION LAB Phone:[**Telephone/Fax (1) 609**] Date/Time:[**2140-11-16**] 1:00 5. Provider: [**Name10 (NameIs) 1570**],[**Name11 (NameIs) 2162**] [**Name12 (NameIs) 1570**] INTEPRETATION BILLING Date/Time:[**2140-11-16**] 1:00
Discharge summary
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Chief Complaint: 24 Hour Events: FEVER - 102.3 F - [**2191-8-25**] 08:00 PM -dilantin level within normal ranges after adjusting for low albumin (14) -sputum cultures show 2+ gram - and 1+ gram positive consistent with MRSA -no neuro recs left -nutrition consulted but did not leave TPN recs yet -fever spiked to 102.4 around 8 pm and was re-pancultured -around 1 AM BP fell to 70s systolic when nursing turned patient; after repositioning, BP failed to improve, was given a 500 cc NS bolus. Pt was restarted on levo to maintain pressures. - episode of aberrancy on telemetry lasting one minute, unable to assess on ECG. Following ECG was unchanged from prior. Allergies: Hydromorphone Unknown; Metoclopramide Unknown; Last dose of Antibiotics: Cefipime - [**2191-8-25**] 02:00 PM Infusions: Norepinephrine - 0.02 mcg/Kg/min Other ICU medications: Fosphenytoin - [**2191-8-26**] 12:00 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2191-8-26**] 07:19 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 39.1 C (102.3 Tcurrent: 37.8 C (100 HR: 105 (89 - 108) bpm BP: 103/42(63) {70/30(43) - 175/70(109)} mmHg RR: 28 (18 - 53) insp/min SpO2: 96% Heart rhythm: ST (Sinus Tachycardia) Wgt (current): 91 kg (admission): 94.2 kg Height: 70 Inch Total In: 386 mL 573 mL PO: 60 mL TF: IVF: 276 mL 573 mL Blood products: Total out: 0 mL 0 mL Urine: NG: Stool: Drains: Balance: 386 mL 573 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CPAP/PSV Vt (Spontaneous): 455 (394 - 488) mL PS : 10 cmH2O RR (Spontaneous): 25 PEEP: 5 cmH2O FiO2: 40% [**Year (4 digits) 1093**]: 82 PIP: 16 cmH2O SpO2: 96% ABG: 7.28/34/96.[**Numeric Identifier 274**]/17/-9 Ve: 11.7 L/min PaO2 / FiO2: 242 Physical Examination Cardiovascular: Gen: unresponsive to voice/command. CV: RRR, nl S1/S2. no r/g/m Lungs: reduced BS at bases Abd: distended, not tense. No sign of tenderness. ABS. Extremiteis: no c/c/e. Sacral edema Neuro: Does not respond to sternal rub. Withdraws to pain stimulus in feet Labs / Radiology 299 K/uL 9.9 g/dL 213 mg/dL 5.8 mg/dL 17 mEq/L 3.6 mEq/L 18 mg/dL 109 mEq/L 142 mEq/L 32.4 % 13.7 K/uL [image002.jpg] [**2191-8-23**] 02:26 PM [**2191-8-23**] 02:28 PM [**2191-8-24**] 04:51 AM [**2191-8-24**] 05:04 AM [**2191-8-25**] 03:35 AM [**2191-8-25**] 04:35 AM [**2191-8-25**] 05:40 PM [**2191-8-26**] 02:26 AM [**2191-8-26**] 02:44 AM [**2191-8-26**] 06:10 AM WBC 11.9 11.2 13.7 Hct 33.7 32.8 33.5 34.6 32.4 Plt [**Telephone/Fax (3) 8641**] Cr 12.6 12.5 7.9 5.8 TCO2 23 17 24 18 17 Glucose 177 180 172 213 Other labs: PT / PTT / INR:23.7/40.6/2.3, ALT / AST:21/49, Alk Phos / T Bili:162/0.8, Amylase / Lipase:55/88, Albumin:2.6 g/dL, Ca++:8.4 mg/dL, Mg++:1.8 mg/dL, PO4:2.3 mg/dL Fluid analysis / Other labs: Vanco - 16.4 Imaging: CXR: inreased hilar density. No effusions Microbiology: Sputum cultures [**2191-8-22**]- MRSA All blood cultures negative to date. Assessment and Plan ALTERATION IN NUTRITION RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name 2**]) FEVER, UNKNOWN ORIGIN (FUO, HYPERTHERMIA, PYREXIA) ALTERED MENTAL STATUS (NOT DELIRIUM) .H/O RENAL FAILURE, END STAGE (END STAGE RENAL DISEASE, ESRD) RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name 2**]) HYPERTENSION, BENIGN HYPOGLYCEMIA DIABETES MELLITUS (DM), TYPE II SEIZURE, WITHOUT STATUS EPILEPTICUS 73 yom HD-dependent, admitted with left acute on chronic SDH c/b seizure, transferred to MICU for concern of sepsis with hypoxia and hypotension. # Respiratory Distress: etiology includes volume overload given resuscitation with anuric renal failure and likely PNA supported by sputum GS significant for GNR and GPC. Barriers to intubation include mental status, fluid overload and underlying infection. - respiratory failure: continue PSV with daily [**Last Name (LF) 1093**], [**First Name3 (LF) 116**] attempt to wean once HD re-initiated - volume overload: continue HD - pneumonia: continue vanomycin (day 10) and cefepime (10) for GP and GN coverage will adjust as cultures and sensitivies return - mental status: continue no sedation for further evaluation of mental status, correct electrolyte disturbances, treat infection # Hypotension / Fevers: Spiked temperatures overnight. Pt was pan cultured. Pt has known MRSA pneumonia. Has completed a course of vanco today. Hypotension as also noted and pt was restarted on levophed - continue vancomycin / cefepime for concern of pneumosepsis pending cultures and sensitivities - f/u cultures - CXR - continue levophed for hypotension, avoid aggressive volume - CT head # Sinus tachy with aberrancy continue strict monitoring of electrolytes. Called renal to discuss HD or CVVH. Recommended starting it tomorrow. Continue monitoring on tele. # High Bilious Output: continued output, reduced to about 300cc over last 24 hrs (down from 1500 - 2000cc). He is having BM and Xray confirmed no obstruction or ileus. This may represent inflammatory process without outflow obstruction. However, liver enzymes do not support inflammatory process of gallbladder or pancreas. Hct trending down. Hct 32.4 today. Transfuse if < 21. - continue [**Hospital1 **] PPI # ESRD: Continue HD or CVVH as tolerated by BP # AF: patient in NSR. Continue to hold anti-coagulation for underlying SDH # Right Upper Extremity Swelling: u/s shows non occlusive clot - will not pull out PICC as non-occlusive # Seizure: no gross evidence of ongoing seizure activity - c/w neuro regarding fosphenytoin dosing considering possible HD # SDH: continue to hold anticoagulation, will follow neurology recs # Glaucoma / Cataracts: continue home eye drops # DM: continue SSI with lantus baseline # Access: double lumen PICC on right; axillary A-line, temp line for HD # Nutrition: consult regarding TPN # PPX: pneumoboots, PPI; bowel reg # Code: full; confirmed with wife on admission via phone # Dispo: to remain in ICU while intubated; may attempt extubation s/p HD ICU Care Nutrition: Glycemic Control: Lines: PICC Line - [**2191-8-21**] 02:07 AM Dialysis Catheter - [**2191-8-22**] 04:10 PM Arterial Line - [**2191-8-23**] 11:58 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Disposition:
Physician
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CCU NURSING 1730-1900 S. INTUBATED O. SEE CAREVUE FLOWSHEET FOR COMPLETE VS, OBJECTIVE DATA CV: PT RETURNED FROM CATH LAB AT ~1730 S/P CARDIAC ARREST W/? PEA RHYTHM, SBP 40/ FOR SUSTAINED PERIOD AFTER UNABLE TO CROSS OCCLUDED LAD LESION VIA R BRACHIAL APPROACH. INTUBATED, IABP PLACED IN L FEMORAL SITE, PA CATHETER IN R FEMORAL SITE, R BRACHIAL SHEATH D/C'D, INITIALLY RECEIVED ATROPINE/EPI/DOPA AND LEVO WIDE OPEN - AFTER IABP PLACED, BP IMPROVED, DOPA WEANED TO OFF AND LEVO WEANED TO .125 MCGS - TRANSFERRED TO CUU FOR FURTHER MANAGEMENT TO STABILIZE; TROPONIN 2, CPK/MB REMAIN ELEVATED CV: HR 80'S SR WITH FREQUENT APC'S, IABP AT 1:1 INITIAL MAPS 80 - TRENDING DOOWN TO 59-60 - LEVO INCREASED TO .2 MCGS/KG W/IMPROVEMENT IN MAPS, IABP TIMING W/FOS, INITIALLY AUGMENTING > 60 POINTS HIGHER THAN PLATEAU - 30CC BALLOON DECREASED TO 26 CC SLOWLY NOW W/AD/PLATEAU PRESSURES WITHIN 25 POINTS; PULSES PRE-PROCEDURE DOP/DOP BILAT, NOW LDP DOP, R DP CONTINUOUS FLOW HEARD (IE VENOUS FLOW) BUT UNABLE TO DOP ART PULSE; PT'S BILAT NOW BOTH ABSENT, L FOOT WARM AND PALE, R FOOT COOL AND MOTTLED TO CALF - CCU TEAM AWARE AND [**Name (NI) 3651**] PT; R BRACHIAL SITE OOZING, R RADIAL PULSE FAINTLY PALPABLE; R AND L FEM STES OOZING BILAT; MIXED VENOUS SAT 42 - CO 2.4/CI 1.7 SVR 1800, LACTYATE 10.9 RESP: LUNGS COARSE, INTUBATED ON 100% FIO2 LAST ABG 7.34/38/106/21/-5, SUX FOR MOD AMOUNTS THICK BLOODY SPUTUM, ORAL CAVITY BLEEDING AS WELL GI: ABDOMEN SOFT, NO STOOL HEME: CALCULATED HCT IN CATH LAB 21 - RECEIVING 1 UNIT PRBC'S, REPEAT HCT PRIOR TO TRANSFUSION CAME BACK 28.9 GU/RENAL: FOLEY IN PLACE NOW DRAINING CLEAR YELLOW URINE IN LG AMTS INITIALLY - NOW TAPERING OFF, BUN/CR 34/1.4 NEURO: PT OPENING EYES SPONTANEOUSLY LIFTING ARMS UP IN AIR TOWARD TUBE, MOVING LEGS ON BED, OPENING MOUTH TO SPEAK; FENTANYL GTT STARTED AT 50MCGS, VERSED AT 1MG/HR, PT NOW APPEARS MORE RESTLFUL SKIN: PT RETURNED TO CCU W/ECCYMOTIC AREA IN 4TH ICS TO LEFT OF STERNUM POST-CPR, FAMILY INFORMED [**Month (only) 83**] BE BROKEN RIBS SECONDARY TO CPR SOCIAL: SON MARK AND DAUGHTER [**Name (NI) **] IN TO VISIT THROUGHOUT DAY, SPOKE WITH RN AT LENGTH REGARDING PT'S CONDITION AND PLAN OF CARE, ALSO SPOKE W/MD [**First Name (Titles) **] [**Last Name (Titles) **] AND CCU TEAM, DR [**Last Name (STitle) **] ALSO CONFIRMED THAT PT IS STILL FULL CODE DESPITE CARDIAC ARREST IN LAB, FAMILY WANTS TO CONTINUE FULL TREATMENT, FULL CODE FOR NOW; CATHOLIC PRIEST [**Name (NI) **] AND VISITED PT PER FAMILY'S REQUEST. A: PT W/HX SEVERE PVD, S/P FEMORAL BYPASSES BILAT, NOW S/P STEMI C/B CARDIAC ARREST IN CATH LAB, INABILITY TO OPEN LAD LESION, CARDIOGENIC SHOCK WITH IABP/SWAN IN PLACE, PRESSORS TO MAINTAIN BP, SHEATHS IN FEMORAL SITES BILAT W/COMPROMISED BLOOD FLOW TO R LEG P: CONTINUE MONITOR HEMODYNAMICS AND SUPPORT PATIENT W/IABP @ 1:1, PRESSORS, ? ADD INOTROPES IN LIGHT OF LOW CO/CI; FOLLOW FEMORAL AND BRACHIAL SHEATH SITES, ASSESS CHEST CONTUSION, ASSESS DISTAL PULSES; FOLLOW LACTATE LEVELS; SEDATION/PAIN MEDS AS NEEDED FOR COMFORT; ASSESS IABP FUNCTION/TIMING, KEEP FAMILY INFORMED OF PATIENTS CONDITION, PLAN OF CARE, EMOTI
Nursing/other
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Chief Complaint: 51 yof with h/o ESLD [**12-26**] ETOH cirrhosis c/b HRS requiring HD admitted for possible KL transplant. 24 Hour Events: - did large volume para - 4.5 liters removed and fluid sent for analysis which showed 130 WBC / 510 RBC / 0 PMN / 27 L / 66 macrophages / protein 2.7 - dobhoff clogged -- placed order for IR dobhoff placement in AM. - hematology recs: continuing antibiotics, lactulose and rifaximin - renal recs: HD today [**11-20**] Allergies: Sulfa (Sulfonamide Antibiotics) Wheezing; Phenylephrine Symptomatic bra Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2169-11-17**] 08:00 AM Micafungin - [**2169-11-19**] 09:27 PM Piperacillin - [**2169-11-19**] 09:27 PM Infusions: Other ICU medications: Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2169-11-20**] 05:53 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.6 C (97.8 Tcurrent: 36.2 C (97.1 HR: 76 (76 - 89) bpm BP: 95/42(58) {87/40(56) - 125/65(83)} mmHg RR: 15 (15 - 23) insp/min SpO2: 98% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 99 kg (admission): 94.5 kg Height: 62 Inch Total In: 710 mL 269 mL PO: 380 mL 240 mL TF: 10 mL IVF: 220 mL 29 mL Blood products: 100 mL Total out: 4,500 mL 0 mL Urine: NG: Stool: Drains: 4,500 mL Balance: -3,790 mL 269 mL Respiratory support O2 Delivery Device: None SpO2: 98% ABG: ///18/ Physical Examination General: somnolent,. NAD HEENT: jaundice Heart: RRR, no MRG Lungs: CTAB no WRR Abdomen: mild distension, soft, diffusely tender, no RG Extremities: no edema, DP 2+ Labs / Radiology 148 K/uL 9.5 g/dL 99 mg/dL 3.9 mg/dL 18 mEq/L 3.9 mEq/L 27 mg/dL 100 mEq/L 135 mEq/L 28.0 % 14.9 K/uL [image002.jpg] [**2169-11-13**] 03:09 AM [**2169-11-13**] 06:30 PM [**2169-11-14**] 04:16 AM [**2169-11-15**] 02:33 AM [**2169-11-15**] 11:14 AM [**2169-11-16**] 02:29 AM [**2169-11-17**] 04:06 AM [**2169-11-18**] 02:53 AM [**2169-11-19**] 04:08 AM [**2169-11-20**] 03:51 AM WBC 20.1 18.1 14.3 14.2 16.5 16.3 13.5 14.9 Hct 24.4 25.7 26.5 26.7 30.3 30.5 28.4 27.4 28.0 Plt 175 148 132 120 127 130 132 148 Cr 2.1 3.6 4.2 3.0 3.9 4.5 3.0 3.9 TCO2 21 Glucose 170 143 104 129 113 119 95 99 Other labs: PT / PTT / INR:23.0/50.3/2.2, ALT / AST:29/108, Alk Phos / T Bili:83/19.6, Amylase / Lipase:/62, Lactic Acid:1.7 mmol/L, Albumin:3.7 g/dL, LDH:391 IU/L, Ca++:9.5 mg/dL, Mg++:1.9 mg/dL, PO4:3.3 mg/dL Microbiology - [**11-19**] paracentesis fluid 1+ PMN s, no bacteria - [**11-19**] c.diff toxin negative - [**11-17**] c.diff toxin negative Radiology - No new imaging Assessment and Plan 51 yof with ESLD [**12-26**] ETOH cirrhosis complicated by HRS req. dialysis. Patient admitted for possible L-K transplant for high MELD score but unable to tolerate testing [**12-26**] hypotension. . #. Hypotension: thought to be [**12-26**] fluid redistribution into extravascular compartments, now off pressors for the past several days and now s/p significant therapeutic and diagnostic paracentesis yesterday - continue midodrine 15 mg TID - goal MAP >65; restart levo if needed and use IVF PRN boluses - f/u hepatology recs - f/u renal recs - antibiotics as below . #. Leukocytosis: trending down from 20 now stable in teens s/p empiric 7 day course of vancomycin and zosyn for hypotension. No infectious source identified to date with negative C.Diff and recent paracentesis not demonstrating SBP. - d/w ID rational for duration of empiric antibiotic course stop vs. extended - follow up cultures (blood, paracentesis) - discontinue PO vancomycin as C. Diff negative x 5 - continue Micafungin 100 mg IV Q24h for empiric fungal coverage(day 1=[**11-13**]) - f/u stool cytotoxin assay, serum histoplasma (send out) . #. End-stage liver disease: Patient currently stable and fully oriented with no clinically symptoms of acute liver decompensation. Patient has been evaluated by the transplant team as an outpatient who recommended admission for possible tranplant based on elevated MELD score. s/p EGD on [**11-7**]. s/p dobhoff placement on [**11-7**]. Listed for transplant for kidney/liver. MELD [**11-7**] 40, [**11-11**] = 42. - Liver Transplant Today - Continue lactulose - Continue rifaximin - Since patient on broad-spectrum antibiotics, d/c d cipro for SBP prophylaxis and then after 7-day course of broad-spectrum antibiotics ends (on [**11-18**]), plan to restart cipro for SBP prophylaxis = today; confirm vanc/zosyn treatment course length first with ID then add back or not the cipro - Active T & S - F/u hepatology recs, transplant recs . # Renal Failure: Creatinine on transfer to MICU 4.2. Requires dialysis three times a week. Patient is candidate for dual liver-renal transplant and followed by Dr. [**Last Name (STitle) 9881**]. Hepato-renal syndrome. Cr now 3.9 up from 3.0. - Kidney Transplant Today - HD today per renal - continue nephrocaps - f/u renal recs - per renal, no more epo . # Nausea: Perhaps due to liver disease, pressors, CVVH, medications. New Dobhoff placed by IR (d/t clog) on [**11-18**]. - try to unclog Dobhoff; if not, call IR for help - Ok to take PO as tolerated/desired by patient, encourage - Dobhoff replaced; tubefeeds should be running slowly, advance as tolerated slowly if possible - Zofran 8mg q8h IV prn aggressive giving of this medication as needed - Morphine 0.5-1mg IV q4h prn - Hold on ativan if possible, given ESLD - per transplant surgery, d/c d PPN . # Metabolic acidosis: bicarb improved s/p HD. Resolved. - Hold on suctioning out bile - Monitor daily . # Alcohol abuse: Patient has not had a drink since [**Month (only) 93**], therefore no need for CIWA. - Discontinued folic acid, thiamine, MVI feel that she is now repleted (ie; getting nutrition, has been supplemented a lot) . # Heel ulcer: - f/u wound care recs; heel boot . FEN: Dobhoff f/u IR placed Dobhoff this AM . PPX: DVT ppx with Pneumoboots; omeprazole 20mg daily; bowel regimen = lactulose. Out of bed today. . ACCESS: Power PICC, R IJ HD catheter, A-line. . CODE STATUS: Full code (confirmed with patient). . EMERGENCY CONTACT: [**Name (NI) **] [**Known lastname 4887**] (husband, [**Name (NI) 117**] [**Telephone/Fax (1) 9882**] (cell), [**Telephone/Fax (1) 9883**], [**Telephone/Fax (1) 9884**]. . DISPOSITION: MICU for continued BP monitoring, may be suitable for floor given stable BP for past several days without pressure requirements. Presently, awaiting & listed for liver/kidney transplant. ICU Care Lines: PICC Line - [**2169-11-6**] 06:43 PM Dialysis Catheter - [**2169-11-6**] 08:00 PM Arterial Line - [**2169-11-14**] 06:50 PM Code status: Full code
Physician
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Chief Complaint: 24 Hour Events: - films ordered will not be ready until wednesday - pt scheduled for transfer to [**Male First Name (un) 1174**] tomorrow - chest tube switched to water seal - repeat CXR no increase in size of PTX S: Pt doing okay this am, breathing comfortably, no CP/ABD pain. Had difficultly sleeping. Lower extremities tight & mildly uncomfortable. Allergies: Heparin Agents Unknown; Last dose of Antibiotics: Infusions: Other ICU medications: senna, colace, bisacodyl, enema prn, Alb/Atrovent nebs, Lactulose, Fondaparinux, oxycodone Other medications: Flowsheet Data as of [**2133-2-3**] 07:31 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.1 C (97 Tcurrent: 36 C (96.8 HR: 98 (98 - 118) bpm BP: 97/64(72) {97/62(72) - 112/69(77)} mmHg RR: 23 (21 - 34) insp/min SpO2: 99% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 112 kg (admission): 91.5 kg Height: 65 Inch Total In: 1,201 mL 150 mL PO: 720 mL TF: IVF: 481 mL 150 mL Blood products: Total out: 695 mL 205 mL Urine: 695 mL 145 mL NG: Stool: Drains: Balance: 506 mL -55 mL Respiratory support Ventilator mode: Standby Vt (Spontaneous): 276 (276 - 276) mL RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 50% PIP: 0 cmH2O SpO2: 99% ABG: ///28/ Physical Examination GEN: NAD, no resp distress HEENT: trach inplace CV: mildly tachy, RR, no m/r/g RESP: Left lung field CTA, right lung with insp/expiratory stridorous BS, but moving air well ABD: soft, NT/ND, NABS EXTR: [**1-11**]+ pitting edema bilaterally, no skin breakdn Neuro: AXO Labs / Radiology 301 K/uL 7.1 g/dL 93 mg/dL 0.8 mg/dL 28 mEq/L 3.8 mEq/L 10 mg/dL 101 mEq/L 135 mEq/L 22.1 % 4.2 K/uL [image002.jpg] [**2133-1-25**] 05:25 AM [**2133-1-26**] 04:25 AM [**2133-1-27**] 05:24 AM [**2133-1-28**] 04:47 AM [**2133-1-29**] 04:00 AM [**2133-1-30**] 06:45 AM [**2133-1-31**] 06:07 AM [**2133-2-1**] 04:59 AM [**2133-2-2**] 05:37 AM [**2133-2-3**] 06:00 AM WBC 3.4 3.2 3.0 3.3 3.7 3.5 2.8 3.9 4.4 4.2 Hct 21.4 22.9 22.9 21.6 21.3 21.8 23.7 21.8 23.5 22.1 Plt 79 124 170 227 292 [**Telephone/Fax (2) 1141**]81 301 Cr 1.0 1.0 1.0 0.9 0.9 0.9 0.8 0.8 0.9 0.8 Glucose [**Telephone/Fax (3) 1063**]05 85 124 93 120 112 93 Other labs: PT / PTT / INR:14.1/32.4/1.2, Differential-Neuts:78.7 %, Band:0.0 %, Lymph:13.8 %, Mono:4.3 %, Eos:3.0 %, Fibrinogen:618 mg/dL, Lactic Acid:3.6 mmol/L, Ca++:9.1 mg/dL, Mg++:1.9 mg/dL, PO4:3.2 mg/dL CXR from [**2133-2-2**] 2pm (after clamping chest tube) Comparison is made to earlier in the same day. A pleural catheter in the left hemithorax is unchanged. The patient is s tatus post tracheostomy. Multiple large bilateral pulmonary masses are again present with similar partial left lower lobe atelectasis. No evidence of pneumothorax or pleural effusion. Subcutaneous air about the left ches t wall is unchanged in extent. IMPRESSION: No evidence of persistent pneumothorax. Assessment and Plan RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name **]) CANCER (MALIGNANT NEOPLASM), GYNECOLOGICAL (OVARIAN, UTERINE, CERVICAL, ENDOMETRIAL) PNEUMOTHORAX, OTHER (NOT HOSPITAL ACQUIRED OR TRAUMATIC) [**Last Name 121**] PROBLEM - ENTER DESCRIPTION IN COMMENTS Heparin Induced Thrombocytopenia TACHYCARDIA, OTHER Improved after chest tube placement PULMONARY EMBOLISM (PE), ACUTE ANEMIA, OTHER ICU Care Nutrition: Soft mechanical diet with supplemental TF Glycemic Control: ISS Lines: PICC Line - [**2133-1-13**] 09:48 PM Prophylaxis: DVT: Fondaparinux Stress ulcer: PPI Communication: Comments: Code status: DNR (do not resuscitate) Disposition: transfer to NY presbyterian today
Physician
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Admission Date: [**2185-8-29**] Discharge Date: [**2185-9-2**] Date of Birth: [**2105-4-15**] Sex: F Service: CARDIOTHORACIC Allergies: Quinolones / Vancomycin Analogues / Levaquin Attending:[**First Name3 (LF) 492**] Chief Complaint: Bronchial stenosis Major Surgical or Invasive Procedure: Flexible bronchoscopy, rigid bronchoscopy with stent removal and balloon dilation of the bronchus intermedius, endobronchial biopsy of the bronchus intermedius. History of Present Illness: Ms.[**Known lastname 32872**] is an 80 year-old woman with lung cancer who has undergone right upper lobectomy and radiation therapy 17 years ago. She presented in [**2185-3-25**] with progressive dyspnea and productive cough. She was ultimately found to have stenosis of the bronchus intermedius and underwent placement of a metal stent [**2185-8-18**]. She continues to complain of cough, mainly over the past 3 days; she reports sputum productive of brownish sputum. She notes her baseline level of dyspnea, which she tells me is 10 -15 feet on level ground. She denies fever, chills, or night sweats. She presents today for bronchoscopy and stent evaluation. Past Medical History: COPD, GERD, CAD with stent placement, breast cancer, s/p l Mastectomy; colon cancer, s/p colectomy; History of syncopes and collapse (not in the last 1.5 years), LLE DVT one year ago Social History: SOCIAL HISTORY: Cigarettes: [ ] never [x] ex-smoker [ ] current Pack-yrs:____ 60 pack year smoking history, quit 18 years ago ETOH: [x] No [ ] Yes drinks/day: Drugs: Exposure: [x] No [ ] Yes [ ] Radiation [ ] Asbestos [ ] Other: Occupation: retired, former hairdresser Marital Status: [ ] Married [x] Single Lives: [ ] Alone [ ] w/ family [ ] Other:lives in nursing home since [**2184-3-25**] Family History: nc Physical Exam: AO x 3 PERRL/EOMI RRR Bilateral rhonchi Soft BS+ no rashes; + ecchymoses on arms no cyanosis, clubbing, or edema Pertinent Results: [**8-29**]: CT Chest FINDINGS: The new stent in the bronchus intermedius is fully expanded and contains eccentric intraluminal soft tissue in its distal course. There is residual narrowing just proximal to the tip of the stent in the right main stem bronchus(3.20). The right middle and lower lobe bronchi are patent. Evaluation of the upper mediastinum is limited due to extensive streak artifact from multiple surgical clips however there is no evidence of disease recurrence at the resection site post- right upper lobectomy. The infectious/inflammatory component of the right upper lung consolidation has resolved with residual post-radiotherapy related consolidation in the right apex, unchanged. The small right pleural effusion has slightly increased in size, and marked peribronchial wall thickening in subsegmental and subsegmental bronchi of the right lower lobe persists with centrilobular nodularity throughout the right lung, suggesting superimposed infection or inflammation. There is increased peribronchial thickening which is severe surrounding the segmental course of a right lower lobe bronchus (3.23) which is most likely due to inflammation or infection, attention to this area should be made on followup to exclude disease recurrence. This is best seen on the coronal sequences (400B.36). Atelectasis in the periphery of the right lower lobe (3.37) is new and mild. No new pathological enlargement of mediastinal or axillary lymph nodes by CT size criteria. Centrilobular emphysema in the left upper lobe is mild and unchanged. Discrete sub 2 mm nodules in the left lower lobe (4.150 and 4.176) are stable. Calcification of the aorta is unchanged, the heart size is normal with no pericardial effusion. Pulmonary arteries are normal, calcification of the aortic valve is stable. Limited views of the upper abdomen are unremarkable except to note atrophy of both kidneys and the pancreas. No new destructive or sclerotic bone lesions, post-surgical changes in the right hemithorax are unchanged with extensive degenerative changes throughout the thoracic spine. IMPRESSION: 1) New stent in the bronchus intermedius with residual proximal stenosis in the right main stem bronchus. The distal stent contains intraluminal secretions/granulation tissue 2)New peribronchial wall thickening in a subsegmental bronchus in the right lower lobe, the presence of enlarged small right pleural effusion and multiple centrilobular nodules suggest superimposed infection or inflammation. 3)Stable sub-2-mm left lower lobe nodules. 4)Status post right upper lobectomy with post-surgical changes including radiation fibrosis in the right apex is stable. 5)Calcification of the coronary artery and aortic valve and mitral valve is unchanged. [**2185-8-30**] WBC-47.8* RBC-3.45* Hgb-10.9* Hct-34.9* MCV-101* MCH-31.7 MCHC-31.4 RDW-15.3 Plt Ct-254 [**2185-9-1**] WBC-12.6* RBC-2.67* Hgb-8.6* Hct-25.7* MCV-97 MCH-32.3* MCHC-33.4 RDW-15.5 Plt Ct-143* [**2185-8-30**] Blood-SM Nitrite-NEG Protein-TR Glucose-NEG Ketone-15 Bilirub-NEG Urobiln-NEG pH-6.5 Leuks-NEG [**2185-8-31**]: C diff neg Bcx x2 NGTD, Ucx neg Brief Hospital Course: 80F hx bronchial stenosis admitted evaluation. Flex bronch and chest CT revealed granulation tissue around metal stent placed [**8-3**]. Stent was subsequently removed and the airway was dilated. The patient's WBC [**Known firstname **] to 47.8 and she was started on Linezolid and Zosyn emperically. C. Diff was negative. The following day WBC count decreased to 16.1. The elevated WBC count may be attributed to a reaction to a colonized stent. Following stent removal the patient did well, maintaining original O2 requirements without SOB or complication. A R PICC was placed for abx. At time of discharge, patient's vitals are stable, she is afebrile. She is tolerating a regular diet, ambulating and breathing without difficulty. Medications on Admission: vitamin B12, aspirin, Advair, Synthroid 50 mcg, Lasix, Omeprazole, albuterol neb'''' atenolol 12.5' Keppra, Dilantin, Lipitor, Coumadin, baclofen, oxygen 2L Discharge Medications: 1. Atorvastatin 20 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 2. Baclofen 10 mg Tablet Sig: 0.5 Tablet PO TID (3 times a day) as needed for pain. 3. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours) as needed for dyspnea. 6. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) Inhalation Q6H (every 6 hours) as needed for dyspnea. 7. Levetiracetam 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 10. Phenytoin 50 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 11. Prednisone 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 13. Atenolol 25 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 14. Docusate Sodium 100 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 15. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 16. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 17. Linezolid 600 mg/300 mL Parenteral Solution Sig: One (1) Intravenous Q12H (every 12 hours) for 6 days. 18. Zosyn 2.25 gram Recon Soln Sig: One (1) Intravenous every eight (8) hours for 6 days. Discharge Disposition: Extended Care Facility: [**Hospital 5399**] Nursing Home - [**Hospital1 **] Discharge Diagnosis: Bronchus intermedius stenosis s/p stent retrieval dilation and bronchial biopsy, COPD, GERD, CAD with stent placement, breast cancer, s/p l Mastectomy; colon cancer, s/p colectomy; History of syncopes and collapse (not in the last 1.5 years), LLE DVT one year ago Discharge Condition: Fair Discharge Instructions: Call Dr.[**Name (NI) 5070**] office [**Telephone/Fax (1) 7769**] if develops increased shortness of breath, cough or chest pain. Followup Instructions: Follow-up with Dr.[**Name (NI) 5070**] [**Name (STitle) 766**] [**9-12**] at 11:30 in the Chest Disease Center in the [**Hospital Ward Name 121**] Building [**Hospital1 **] I [**Telephone/Fax (1) 7769**] Flexible Bronchoscopy [**2188-9-12**]:30 in the Chest Disease Center NOTHING TO EAT OR DRINK AFTER MIDNIGHT [**2185-9-12**] for flex bronchoscopy [**First Name8 (NamePattern2) **] [**Name8 (MD) **] MD [**Doctor First Name 494**] Completed by:[**2185-9-6**]
Discharge summary
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[**Age over 90 **] y/o M ([**Hospital1 328**] speaking only) with hx of HTN, hyperlipidemia, GERD and CKD presented from home with increasing confusion. Mr. [**Known lastname 14418**] became acutely confused while at synagogue. He stood up, was clutching his head, complaining that he could not see or hear. [**Name8 (MD) **] MD was present and found pt to have normal pulse, non-diaphoretic, and told family pt likely hypoglycemic; pt took grape juice and remained at service. He remained confused, did not respond when people shook his hand, could not follow readings. He then returned home, walked on his own into the house, and continued complaining of inability to hear. His son called EMS, and he was brought in to the ED by EMS. Pt was reportedly well prior to this event, which began acutely. Only recent illness was cough 2 weeks prior with clear CXR per son, treated with prednisone X [**3-17**] days and abx X 5 days. . In the [**Name (NI) 73**], pt was agitated and unable to answer questions; he was sedated with 2 mg Ativan. His son, wife, and family were present. Initial vs were T 97.4, P 72, BP 110/46, R 20, 100%. Head CT was negative for bleeds. The pt continued to become more and more agitated, tachypneic, and was noted to have ST depressions. He was intubated for tachypnea and agitation to protect his airway; sedation with fentanyl/versed; VSS. CXR showed possible RUL PNA. He had an mri which showed multi embolic strokes. He was started on a heparin gtt which was stopped today.. Pt was extubated on [**4-19**] and has remained stable since. He has had daily ekg Pt alert, oriented per family to interpret. Mae. Follows commands. Perrl. Pt cooperative today. A-febrile. Hr 48-50 s, sinus. Sbp 90-100 s. skin w+d. +pp. denies pain. Ls cta. O2 sat 96% ra. Nard noted. Abd soft/nt/nd. +bs. Tol po s. foley removed. Voided via urinal. Stood and took few steps to chair with 1-2 assist. Tol well. Pt is to have carotid ultrasound at 08:30 [**2196-4-21**]. Demographics Attending MD: [**Doctor Last Name **] [**Doctor Last Name **] F. Admit diagnosis: ALTERED MENTAL STATUS;PNEUMONIA Code status: Full code Height: Admission weight: 72.4 kg Daily weight: 72.6 kg Allergies/Reactions: Augmentin (Oral) (Amox Tr/Potassium Clavulanate) Unknown; Precautions: PMH: CV-PMH: Additional history: Surgery / Procedure and date: Latest Vital Signs and I/O Non-invasive BP: S:106 D:37 Temperature: 97 Arterial BP: S: D: Respiratory rate: 8 insp/min Heart Rate: 52 bpm Heart rhythm: SB (Sinus Bradycardia) O2 delivery device: None O2 saturation: 94% % O2 flow: FiO2 set: 50% % 24h total in: 1,266 mL 24h total out: 365 mL Pertinent Lab Results: Sodium: 138 mEq/L [**2196-4-20**] 02:56 AM Potassium: 3.7 mEq/L [**2196-4-20**] 02:56 AM Chloride: 104 mEq/L [**2196-4-20**] 02:56 AM CO2: 24 mEq/L [**2196-4-20**] 02:56 AM BUN: 25 mg/dL [**2196-4-20**] 02:56 AM Creatinine: 0.9 mg/dL [**2196-4-20**] 02:56 AM Glucose: 95 mg/dL [**2196-4-20**] 02:56 AM Hematocrit: 37.1 % [**2196-4-20**] 02:56 AM Finger Stick Glucose: 136 [**2196-4-20**] 04:00 PM Valuables / Signature Patient valuables: Hearing aids: (Right Ear, Left Ear ) Other valuables: Clothes: Sent home with: Wallet / Money: No money / wallet Cash / Credit cards sent home with: Jewelry: Transferred from: [**Hospital 2517**] Transferred to: [**Wardname 7098**] Date & time of Transfer: [**2196-4-20**] . .
Nursing
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[**2137-4-26**] 4:55 PM MR HEAD W & W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 41666**] MRV HEAD W/O CONTRAST Reason: repeat MRI for VST Admitting Diagnosis: CAVERNOUS SINUS THROMBOSIS Contrast: MAGNEVIST Amt: 17 ______________________________________________________________________________ [**Hospital 2**] MEDICAL CONDITION: 27 year old woman with VST REASON FOR THIS EXAMINATION: repeat MRI for VST No contraindications for IV contrast ______________________________________________________________________________ PROVISIONAL FINDINGS IMPRESSION (PFI): RXRa SAT [**2137-4-27**] 12:42 PM Areas of restricted diffusion are demonstrated in the thalamus bilaterally and basal ganglia, more significant on the left and also in the splenium of the corpus callosum, high signal intensity is noted in the straight sinus and perisplenial veins, there is also evidence of slow flow in the left transverse sinus and sigmoid sinus, consistent with venous sinus thrombosis. These findings were discussed with Dr. [**First Name (STitle) 33594**] [**Name (STitle) 21808**] on [**2137-4-25**]. ______________________________________________________________________________ FINAL REPORT MRI AND MRA OF THE BRAIN AND MRV OF THE HEAD CLINICAL INDICATION: 27-year-old woman with venous sinus thrombosis. COMPARISON: Prior MRI from an outside institution ([**Hospital 3591**] Hospital). TECHNIQUE: Pre-contrast sagittal and axial T1-weighted images were obtained, axial FLAIR, axial T2, axial magnetic susceptibility, and axial diffusion-weighted sequences. The T1-weighted images were repeated after the administration of gadolinium contrast in axial T1, sagittal MP-RAGE, multiplanar reconstructions were provided. MRV of the head. 2D time-of-flight venography of the head was provided, multiple source images were reviewed and also maximum-intensity projection images. FINDINGS: The images without contrast, demonstrate slow flow in the left transverse sinus, sigmoid sinus, straight sinus, and perisplenial veins, consistent with venous sinus thrombosis. Restricted diffusion is noted in the thalamus, basal ganglia, and splenium of the corpus callosum, these areas are more significant on the left, few scattered foci of restricted diffusion are noted in the subcortical white matter bilaterally in the frontal lobes. There is no evidence of hemorrhagic transformation. The ventricles and sulci are normal in size and configuration with no evidence of hydrocephalus. The orbits are unremarkable. The paranasal sinuses demonstrate mucosal thickening in the sphenoid sinus and right ethmoidal air cells. IMPRESSION: Venous sinus thrombosis involving the left transverse sinus, sigmoid sinus, perisplenial veins, and straight sinus as described in detail above. Areas of restricted diffusion, consistent with ischemia, possibly subacute involving the thalamus, basal ganglia, splenium of the corpus (Over) [**2137-4-26**] 4:55 PM MR HEAD W & W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 41666**] MRV HEAD W/O CONTRAST Reason: repeat MRI for VST Admitting Diagnosis: CAVERNOUS SINUS THROMBOSIS Contrast: MAGNEVIST Amt: 17 ______________________________________________________________________________ FINAL REPORT (Cont) callosum, caudate nucleus, and bifrontal subcortical white matter. MRV OF THE HEAD: There is lack of flow throughout the straight sinus, left transverse sinus, and sigmoid sinus, consistent with venous sinus thrombosis. A preliminary report was communicated and discussed with Dr. [**First Name (STitle) 33594**] [**Name (STitle) 21808**] on [**2137-4-25**].
Radiology
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[**2109-12-22**] 7:35 PM MR HEAD W & W/O CONTRAST Clip # [**Clip Number (Radiology) 27735**] Reason: Invasive sinusitis? Brain abscess? Contrast: MAGNEVIST Amt: 20 ______________________________________________________________________________ FINAL ADDENDUM ADDENDUM: Additional information has been obtained from CareWeb Clinical Lookup since the approval of the original report. Reason for exam should also state delirium. [**2109-12-22**] 7:35 PM MR HEAD W & W/O CONTRAST Clip # [**Clip Number (Radiology) 27735**] Reason: Invasive sinusitis? Brain abscess? Contrast: MAGNEVIST Amt: 20 ______________________________________________________________________________ [**Hospital 3**] MEDICAL CONDITION: 62 year old diabetic with bloody, prurulent nasal drainage and rapidly progressive mental status changes REASON FOR THIS EXAMINATION: Invasive sinusitis? Brain abscess? ______________________________________________________________________________ FINAL REPORT MRI OF THE BRAIN, [**2109-12-22**]: INDICATION: Diabetic with purulent bloody nasal discharge. Rapidly progressive mental status changes. Rule out brain abscess from invasive sinusitis. TECHNIQUE: Sagittal T1W images which demonstrate a small portion of the upper cervical spine reveal mottled marrow signal within the C2 and C3 vertebra. There is also patchy decreased T1 signal in the clivus. This could represent an infiltrative marrow process, such as metastases or myeloma, and clinical correlation is recommended. There is also mucosal thickening in the sphenoid sinuses, and within the maxillary and ethmoid air cells. Fluid levels are identified in the posterior ethmoid air cells and in the left sphenoid sinus. There is opacification of some of the mastoid air cells as well and a fluid level in the posterior mastoid air cell on the right. Overall, the sulcal and gyral pattern of the brain is normal. The ventricles are prominent, but not dilated. There is a mild degree of T2 signal hyperintensity in the periventricular white matter. There is also a faint focus of increased T2 signal along the cortical surface of the right frontal lobe. There is no clearly identifiable abnormal enhancement in this location or elsewhere within the brain. No enhancing masses are identified to suggest the presence of an abscess. There is no abnormal dural enhancement to indicate empyema. Flow is identified in the major branches of the Circle of [**Location (un) 286**] and in the major intracranial veins. IMPRESSION: 1) Sinusitis is identified, no definite penetration of the paranasal sinuses into adjacent structures, is identified. 2) There are no cerebral abscesses or empyema. 3) There is a small focus of increased T2 signal in the right frontal lobe which could represent the site of small cortical infarction, age indeterminate. 4) Bony evaluation is recommended, since irregular marrow signal is identified in the clivus and upper cervical vertebra. (Over) [**2109-12-22**] 7:35 PM MR HEAD W & W/O CONTRAST Clip # [**Clip Number (Radiology) 27735**] Reason: Invasive sinusitis? Brain abscess? Contrast: MAGNEVIST Amt: 20 ______________________________________________________________________________ FINAL REPORT (Cont)
Radiology
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CRITICAL CARE ATTENDING 01:00 I saw and examined Ms. [**Known lastname 6072**] with Dr. [**Last Name (STitle) 6369**], whose note reflects my input. I would add/emphasize that this [**Age over 90 **]-year-old woman presents from rehab (after a recent discharge) with altered mental status and dyspnea. Her recent hospitalization was complicated (cholecystitis, sepsis, respiratory failure, NSTEMI with CHF, acute renal failure, and possible S. milleri endocarditis) and is well-detailed in OMR. In the ED, was treated with NIMV, dexamethasone, nebs, and antibiotics for wheezing and respiratory distress. Tolerated for a while but became unable to tolerate due to agitation (and also had increasing BP); she was intubated. PMH, SH, FH, Meds, Allergies as per Dr. [**Last Name (STitle) 6369**] s note. On exam she is sedated on the ventilator. Pupils are midline and small. Lungs are clear without wheezes at present. Heart is regular with holosystolic murmur. Abdomen is soft without clear tenderness. There is a sacral decub. Scant edema. She is sedated, so neurologic exam is limited. However, she has sustained bilateral lower extremity clonus. Upper extremity reflexes are brisk but there is no clonus. Toes are mute. (Note that she was seen by neurology prior to intubation and they did not find localizing signs.) PICC site looks clean. Labs review in OMR. Notable for 7.37 / 57 / 121; no leuks on UA; HCO3 33 (increased); WBC 8. Imaging CXR showed ?some improvement from prior. CT torso interpreted as ground glass opacities predominately with in upperlobes may represent infection. small b/l pleural eff; contracted gallbladder with enhancing wall, significantly decompressed compared to prior study and may represent chronic cholecystitis. diverticulosis w/o diverticulitis. CT of the head interpreted as severely limited study secondary to motion artifact. low density noted within the left aspect of the pons and midbrain which could represent artifact vs infarct. Assessment and Plan [**Age over 90 **]-year-old woman with recent admission notable for cholecystitis, NSTEMI with LV systolic dysfunction, S. milleri bacteremia (treated presumptively as endocarditis/discitis but no confirmatory imaging was able to be obtained) now presents with apparently acutely altered mental status, respiratory distress, and abnormal chest imaging. Notably, there is no fever and no leucocytosis. It is unclear which came first: respiratory distress delirium, or delirium increased SVR increased MR pulmonary edema. Her CT imaging could be either pulmonary edema (seems a bit more likely) or infectious. Finally, the lower extremity clonus raises the possibility of serotonin syndrome, though seems less likely given lack of fever, rigidity, and chronicity of most of her medications. Although infection seems less likely, a [**Age over 90 **]-year-old woman could certainly present with meaningful infection without fever. Given the apparent acuity of symptoms and the broad differential diagnosis, we will therefore plan: We will plan: 1) LP (primarily to exclude HSV) 2) Viral DFA 3) Sputum culture and mini-BAL 4) Treat empirically for HCAP at present. 5) Leave PICC in place pending BCx and further evaluation. 6) Discuss with her prior I.D. physicians tomorrow: given previous uncertainty of endocarditis and osteomyelitis, would management be changed by TEE or MRI at this point? (while intubated) 7) Ask neuro to re-examine; discuss role of spine MRI (several reassuring signs on exam, but will discuss our finding of clonus) 8) Hold serotenergic meds pending further evaluation 9) If above is unrevealing, consider trial of CHF treatment. She is critically ill. 50 minutes. ------ Protected Section ------ Procedure: LP (unsuccessful) 2:30 Multiple attempts at LP by resident and myself. Unsuccessful unable to enter space. ------ Protected Section Addendum Entered By:[**Name (NI) **] [**Last Name (NamePattern1) 906**], MD on:[**2163-6-7**] 02:34 ------ Critical Care Staff Addendum 2:30 am Unable to complete LP. Will consult neuro for assistance. Although pretest probability is low, HSV and Listeria could present in this way. Will therefore cover empirically while reviewing with neurology. 25 minutes ------ Protected Section Addendum Entered By:[**Name (NI) **] [**Last Name (NamePattern1) 906**], MD on:[**2163-6-7**] 02:38 ------
Physician
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Chief Complaint: Elective intbuation for bronchoscopy Reason for ICU admission: hypoxia HPI: Ms [**Known lastname 11669**] is an 81 year old woman with past medical history significant for chronic low back pain, coronary artery disease, hypertension, hyperlipidemia, and question of vasculitis, transferred to medicine from PACU after undergoing bronchoscopy for workup or a right lower lobe mass and developing a new oxygen requirement now transfered to the [**Hospital Unit Name 10**] for possible radiation. . Briefly, Ms [**Known lastname 11669**] began having a chronic cough and some hemoptysis this past [**Month (only) 1961**]. Workup for this included a CT scan, which revealed a large (6cm) cavitary lesion. She underwent extensive evaluation for possible metastatic disease including head MRI, PetCT and bronchoscopy, however although Pet revealed markedly FDG avid right lower lobe mass with a satellite nodule, transbronchial biopsy and washings were non diagnostic. Patient was electively admitted [**2151-3-22**] to have repeat rigid bronchoscopy with FNA of lymph nodes under ultrasound guidance. Patient was extubated without difficulty however she remained hypoxic was still requiring supplemental oxygen on admission to MICU [**Location (un) **]. . Patient denied any pain, but reported being slightly disoriented still. Had a heavy cough and reports some difficulty breathing, no nausea. . In the PACU, 137/68 96 93% on 50% face tent. Patient was given Lasix 20mg IV and was admitted to MICU team for further management. . In MICU [**Location (un) **] she continued to be hypoxic, thought [**1-26**] PNA, and was electively intubated on [**2151-3-23**] and started on Vancomycin/Cefepime. At this time she was also having episodes of VT that were treated with amiodarone load and then gtt. Since then these episodes seem to be resolved. She had an a-line and [**Date Range 864**] placed as well. She was extubated on [**3-24**] but overnight was having increased work of breathing, many secretions, coughing and was re-intubated. Currently on propofol with good oxygenation. The biopsy results came back positive for non-small cell carcinoma and today rad-onc was consulted. She was transferred to the [**Hospital Unit Name 10**] to initiate this treatment with rad-onc. On admission to the [**Hospital Unit Name 10**] the patient was intubated, sedated but able to answer questions. She denied pain and trouble breathing. Rest of ROS limited [**1-26**] intubation. Patient admitted from: [**Hospital1 1**] [**Hospital1 192**] History obtained from [**Hospital 31**] Medical records Patient unable to provide history: Sedated Allergies: No Known Drug Allergies Last dose of Antibiotics: Levofloxacin - [**2151-3-23**] 12:20 AM Ampicillin/Sulbactam (Unasyn) - [**2151-3-23**] 02:00 PM Cefipime - [**2151-3-24**] 06:30 PM Vancomycin - [**2151-3-25**] 08:00 AM Infusions: Fentanyl - 25 mcg/hour Midazolam (Versed) - 1 mg/hour Other ICU medications: Morphine Sulfate - [**2151-3-25**] 05:00 AM Other medications: CURRENT HOME MEDICATIONS: </b> Lasix 20 mg daily Lisinopril 20/HCTZ 12.5 mg a day Inderal 20 mg q.i.d. (for tremor) Gemfibrozil 600 mg b.i.d Simvastatin 20 mg a day Omeprazole 20 mg a day Caltrate 600 mg a day Iron 65 mg a day Aspirin 81 mg a day Protonix 40 mg a day Alprazolam 0.25 mg q.i.d. p.r.n. Lyrica 150 mg a day Darvocet p.r.n. SLNG as needed . CURRENT IN-HOSPITAL MEDICATIONS: </b> Codeine Sulfate 15 mg PO/NG Q4H:PRN cough [**3-22**] @ 2256 Morphine Sulfate 0.5-1 mg IV Q4H:PRN pain Acetaminophen 325-650 mg PO/NG Q6H:PRN pain/fever [**3-22**] @ 2329 Simvastatin 20 mg PO/NG DAILY [**3-22**] @ 2329 Aspirin 81 mg PO/NG DAILY Start: In am [**3-22**] @ 2329 Lidocaine 5% Patch 1 PTCH TD DAILY [**3-23**] @ 0925 Alprazolam 0.25 mg PO/NG TID:PRN anxiety [**3-23**] @ 0925 Fentanyl Citrate 25-100 mcg/hr IV DRIP INFUSION [**3-23**] @ 1511 Midazolam 0.5-2 mg/hr IV DRIP INFUSION Albuterol Inhaler 6 PUFF IH Q4H:PRN wheezing [**3-23**] @ 1638 Ipratropium Bromide MDI 6 PUFF IH Q4H:PRN wheezing [**3-23**] @ 1638 CefePIME 2 g IV Q24H [**3-23**] @ 1708 Vancomycin 1000 mg IV Q 24H Phenylephrine 0.5-5 mcg/kg/min IV DRIP TITRATE TO MAP > 60 [**3-23**] @ [**2053**] Pantoprazole 40 mg IV Q24H [**3-24**] @ 0148 Lorazepam 0.5 mg IV Q6H:PRN anxiety - please give ONLY IF UNABLE TO TAKE PO XANAX Past medical history: Family history: Social History: CAD - with reversible defect on p-mibi [**2146**] Diastolic Dysfunction - EF 67% Low anterior resection [**2146**] for complicated diverticular disease HTN Hyperlipidemia Vasculitis? Lower extremity neuropathy Post operative pulmonary embolis <br><b>PAST SURGICAL HISTORY: </b> ILEOSTOMY [**1-26**] DIVERTICULITIS s/p takedown in [**2146**] No family history of lung cancer Sister with breast cancer Occupation: Drugs: Tobacco: Alcohol: Other: Ex smoker, 20 pack year history. Denies alcohol or drug use. Lives with room mate, is originally from [**Country 10520**]. Review of systems: Flowsheet Data as of [**2151-3-25**] 10:27 AM Vital Signs Hemodynamic monitoring Fluid Balance 24 hours Since [**52**] AM Tmax: 37.6 C (99.6 Tcurrent: 36.5 C (97.7 HR: 102 (83 - 133) bpm BP: 112/64(81) {96/50(65) - 160/90(116)} mmHg RR: 22 (20 - 33) insp/min SpO2: 92% Heart rhythm: ST (Sinus Tachycardia) Wgt (current): 73.7 kg (admission): 74.4 kg Total In: 1,485 mL 571 mL PO: TF: IVF: 1,425 mL 571 mL Blood products: Total out: 655 mL 360 mL Urine: 655 mL 360 mL NG: Stool: Drains: Balance: 830 mL 211 mL Respiratory O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 450 (450 - 450) mL Vt (Spontaneous): 426 (426 - 675) mL PS : 8 cmH2O RR (Set): 20 RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 50% PIP: 18 cmH2O Plateau: 17 cmH2O Compliance: 37.5 cmH2O/mL SpO2: 92% ABG: 7.41/41/175/23/1 Ve: 10.5 L/min PaO2 / FiO2: 350 Physical Examination VITAL SIGNS - Temp99.1 F, BP 118/65mmHg, HR 109-125 BPM, RR 22', O2-sat 97% on AC 450X20 50% FiO2 5 peep GENERAL - well-appearing female in NAD, comfortable, intubated HEENT - NC/AT, PERRLA, EOMI, sclerae anicteric, dry MM, NECK - supple, no JVD, RIJ without erythema/exudate LUNGS - good air movement, resp unlabored bronchial BS on right middle with otherwise CTA anterior lung fields HEART - PMI non-displaced, RRR, no MRG, nl S1-S2 ABDOMEN - NABS, soft/ND, no masses or HSM, no rebound/guarding but slight TTP RUQ. EXTREMITIES - trace edema bilaterally Labs / Radiology 563 K/uL 8.2 g/dL 108 mg/dL 0.8 mg/dL 18 mg/dL 23 mEq/L 105 mEq/L 3.6 mEq/L 138 mEq/L 26.7 % 15.5 K/uL [image002.jpg] [**2146-12-26**] 2:33 A3/30/[**2150**] 07:13 AM [**2146-12-30**] 10:20 P3/30/[**2150**] 04:21 PM [**2146-12-31**] 1:20 P3/30/[**2150**] 04:39 PM [**2147-1-1**] 11:50 P3/30/[**2150**] 10:31 PM [**2147-1-2**] 1:20 A3/31/[**2150**] 03:44 AM [**2147-1-3**] 7:20 P3/31/[**2150**] 03:54 AM 1//11/006 1:23 P3/31/[**2150**] 07:39 AM [**2147-1-26**] 1:20 P3/31/[**2150**] 04:06 PM [**2147-1-26**] 11:20 P4/1/[**2150**] 02:13 AM [**2147-1-26**] 4:20 P4/1/[**2150**] 05:04 AM WBC 17.8 28.1 19.3 15.5 Hct 28.6 30.2 28.0 26.7 Plt 695 648 766 563 Cr 1.0 1.1 1.0 0.8 TropT 0.07 0.25 0.19 TC02 29 31 28 26 27 Glucose 89 129 116 110 118 100 108 Other labs: PT / PTT / INR:16.3/95.5/1.4, CK / CKMB / Troponin-T:42//0.19, ALT / AST:[**4-6**], Alk Phos / T Bili:72/0.2, Differential-Neuts:91.2 %, Lymph:6.0 %, Mono:2.2 %, Eos:0.5 %, Lactic Acid:1.5 mmol/L, Albumin:2.2 g/dL, Ca++:11.2 mg/dL, Mg++:1.9 mg/dL, PO4:2.2 mg/dL Fluid analysis / Other labs: Last ABG: 7.41/41/175/27 on 450X20 50% peep5 Imaging: CXR [**2151-3-25**]: FINDINGS: As compared to the previous examination, the monitoring and support devices are in unchanged position. The extent of the right-sided pleural effusion has minimally decreased. On the left, no effusion is present. In unchanged manner, mild-to-moderate pulmonary edema is present. Unchanged retrocardiac atelectasis. No evidence of newly appeared focal parenchymal opacities suggesting pneumonia. . CTA CHEST ([**2151-1-15**]) IMPRESSION: 1. Large, necrotic right lower lobe cavitated 6 cm mass, and adjacent necrotic 2 cm nodule, both with peripheral enhancement. Differential diagnosis includes necrotic neoplasm, infection (including granulomatous infection), or vasculitis, such as Wegener's granulomatosis. Recommend biopsy/tissue sampling - the larger mass is amenable to either bronchoscopic or percutaneous approach for biopsy. 2. Emphysema. 3. Stable nonspecific mild subpleural interstitial fibrosis. . ECHO: ([**2150-3-26**]) The left atrium is elongated. The right atrium is moderately dilated. Left ventricular wall thicknesses and cavity size are normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded but appears the inferior wall is hypokinetic. Transmitral Doppler and tissue velocity imaging are consistent with Grade I (mild) LV diastolic dysfunction. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. Mild (1+) mitral regurgitation is seen. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2147-5-23**], there is no significant change IMPRESSION: Focal left ventricular dysfunction c/w CAD. Mild mitral regurgitation. Microbiology: [**2151-3-23**] 6:00 pm BRONCHOALVEOLAR LAVAGE GRAM STAIN (Final [**2151-3-23**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. NO MICROORGANISMS SEEN. RESPIRATORY CULTURE (Preliminary): NO GROWTH, <1000 CFU/ml. PATHOLOGY: ([**2151-3-23**]) II. Right lung, transbronchial biopsy: Poorly-differentiated non-small cell carcinoma with squamoid features. Assessment and Plan RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name 2**]) Ms [**Known lastname 11669**] is an 81 year old woman with past medical history significant for coronary artery disease and hypertension, admitted for elective bronchoscopy to workup right lower lobe mass found to be non-small cell carcinoma complicated by hypoxic respiratory failure now transfered to the [**Hospital Unit Name 10**] for possible radiation. . #. Hypoxic Respiratory Failure: Likely [**1-26**] PNA and underlying malignancy although BAL at bedside did not reveal any organisms. CXR not consistent with ARDS and other etiologies more likely than PE. Does have history of diastolic CHF and was getting 20mg IV lasix PRN in MICU to help with hypoxia given CXR finding of increased pulm edema. - Continue ARDSNET ventilation - Treat malignancy as below - contiue current abx (vanc/cfp) for HCAP. Today is day [**3-7**]. - Attempt weaning vent settings after rad onc treatment - consider therapeutic thoracentesis if continues to be hypoxic - F/U rad-onc recs although preliminarily they believe this will not be helpful to the acute hypoxia it may help the airway irritation/secretions that caused her to be reintubated overnight->suggest CT Chest to better evaluate. Attending will see her later today - Lasix 20mg IV PRN with goal -500-1L today. . # Hypercalcemia: Albumin only 2.2 so corrected calcium actually >12. With appropriately low PTH this is likely from malignancy related tumor factors. - Follow up parathyroid related peptide - Treat with lasix PRN - Consider bisphosphonates . # Anemia: LIkely ACD however hct lower today than has been (26 from 28). - Check PM hct and if lower send hemolysis labs, iron studies. . #. Non-small Cell CA: Biopsy results confirmed this diagnosis - patient is unaware of the diagnosis. - Follow up rad-onc recs re: radiation treatment in next week - DVT prophylaxis . # VT. Possibly triggered by hypoxia/respiratory distress. 4 episodes over ~30 minutes which broke with amiodarone (150 x 2 and then 0.5 mg/min drip) and respiratory support. Was intubated and started on amiodarone drip with no more episodes. Completed amiodarone drip, monitored off PO with no more episodes. - Monitor on telemetry . # Troponin leak. With known h/o CAD this was likely demand ischemia in setting of tachyarrhythmia, hypoxia. No significant increase in CK, CK-MB. Troponins now down-trending. - Trend EKG - Continue ASA, statin. . # Hyperlipidemia: Continue statin. . # Chronic Diastolic Heart Failure: Has h/o HF with normal EF on TTE last year. Currently with pulm edema on CXR that may be contributing to hypoxia as above. - I/O - 500-1L today - Daily weights . #. FEN - No IVF, E- replete PRN, N- NPO ->will need to start tube feeds after rad-onc recs . #. Access - [**Last Name (LF) 864**], [**First Name3 (LF) 865**] . #. PPx - -DVT ppx with SC heparin -Bowel regimen colace/senna -Pain management with fent/midaz . #. Code - full . # Communication: with neice . #. Dispo - ICU pending clinical improvement ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2151-3-23**] 01:58 PM 18 Gauge - [**2151-3-23**] 02:20 PM Arterial Line - [**2151-3-23**] 03:30 PM Multi Lumen - [**2151-3-23**] 05:45 PM Prophylaxis: DVT: SQ UF Heparin Stress ulcer: PPI VAP: HOB elevation, Mouth care, Daily wake up, RSBI Comments: Communication: Comments: Code status: Full code Disposition: ICU
Physician
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Chief Complaint: resp failure I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 24 Hour Events: CARDIOVERSION/DEFIBRILLATION - At [**2167-10-19**] 11:50 AM aqdenosine 6mg given X 1 by cardiologist to assess pt's rhythm. Pt tolerated well. Held Valium ansd Benedryl and has done well without Allergies: Penicillins Rash; blisters; Tetracycline Rash; Sulfa (Sulfonamides) Rash; Last dose of Antibiotics: Infusions: Other ICU medications: Other medications: Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2167-10-20**] 11:48 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.5 C (97.7 Tcurrent: 36.5 C (97.7 HR: 118 (76 - 144) bpm BP: 131/72(85) {93/43(0) - 154/134(138)} mmHg RR: 26 (12 - 36) insp/min SpO2: 94% Heart rhythm: ST (Sinus Tachycardia) Wgt (current): 106 kg (admission): 94.2 kg Height: 67 Inch Total In: 1,945 mL 680 mL PO: TF: IVF: 1,800 mL 560 mL Blood products: Total out: 2,300 mL 680 mL Urine: 2,245 mL 680 mL NG: 55 mL Stool: Drains: Balance: -355 mL 0 mL Respiratory support O2 Delivery Device: High flow neb, Tracheostomy tube Ventilator mode: MMV/PSV/AutoFlow Vt (Set): 500 (500 - 500) mL Vt (Spontaneous): 319 (319 - 319) mL PS : 10 cmH2O RR (Set): 12 RR (Spontaneous): 15 PEEP: 5 cmH2O FiO2: 50% RSBI Deferred: No Spon Resp PIP: 15 cmH2O SpO2: 94% ABG: ///36/ Ve: 5.5 L/min Physical Examination Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 10.0 g/dL 548 K/uL 128 mg/dL 0.8 mg/dL 36 mEq/L 4.1 mEq/L 6 mg/dL 105 mEq/L 148 mEq/L 32.7 % 7.6 K/uL [image002.jpg] [**2167-10-13**] 05:00 AM [**2167-10-14**] 02:06 AM [**2167-10-15**] 07:34 AM [**2167-10-16**] 03:50 AM [**2167-10-16**] 06:22 AM [**2167-10-17**] 02:58 AM [**2167-10-18**] 03:43 AM [**2167-10-18**] 05:02 PM [**2167-10-19**] 03:36 AM [**2167-10-20**] 02:30 AM WBC 5.9 7.5 5.6 6.1 7.0 7.1 7.1 6.9 7.6 Hct 27.2 26.8 27.0 27.0 29.7 28.9 29.2 27.8 32.7 Plt 296 306 335 [**Telephone/Fax (3) **] 452 467 548 Cr 0.7 0.6 0.5 0.7 0.7 0.6 0.7 0.8 0.7 0.8 Glucose 134 134 121 [**Telephone/Fax (3) 1444**] 104 108 131 128 Other labs: PT / PTT / INR:48.3/33.3/5.5, CK / CKMB / Troponin-T:72//<0.01, ALT / AST:25/19, Alk Phos / T Bili:106/0.2, Amylase / Lipase:[**10-22**], Differential-Neuts:83.4 %, Lymph:10.4 %, Mono:2.8 %, Eos:3.0 %, Fibrinogen:710 mg/dL, Lactic Acid:1.1 mmol/L, Albumin:3.5 g/dL, LDH:192 IU/L, Ca++:10.0 mg/dL, Mg++:2.5 mg/dL, PO4:4.3 mg/dL Assessment and Plan 1. Tachycardia: runs of atach versus AVNRT. On bblocker be not very effective- EP consult for ? is there an ablatable focus. 2. Resp Failure Trach mask trials as tolerating (needing QHS support at present) PMV trials S/P rx for pan [**Last Name (un) 46**] Klebs PNA. Per IP not stent planned as technically not possible to place into her airway 3. DVT and coagulopathy On warfarin but high inr. Hold warfarin until inr 2-2.5 range or bridge with loveox if may get procedures 4. Feeding tube Getting reglan trial but still with emesis. Need to coordinate IR advance of G to J tube with Thoracics 5. Hypernatremia Replete free water. Please see today s ICU team note for other issues. ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2167-10-19**] 12:00 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition :ICU Total time spent:
Physician
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Admission Date: [**2130-7-3**] Discharge Date: [**2130-7-6**] Service: Medicine Intensive Care Unit - Green CHIEF COMPLAINT: The patient came in with hematemesis, melanotic stools. HISTORY OF PRESENT ILLNESS: This is an 83 year old female with past medical history of cerebrovascular accident, congestive heart failure, hypertension, prior seizure disorder treated one month ago for congestive heart failure flare, diagnosed at [**Hospital6 256**] in the Emergency Department by chest x-ray. The patient had two episodes of hematemesis and multiple episodes of melena. The patient was admitted to the Emergency Department from the nursing home PD. No 1:2 contact and could not communicate well with anyone at the nursing home. In the Emergency Room the patient had one episode of hypotension. A right internal jugular central line was placed. The patient had nasogastric lavage which was grossly bloody with no clots. The patient received 1.9 liters of fluid and was hemodynamically stable. The patient also received 5 mg Vitamin K subcutaneously. The patient received 1 unit of fresh frozen plasma in the Emergency Department and 1 unit of fresh frozen plasma on the way to the unit. The patient was Do-Not-Resuscitate, Do-Not-Intubate and the patient had no shortness of breath or chest pain. PHYSICAL EXAMINATION: On physical examination the patient had a temperature of 97. The patient had a blood pressure of 116/63, pulse of 80, respiratory rate of 21 and was sating 96% on room air. Pertinent physical findings revealed the patient's chest was clear to auscultation bilaterally. Heart, regular rate and rhythm, no murmurs, rubs or gallops. Abdomen was soft and obese and she had some right upper quadrant tenderness. Extremities were 1+ edema bilateral lower. Neurologically she had some right facial weakness, otherwise cranial nerves were grossly intact. LABORATORY DATA: She came in with a hematocrit of 31.6 and an INR of 4.2. The patient had a chest x-ray which showed a right venous catheter and bilateral mid to lower lung sound atelectasis. The patient had electrocardiogram, sinus at 96 with normal axis, normal intervals, no ST-T wave changes except for flip Ts in 1 and AVL which were consistent with previous electrocardiogram. HOSPITAL COURSE: The patient was admitted to the Medicine Intensive Care Unit and diagnosed with gastrointestinal bleed. The patient received 2 units of blood and a total of 4 units of fresh frozen plasma over the course of the stay for the gastrointestinal bleed. On [**7-6**], the patient underwent an upper esophagogastroduodenoscopy that showed gastritis and two ulcers in the duodenal bulb which were not given any treatment. There was no blood and they stabilized on their own. The patient also received Protonix 40 mg intravenously b.i.d. Cardiac - The patient has a history of congestive heart failure, coronary artery disease, kept hematocrit greater than 30 with 2 units of packed red blood cells and gave only careful hydration, one bolus of 250 cc. The patient also had Zestril changes to Captopril in case of bleed. That should be decided by outpatient doctor, what to do with cardiac medications. Chest - We monitored the patient for congestive heart failure. The patient was fine. Heme - The patient received fresh frozen plasma and packed red blood cells as previously stated. The patient also received Vitamin K as previously stated. INR was reduced to 1.3. The patient is to have Pneuma boots in [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **] rather than Coumadin because of bleed risk. Outpatient doctor [**First Name (Titles) **] [**Last Name (Titles) 11197**] in future for Coumadin. Neurological - The patient had previous cerebrovascular accident and we continued on Phenobarbital and Prozac with seizure history. Infectious disease - No issues. Genitourinary - The patient had Foley catheter placed to monitor intake and output. Electrolytes were monitored over the course of the stay. The patient had a brief episode of hypernatremia treated with free water. The patient prepared for discharge with discontinuation of right internal jugular line, central line, right nasal cannula, Foley catheter and Telemetry. CONDITION ON DISCHARGE: Stable. DISCHARGE STATUS: Back to [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **], already talked to the nurse on the floor. DISCHARGE DIAGNOSIS: 1. Upper gastrointestinal bleed due to duodenal bulb ulcers DISCHARGE MEDICATIONS: 1. Pantoprazole 40 mg p.o. q. 12 hours 2. Phenobarbital 90 mg p.o. q. AM 3. Fluoxetine 20 mg p.o. q.d. 4. Colace 100 mg p.o. b.i.d. prn The patient did not receive ACE inhibitors in-house on [**7-6**] due to low blood pressure. Outpatient doctor to decide, though the patient's pressure remains low. [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(1) 968**] Dictated By:[**Name8 (MD) 23023**] MEDQUIST36 D: [**2130-7-6**] 11:53 T: [**2130-7-6**] 14:23 JOB#: [**Job Number 31671**]
Discharge summary
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CVICU HPI: 52yoM POD # 1 from AVR (25 StJude Mech)/Asc Ao replacement/CABG x1(LIMA-LAD) PMHx: Complete Heart Block(PPM), Postop DVT in LUE [**3-20**] following lead extraction, Hyperlipidemia, s/p Dual chamber pacemaker '[**87**], s/p replacement PM generator '[**96**], s/p Lead extraction & reimplantation of PPM [**3-20**], Hernia repair as child Current medications: Acetaminophen, Albumin 5% (25g / 500mL), Aspirin EC, CefazoLIN, Docusate Sodium, Furosemide, Insulin, Ketorolac, Magnesium Sulfate, Metoclopramide, Metoprolol Tartrate, Milk of Magnesia, Morphine Sulfate, Oxycodone-Acetaminophen, Potassium Chloride, Ranitidine, Warfarin 24 Hour Events: WOUND CULTURE - At [**2105-2-3**] 01:25 PM OR RECEIVED - At [**2105-2-3**] 01:25 PM INVASIVE VENTILATION - START [**2105-2-3**] 01:25 PM ARTERIAL LINE - START [**2105-2-3**] 01:50 PM [**Location (un) **] LINE - START [**2105-2-3**] 01:51 PM CCO PAC - START [**2105-2-3**] 01:51 PM EKG - At [**2105-2-3**] 03:30 PM EXTUBATION - At [**2105-2-3**] 08:35 PM Allergies: Penicillins Unspecified Last dose of Antibiotics: Cefazolin - [**2105-2-4**] 04:05 AM Other ICU medications: Ranitidine (Prophylaxis) - [**2105-2-3**] 05:44 PM Morphine Sulfate - [**2105-2-3**] 09:30 PM Insulin - Regular - [**2105-2-4**] 03:01 AM Furosemide (Lasix) - [**2105-2-4**] 06:00 AM Flowsheet Data as of [**2105-2-4**] 08:40 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**06**] a.m. HR: 85 (73 - 104) bpm BP: 98/64(71) {98/64(71) - 102/79(85)} mmHg RR: 23 (12 - 32) insp/min SPO2: 98% Heart rhythm: V Paced Wgt (current): 135.5 kg (admission): 125 kg Height: 71 Inch CVP: 14 (3 - 16) mmHg PAP: (31 mmHg) / (21 mmHg) CO/CI (Fick): (7.7 L/min) / (3.2 L/min/m2) CO/CI (CCO): (6 L/min) / (3.9 L/min/m2) SvO2: 69% Mixed Venous O2% sat: 82 - 82 Total In: 5,712 mL 685 mL PO: 120 mL 200 mL Tube feeding: IV Fluid: 5,592 mL 235 mL Blood products: 250 mL Total out: 1,195 mL 820 mL Urine: 785 mL 600 mL NG: 50 mL Stool: Drains: Balance: 4,517 mL -136 mL Respiratory support O2 Delivery Device: Nasal cannula Ventilator mode: CPAP/PSV Vt (Set): 600 (550 - 600) mL Vt (Spontaneous): 771 (771 - 771) mL RR (Set): 18 RR (Spontaneous): 14 PEEP: 5 cmH2O FiO2: 50% RSBI: 14 PIP: 17 cmH2O Plateau: 17 cmH2O SPO2: 98% ABG: 7.37/44/198/23/0 Ve: 14.2 L/min PaO2 / FiO2: 396 Physical Examination General Appearance: No acute distress HEENT: PERRL Cardiovascular: (Rhythm: Regular) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Diminished: bases) Abdominal: Soft, Non-distended, Non-tender Left Extremities: (Edema: 2+), (Temperature: Warm), (Pulse - Dorsalis pedis: Present), (Pulse - Posterior tibial: Present) Right Extremities: (Edema: 2+), (Temperature: Warm), (Pulse - Dorsalis pedis: Present), (Pulse - Posterior tibial: Present) Skin: (Incision: Clean / Dry / Intact) Neurologic: (Awake / Alert / Oriented: x 3), Follows simple commands, Moves all extremities Labs / Radiology 188 K/uL 10.1 g/dL 133 mg/dL 0.7 mg/dL 23 mEq/L 4.9 mEq/L 14 mg/dL 108 mEq/L 138 mEq/L 30.9 % 12.6 K/uL [image002.jpg] [**2105-2-3**] 12:01 PM [**2105-2-3**] 12:21 PM [**2105-2-3**] 12:24 PM [**2105-2-3**] 01:32 PM [**2105-2-3**] 01:51 PM [**2105-2-3**] 02:42 PM [**2105-2-3**] 03:40 PM [**2105-2-3**] 07:28 PM [**2105-2-3**] 07:47 PM [**2105-2-4**] 02:43 AM WBC 13.1 12.6 Hct 29 28 29.6 29.6 30.9 Plt [**Telephone/Fax (3) 11170**] Creatinine 0.6 0.7 TCO2 23 24 25 24 24 26 Glucose 153 136 113 106 115 138 133 Other labs: PT / PTT / INR:12.9/27.7/1.1, Fibrinogen:181 mg/dL, Lactic Acid:4.4 mmol/L, Mg:1.8 mg/dL Imaging: CXR: sm pleural effusions L>R Microbiology: NGTD ECG: SR Assessment and Plan CORONARY ARTERY BYPASS GRAFT (CABG), VALVE REPLACEMENT, AORTIC MECHANICAL (AVR), ACUTE PAIN Assessment and Plan: s/p AVR(25 StJude Mech)Asc Ao replacement/CABG x1(LIMA-LAD)[**2-3**] now extubated successfuly Neurologic: Neuro checks Q: 4 hr, Pain controlled, On percocet and toradol Cardiovascular: Aspirin, Beta-blocker, HD stable. Pacemaker interrogation by EP was normal, remove epicardial wires. Start home dose of zocor today. Will start 5 mg coumadin tonight for mechanical valve. SBP goal <120. Pulmonary: IS, OOB chair, ambulate. [**Month (only) 11**] discontinuing chest tube later based on output. Gastrointestinal / Abdomen: Bowel regimen Nutrition: Regular diet Renal: Foley, Adequate UO, Diurese for goal of [**12-12**].5 L negative today. Hematology: Serial Hct, post-operative anemia, monitor for now Endocrine: RISS with adequate BG control, Blood glucose goal of <150 Infectious Disease: No evidence of infection. Peri-op cefazolin Lines / Tubes / Drains: Foley, Chest tube - pleural , Chest tube - mediastinal, Pacing wires Wounds: Dry dressings Consults: Cardiovascular, P.T. ICU Care Nutrition: Heart healthy Glycemic Control: RISS, blood glucose goal <150 Lines: 18 Gauge - [**2105-2-3**] 01:52 PM Prophylaxis: DVT: Boots Stress ulcer: H2 blocker VAP bundle: HOB elevated, mouth care Communication: Patient discussed on morning rounds by surgical team Code status: Full code Disposition: Transfer to floor Total time spent: 20 min
General
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[**2136-2-13**] 1:08 PM CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 26937**] Reason: Changes from reference CT scan. ? continued abdominal proces Admitting Diagnosis: ISCHEMIC BOWEL Contrast: OMNIPAQUE Amt: 130 ______________________________________________________________________________ [**Hospital 2**] MEDICAL CONDITION: 74 year old man enteritis/colitis with continued diarrhea. Looking for areas of inflammation for possible biopsy on [**2136-2-14**]. Would like PO/IV contrast REASON FOR THIS EXAMINATION: Changes from reference CT scan. ? continued abdominal process. No contraindications for IV contrast ______________________________________________________________________________ FINAL REPORT HISTORY: 74 year male with enteritis and continued diarrea. COMPARISON: Prior CTs from [**Hospital3 **] dated [**2136-2-3**], [**2-5**], [**2135**], and [**2136-2-7**] and prior CT from [**Hospital1 26938**] dated [**2136-2-9**]. TECHNIQUE: Multidetector helical acquisition was obtained through the abdomen and pelvis with 130 mL of intravenous contrast. Additional sagittal and coronal reformatted images were obtained. ABDOMEN: There is stable cardiomegaly. The lung bases are clear. The liver, gallbladder, adrenals, pancreas and spleen appear normal. There are small stable bilateral renal cysts. There is atherosclerotic disease of the aorta. There is no retroperitoneal adenopathy. There is interval increase in the amount of abdominal ascites. There is unchanged mural thickening, edema and heterogeneous enhancement essentially contiguously from the distal jejunum through the terminal ileum to the ileocecal valve. The colon is fluid filled; however, the colonic wall is normal in thickness and enhancement. PELVIS: The bladder is collapsed with a Foley catheter within it with interval decrease in the perivesicular stranding. There is pelvic ascites, which has increased from the prior exam. There is no pelvic adenopathy or mass. The osseous structures are intact. IMPRESSION: Unchanged mural thickening, edema and heterogeneous enhancement essentially contiguously from the distal jejunum through the terminal ileum to the ileocecal valve. Interval increase in the amount of ascites. This is most suggestive of an inflammatory enteritis (eg, autoimmune or eosinophilic but not Crohn's) or infectious enteritis given the appearance and progression from [**2136-2-5**] through [**2136-2-9**] CTs. Decreased perivesicular stranding. (Over) [**2136-2-13**] 1:08 PM CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 26937**] Reason: Changes from reference CT scan. ? continued abdominal proces Admitting Diagnosis: ISCHEMIC BOWEL Contrast: OMNIPAQUE Amt: 130 ______________________________________________________________________________ FINAL REPORT (Cont)
Radiology
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MICU Intern Progress Note: 24 Hour Events: FEVER - 103.0 F - [**2170-5-17**] 12:00 AM - HIV, pcp negative [**Name Initial (PRE) **] sent [**Doctor First Name **], ANCA - changed CTX to Cefepime - continues to [**Last Name (LF) **], [**First Name3 (LF) **] far cultures negative Allergies: Atorvastatin Nausea/Vomiting Ibuprofen Nausea/Vomiting Levofloxacin Hives; Last dose of Antibiotics: Ceftriaxone - [**2170-5-15**] 05:36 PM Azithromycin - [**2170-5-16**] 10:00 AM Vancomycin - [**2170-5-16**] 08:07 PM Cefipime - [**2170-5-17**] 12:29 AM Infusions: Fentanyl (Concentrate) - 200 mcg/hour Midazolam (Versed) - 4 mg/hour Other ICU medications: Heparin Sodium (Prophylaxis) - [**2170-5-16**] 04:00 PM Famotidine (Pepcid) - [**2170-5-16**] 07:30 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2170-5-17**] 07:19 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 39.4 C (103 Tcurrent: 38.3 C (101 HR: 92 (85 - 94) bpm BP: 118/55(75) {99/48(64) - 133/63(86)} mmHg RR: 16 (13 - 29) insp/min SpO2: 96% Heart rhythm: ST (Sinus Tachycardia) Height: 59 Inch CVP: 15 (8 - 15)mmHg Total In: 2,422 mL 182 mL PO: TF: IVF: 2,322 mL 182 mL Blood products: Total out: 643 mL 400 mL Urine: 643 mL 400 mL NG: Stool: Drains: Balance: 1,779 mL -218 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV/ASSIST Vt (Set): 350 (350 - 350) mL RR (Set): 26 RR (Spontaneous): 0 PEEP: 18 cmH2O FiO2: 60% RSBI Deferred: PEEP > 10 PIP: 30 cmH2O Plateau: 24 cmH2O Compliance: 58.3 cmH2O/mL SpO2: 96% ABG: 7.31/47/90.[**Numeric Identifier 433**]/20/-2 Ve: 9.2 L/min PaO2 / FiO2: 150 Physical Examination General Appearance: Overweight / Obese, intubated, sedated Cardiovascular: (S1: Normal), (S2: Normal), distant heart sounds, no m/r/g appreciated Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Crackles : anterior and posterior crackles throughout, No(t) Bronchial: , Wheezes : end expiratory wheezes and squeaking Abdominal: Soft, Bowel sounds present, non-tender, nondistended Musculoskeletal: diffuse tenderness to palpation Skin: warm and well perfused Neurologic: Attentive, Follows simple commands, Responds to: Verbal stimuli, Oriented (to): self, person, place, Movement: Purposeful, Tone: wnl. AAO X 3, slightly tearful during exam. Follows commands. Decreased sensation to light touch entire left side including facial area. Motor: [**3-4**] upper extremity bilateral and [**4-3**] lower extremity bilateral. Labs / Radiology 373 K/uL 9.9 g/dL 106 mg/dL 1.2 mg/dL 20 mEq/L 3.5 mEq/L 28 mg/dL 110 mEq/L 142 mEq/L 29.1 % 8.7 K/uL [image002.jpg] [**2170-5-15**] 08:45 PM [**2170-5-15**] 11:14 PM [**2170-5-16**] 02:55 AM [**2170-5-16**] 03:45 AM [**2170-5-16**] 03:59 AM [**2170-5-16**] 06:56 AM [**2170-5-16**] 02:43 PM [**2170-5-16**] 05:11 PM [**2170-5-17**] 04:44 AM [**2170-5-17**] 05:00 AM WBC 7.9 8.7 Hct 31.1 29.1 Plt 321 373 Cr 0.6 1.2 TCO2 25 25 28 26 27 27 26 25 Glucose 93 106 Other labs: PT / PTT / INR:16.3/30.1/1.4, CK / CKMB / Troponin-T:41/2/<0.01, ALT / AST:27/36, Alk Phos / T Bili:121/0.3, Differential-Neuts:78.2 %, Lymph:17.5 %, Mono:3.5 %, Eos:0.7 %, Lactic Acid:1.1 mmol/L, LDH:583 IU/L, Ca++:7.8 mg/dL, Mg++:2.0 mg/dL, PO4:2.6 mg/dL Assessment and Plan 54F w DM2, HTN, NSTEMI who p/w fever, cough, myalgias, n/v/d and found to have hypoxia and multi-focal infiltrates on CXR. # Respiratory distress: [**1-1**] multi-focal pneumonia requiring intubation. Differential includes PNA secondary to staph, pneumococal, atypicals (Mycoplasma, Chlamyadia), aspiration PNA. Also on differential less common etiologies such as Histoplasma, Ehrlichia and Babesia. Legionella and influenza negative. Continues to have fevers. Also on differential is autoimmune etiology. S/p ceftriaxone. - continue vancomycin ([**5-13**] - - continue cefepime - continue azithro ([**5-13**] - ) - consider adding doxycycline if patient s clinical status worsens - consider gentle diuresis (goal: even to negative -500cc per 24 hrs) - f/u serologies for Mycoplasma, Chlamyadia, Histoplasma, Ehrlichia and Babesia - f/u urine S. pneumoniae AG - f/u bl cxs, urine cx - f/u HIV test - f/[**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], ANCA to eval vasculitis - ID c/s - CIS - continue mechanical ventilation - follow ABGs - consider mini BAL # ARF: possibly pre-renal [**1-1**] hypotension, sepsis vs autoimmune vasculitis - monitor UOP - check urine lytes - goal even to -500cc per 24 hrs - renally dose meds - avoid nephrotoxins # Headache: Chronic. CT head unremarkable. Prior to admission MRI/MRA unremarkable. Low suspicion of meningitis on admission. - Continue sedation # Tranaminitis: Trending down. Slight elevation in AST/ALT/alkphos but TBili wnl. Final CT abd/pelivs fatty liver only. - Trend LFTs daily. # HTN Hold outpatient metoprolol until BP stable. # s/p NSTEMI Continue ASA and Statin. # Depression/anxiety: Continue sertraline. # DM: HISS ICU Care Nutrition: - nutrition consult for tube feeds Glycemic Control: Lines: 18 Gauge - [**2170-5-13**] 07:49 PM 20 Gauge - [**2170-5-14**] 12:18 PM Multi Lumen - [**2170-5-15**] 08:00 PM Arterial Line - [**2170-5-15**] 08:00 PM Prophylaxis: DVT: heparin SC Stress ulcer: famotidine VAP: Comments: Communication: Comments: Code status: Disposition: ------ Protected Section ------ I have seen and examined the patient with the resident and agree substantially with the assessment and plan with the following emphasis/changes: 54 year old history of DM who presents with fever, cough, headache and found to have significant hypoxemia and multifocal pneumonia. Worsened respiratory status requiring endotracheal intubation. Overnight, continues to have problems oxygenating and continues to have fevers. T 100.3 P 87 BP 116/60 RR SaO2: 94% on PEEP 18, Fio2 0.6 Gen: Intubated, sedated Chest: bilateral crackles and wheeze Heart: S1 S2 reg Abd: soft, NT ND Ext: No edema Neuro: sedated WBC: 8.7 Plt: 273 CXR: bilateral infiltrates Cultures: No growth ECHO: EF 55%, no vegetations, borderline pulmonary hypertension, 1. Respiratory Failure secondary to Pneumonia a. Continue broad-spectrum antibiotics (Cefepime/Vanco/Azithro) b. ID consult to discuss additional coverage/other etiologies c. Increase PEEP and follow to see if improvement in oxygenation; maintain Fio2 of 0.6 d. Maintain low tidal volume ventilation with goal plateau pressure < 30 mmHg 2. Headache: If respiratory status stabilizes, will perform LP 3. Nausea/vomiting/diarrhea: resolved 4. Depression/anxiety: continue Zoloft Addendum: At the end of the afternoon, patient s oxygen saturation worsened. We paralyzed patient with minimal improvement and increased PEEP from 18 to 20 with improvement in saturation from saturation from 89% to 94%. She still has room on her Fio2 and can bring up as needed overnight. Hemodynamics remain stable. Critical Care Time: 90 minutes ------ Protected Section Addendum Entered By:[**Name (NI) **] [**Last Name (NamePattern1) 402**], MD on:[**2170-5-17**] 11:46 PM ------
Physician
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Hyponatremia (low sodium, hyposmolality) Assessment: SIADH associated with TBI. Serum Na 143 with serum osmolality 302 Action: Q 4hour Na & osmolality monitored Salt tabs 2 grams TID continue 3% saline infusion discontinued Mannitol dosing changed to 12.5 gm Q 12 hours Neuro checks Q2 hour; dilantin dosing continues Response: Serum NA 142; osmolality 300 Fluid balance continues negative > 1Liter today No change neuro exam at this time; no seizure activity noted Pt craves water. Plan: Continue monitoring NA/osmolality Q4 hour; goal remains Na 145, osmolality >300<320 Continue to monitor urine output & total fluid balance Continue salt tabs and Mannitol dosing Neuro checks Q 2/hour: monitor for altered mental status Altered mental status (not Delirium) Assessment: A&O x2-3 today; pt is cooperative and appropriate; speech is clear & articulate. Action: Periods of sound napping provided Monitored for changes in mental status Response: At times, pt is transiently disoriented to place when wakens from deep sleep; reorients quickly; more restful following napping. Pt continues to engage with staff and family/visitors appropriately; remains A&O x2-3, cooperative & appropriate in manner. Decrease in impulsive behavior noted; pt able to recall and comply with activity restrictions but less so with dietary restrictions- which requires close supervision. Plan: Cont to monitor for changes in MS Cont to provide time to sleep; reorient as needed. Ineffective Coping Assessment: Pt s S.O. spent night in room. Family presented today with calm, rested demeanor and behavior after sleeping at home last night. Parents conversing amicably together in room, even joking. Parent s behaviors are notably more relaxed and they are compliant with call in guidelines. Action: Ongoing access to patient provided to family. Updates provided and; questions answered; POC reviewed. Dietary restrictions reviewed as needed. Plan made for family member to remain overnight Response: Parents visited throughout the day and able to return home in late afternoon without obvious distress. Mother spoke of returning to work next week; family has plans for father and sister to be at home with patient when ready for discharge. Father spoke calmly & excitedly of plans to discuss discharge plans next week with appropriate health team members. Parents demonstrated understanding of current care actions and goals and were able to reinforce these to pt when he had questions (i.e. regarding diet restrictions). Plan: Continue with current plan for flexible visitations and overnight stay of one family member. Cont to provide support and reassurance to all family members Headache Assessment: Continue complaints of right side posterior HA pain that remains sharp and rated [**2181-4-2**] Action: Percocet 2 tablets provided Response: Pain rating reduced to [**2-8**].] Return of HA in late afternoon to [**5-7**]; pt did not want to take something that would put him to sleep yet. Tylenol 650mg given without change in c/o after 45 minutes. Plan: Continue to assess, treat, and evaluate pain. Intracerebral hemorrhage (ICH) Assessment: Pt 1 week s/p assault causing fall onto head with TBI: bil frontal IPH and right occipital epidural bleed requiring evacuation. Pt s course then complicated by 2 episodes of increased cerebral edema and herniation associated with hyponatremia. Neuro exam has remained stable with perrl/brisk @ 3-5mm, consistently following commands and absent of focal deficits. No seizures; therapeutic dilantin levels. Action: Q 2 hour neuro checks; hemodynamics monitored Dilantin dosing continues and changed to po route Changes made in sodium/osmolality therapy: see above problem Response: [**Name2 (NI) 7080**] & unchanged neuro exam BP remains within goal range of <160 systolic without intervention Plan: Q 2 hour neuro checks; maintain safe environment; monitor & treat bp to keep within goal range with prn medications. Pt continues on pureed diet with nectar thickened liquids. Pt tolerating po diet with some coughing following ingestion of ice chips added to fluids. Pt continues to crave & request water . He ingests his thickened fluids quickly in spike of encouragement to drink slowly. He continues to require reinforcement about restrictions and supervision with fluid diet.
Nursing
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Admission Date: [**2199-12-26**] [**Year/Month/Day **] Date: [**2199-12-30**] Date of Birth: [**2119-1-27**] Sex: F Service: SURGERY Allergies: Sulfa (Sulfonamide Antibiotics) / Cephalosporins / Flagyl Attending:[**First Name3 (LF) 1481**] Chief Complaint: s/p Fall Major Surgical or Invasive Procedure: [**2199-12-27**] ORIF left intratrochanteric hip fracture History of Present Illness: 80 y/o female s/p fall to floor from standing Past Medical History: Chronic anemia - receives transfusions monthly per patient (has right portacath for chonic transfusions), recent dementia like symptoms, Diverticulitis, Colitis, ? COPD Social History: Had recently been staying with family secondary to increasing difficulty, her own home is a single story [**Last Name (un) **]. Family History: Noncontributory Physical Exam: Upon admission: O: T: BP: 132/41 HR:86 R16 O2Sats 100% Gen: WD/WN, comfortable, NAD. HEENT: Pupils: [**3-27**] EOMs full Neck: Supple. Lungs: CTA bilaterally. Cardiac: RRR. S1/S2. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Awake and alert, cooperative with exam, normal affect. Orientation: Oriented to person, place, and date (thought it was [**2099**]). Recall: 0/3 objects at 5 minutes. Language: Speech fluent with good comprehension and repetition. Naming intact. No dysarthria or paraphasic errors. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light,3 to 2 mm bilaterally. Visual fields are full to confrontation. III, IV, VI: Extraocular movements intact bilaterally without nystagmus. V, VII: Facial strength and sensation intact and symmetric. VIII: Hearing intact to voice. IX, X: Palatal elevation symmetrical. [**Doctor First Name 81**]: poor effort on right not tested on leftSternocleidomastoid and trapezius normal bilaterally. XII: Tongue midline without fasciculations. Motor: Has left shoulder fx left grip , left hip fx is able to wiggle toes. Right Bicep 4+ and Tricep 4+ grip 4+; Unable to test drift does not appear to drift on right Sensation: Intact to light touch CT/MRI: Small left sided occiptal subdural Pertinent Results: [**2199-12-26**] 10:50AM PT-13.8* PTT-27.0 INR(PT)-1.2* [**2199-12-26**] 10:50AM PLT COUNT-232 [**2199-12-26**] 10:50AM WBC-13.6* RBC-3.40* HGB-10.1* HCT-28.8* MCV-85 MCH-29.7 MCHC-35.0 RDW-21.8* [**2199-12-26**] 10:50AM cTropnT-<0.01 [**2199-12-26**] 10:50AM CK(CPK)-19* [**2199-12-26**] 10:50AM GLUCOSE-132* UREA N-16 CREAT-0.4 SODIUM-137 POTASSIUM-4.0 CHLORIDE-100 TOTAL CO2-31 ANION GAP-10 [**2199-12-26**] 01:00PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-SM UROBILNGN-8* PH-6.5 LEUK-NEG [**2199-12-26**] 01:00PM URINE RBC-0-2 WBC-0-2 BACTERIA-OCC YEAST-NONE EPI-0 [**2199-12-26**] 07:41PM WBC-11.1* RBC-3.33* HGB-9.9* HCT-27.8* MCV-84 MCH-29.8 MCHC-35.7* RDW-21.0* [**2199-12-26**] 07:41PM PLT COUNT-227 Brief Hospital Course: She was admitted to the Trauma Service and transferred to the trauma ICU. On initial workup she was noted to have a left chronic subdural hemorrhage with acute blood, a proximal humerus fracture, right inferior ramus and acetabular fracture and a left intratrochanteric fracture. She was evaluated by Neurosurgery for the SDH which was nonoperative. It was recommended that a repeat head CT be done which was stable. It was initially thought there may be a fracture of her cervical spine at C1-C2; an MRI was done and reviewed by Neurosurgery and no fracture was noted, just degenerative changes. The cervical collar was removed. She will follow up with Dr. [**First Name (STitle) **] in 4 weeks for a repeat head CT and will continue with the Keppra until that time. Orthopedics was consulted for the hip fracture; she was taken to the operating room on [**2199-12-27**] for ORIF of the left hip. Postoperatively she was transferred to the regular nursing unit. It was recommended to start Lovenox for a total of 4 weeks. she may weight bear as tolerated and will follow up with Dr. [**Last Name (STitle) **] in 2 weeks. Her humeral fracture was managed non operatively with a sling. Given her history of chronic anemia and need for monthly blood transfusions her hematocrits were monitored closely and remained relatively stable given her hip surgery. Last hematocrit on [**12-30**] was 23.4 (postop Hct was 23.5 on POD #1). She is followed by her PCP [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 6164**] in [**Hospital1 **], MA. She was evaluated by Physical and Occupational therapy and has been recommended for rehab after her acute hospital stay. Medications on Admission: Lasix 40 QD, Spironlactone 25mg [**Last Name (LF) 244**], [**First Name3 (LF) **] 325 QD + prn, Combivent and Advair [**First Name3 (LF) **] Medications: 1. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol Sig: [**12-27**] Puffs Inhalation Q6H (every 6 hours) as needed. 2. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 5. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 6. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed. Disp:*60 Tablet(s)* Refills:*0* 7. Enoxaparin 30 mg/0.3 mL Syringe Sig: One (1) 30mg/0.3ml Subcutaneous DAILY (Daily) for 4 weeks. Disp:*qs 30mg/0.3ml* Refills:*0* 8. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 9. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO at bedtime: hold for loose stools. 10. Multivitamins Tablet, Chewable Sig: One (1) Tablet PO DAILY (Daily). 11. Ascorbic Acid 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Zinc Sulfate 220 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). [**Hospital1 **] Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**] [**Location (un) **] Diagnosis: s/p Fall Subdural hemorrhage Left proximal humerus fracture Left acetabular fracture Left intratrochanteric hip fracture Pressure ulcer coccyx region (unstageable) Right pelvic ring fracture [**Location (un) **] Condition: Hemodynamically stable, tolerating a regular diet, pain adequately controlled. [**Location (un) **] Instructions: DO NOT bear any weight on your left arm because of your fracture. Continue to wear the sling for comfort. Continue the Keppra until follow up with Neurosurgery. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) **], Orthopedics in two weeks. Please call [**Telephone/Fax (1) 1228**] to schedule an appointment. Follow up with Dr. [**First Name (STitle) **], Neurosurgery in 4 weeks for a repeat head CT scan. Call [**Telephone/Fax (1) 1669**] for an appointment. A follow up MRI of your cervical spine is also being recommend at that time. Follow up with your primary care doctor [**First Name (Titles) **] [**Last Name (Titles) **] from rehab regarding an incidental finding on MRI imaging of your cervical spine (copy of report included in your [**Last Name (Titles) **] summary). You or a family member will need to call for an appointment. Completed by:[**2200-1-1**]
Discharge summary
Classify the following medical document.
TITLE: Chief Complaint: 24 Hour Events: INVASIVE VENTILATION - STOP [**2196-4-19**] 11:17 AM received from EW at 1421 - MR head final read: Small acute infarcts in the left occipital and right posterior temporal lobes. Embolic etiology should be considered. - Stroke team consulted; recs: MRA (or CTA) of head/neck; check HbA1c and lipid panel; continue heparin gtt; F/U telemetry for signs of A-fib (if develops, will need anticoagulation); keep euglycemia/euthermic - EEG pending - Endocrine consulted; recs: Suspect that this is PRIMARY adrenal insufficiency (not secondary/panhypopit) given the hypotension and hyperkalemia which are not seen in secondary insufficiency. Therefore, no need to pursue further pituitary fxn testing. Add on cortisol to admission labs (pre-steroids). Consider CT of adrenals to check for atrophied glands. Continue hydrocort 50 IV q8h while in ICU, start to taper [**4-20**] if clinicall stable (go to 25 IV q8h). - Antimicrobials (levofloxacin, acyclovir) stopped [**4-19**] - Continued heparin gtt per neuro recs Allergies: Augmentin (Oral) (Amox Tr/Potassium Clavulanate) Unknown; Last dose of Antibiotics: Vancomycin - [**2196-4-17**] 02:30 PM Ampicillin - [**2196-4-17**] 02:42 PM Levofloxacin - [**2196-4-18**] 07:36 PM Acyclovir - [**2196-4-19**] 09:41 AM Infusions: Heparin Sodium - 550 units/hour Other ICU medications: Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2196-4-20**] 07:16 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**98**] AM Tmax: 36.4 C (97.6 Tcurrent: 36.4 C (97.6 HR: 48 (44 - 59) bpm BP: 92/39(52) {92/39(52) - 111/55(69)} mmHg RR: 9 (6 - 12) insp/min SpO2: 96% Heart rhythm: SB (Sinus Bradycardia) Wgt (current): 72.6 kg (admission): 72.4 kg Total In: 1,470 mL 740 mL PO: 120 mL TF: IVF: 1,350 mL 740 mL Blood products: Total out: 1,295 mL 244 mL Urine: 1,295 mL 244 mL NG: Stool: Drains: Balance: 175 mL 496 mL Respiratory support O2 Delivery Device: None Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 500 (500 - 500) mL RR (Set): 12 RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 50% PIP: 21 cmH2O Plateau: 16 cmH2O SpO2: 96% ABG: //// Ve: 5.9 L/min Physical Examination Exam deferred in early morning as patient resting peacefully. Will reassess later in the day. Labs / Radiology Chem 7and CBC/diff and coags and LFTS from today pending CBC 9.3 / 37.1 / 243; Diff 89P, 6.5L Results from [**4-19**]: 237 K/uL 12.8 g/dL 110 mg/dL 1.2 mg/dL 22 mEq/L 4.3 mEq/L 28 mg/dL 99 mEq/L 132 mEq/L 37.3 % 10.1 K/uL [image002.jpg] [**2196-4-17**] 01:17 PM [**2196-4-17**] 03:27 PM [**2196-4-17**] 11:00 PM [**2196-4-18**] 05:30 AM [**2196-4-18**] 02:13 PM [**2196-4-19**] 12:55 AM WBC 10.6 6.6 6.6 9.5 10.1 Hct 41.6 37.7 36.5 34.5 37.3 Plt 200 212 217 214 237 Cr 1.5 1.3 1.2 1.2 1.2 TropT 0.21 1.08 0.92 0.45 Glucose 125 80 139 134 118 110 Other labs: PT / PTT / INR:13.2/53.6/1.1, CK / CKMB / Troponin-T:288/15/0.45, ALT / AST:29/64, Alk Phos / T Bili:96/0.4, Amylase / Lipase:/20, LDH:232 IU/L, Ca++:8.8 mg/dL, Mg++:1.7 mg/dL, PO4:3.9 mg/dL HbA1c pending Lipids pending TSH [**4-18**] 0.26; TSH [**4-17**] 1.1 Cortisol [**4-17**] 15.7 (admission lab) ACTH, renin pending HSV PCR on CSF - negative EKG [**4-20**] MRI head There are small foci of slow diffusion in the inferior posterior left occipital lobe and in the posterior right temporal lobe, consistent with acute infarctions. There is corresponding high signal on T2-weighted and FLAIR images, indicating that they are at least [**6-25**] hours old. There is a small chronic lacunar infarct in the right pons. There are multiple small foci of high T2 signal in the subcortical, periventricular, and deep white matter of the cerebral hemispheres, likely related to chronic small vessel ischemic disease. The ventricles and sulci are normal in size and configuration for age. There is no evidence of intracranial blood products. There is a 4-mm oval, smoothly marginated, fluid-intensity lesion in genu of the corpus callosum in the midline, which may represent a prominent perivascular space or a cyst, rather than a chronic infarct, given its smooth margins. The major arterial flow voids appear patent. The pituitary gland appears normal in size. IMPRESSION: Small acute infarcts in the left occipital and right posterior temporal lobes. Embolic etiology should be considered. Micro: No growth in blood or CSF or urine cultures Assessment and Plan [**Age over 90 **] y/o M with hx of HTN, hyperlipidemia, GERD and CKD presents from home today with confusion and complaints of inability to hear, in the ED found to be febrile to 100.8, was intubated for agitation and tachypnea, admitted to MICU. . # CHANGE IN MENTAL STATUS: Pt confused, with headache, complaining of inability to hear. DDx of change in mental status includes sepsis/infection, acute intracranial process (found to have multi-embolic stroke on MRI), seizure, infectious meningitis/encephalitis, hypoxemia (e.g. from arrhythmia), electrolyte imbalance, adrenal insufficiency, toxins. LP performed in ED does not show a pattern typical for bacterial infection. Acute hearing loss may be more consistent with viral infectious etiology. Non-infectious etiology including vasculitis or microvascular thrombosis/TIA could also cause acute hearing loss. Given low TSH, abnormal [**Last Name (un) 402**] stim test suspect panhypopituitarism related to ? central process; however as pt received high-dose dexamethasone in ED for empiric meningitis treatment, his decreased pituitary axis is likely related to that rather than a pre-existing proceess. His low response to the [**Last Name (un) 402**] stim test is somewhat surprising though and he may have underlying primary (adrenally mediated, not pituitary-mediated) adrenal insufficiency. - Endocrine following; appreciate recs. - Start to taper hydrocort today if clinically stable (go to 25 IV q8h). - No need to pursue further pituitary fxn testing. - Consider CT of adrenals to check for atrophied glands - Neuro following for stroke; believes triggering event may have been paroxysmal arrhythmia that led to multiple emboli to brain. See below for recs. - Antibiotics/acyclovir stopped yesterday (HSV PCR negative in CSF) - Infectious work-up as below (see #FEVER) - EEG given UE shaking, read pending . # STROKE. MR head final read: Small acute infarcts in the left occipital and right posterior temporal lobes. Embolic etiology should be considered. - Neuro following; appreciate recs. - Consider MRA (or CTA) of head/neck will confirm purpose of this study with neuro - HbA1c and lipid panel pending - Plan to stop heparin gtt today - F/U telemetry for signs of A-fib (if develops, will need anticoagulation) - Maintain euglycemia/euthermic # ELEVATED TROPONIN: likely demand in the setting of an acute infection. Had ST depressions when agitated and moving. Troponins elevated to 1.08, now normalizing. Repeat EKG ~unchanged. - cycle enzymes - Continue daily EKGs while enzymes remain elevated - high dose statin/asa, consider starting low-dose beta blocker when pressure permits - on heparin gtt without bolus per cards recs - will need workup after acute issues improve with stress test - TTE shows EF 55-60%, possible inferior/inferolateral hypokinesis but otherwise normal . # FEVER/POSSIBLE PNA. Pt with rectal temp to 100.8 on DOA, spiked to 100.7 o/n on [**4-17**]-5, b/l UE shaking. Unclear source: ddx includes meningitis given confusion and headache and deafness but normal LP and HSV PCR, possible LUL PNA given CXR findings, viral infection (URI), endocarditis but negative blood cultures and TTE, abdominal process (eg diverticulitis). UTI unlikely with negative UA. Urine legionella negative. Urine cx negative. - Follow blood cx, CSF cx - sputum cx contaminated - Levofloxacin stopped [**4-19**], acyclovir stopped [**4-19**] given lack of compelling evidence for infectious process . # ARF. Acute on chronic, with mildly elevated Cr to 1.3 one year prior that normalized to baseline of 1.1. For acute elevation, suspect component of prerenal, ?ATN in setting of possible sepsis though not objectively hypotensive on admission; urine lytes with FeNa 4% and FeUN 51%. Neg urine eos, Na 98. Urine sediment benign. - Now at baseline creatinine; creatinine clearance by Cockcroft-gault is 41. - IVF (bolus to maintain UOP > 50 cc/hr) - Renally dose meds; avoid nephrotoxins - D/C foley . # HYPONATREMIA: likely secondary to appropriate ADH response to dehydration, improving; ?adrenal insufficiency. Resolved. - IV fluids as needed for UOP > 50 cc/hr - Follow-up ACTH/renin - trend electrolytes . # HYPERKALEMIA. Elevated to 6.7 with EKG changes; pt received insulin/dextrose, bicarb, calcium, kayexalate X2. Likely secondary to acute on chronic kidney disease. Resolved. - Normalized now that pt is at baseline creatinine. Will follow results of daily labs. . # SUDDEN HEARING LOSS. Resolved. Likely in setting of confusion, acute stroke. . # Elevated coags/LFTs. - Unclear etiology, repeat labs pending. . # Hypertension. Hold home meds for now (lasix, diltiazem, isosorbide mononitrate) . # Hyperlipidemia. High dose statin as above. . # GERD. Continue home PPI. . # Agitation/discomfort. Morphine prn pain. . # RESPIRATORY DISTRESS. Pt initially intubated for tachypnea/airway protection in setting of agitation/change in mental status/tachypnea. Pt now successfully extubated on [**4-19**]. . # FEN: IVF boluses as needed, replete electrolytes, advance diet as tolerated # Prophylaxis: On heparin drip for embolic stroke, pneumoboots; PPI # Access: peripheral # Communication: Son, [**Name (NI) 2476**] [**Name (NI) 14418**], [**Telephone/Fax (1) 14419**] # Code: Presumed full per initial discussion with family, unable to discuss with patient. # Disposition: ICU pending clinical improvement call out to floor (CM should see pt) ICU [**Name (NI) 81**] Nutrition: Glycemic Control: Lines: 20 Gauge - [**2196-4-19**] 04:33 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Disposition: ------ Protected Section ------ MICU ATTENDING ADDENDUM I saw and examined the patient, and was physically present with the ICU team for the key portions of the services provided. I agree with the note above, including the assessment and plan. I would emphasize and add the following points: [**Age over 90 **]M HTN, HLD, CKD p/w hyperkalemia, ARF, and acute alteration in mental status / agitation c/b respiratory failure. MRI c CVA x2. Cortisol prior to dex 15.7. Exam notable for Tm 97.6 BP 100/50 HR 50 RR 18 with sat 99 on VAC 500x12 5 0.5. WD man, comfortable, NAD PERRL. CTA B. RRR s1s2. Soft +BS. No edema / rash. Labs notable for WBC 9K, HCT 37, K+ 3.7, Cr 0.9. Agree with plan to manage acute CVA with full dose aspirin, suspect we can d/c heparin - will d/w neuro. For adrenal insufficiency - will taper HC today. For [**Last Name (LF) 1882**], [**First Name3 (LF) **] continue asa, statin. Elevated LFTs / ARF / hyperkalemia - resolved. ADAT. Remainder of plan as outlined above. Total time: 35 min ------ Protected Section Addendum Entered By:[**Name (NI) 453**] [**Last Name (NamePattern1) 775**], MD on:[**2196-4-20**] 06:51 PM ------
Physician
Classify the following medical document.
Chief Complaint: Shock , MODS I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 44F admitted with multiorgan failure secondary to diffuse microangiopathy and DIC of unknown etiology. Issues include CVA, RCA NSTEMI, respiratory failure s/p trach, hemopytsis, ARF, limb ischemia. 24 Hour Events: Empiric hydrocortisone strated yesterday. Progressive limb ischemia. Heparin gtt being started this am. Increased levophed requiremen to 0.18 overnight secondary to HoTN. Discussed case with hematology who did not recommend empiric trial of plamapheresis because of concerns about patient being able to tolerate procedure. Got 1 U cryo overnight. Vanco course completed. CMV serologies sent. History obtained from Medical records Patient unable to provide history: Sedated, Encephalopathy Allergies: Sulfasalazine Unknown; Last dose of Antibiotics: Vancomycin - [**2193-8-16**] 08:00 PM Infusions: Norepinephrine - 0.14 mcg/Kg/min Heparin Sodium - 850 units/hour Other ICU medications: Heparin Sodium (Prophylaxis) - [**2193-8-18**] 06:06 AM Other medications: prevacid RISS peridex plavix thiamine folate mvit asa Calcium Acetate nystatin hydyrocort 50 q6 (day 2) Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2193-8-18**] 08:53 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37 C (98.6 Tcurrent: 36.6 C (97.8 HR: 106 (90 - 111) bpm BP: 105/70(79) {80/22(35) - 113/87(92)} mmHg RR: 31 (17 - 37) insp/min SpO2: 91% Heart rhythm: AF (Atrial Fibrillation) Wgt (current): 78.1 kg (admission): 92 kg Height: 66 Inch Total In: 4,187 mL 1,043 mL PO: TF: 732 mL 239 mL IVF: 2,892 mL 774 mL Blood products: 103 mL Total out: 155 mL 12 mL Urine: 55 mL 12 mL NG: Stool: Drains: Balance: 4,032 mL 1,031 mL Respiratory support O2 Delivery Device: Tracheostomy tube Ventilator mode: CPAP/PSV Vt (Spontaneous): 624 (219 - 908) mL PS : 5 cmH2O RR (Spontaneous): 35 PEEP: 5 cmH2O FiO2: 50% RSBI: 71 PIP: 17 cmH2O SpO2: 91% ABG: ///16/ Ve: 25.7 L/min Physical Examination Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 7.3 g/dL 65 K/uL 156 mg/dL 2.7 mg/dL 16 mEq/L 4.4 mEq/L 66 mg/dL 98 mEq/L 133 mEq/L 23.5 % 18.8 K/uL [image002.jpg] [**2193-8-13**] 11:34 AM [**2193-8-14**] 03:49 AM [**2193-8-14**] 03:48 PM [**2193-8-14**] 09:27 PM [**2193-8-15**] 04:56 AM [**2193-8-15**] 04:28 PM [**2193-8-16**] 03:26 AM [**2193-8-17**] 03:52 AM [**2193-8-17**] 04:29 PM [**2193-8-18**] 03:51 AM WBC 25.3 25.7 27.6 24.8 22.0 18.8 Hct 25.9 25.8 26.1 25.6 26.5 26.8 24.9 24.0 23.5 Plt 104 119 83 91 88 88 93 65 65 Cr 2.8 2.6 3.4 2.0 2.4 2.7 Glucose 126 130 153 156 154 156 Other labs: PT / PTT / INR:16.9/32.5/1.5, CK / CKMB / Troponin-T:6617/144/2.54, ALT / AST:471/218, Alk Phos / T Bili:156/1.4, Amylase / Lipase:189/98, Differential-Neuts:85.0 %, Band:2.0 %, Lymph:6.0 %, Mono:4.0 %, Eos:0.0 %, D-dimer:6053 ng/mL, Fibrinogen:179 mg/dL, Lactic Acid:2.5 mmol/L, Albumin:3.1 g/dL, LDH:1870 IU/L, Ca++:8.1 mg/dL, Mg++:2.0 mg/dL, PO4:5.3 mg/dL Imaging: CXR: trach in place. Clear lungs Assessment and Plan Ciritically ill patient with MODS of unclear etiology now progressing to digital ischemia in the setting of persistant levophed use and DIC. The patient appears to NEURO: Nodding intermittently to questions which is somewhat improved. Increased respiratory rate may be secondary pain or metabolic in nature. Will check VBG and will also try fentanyl gtt. CV: Persistent pressor requirement in the setting of distributive shock and ongoing DIC. Will continue steroids as seoncdary pressor. On asa and plavix. LUNGS: High MV (23) may be either CNS, metabolic or increased VD/VT. Wil try fentanyl first, then bicarb. If neither decrease MV then will get PetCo2 monitor to infer alveolar dead space. GI: Tube feeds at goal. ENDO: Persistent hypoglycemia an ominus sign, but FS maintained on D10 gtt. Will continue to check. GU: Will ask renal about HD today vs CVVH ID: On no abx. CMV serologies pending. Will pan CT scan to look for focal abscess. RHEUM: Consult has no further recs. CPKs appear to be trending down. HEME: Heme consult appreciated. Cryo/blood products as needed. Will start PPX: peridex, pneumoboots, prevacid DISPO: Critically ill, prognosis very grim. Will speak with family today. ICU Care Nutrition: Nutren Renal (Full) - [**2193-8-18**] 05:01 AM 30 mL/hour Glycemic Control: Blood sugar well controlled, Comments: On D10 drip Lines: Multi Lumen - [**2193-8-11**] 07:09 PM Dialysis Catheter - [**2193-8-13**] 06:08 PM Prophylaxis: DVT: Boots(Systemic anticoagulation: Heparin gtt) Stress ulcer: VAP: HOB elevation, Mouth care Comments: Communication: Family meeting held Comments: Code status: Full code Disposition :ICU Total time spent: 30 minutes Patient is critically ill
Physician
Classify the following medical document.
Chief Complaint: CML with GVHD 24 Hour Events: NASAL SWAB - At [**2124-10-15**] 01:15 PM rapid respiratory viral culture PICC LINE - START [**2124-10-15**] 04:32 PM dressing changed PICC LINE - STOP [**2124-10-15**] 04:37 PM dressing changed - Speech and swallow cancelled as he had passed his last one just fine and nursing felt that it was not indicated - Flu swab negative, dc'ed respiratory precautions Allergies: No Known Drug Allergies Last dose of Antibiotics: Vancomycin - [**2124-10-15**] 08:00 PM Voriconazole - [**2124-10-15**] 08:00 PM Piperacillin/Tazobactam (Zosyn) - [**2124-10-16**] 03:34 AM Infusions: Other ICU medications: Other medications: Acyclovir 3. Albuterol-Ipratropium 4. Albuterol 0.083% Neb Soln 5. Budesonide 6. Calcium Carbonate 7. Docusate Sodium 8. Enoxaparin Sodium 9. Fentanyl Patch 10. Heparin Flush (10 units/ml) 11. Lansoprazole Oral Disintegrating Tab 12. Lidocaine 5% Patch 13. Lidocaine 5% Patch 14. Lorazepam 15. Methadone 16. Metoprolol Tartrate 17. Methadone 18. Morphine Sulfate IR 19. Morphine Sulfate 20. Multivitamins W/minerals 21. Mycophenolate Mofetil 22. Mycophenolate Mofetil 23. Ondansetron 24. Pancrease MT 16 25. Piperacillin-Tazobactam 26. Polyethylene Glycol 27. Pregabalin 28. PredniSONE 29. Senna 30. Sulfameth/Trimethoprim SS 31. Tobramycin Inhalation Soln 32. Vancomycin 33. Vitamin D 34. Voriconazole Changes to medical and family history: In [**Location (un) 308**] prior discharge summary from [**2124-7-6**], discovered that patient had profuse bleeding while on full anticoagulation with lovenox, thus has been on reduced dose of 40 mg Q12H since that time Review of systems is unchanged from admission except as noted below Review of systems: no CP, feels still has increased work of breathing from baseline, mild cough, +abd pain (not any worse) Flowsheet Data as of [**2124-10-16**] 07:40 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.9 C (98.4 Tcurrent: 36.2 C (97.1 HR: 69 (63 - 99) bpm BP: 108/68(77) {98/55(66) - 136/83(89)} mmHg RR: 12 (11 - 21) insp/min SpO2: 99% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 69.3 kg (admission): 69.3 kg Height: 61 Inch Total In: 1,130 mL 251 mL PO: TF: IVF: 1,130 mL 251 mL Blood products: Total out: 1,160 mL 710 mL Urine: 1,160 mL 710 mL NG: Stool: Drains: Balance: -30 mL -459 mL Respiratory support O2 Delivery Device: Nasal cannula, Aerosol-cool, Face tent SpO2: 99% ABG 7.40/70/57 ([**10-14**]) Physical Examination Gen: sleeping, easily aroused, alert and oriented CV: rrr nl s1/s2 no murmurs Pulm: crackles b/l Abd: +BS, distended, very tender diffusely, no rebound or guarding Ext: erythema anteriorly and warm, moving all exts Labs / Radiology 204 K/uL 8.9 g/dL 75 mg/dL 0.5 mg/dL 43 mEq/L 3.9 mEq/L 14 mg/dL 98 mEq/L 143 mEq/L 27.2 % 4.6 K/uL [image002.jpg] [**2124-10-14**] 08:50 PM [**2124-10-14**] 11:16 PM [**2124-10-15**] 04:02 AM [**2124-10-16**] 03:46 AM WBC 5.4 4.6 Hct 28.7 27.2 Plt 231 204 Cr 0.7 0.5 TCO2 46 45 Glucose 200 75 Other labs: PT / PTT / INR:11.1/25.7/0.9, Differential-Neuts:88.0 %, Band:2.0 %, Lymph:5.0 %, Mono:3.0 %, Eos:1.0 %, Ca++:8.7 mg/dL, Mg++:2.2 mg/dL, PO4:2.9 mg/dL Microbiology: [**10-15**] Negative for Respiratory Viral Antigen. Viral ctx pending [**10-15**] sputum ctx pending 2+ (1-5 per 1000X FIELD): BUDDING YEAST. 1+ (<1 per 1000X FIELD): GRAM POSITIVE ROD(S). 1+ (<1 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS. [**10-14**] blood pending Assessment and Plan IMPAIRED SKIN INTEGRITY PAIN CONTROL (ACUTE PAIN, CHRONIC PAIN) HYPOXEMIA 58 yo M with history of CML treated with allogeneic stem cell transplant in [**2121**] and complicating graft versus host disease presents from rehab following an episode of hypoxia to the 70s earlier today. Patient was discharged from the ICU to the high level rehab facility on [**2124-10-11**]. #. Hypoxia: Patient with underlying bronchiolitis related to GVHD and with multiple respiratory pahtogens in recent past. The patient may have developed a healthcare associated pneumonia given his recent prolonged hospitalizations. On CT, there is collapse of nearly entire LLL and some of RLL as well as persistent pleural effusions. No evidence of obstruction by mucous plug, so bronch is not likely to be helpful in this case. Recent 7 day course of tamiflu from [**2124-10-2**] to [**2124-10-8**] - Cover for healthcare associated pneumonia with vancomycin and zosyn (zosyn chosen with regard to prior sensitivities). Day 3 of a 8 day course. - Continue prednisone 30 mg daily - Pulmonary hygiene with mechanical in-exsufflator, incentive spirometry, acapella valve, deep suction - f/u sputum ctx - Follow-up blood cultures - pt can be put in for diet? #Fever: In [**Name (NI) **], pt. with low grade fever of 100.1F, could represent atelectasis vs. HAP vs. cellulitis on LE given erythema and warmth. WBC trending down, afebrile. -Will continue empiric treatment with Vanc and Zosyn as above -Trend WBC counts and fever curves -f/u Blood cultures . #. CML s/p BMTs, complicated by chronic GVHD: At previous admission patient was started on a prednisone taper of 60 mg daily and had been titrated down to 30 mg daily. - Continue mycophenolate mofetil - Continue prednisone at 30 mg daily and reassess prior to planned taper down to 20 mg daily on [**2124-10-19**]. #. Chronic abdominal pain and back pain: Thought to be attributable to GVHD after negative prior work-up. - Continue fentanyl patch, methadone, morphine, lidocaine patches, pregabalin #. Hx of PE, DVT: Patient with multiple prior thrombotic events. - Continue enoxaparin 40 mg Q12H ICU Care Nutrition: Glycemic Control: Lines: PICC Line - [**2124-10-14**] 10:00 PM Prophylaxis: DVT: LMW Heparin Stress ulcer: lansoprazole VAP: Comments: Communication: Comments: Code status: Full code Disposition: ?c/o once can move without desats, maybe today
Physician
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Chief Complaint: Respiratory Distress 24 Hour Events: -No CVVH done yesterday as line became clotted. Pt. remained intubated, weaned off sedation. Started on high dose lactulose with good effect. VAC was changed on [**4-17**] by ortho, stable. Allergies: No Known Drug Allergies Last dose of Antibiotics: Piperacillin/Tazobactam (Zosyn) - [**2120-4-17**] 12:00 AM Micafungin - [**2120-4-18**] 08:10 AM Piperacillin - [**2120-4-18**] 04:00 PM Daptomycin - [**2120-4-18**] 06:04 PM Infusions: Norepinephrine - 0.03 mcg/Kg/min Other ICU medications: Famotidine (Pepcid) - [**2120-4-18**] 02:55 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2120-4-19**] 07:03 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**22**] AM Tmax: 37.8 C (100 Tcurrent: 37.3 C (99.1 HR: 67 (47 - 76) bpm BP: 94/68(79) {86/42(60) - 141/71(84)} mmHg RR: 12 (12 - 35) insp/min SpO2: 99% Heart rhythm: SR (Sinus Rhythm) Height: 72 Inch CVP: 3 (0 - 4)mmHg Total In: 3,726 mL 492 mL PO: TF: IVF: 3,186 mL 372 mL Blood products: Total out: 2,813 mL 1,010 mL Urine: 29 mL 10 mL NG: 790 mL Stool: Drains: Balance: 913 mL -518 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CPAP/PSV Vt (Spontaneous): 553 (542 - 919) mL PS : 5 cmH2O RR (Spontaneous): 13 PEEP: 5 cmH2O FiO2: 30% RSBI: 51 PIP: 11 cmH2O SpO2: 99% ABG: 7.27/53/104/22/-2 Ve: 7.9 L/min PaO2 / FiO2: 347 Physical Examination Gen: NAD, becomes mildly agitated when awoken, but does not follow commands Pulm: coarse bilaterally CV: RRR, 2/6 systolic murmur heard all fields Abd: + BS, soft, mildly distended, dry dressing over previous paracentesis site without noticeable drainage. Peripheral Vascular: radial pulses and L PT pulse intact, RLE with ex-fix in place, no drainage, no worsening erythema Skin: warm, dry Neurologic: intubated, becomes mildy agitated with awakening, opened eyes, but not to command, moving all extremities Labs / Radiology 114 K/uL 7.9 g/dL 177 mg/dL 3.3 mg/dL 22 mEq/L 4.5 mEq/L 25 mg/dL 104 mEq/L 137 mEq/L 26.6 % 13.3 K/uL [image002.jpg] [**2120-4-17**] 09:29 PM [**2120-4-18**] 04:05 AM [**2120-4-18**] 04:19 AM [**2120-4-18**] 10:22 AM [**2120-4-18**] 10:28 AM [**2120-4-18**] 02:34 PM [**2120-4-18**] 02:58 PM [**2120-4-18**] 11:07 PM [**2120-4-19**] 03:51 AM [**2120-4-19**] 04:08 AM WBC 13.5 14.9 13.3 Hct 27.2 26.8 26.6 Plt 115 111 114 Cr 2.3 2.3 2.6 3.3 TCO2 25 27 25 24 26 25 Glucose 188 193 180 177 Other labs: PT / PTT / INR:17.6/35.6/1.6, CK / CKMB / Troponin-T:60//, ALT / AST:43/148, Alk Phos / T Bili:187/2.5, Amylase / Lipase:/101, Differential-Neuts:79.4 %, Band:1.0 %, Lymph:12.6 %, Mono:3.9 %, Eos:3.7 %, Lactic Acid:2.1 mmol/L, Albumin:3.3 g/dL, LDH:219 IU/L, Ca++:9.5 mg/dL, Mg++:1.9 mg/dL, PO4:3.7 mg/dL Assessment and Plan 62M NASH, NSTEMI, trimalleolar fracture s/p ex-fix with deep infection s/p multiple debridements, OSA, progressive ARF [**3-12**] hepatorenal syndrome on midodrine and albumin and volume overload originally brought to ICU with respiratory distress and bradycardia in the setting of volume overload and aspiration. # Respiratory Distress: Pt. remains intubated but doing well on SBT without significant change in pCO2. Seems more arousable now off sedation and with high dose lactulose. Patient has significant history of sleep apnea as well. Original respiratory distress likely volume overload as well as aspiration given history, CXR with bilateral infiltrate as well as volume overload from ascites, renal failure and oliguria. On dapto, micafungin, zosyn. Patient received lasix/diuril in attempt to diurese, however unsuccessful. CVVH held on [**4-18**] due to the fact that his dialysis catheter became clotted. On [**4-18**] he had an episode of vomiting, repeat CXR not markedly different, but concern for possibly evolving L opacity. Right was improved. - continue ventilator today, consider extubation soon - continue lactulose 60 mg q4h for encephelopathy - continue zosyn/dapto/micafungin renally dosed; h/o MRSA in lungs - continue famotidine - CVP <4 or rise in pressor requirement >0.1 indicates approaching euvolemia he is approaching this today and will discuss with renal drive # Acute renal failure now without Dialysis Access: Patient with large volume of ascites which is not helping his respiratory status and now with worsening renal function and decreasing urine output. Per hepatology and renal notes, he has suspected hepatorenal syndome and has been on albumin, octreotide and midodrine. However, there has been worsening on this regimen, so unclear if actually a different etiology. Acidemia mixed respiratory and metabolic, CNS appears comfortable at pCO2 at 50. - address line placement today, either tunneled or temporary, will discuss with renal - plan for HD tomorrow - renally dose medications - continue midodrine for HRS albumin stopped on [**4-13**] - f/u renal recs in AM - strict I&Os - tx as above #Cirrhosis: Not transplant candidate per hepatology. Has had some increasing encephalopathy on the floor. No fever or abdominal pain concerning for SBP though always a possibility. Paracentesis performed [**4-13**] with 3 L removed and no evidence of SBP. Albumin and nadolol DC on [**4-13**]. - If IAB >3.5, consider parascentesis - increase lactulose as above, 60 mg q4h - continue rifaximin - continue midodrine - f/u liver recs # Mental Status: continues to be agitated at times. - re-order restraints - continue to hold sedating meds # Leukocytosis: WBC now 13.5 not on steroids, temps 96, hypotensive but bradycardic. Cannot rule out sepsis. - continue daptomycin, micafungin, pip-tazo # RLE Cellulitis/Osteomyelitis: has cx with VRE and C. glabrata. Followed by ortho and will likely need s/p washout in the OR on [**4-15**]. [**Month (only) 11**] need amputation in future. - Plan for bedside wound vac change tomorrow per ortho, OR on Monday - continue daptomycin, micafungin, pip-tazo - f/u sensitivities for C. glabrata - monitor wound cultures, blood cultures - surveillance blood cultures - f/u ortho recs wound vac changed per ortho - f/u ID recs # Gut Motility/Concern for Ileus: Moved bowels overnight. On reglan. - Continue Reglan - Give PO meds - Give lactulose as above - restart tube feeds today # Bradycardia originally thought likely d/t hypoxemia. Intubated on [**4-13**] and pt. has had HR in 50s. Nadolol held starting on [**4-13**]. - octreotide was DC - continue to hold nadolol - continue to monitor # Anemia: HCT stable though trending down slowly. EGD on [**3-29**] showed varices and is now s/p banding/glueing. Hct stable today. - check QD HCTs - continue PPI - hold nadolol 20mg in setting of bradycardia - transfusion goal of 21 or evidence of bleeding or hypoperfusion - will need follow up EGD will speak with liver regarding this # Thrombocytopenia: Stable, >100. Likely secondary to cirrhosis. - daily PLT - transfuse <10 or evidence of bleeding # Diabetes mellitus: Continue SSI - follow up [**Hospital 294**] Clinic recs now that patient is intubated - increase ISS - will continue dose of lantus (8 units) today; increase tomorrow as needed # Hypertension: of note, will target peripheral BPs as A line appears to be giving diminished readings - hold nadolol d/t intermittent bradycardia - Holding metoprolol and amlodipine # Obstructive sleep apnea: - pt. intubated # Rheumatoid arthritis: not on home medications. Will monitor for symptoms. No acute treatment needed currently. # Depression: Continue escitalopram and bupropion. # FEN: intubated, extubation trial today if more alert, OG tube in place - NPO now except for meds - NGT to suction # PPX: H2 blocker, SC heparin, bowel regimen # ACCESS: PICC double lumen, HD line, A-line Lines: PICC Line - [**2120-4-12**] 10:10 PM Arterial Line - [**2120-4-13**] 09:25 PM Dialysis Catheter - [**2120-4-13**] 09:29 PM # CODE: FULL CODE # CONTACT: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 11361**] c [**Telephone/Fax (1) 11362**] / home [**Telephone/Fax (1) 11363**] - will clarify if [**Hospital1 **] is legal HCP # DISPO: ICU
Physician
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BONE MARROW SCAN Clip # [**Clip Number (Radiology) 77369**] Reason: 30YR OLD WOMAN WITH ESRD ON HD, S/P TIB/FIB FX WITH HARDWARE INFECTION S/P HARDWARE REMOVAL WITH EX-FIX ______________________________________________________________________________ FINAL REPORT RADIOPHARMECEUTICAL DATA: 6.4 mCi Tc-[**Age over 90 26**]m Sulfur Colloid ([**2177-10-17**]); HISTORY: 30 year old female with history of end stage renal disease on dialysis with right tibia/fibula fractures complicated by hardware infection. Hardware recently removed and external fixator placed. Concern for osteomyelitis. RADIOPHARMECEUTICAL DATA: 403.0 uCi In-111 WBCs (administered [**2177-10-15**]) 6.4 mCi Tc-[**Age over 90 26**]m labeled sulfur colloid (administered [**2177-10-17**]). COMPARISON: Indium-111 tagged white blood cell scan [**2177-10-16**]. PHYSICAL EXAM: Open wound of the anterior distal right lower extremity covered with vacuum dressing. External fixator securing lower right leg with anterior, medial, and lateral hardware components. Autologous white blood cells labeled with In-111 were injected on [**2177-10-15**] and I In-111 imaging was performed on [**2177-10-16**]. Today, [**2177-10-17**], Tc-[**Age over 90 26**]m labeled sulfur colloid was administered and further imaging performed. Dual photopeak imaging was obtained of the lower extremities in anterior and lateral projections. Indium-111 photopeak imaging again demonstrates marked focal uptake of tracer along the anterior aspect of the distal third of the right distal lower extremity, in the same distribution as seen on yesterday's images. Tc-[**Age over 90 26**]m photopeak imaging shows expanded bone marrow activity extending into the distal lower extremities. On the left leg, there is smooth distal tapering of the activity. Bone marrow activity is present in the proximal right tibia with sharp cutoff at the level of the patient's wound with photopenia of the right tibia at the site of the wound. There are photopenic defects of the proximal [**12-11**] of the right tibia and fibula which are presumed due to the fixator hardware overlying these sites. Compared with the prior white cell study dated [**2177-10-16**], there is still active accumulation of white cells in the lower third of the right distal lower extremity. IMPRESSION: Increased uptake in the distal third of the right distal lower extremity consistent with continued active infection. No other sites of white blood cell uptake. Extension of the bone marrow to the distal lower extremities bilaterally compatible with prolonged stimulation. Cut off of bone marrow activity at the site of white cell uptake is suggestive of osteomyelitis involving the distal third of the right tibia. (Over) BONE MARROW SCAN Clip # [**Clip Number (Radiology) 77369**] Reason: 30YR OLD WOMAN WITH ESRD ON HD, S/P TIB/FIB FX WITH HARDWARE INFECTION S/P HARDWARE REMOVAL WITH EX-FIX ______________________________________________________________________________ FINAL REPORT (Cont) [**First Name8 (NamePattern2) 59**] [**Last Name (NamePattern1) 729**], M.D. [**Initials (NamePattern4) 61**] [**Last Name (NamePattern4) 62**] [**Last Name (NamePattern1) 63**], M.D. Approved: TUE [**2177-10-21**] 4:15 PM West [**Medical Record Number 77368**] RADLINE [**Telephone/Fax (1) 31**]; A radiology consult service. To hear preliminary results, prior to transcription, call the Radiology Listen Line [**Telephone/Fax (1) 32**].
Radiology
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Chief Complaint: 24 Hour Events: BLOOD CULTURED - At [**2192-8-28**] 03:08 PM -40mg IV lasix with good urine output (approx 500cc) -medications changed to PO if possible to avoid excess urine, decreased free water flushes with TFs -switched to AC overnight for persistent apnea Allergies: Aspirin Unknown; Penicillins Unknown; Bactrim (Oral) (Sulfamethoxazole/Trimethoprim) Rash; Last dose of Antibiotics: Levofloxacin - [**2192-8-27**] 06:19 PM Vancomycin - [**2192-8-28**] 08:00 AM Metronidazole - [**2192-8-28**] 09:06 PM Amikacin - [**2192-8-28**] 09:07 PM Infusions: Other ICU medications: Pantoprazole (Protonix) - [**2192-8-28**] 08:00 AM Heparin Sodium (Prophylaxis) - [**2192-8-28**] 08:00 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2192-8-29**] 07:05 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.7 C (99.8 Tcurrent: 37.2 C (98.9 HR: 73 (57 - 78) bpm BP: 144/58(81) {128/51(71) - 165/71(96)} mmHg RR: 15 (11 - 29) insp/min SpO2: 100% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 77 kg (admission): 66.5 kg Height: 66 Inch Total In: 2,294 mL 358 mL PO: TF: 324 mL 238 mL IVF: 1,400 mL 71 mL Blood products: Total out: 2,400 mL 790 mL Urine: 2,400 mL 790 mL NG: Stool: Drains: Balance: -106 mL -432 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CMV Vt (Set): 450 (450 - 450) mL Vt (Spontaneous): 430 (319 - 480) mL PS : 0 cmH2O RR (Set): 12 RR (Spontaneous): 3 PEEP: 5 cmH2O FiO2: 40% RSBI Deferred: No Spon Resp PIP: 18 cmH2O Plateau: 16 cmH2O SpO2: 100% ABG: ///32/ Ve: 7.3 L/min Physical Examination GEN: Intubated, sedated HEENT: NCAT MMM anicteric pale conjunctiva CV: RRR S1S2 PULM: rhonchi at mid-lung fields, likely [**1-7**] intubation otherwise clear while supine ABD: soft, distended, nontender +bs no palp masses EXT: WWP 1+ bipedal edema 1+dp pulses no cyanosis SKIN: no new lesions, rashes noted Labs / Radiology 666 K/uL 8.0 g/dL 152 mg/dL 1.1 mg/dL 32 mEq/L 3.5 mEq/L 13 mg/dL 102 mEq/L 138 mEq/L 24.9 % 15.4 K/uL [image002.jpg] [**2192-8-24**] 03:46 AM [**2192-8-24**] 09:00 PM [**2192-8-25**] 01:47 AM [**2192-8-25**] 02:07 AM [**2192-8-27**] 04:35 AM [**2192-8-27**] 05:32 AM [**2192-8-28**] 04:12 AM [**2192-8-28**] 08:43 AM [**2192-8-28**] 02:53 PM [**2192-8-29**] 05:54 AM WBC 24.0 26.1 16.1 15.7 15.4 Hct 26.1 28.7 22.5 23.4 24.9 Plt 195 312 583 548 666 Cr 0.9 0.9 1.1 1.1 1.0 1.1 TropT 0.10 TCO2 28 27 28 Glucose 141 69 216 83 105 152 Other labs: PT / PTT / INR:15.5/27.6/1.4, CK / CKMB / Troponin-T:37/3/0.10, ALT / AST:[**9-23**], Alk Phos / T Bili:79/0.3, Amylase / Lipase:153/139, Differential-Neuts:88.3 %, Band:3.0 %, Lymph:7.9 %, Mono:3.0 %, Eos:0.7 %, Fibrinogen:661 mg/dL, Lactic Acid:1.0 mmol/L, Albumin:2.3 g/dL, LDH:256 IU/L, Ca++:7.5 mg/dL, Mg++:2.0 mg/dL, PO4:2.8 mg/dL Assessment and Plan 82 year old female with a history of breast cancer, CVA, hypertension with recent MICU stay for E.coli urosepsis, providencia UTI, and RLL aspiration PNA presents from medical floor after likely PEA arrest now with worsening mental status than on previous transfer now 48 hours after the event. # Cardiopulmomary Arrest: Patient found pulseless, ashen, and cool, down for no longer than 10 minutes. Patient not monitored on telemetry at the time of the event. She quickly regained rhythm after intubation and 1gm epinephrine w/ CPR. In the setting of underlying RLL infiltrate, concern for worsening pulmonary edema on the floor, most likely etiology respiratory arrest w/ mucous plug. No further events since admission to ICU, although continues to have episodes of apnea while on PS. - treat underlying cause of PNA, provide respiratory support with ventilator for now - continue to trend lactate - monitor on telemetry, patient appears to be hemodynamically stable -CT head to evaluate for any acute insults that may be causing her apneic periods . # Hypercarbic Respiratory Failure: S/p intubation x2. Hypercarbic likely to arrest d/t pulmonary etiology (mucus plugging, apneic period). Overnight with significant secretions needing frequent suctioning. Will continue to wean as tolerated to PS although not ready for extubation. Will discuss goals of care with niece this morning (extubation, trach placement etc.) - Wean FIO2 as tolerated, to PS - weak cough, no gag per RT - suction prn, nebs prn - -d/w family re: trach . # HAP/Aspiration PNA/sepsis: Patient on broad spectrum coverage since admission, has grown GPC pairs/clusters in sputum and E.coli in blood and urine. CT from [**8-25**] showed persistent RLL infiltrate. CBC showing new bands on diff in setting of code. - continue vanc/levo/flagyl, patient currently on day 11 of ABX, (3 more days) - sputum from [**8-27**] - GRAM STAIN (Final [**2192-8-27**]): >25 PMNs and <10 epithelial cells/100X field. 1+ (<1 per 1000X FIELD): GRAM POSITIVE COCCI IN PAIRS AND CLUSTERS. RESPIRATORY CULTURE (Preliminary): NO GROWTH. - only positive blood culture so far from [**8-17**] - ESCHERICHIA COLI | AMPICILLIN------------ =>32 R AMPICILLIN/SULBACTAM-- 4 S CEFAZOLIN------------- <=4 S CEFEPIME-------------- <=1 S CEFTAZIDIME----------- <=1 S CEFTRIAXONE----------- <=1 S CEFUROXIME------------ 4 S CIPROFLOXACIN--------- =>4 R GENTAMICIN------------ <=1 S MEROPENEM-------------<=0.25 S PIPERACILLIN/TAZO----- <=4 S TOBRAMYCIN------------ <=1 S TRIMETHOPRIM/SULFA---- <=1 S . # Urosepsis: E.coli bacteremia, and e.coli/providencia UTI. Repeat cultures have been negative. Has been on amikacin, last day [**9-2**]. - f/u amikacin levels this morning . # Acute Kidney Failure: Creatinine 1.1 from baseline of 0.6, currently on CVVH. Likely prerenal in etiology secondary to episode of hypoperfusion. - suspect that some of renal failure is likely due to poor forward flow and patient looks volume overloaded by physical exam - trend creatinine - goal I/O is negative 1 liter per day, would give lasix as needed to achieve this . # Hypertension: On lisinopril, metoprolol as outpatient - restart lisinopril today, uptitrate as tolerated - lasix 40mg IV qd, monitor UOP . # Dementia: Currently intubated without need for sedative medications. Concern for possible cerebral ischemic insult during her PEA arrest that may be causing her apnea. - continue namenda and aricept - -CT head as above . FEN: tubes feeds, monitor electrolytes, repleted K aggressively this morning for K of 2.6 . # Prophylaxis: SC heparin, d/c bowel regimen in the setting of persistent diarrhea, PPI . # Communcation: Sister [**Name (NI) **] [**Name (NI) 5333**] [**Telephone/Fax (1) 5334**], will decide on trach in the morning . # Code: FC - plan to reassess with sister today . # Disposition: ICU care for now ICU Care Nutrition: Replete with Fiber (Full) - [**2192-8-29**] 02:32 AM 40 mL/hour Glycemic Control: Lines: PICC Line - [**2192-8-27**] 01:15 PM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition: ------ Protected Section ------ ERROR: In note patient is said to be on CVVH. This is an error and should be disregarded. Patient is currently not on any form of HD and has not been during this admission. ------ Protected Section Addendum Entered By:[**Name (NI) 5095**] [**Name8 (MD) 5096**], MD on:[**2192-8-30**] 10:46 ------
Physician
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T/Sicu Nsg Note 0700>>[**2197**] Events- Second left pleural CT for persistent pneumotx weaned from levo after additional IVF(FFP) improved MAP..CPP values tolerating small doses fentanyl w/effect>>improved sedation CT for many scans including TLS...pnd resolving met acidosis Neuro- perrl @ 3>2mm/brisk with impaired corneals impaired gag/cough..sedation ongoing no spont movements noted except overbreathing vent Pt localizes to nailbed pressure when propofol suspended x 20 min: no movement of LUE; LE's moving more vigorously. [**Last Name (un) **] catheter in place with ICP values of high teens to 11 CPP initial <60 d/t map in low 70's..improved with increased levo> increased bp/map. Extra 500mg dilantin given for level of 2.5 today. No seizure activity noted. CVS- levo increased initially to improve map's; able to wean off with stable neurohemodynamics. Adequate svo2 & co/ci..see careview data. Maintained on ivf of 100/hr. Electrolytes repleted prn. Resp- fio2 weaned to 40% with adequate PaO2 and sats. RR weaned to x 14 with goal of PCO2 of normocardia. Pt easily breaths over vent when lightened; more in phase with vent with improved sedation...pco2 currently 34. Coarse/diminished [**Last Name (un) 124**] sounds with left lung fields more decreased. ** Second left pleural ct placed for persistent pneumothorax. Both left ct have air leaks; right pleural ct has [**Last Name (un) **] small leak. Small sanginous drainage from all tubes. ..Resolving base deficit/met acidosis...lactate now <1 ..sputum cultures sent; secretins are thick & bloody Renal- adequate hourly u/o urine culture sent ID- afebrile wkith wbc wnl remains on vanc, clina, ceftaz cultures requested today; [**Doctor First Name **] blood cultures x2 done heme- hct 33 after 1u pc's on nights...now tending to 28..to follow INR 1.3...1u ffp given with repeat INR 1.3 platelets cont on downward trend..no heparin being given endo- riss coverage for glucose 120-145 GI- npo with ogt to LCS with bilious drainage soft abd w/absent bowel sounds protonix peripheral/vascular- warm extremities with +3 palpable pulses. LUE with ^^ edema>>elevated on pillow. LLE remains in knee immobilizer. compression boot on RLE only skin- forehead and left eyebrow lacs have been sutured by OMF resident; pressure dsg applied to site for 24 hours, after which it can be removed . Wound care: cleanse lacs with 1/2 stenth H2O2 to remove dry blood and apply bacitracin to keep areas moist..[**Hospital1 **] & prn. ..^^ edema of left shoulder area; bruising noted at shoulder, skin intact. ..anterior torso with red, peticheal markings(from windshield trauma) is intact. ..back & buttocks intact ..skin under c-collar is intact..pressure line noted n chin probably from field collar. [**Location (un) **]-J collar now in place. **NO sc Heparin** Social- family in/out throughout the day for brief visits. Updates re pt progress provided. Wife has multiple supports availabe and is handling pt's situation well. Social [**Last Name (un) **]
Nursing/other
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Chief Complaint: respiratory and renal failure 24 Hour Events: DIALYSIS CATHETER - STOP [**2117-7-23**] 04:30 PM placed in IR UNPLANNED LINE/CATHETER REMOVAL (NON-PATIENT INITATED) - At [**2117-7-23**] 04:30 PM - Pt's position was being changed, and her tunneled HD line was pulled out. CVVH stopped. Renal will have to assess when CVVH needs to be restarted. If needs before Monday, renal will have to put in temporary dialysis catheter. - Pt on levophed for hyptension - HCT stable - Pt on pressure support Allergies: Flagyl (Oral) (Metronidazole) Rash; Last dose of Antibiotics: Cefipime - [**2117-7-23**] 04:00 PM Ciprofloxacin - [**2117-7-23**] 06:00 PM Micafungin - [**2117-7-23**] 08:17 PM Vancomycin - [**2117-7-24**] 12:36 AM Infusions: Norepinephrine - 0.03 mcg/Kg/min Other ICU medications: Famotidine (Pepcid) - [**2117-7-23**] 12:00 PM Heparin Sodium (Prophylaxis) - [**2117-7-24**] 12:36 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2117-7-24**] 07:38 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.4 C (99.3 Tcurrent: 37 C (98.6 HR: 89 (73 - 97) bpm BP: 104/41(60) {76/34(47) - 114/71(81)} mmHg RR: 16 (13 - 21) insp/min SpO2: 98% Heart rhythm: AF (Atrial Fibrillation) Wgt (current): 98.2 kg (admission): 110 kg Height: 66 Inch Total In: 7,372 mL 606 mL PO: TF: 1,560 mL 466 mL IVF: 5,692 mL 80 mL Blood products: Total out: 6,812 mL 25 mL Urine: 23 mL 25 mL NG: Stool: Drains: Balance: 560 mL 581 mL Respiratory support O2 Delivery Device: Tracheostomy tube Ventilator mode: CPAP/PSV Vt (Set): 400 (400 - 400) mL Vt (Spontaneous): 174 (174 - 577) mL PS : 15 cmH2O RR (Set): 18 RR (Spontaneous): 21 PEEP: 10 cmH2O FiO2: 60% RSBI Deferred: PEEP > 10 PIP: 25 cmH2O SpO2: 98% ABG: 7.36/49/77/26/0 Ve: 7.5 L/min PaO2 / FiO2: 128 Physical Examination General Appearance: No(t) Well nourished, No acute distress, Overweight / Obese Head, Ears, Nose, Throat: Normocephalic Cardiovascular: (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Respiratory / Chest: (Expansion: Symmetric), Coarse breath sounds bilaterally Abdominal: Soft, Non-tender, Bowel sounds present, No(t) Distended, Obese, anisarcic (slightly worse than yesterday) Extremities: Right: 1+, Left: 1+ Skin: Warm Neurologic: Alert, opens eyes. Tracks movement. Labs / Radiology 258 K/uL 8.0 g/dL 104 mg/dL 2.0 mg/dL 26 mEq/L 4.8 mEq/L 26 mg/dL 98 mEq/L 134 mEq/L 26 11.3 K/uL [image002.jpg] [**2117-7-23**] 04:02 AM [**2117-7-23**] 09:52 AM [**2117-7-23**] 10:06 AM [**2117-7-23**] 12:45 PM [**2117-7-23**] 12:57 PM [**2117-7-23**] 03:49 PM [**2117-7-23**] 04:23 PM [**2117-7-23**] 06:05 PM [**2117-7-24**] 03:10 AM [**2117-7-24**] 05:02 AM WBC 11.3 Hct 26.5 25.4 26.1 26 Plt 258 Cr 1.7 2.0 TCO2 27 28 27 28 29 Glucose 154 211 107 104 Other labs: PT / PTT / INR:16.3/34.6/1.4, CK / CKMB / Troponin-T:88/10/0.76, ALT / AST:20/21, Alk Phos / T Bili:98/0.3, Differential-Neuts:75.0 %, Band:0.0 %, Lymph:16.0 %, Mono:9.0 %, Eos:0.0 %, Fibrinogen:489 mg/dL, Lactic Acid:1.1 mmol/L, Albumin:3.1 g/dL, LDH:363 IU/L, Ca++:8.7 mg/dL, Mg++:1.9 mg/dL, PO4:3.1 mg/dL Imaging: [**2117-7-24**] CXR: Radiology read pending. HD line no longer present, otherwise no interval change Microbiology: BC [**7-21**] and [**7-23**] pending [**2117-7-21**] Urine culture: yeast, awaiting speciation [**2117-7-22**] Mini-BAL: gram stain negative, but awaiting culture finalization (pre-lim shows no growth) [**2117-7-21**] Stool culture pending, but c.diff negative Assessment and Plan SEPSIS, SEVERE (WITH ORGAN DYSFUNCTION) SHOCK, OTHER RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name **]) PULMONARY HYPERTENSION (PULM HTN, PHTN) ALTERATION IN NUTRITION ANEMIA, CHRONIC OBESITY (INCLUDING OVERWEIGHT, MORBID OBESITY) ALTERED MENTAL STATUS (NOT DELIRIUM) RENAL FAILURE, ACUTE (ACUTE RENAL FAILURE, ARF) HEART DISEASE, OTHER HEMOPTYSIS RESPIRATORY FAILURE, CHRONIC C. DIFFICILE INFECTION (C DIFF, CDIFF COLITIS, CLOSTRIDIUM DIFFICILE) 78 y/o female with MMP including OSA requiring trach, d CHF, AFib, chronic C. diff infection presents from LTAC with worsening mental status and failure to improve. # Septic shock -potentially septic picture, CT with no evidence of intrathoracic/abdominal source for infection. Restarted levophed overnight for MAPS < 60 -Ucx grew yeast, requested speciation - awaiting results of blood culture. Mini-BAL gram stain was negative, but final culture pending (pre-lim shows no growth). Stool culture pending, but C.diff negative - cont Vanc/Cef/Cipro/Mica. If cx negative on Sunday, d/c abx - Levophed to maintain MAPs > 60, if too much ventricular ectopy switch to neosynephrine. # Respiratory Failure potentially related to sepsis -Pt tolerated pressure support well, try to decrease PEEP today -check ABGs Q6H #Renal failure: - CVVH on hold due to no access. Will discuss when pt needs temporarily line vs. waiting until monday for permanent line. - f/u renal recs # anemia/coagulopathy- hcts stable, patient oozing from every needle stick. Site of line removal looks stable, with no hematoma formation. Guiac + and has h/o trach bleed. Per thoracics: if rebleeds, would want to consider source in deep lung parenchyma. - Hct Q8H -cont. SQ heparin -transfuse for hct <22 # Hx of C.diff Infection - C diff negative x 3 - ID recs: PO vanc 14 days after last dose of antibiotics; on antibiotics now # Diastolic Heart Failure/volume overload - Holding CVVH for now # dysrrhthmias - HR stable in 80s -currently on levophed, if too much ventricular ectopy, switch to neosynephrine ICU Care Nutrition: Vivonex (Full) - [**2117-7-24**] 04:00 AM 65 mL/hour Glycemic Control: Regular insulin sliding scale Lines: PICC Line - [**2117-7-20**] 04:16 PM Arterial Line - [**2117-7-21**] 03:00 PM 20 Gauge - [**2117-7-22**] 09:30 AM Prophylaxis: DVT: Boots, SQ UF Heparin Stress ulcer: H2 blocker VAP: HOB elevation, Mouth care, Daily wake up Comments: Communication: Comments: Code status: Full code Disposition:ICU
Physician
Classify the following medical document.
Admission Date: [**2182-5-8**] Discharge Date: [**2182-5-14**] Date of Birth: [**2120-10-23**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1283**] Chief Complaint: Decreased exercise tollerance. Major Surgical or Invasive Procedure: Aortic valve replacement and mitral valve replacement [**2182-5-8**]. History of Present Illness: This is a 61 yo male with long history of aortic stenosis with slowly evolving decreased exercise tollerance Past Medical History: Hypertension. Depression. Rheumatic fever. Cholecysectomy. Social History: Patient lives with wife in [**Name (NI) 5176**]. He works as a gynecologist. Denies tobacco use. Reports occasional ETOH on weekends. Family History: Non-contributory. Pertinent Results: [**2182-5-11**] 05:45AM BLOOD WBC-12.8* RBC-3.10* Hgb-9.2* Hct-27.4* MCV-88 MCH-29.6 MCHC-33.5 RDW-14.2 Plt Ct-158 [**2182-5-14**] 05:50AM BLOOD PT-14.3* PTT-42.5* INR(PT)-1.3 [**2182-5-13**] 04:55PM BLOOD Glucose-106* UreaN-27* Creat-1.1 Na-139 K-4.4 Cl-103 HCO3-28 AnGap-12 [**2182-5-13**] 04:55PM BLOOD Mg-2.2 Brief Hospital Course: Dr. [**Known lastname 58695**] was admitted on [**2182-5-8**] and proceeded directly to the operating room for an aortic valve replacement and mitral valve replacement with Dr. [**Last Name (STitle) **]. Please see op note for full details. He was seccessfully weened and extubated on his operative evening. On POD one he continued to progress well and was transferred out of the intensive care unit. Also on POD one, he converted to atrial fibrillation treated with IV and PO lopressor. On POD two he continued to be in atrial fibrillation (rate controlled) and was started on amiodarone and heparin IV for anticoagulation. His chest tubes and cardiac pacing wires were removed. On POD three he strated on PO coumadin for anticoagulation. In the aftrenoon he converted to a normal sinus rhythm. PODs four and five were uneventful with ongoing heparin drip and PO coumadin. He continued to have a significant amount of peripheral edema and his lasix was increased. Physical therapy continued to follow pt closely and on POD five he was found to be safe for home from their standpoint. On POD six, his INR continued to be low at 1.3 but it was decided that his heparin could be discontinued and he would be discharged home with PO coumadin only. Medications on Admission: Atenolol 20 mg daily. Prozac 50 mg daily. Discharge Medications: 1. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO DAILY (Daily) for 7 days. Disp:*7 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 3. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 4. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO every 4-6 hours as needed for pain. Disp:*30 Tablet(s)* Refills:*0* 5. Atorvastatin Calcium 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Fluoxetine HCl 20 mg Tablet Sig: 2.5 Tablets PO DAILY (Daily). 7. Furosemide 20 mg Tablet Sig: One (1) Tablet PO once a day for 7 days. Disp:*7 Tablet(s)* Refills:*0* 8. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 9. Warfarin Sodium 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): 5 mg on [**5-14**] and [**5-15**]. Have VNA draw blood and check INR on [**5-16**] and Dr. [**Last Name (STitle) 3306**] will dose coumadin. Disp:*150 Tablet(s)* Refills:*2* 10. Amiodarone HCl 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day) for 3 days. Disp:*12 Tablet(s)* Refills:*0* 11. Amiodarone HCl 200 mg Tablet Sig: Two (2) Tablet PO once a day for 7 days: To start following 400 mg [**Hospital1 **] dosing. Disp:*14 Tablet(s)* Refills:*0* 12. Amiodarone HCl 200 mg Tablet Sig: One (1) Tablet PO once a day: To beging after 400 mg [**Hospital1 **] and 400 mg daily doses are completed. Disp:*30 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital3 3765**] Hospice Program Discharge Diagnosis: Aortic stenosis/ Aortic insufficiency. Mitral stenosis. Post-operative atrial fibrillation. Discharge Condition: Stable. Discharge Instructions: Shower daily and wash incisions with soap and water -- rinse well. Do not apply any creams, lotions, powders, or ointments. No swimming or tub bathing. No lifting greater than 10 pounds. No driving x 6 weeks. Followup Instructions: Call to schedule appointments with: [**Last Name (Prefixes) 413**],[**First Name3 (LF) 412**] [**Telephone/Fax (1) 170**] follow-up appointment in 4 weeks [**Last Name (LF) **],[**First Name3 (LF) **] [**Telephone/Fax (1) 58696**] follow-up appointment in 2 weeks Cardiologist in [**2-3**] weeks Please have NVA draw blood and check INR on [**5-16**] and call results into Dr. [**Last Name (STitle) 3306**]' office. Completed by:[**2182-5-14**]
Discharge summary
Classify the following medical document.
Admission and NPN 01-0700: This is a 54 yo male pt with a hx of HCV, hepatocellular CA, cirrhosis, etho, who has been living in a nursing home transitioning to hospice. Plan was for pt to go back to [**Country 1948**] where he would likely die soon. Instructions were that he wanted to remain full code in hopes that he would be able to make it back to [**Country 1948**]. Yesterday, pt was noted to have MS changes and was sent to ED. On arrival he was noted to be hypotensive SBP 60s, given NS boluses and started on Levophed drip. Lactate was 10.6, EKG showed peaked T wave and K was 6.8. An NG tube was placed and was given Kayexalate; coffee ground material was aspirated. Given IV vancomycin, Flagyl, Levofloxacin, Albumin, and Protonix. LFTs were c/w cholangitis and RUQ US showed no significant changes from prior exam. Surgery was consulted and felt that pt is not a surgical candidate given comorbidities and overall prognosis. This was communicated to pt's friends who accompanied him in the [**Name (NI) **], but they felt uncomfortable changing his code status. His brother is flying to [**Name (NI) 47**] from [**Country 1948**] and the wish was expressed that the pt be supported fully, including intubation if necessary, until his brother arrives today ([**6-17**]). CXR showed pulmonary edema, a presept catheter was inserted in ED and started on sepsis protocol, transferred to [**Hospital Unit Name 65**] to continue sepsis protocol and intubate if needed. ROS: Neuro: Pt is lethargic, answers questions intermittently with an unclear speech, oriented to name and place (names [**Hospital3 1015**]), R/O hepatic encephalitis started on Lactulose, c/o abdominal pain given Morphine sulfate 2 mg IV. RUQ US preliminary showed portal vein thrombosis, rt lobe liver lesions consistent with HC, minimal amount of ascites, gallbladder thickening with no evidence of acute cholecystitis. Resp: Breathing regularly on NC 4 L/min, at times desats to 88% reminded to take deep breaths goes up to 94-95%, RR 20-26, LS coarse all through, CXR showed multifical pneumonia/asymmetric pulmonary edema. CV: ST HR 105-115, BP 97-114/43-56, with presep cath and 2 peripheral IV lines, on Levophed at 0.15 mcg/kg/min, with edema all over especially extremities and ascites, on Vancomycin, Flagyl and Zosyn, bld tests revealed Hct 35, WBC 9.6, Lactate 6.2, INR 2.1 given vit. K. EKG done in ICU, CVP 12-14, SVO2 80-84, sepsis protocol continued. GI/GU: With NGT in place, to be kept NPO (except for meds) for possible intubation. Abdomen softly distended with ascites, with Foley cath drained 100-140 ml/hr clear yellowish u/o. Integ: With jaundice, icteric eyes, edema all over, peripheral pulses weak. Social:No contacts from family/friends during the night. Plan: Minitor BP and continue Levophed to maintain MAP above 60, monitor CVP and bolus with 500 ml NS if less than 12, monitor for worsening of pulmonary edema, repeat CXR, continue sepsis protocol, monitor lytes especially K and replete accordingly (or give Kayexalate if K is high), Keep NPO except for meds for possible intubation if needed.
Nursing/other
Classify the following medical document.
Admission Date: [**2186-11-24**] Discharge Date: [**2186-11-28**] Date of Birth: [**2108-3-6**] Sex: F Service: MEDICINE Allergies: Penicillins / Accupril / Celebrex Attending:[**First Name3 (LF) 2009**] Chief Complaint: "spitting up dark vomit" Major Surgical or Invasive Procedure: none History of Present Illness: Ms. [**Known lastname **] is a 78y/o lady with dementia, HTN, SLE on Prednisone/Plaquenil, [**Known lastname 2091**] stage IV (baseline Cr 1.5), amyloid angiopathy with recent ICH who presents from nursing home due to hematemesis. . She is a resident at [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **]; at her baseline she is disoriented and does not speak very much, though she can answer questions appropriately. She has had a complicated recent course including hospitalizations x2 at [**Hospital1 2177**] over the past month for multiple intracerebral hemorrhages/hemorrhagic strokes. It was felt that these strokes were related to hypertension and amyloid angiopathy. Goal SBP has been less than 150. Prior to her recent hospitalization she reportedly fell, was on the ground for a prolonged amount of time, and was also noted to be "spitting up dark vomit." . On the day of presentation she reported "burning" but did not elaborate when asked. She had a BP 200/100. Vomited dark brown/marroon vomit and the paramedics were called. En route, she again vomited maroon emesis. . She was recently admitted to [**Hospital1 2177**] in [**Month (only) 216**] for a cerebellar ICH, and again on [**11-21**] for lethargy/somnolence. CT scan of the head revealed a new left posterior temporal lobe intraparenchymal hemorrhage without mass effect. No MRI done due to agitation. BP controlled and she was subsequently discharged. Of note, she had a few runs of SVT there that were beta blocker responsive. . In the ED, initial VS: T98.3, HR 108, BP 171/120, RR 18, POx 100% 3L NC. Labs notable for Hct 47.3 (at baseline), Cr 1.8 (at baseline), lipase slightly elevated at 111. She had no more episodes of emesis after arrival. NG lavage mstly clear with some maroon sediment and coffee ground emesis. She had PIVx2 placed, was started on normal saline @150cc/hr, Pantoprazole 80 mg IV bolus then drip at 8mg/hr. Her SBP was noted to be >180; she was given Diltiazem 10mg IV given recent ICH. She was admitted to Medicine for management of upper GI bleed. VS prior to transfer were: T98.4, HR74, BP156/78, RR16, POx98%RA. . This morning on the medicine floor, she had no further episodes of hematemesis or coffee grounds. Repeat HCT to 43 this AM. She was noted to be hypertensive to 200-210 systolic. The stroke team was involved given the finding of ?ICH on CT head. After obtaining [**Hospital1 2177**] records, teams were reassured that imaging abnormalities were present during most recent admission a few days ago. Strict BP control recommended, along with MRI. She got hydralazine 10mg IV x2 which brought BP down to 160s. She then developed SVT with rates to 160s that was initially responsive to vagal maneuvers but eventually required lopressor 5mg IV x2. She retained hemodynamic stability throughout these episodes. . Upon arrival to the MICU, she complains of no pain but resists continued questioning, getting somewhat irritated with physical exam as well. Denies abdominal pain, N/V/D, bloody emesis, chest pain, SOB. No further ROS could be elicited. Past Medical History: - intracerebral hemorrhages, involved the left cerebellar and right parietal lobes - dementia - [**Hospital1 2091**] IV, baseline Cr 1.5-1.8 - HTN - SLE - DM2 - DJD, knees - acute gout flare, on prednisone taper - rotator cuff surgery - patient has had most of her care at [**Hospital1 2177**] Social History: Widowed, now at [**First Name4 (NamePattern1) 1785**] [**Last Name (NamePattern1) **]. Never smoker. No alcohol. Never drugs. Family History: non-contributory Physical Exam: ADMISSION PHYSICAL EXAM: VS - Temp 96.1F, BP 182/91, HR 80, R 18, O2-sat 98% RA GENERAL - elderly lady in NAD HEENT - EOMI, sclerae anicteric, dry MM, OP clear NECK - no JVD, no carotid bruits LUNGS - CTA bilaterally HEART - PMI non-displaced, RRR, no MRG, nl S1-S2 ABDOMEN - (+) bowel sounds; no tenderness to palpation in any quadrant; no rebound RECTAL: deferred; was guaiac negative in the ED EXTREMITIES - warm, no edema, 2+ DP pulses bilaterally NEURO - awake, oriented to self only. Smile reveals very mild flattening of left nasolabial fold and very mild down-turning of left mouth. Sensation to light touch intact V1-V3. Can keep eyes closed when attempted to force open. Tongue is midline. Normal muscle bulk and tone. Sensation to light touch grossly intact throughout. Right hand finger-to-nose test is slow/deliberate with hesitancy as approaches target; left hand is even more inaccurate Slow alternating movements of hands in lap; cannot perform task faster. LEs with 4+/5 strength of hip flexion and toe dorsi/plantar flexion. UEs with 5/5 flexion/extension at elbow. Oriented to self only. When asked if this might be a restaurant or school or hospital or apartment, she says, "I'm, I think it is a sool, shool, a shool." Two minutes after telling her where she is, when asked if she remembers which hospital this is she does not remember. DISCHARGE PHYSICAL EXAM: VS: 96.8 128/76 68 18 96%RA Exam is otherwise unchanged Pertinent Results: LABS: On admission: [**2186-11-23**] 09:30PM BLOOD WBC-10.3 RBC-5.43* Hgb-15.6 Hct-47.3 MCV-87 MCH-28.8 MCHC-33.1 RDW-14.1 Plt Ct-270 [**2186-11-23**] 09:30PM BLOOD Neuts-86* Bands-0 Lymphs-11* Monos-3 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2186-11-23**] 09:30PM BLOOD PT-12.4 PTT-23.9 INR(PT)-1.0 [**2186-11-23**] 09:30PM BLOOD Glucose-208* UreaN-31* Creat-1.8* Na-144 K-4.2 Cl-104 HCO3-24 AnGap-20 [**2186-11-23**] 09:30PM BLOOD ALT-25 AST-27 AlkPhos-76 TotBili-0.2 [**2186-11-23**] 09:30PM BLOOD Lipase-111* [**2186-11-23**] 09:30PM BLOOD Albumin-4.4 Calcium-10.6* Phos-3.1 Mg-1.8 On discharge: [**2186-11-28**] 07:00AM BLOOD WBC-8.4 RBC-5.07 Hgb-14.7 Hct-44.1 MCV-87 MCH-29.1 MCHC-33.4 RDW-13.9 Plt Ct-229 [**2186-11-28**] 07:00AM BLOOD Plt Ct-229 [**2186-11-28**] 07:00AM BLOOD Glucose-139* UreaN-35* Creat-1.6* Na-140 K-4.3 Cl-104 HCO3-25 AnGap-15 [**2186-11-27**] 07:05AM BLOOD ALT-17 AST-16 LD(LDH)-252* AlkPhos-50 TotBili-0.4 [**2186-11-28**] 07:00AM BLOOD Calcium-9.5 Phos-3.7 Mg-2.1 IMAGING: [**11-24**] CT head: IMPRESSION: 1. New hyperdense focus within the left parietal lobe may represent new hemorrhagic stroke versus hemorrhagic tumor versus a focus of hemorrhage. Additional low-attenuating region within the right parietal and iso- to hyperdense focus within the left cerebellar region may correspond to patient's history of hemorrhagic stroke. Overall, findings may suggest an embolic phenomenon; however, correlation with clinical history is recommended. NOTE ADDED AT ATTENDING REVIEW: The hemorrhagic lesions in the left cerebellar hemisphere and left parietal lobe might represent hemorrhagic infarctions, however, the possibility of neoplasms should be considered. The hypodense right parietal mass with a thin hyperdense rim would be an unusual appearance for infarction, acute or chronic, and the possibility of neoplasm should be strongly considered. Given these findings, an MR with contrast is recommended to pursue the possibility than one or more of the lesions may be due to a malignancy, such as metastatic disease. After discussion by Dr. [**Last Name (STitle) **] with Dr. [**Last Name (STitle) 7886**] of Stroke Neurology, at 10:30 am on [**2186-11-24**] by telephone, it appears these lesions were pursued with CT as well as MR [**First Name (Titles) 151**] [**Last Name (Titles) **] enhancement during a recent evaluation at [**Hospital6 **]. These studies are not available for comparison at this time, but apparently reports interepreted the lesions described above as benign hemorrhages. As discussed with Dr. [**Last Name (STitle) 7886**], the best approach may be to obtain these studies and compare them to the current examination. If this is not possible, then it would be best to obtain an MR [**First Name (Titles) 151**] [**Last Name (Titles) **] when the patient's renal function will permit this. [**11-25**] CXR: In comparison with study of [**2184-2-14**], there is little overall change. No evidence of acute cardiopulmonary disease. Specifically, the left base appears clear. Brief Hospital Course: 78 year old female with dementia, HTN, SLE on Prednisone/Plaquenil, [**Date Range 2091**] stage IV (baseline Cr 1.8) and amyloid angiopathy with recent ICH who presented from nursing home due to hematemesis on [**2186-11-24**] noted to have hypertensive emergency, recent bleeds on head CT unchanged. She was transferred briefly to the ICU for careful neuro checks, frequent blood pressure monitoring, management of SVT (see below), but was stable for transfer back to the floor within 1 day. Non-emergenct EGD showed no active bleeding, only candidal esophagitis. Please see below for more details on each hospital problem. . ACTIVE PROBLEMS: # AMYLOID ANGIOPATHY/ICH: Given hypertensive urgency in the ED with recent ICH, stat head CT obtained when she arrived on the floor. The CT showed multiple sites of bleed, initially concerning for acute new hemorrhage. She was evaluated emergently by the Neuro Stroke service, who reviewed reports from her OSH CT and MRI the previous week were obtained and it was decided that what we were seeing was more likely due to older bleeds. They recommended conservative managment with aggressive control of BP, with goal BP <140/90. She was started on metoprolol for blood pressure control (as well as prevention of SVT- see below) and restarted on home dose of felodipine. She will be continued on these two medications at discharge. Good blood pressure control will be of paramount importance in preventing new intracranial bleeds, so this is something that should continued to be monitored frequently (at least every 8 hours) at her rehab facility. . # MAROON EMESIS: Hct at baseline on admission, NG lavage in ED showed mostly clear fluid with some dark sediment. Made NPO and started PPI IV. Repeat hematocrits showed no clinically significant drop, and she hemodynamically stable with no recurrence of hematemesis. EGD on [**2186-11-27**] revealed esophageal candidiasis, likely as a result of her high dose prednisone (even though this was started just 1 week ago). No other signs to point to underlying immunodeficiency, however it would not be unreasonable to order an HIV test as an outpatient, will defer to outpatient PCP. [**Name10 (NameIs) **] was started on fluconazole 200 mg qday for a planned 3 week course (from [**Date range (1) 97861**]). LFTs sent at the initiation of therapy to establish a baseline (normal). Continued on omeprazole 20 mg for additional gastric protection on discharge. A biopsy of the candidal plaques as taken, so this will need to be followed up as an outpatient. . # SUPRAVENTRICULAR TACHYCARDIA: Placed on telemetry on arrival given concern for GI bleed, noted to have short runs of narrow complex tachycardia which initially self-resolved on the morning of admission. Then went into another run of SVT (appeared to be AVNRT) to the 160s which was sustained. Attempted carotid massage and vagal maneuvers, then metoprolol 5 mg IV x2 with minimal response (rate decreased to 130s). She was then transferred to the ICU for higher level of nursing care, and her SVT broke while en route, converting back to sinus rhythm in the 80s. She was started on metoprolol for rate control. She remained on telemetry throughout her stay and did not have a recurrence. . #. DEMENTIA/DELIRIUM: Per daughter, pt is forgetful at baseline, usually oriented to herself but not time or place. She appeared to be baseline mental status throughout most of her stay, but she was at times somewhat agitated. Likely a degree of acute delirium, given her illness and frequent transfers between floors. Her medication list from [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **] listed seroquel 12.5 mg [**Hospital1 **] as one of her outpatient medications, so she was started on this dose of seroquel with PRN haloperidol. Her agitation was decreased with this medications, but she was somewhat sleepy. She seemed to do better with a decreased dose of 6.25 mg qHS, with additional 6.25 mg PRN (never needed to be given this). She is being discharged on this decreased dose of seroquel. . # HYPERNATREMIA: Na elevated to 146 on admission, likely due to poor PO intake in the setting of dementia. Improved after getting boluses of D5W, unlikely to have contributed to her mental status. . # HYPERTENSION: BP control as above. . INACTIVE PROBLEMS: #. [**Name2 (NI) 2091**]: Cr 1.7, remained within recent range through her hospitalization. She was also continued on her calcitriol. . #. SLE, gout: Continued on outpatient doses of plaquenil and allopurinol. She also came in on Prednisone for gout flare, and supposedly this was to be tapered, but have not been able to touch base with the PCP on this. Will send her back to [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **] on a taper over 6 days. She will be covered with sliding scale insulin for steroid-induced hyperglycemia during these 6 days. . TRANSITIONAL ISSUES: - Amyloid angiopathy: will need very tight control of her BP with checks every 8 hours at her ECF. Does not need repeat imaging unless clinical status changes - Esophageal candiasis: given 3 week course of fluconazole, should have LFTs checked and consider HIV test as screen for causes of immunosuppression - Follow up biopsy of esophagus DNR/DNI throughout hospital stay, confirmed w daughter/HCP [**Name (NI) **] Outstanding tests: Esophageal biopsy [**11-27**] - returned consistent with candidal esophagitis. Medications on Admission: - prednisone 40 mg PO daily (being tapered) - hydrochloroquine 200 mg PO BID - felodipine 10 mg PO daily - allopurinol 150 mg PO daily - seroquel 12.5 mg PO daily - prilosec 20 mg PO daily - calcitriol 0.25 mcg PO daily - folic acid 1 mg PO daily - colace 100 mg PO BID - Tylenol PRN - Senna PRN - Miralax PRN Discharge Medications: 1. prednisone 10 mg Tablet Sig: Three (3) Tablet PO once a day for 2 days. 2. prednisone 10 mg Tablet Sig: Two (2) Tablet PO once a day for 2 days. 3. prednisone 10 mg Tablet Sig: One (1) Tablet PO once a day for 2 days. 4. hydroxychloroquine 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. felodipine 10 mg Tablet Extended Release 24 hr Sig: One (1) Tablet Extended Release 24 hr PO once a day. 6. allopurinol 300 mg Tablet Sig: 0.5 Tablet(s) (150 mg) PO once a day. 7. quetiapine 25 mg Tablet Sig: 0.25 Tablet PO qHS (bedtime), may repeat x1 as needed. 8. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 9. calcitriol 0.25 mcg Capsule Sig: One (1) Capsule PO DAILY (Daily). 10. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 12. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain/fever. 13. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day): Please hold for SBP<100 or HR<60 . 14. senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day. 15. insulin lispro 100 unit/mL Solution Sig: per sliding scale Subcutaneous four times a day for 6 days: Sliding scale: 200-250 1 unit, 251-300 2 units, 301-350 3 units, 351-400 4 units. 16. fluconazole 200 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 3 weeks: Please stop on [**12-18**] . Discharge Disposition: Extended Care Facility: [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **] - [**Location (un) 538**] Discharge Diagnosis: Hypertensive urgency Esophageal candidiasis Amyloid angiopathy with h/o intracranial hemorrhage Supraventricular tachycardia Chronic kidney disease Hypernatremia Discharge Condition: Mental Status: Confused - always. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Dear Ms. [**Known lastname **], It was a pleasure to take care of you at [**Hospital1 18**]. You were admitted to the hospital after you vomited some blood. We looked down your throat with a camera, and we did not see any bleeding but did find that you have a thrush infection of your throat. We are prescibing you a 3 week course of a medicine called fluconazole to help treat this. We did a CT scan of your head and found that the bleeding from your strokes looks stable. Because of your high blood pressure, you are at an increased risk to bleed again. It is very important that you continue taking your blood pressure medicines and have your blood pressure checked regularly to make sure that it does not get too high again. Changes to your medications: START fluconazole 200 mg daily for 3 weeks (until [**12-18**]) START metoprolol 25 mg three times a day DECREASE prednisone to 30 mg for 2 days, then 20 mg for 2 days, then 10 mg for 2 days, then stop START insulin sliding scale four times a day (can stop when done with prednisone taper) Followup Instructions: Please follow up with the on-staff doctor [**First Name8 (NamePattern2) **] [**First Name4 (NamePattern1) 1188**] [**Last Name (NamePattern1) **]
Discharge summary
Classify the following medical document.
Neonatology Attending Admission Note Infant known to [**Hospital1 21**] NICU as was delivered and initially admitted here ([**2170-12-8**]). Subsequently transferred later on delivery day to [**Hospital3 50**] for surgical management of imperforate anus. Has done well s/p colostomy for imperforate anus and transferred today for continued care. Infant now a 10 day old, former 34 [**2-5**] week twin who was born to a 35 y.o. G1P0-2 mother with prenatal screens of A+, antibody negative, HBsAg negative, RPR NR, RI, GBS unknown. Pregnancy complicated by poor fetal growth of this twin which prompted early delivery. Delivery by cesarean section as this twin was in breech position. Infant did well at delivery with Apgars of [**8-7**]. Hospital course at [**Hospital3 50**]: 1. Respiratory: Briefly intubated for surgical procedure and postoperatively. Currently in RA. No apnea of prematurity. 2. Cardiology: Initial ECHO done at [**Hospital1 21**] prior to transfer to [**Hospital1 **] was normal. 3. FEN/Gastrointestinal: Colostomy performed for imperforate anus. Initially maintained on IVFs. Started feedings on 2nd post-op day. Now receiving NeoSure24 140cc/k/day. 4. Genitourinary: Initial renal u/s suggestive of hydronephrosis. Subsequent study was normal. VCUG revealed mild obstruction from posterior urethral valves. Will need urodynamic studies at a later date. Infant placed on amoxicillin prophylaxis mainly for colonic-urethral fistula. 5. Infectious Diseases: Received 48 hour course of amp/gent then switched to amox prophylaxis. 6. Neurology/Neurosurgery: Initial HUS concerns for PV echogenicity, but follow-up normal. Ophthalmology exam normal. Spine u/s revealed tethered cord. 7. Oral-cleft palate: Followed by plastics service, feeds with [**Last Name (un) **] nipple. 8. Genetics: consult obtained. No syndrome identified. Signature Chip results pending. 9. Hematology: Course of phototherapy 10: Orthopedics: Hypoplastic sacrum, right clavicular anomaly. Hip US normal. Consultative services: cardiology, genetics (Dr. [**First Name4 (NamePattern1) 908**] [**Last Name (NamePattern1) 2906**]), neurosurgery (Dr. [**Last Name (STitle) 2907**], plastics (Drs. [**Name5 (PTitle) 1172**]/Mullikan), orthopedics (Drs. [**Name5 (PTitle) 2908**]/[**Doctor Last Name 2909**], [**Telephone/Fax (1) 2910**]), urology (Dr. [**Last Name (STitle) 2634**] Exam: Vital signs in CareView Resting comfortably on radiant warmer. AFSF. Low-set ears. Cleft palate. Neck supple. Lungs CTA, =. CV RRR, no murmur, 2+FP. Abd soft, +BS. Colostomy bag intact. Nl phallus, testes desc bilat. Imperforate anus. Sacral dimple. Negative hip exam. Ext pink and well perfused. Clinodactyly. Impression: 1. Preterm male newborn 2. Imperforate anus, s/p colostomy 3. Cleft palate 4. Multiple congenital anomalies Plan: Will continue current feedings and amoxicillin. Continue to encourage po feeds. Follow-up on all recommended tests and appointments by consultative services. Orthopedics: anticipate no functional concerns secondary to clavicular anomaly (pseudoarthrosis). Rec f/u as outpatient in [**12-31**] months Plastics: Cleft repair at 8-10 months of age Neurosurgery: Spine MRI at 3 months of age Genetics: f/u on Sig Chip results Urolog
Nursing/other
Classify the following medical document.
Admission Date: [**2185-3-9**] Discharge Date: [**2185-4-20**] Date of Birth: [**2145-10-21**] Sex: F Service: SURGERY Allergies: Sulfonamides / Zithromax / Biaxin / Plaquenil / Amantadine / Amoxicillin / Fish Product Derivatives / Hydromorphone / Ativan / Versed / Tegaderm / Zyrtec / Vicodin / Dilaudid / Midazolam / Shellfish Derived / Fentanyl / Iodine; Iodine Containing Attending:[**First Name3 (LF) 6346**] Chief Complaint: Abdominal pain, nausea, vomiting Major Surgical or Invasive Procedure: [**2185-3-10**] 1. Exploratory laparotomy. 2. Lysis of adhesions. 3. Small bowel resection. 4. Temporary abdominal closure. 5. primary classical cesarean delivery [**2185-3-11**] Re-exploration, washout and temporary closure [**2185-3-14**] Re-exploration of the abdomen, end-ileostomy, abdominal fascial closure. History of Present Illness: Patient is a 38 year old female with an extensive past medical history significant for chronic abd pain and Sphincter of Oddi stenosis. She is s/p major duodenal papilla sphincteroplasty with open J tube and open G tube placement on [**2184-4-20**]. She responded very well to this surgery in terms of management of her chronic abdominal pain. She is now 25 weeks pregnant. She presents [**2185-3-9**] with exquisite epigastric abdominal pain that woke her from sleep at 4am. It started suddenly and has been unremitting and not controlled with her home darvocet pain meds. She was seen earlier this month with less intense abd pain and was monitored clinically. Per pt, she saw Dr. [**Last Name (STitle) **] in clinic and he reduced a hernia. Pt denies fevers or chills, vomiting, or diarrhea. She has some nausea and still has flatus. She also has abdominal wall pain secondary to known neuromas from her previous surgeries that had been treated by Dr. [**Last Name (STitle) 957**] with injections. Past Medical History: Past Medical History: - Sphincter of Oddi dysfunction with stricture of the main pancreatic duct s/p major duodenal papilla sphincteroplasty with open J tube and open G tube placement - Pancreatic insufficiency and pancreatitis - h/o Lyme disease - Thyroiditis - [**Last Name (un) 8061**] syndrome with vasculitis - Chronic neuropathic pain and optic neuritis PSH: Age 4, tonsillectomy and an adenoidectomy. [**2173**] - rhinoplasty. [**2164**] - cystoscopy. [**12/2169**] and [**4-/2173**] - pelviscopy (? hystero-salpingoscopy or colposcopy) [**2172**] to [**2175**] - three Hickman catheters for IV antibiotics for Lyme disease. [**2174**] - Laparoscopic cholecystectomy @ [**Hospital1 112**], [**2174**] [**2177**] - Hernia repair [**2-/2183**] - EGD [**5-/2183**] - Lipoma and incisional hernia on the left side and a lipoma on the right side 1.5 cm2. [**4-/2184**] - Biliary and pancreatic sphincteroplasty, open G tube and J tube for sphincter of oddi stenosis Social History: lives with husband, does not work denies tobacco, alcohol, or illicit drug use Family History: non-contributory Physical Exam: On day of admission: T 97.9 P 84 BP 100/52 R 20 SaO2 99%RA Gen: mild distress with obvious pain Neck: supple Heent: an-icteric Lungs: clear Heart: RRR Abd: well healed horizontal incisions, very tender over epigastric incision site. Small palpable nodule. No hernia palpated although exam limited by tenderness. soft, nondistended, gravid, nontender uterus Extrem: warm, well-perfused Pertinent Results: [**2185-3-9**] 04:30PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2185-3-9**] 03:13PM URINE bnzodzpn-NEG barbitrt-NEG opiates-POS cocaine-NEG amphetmn-NEG mthdone-NEG [**2185-3-9**] 09:00AM GLUCOSE-90 UREA N-6 CREAT-0.3* SODIUM-136 POTASSIUM-3.6 CHLORIDE-104 TOTAL CO2-21* ANION GAP-15 [**2185-3-9**] 09:00AM ALT(SGPT)-12 AST(SGOT)-17 LD(LDH)-149 ALK PHOS-52 AMYLASE-54 TOT BILI-0.2 [**2185-3-9**] 09:00AM LIPASE-20 [**2185-3-9**] 09:00AM CALCIUM-8.3* PHOSPHATE-3.2 MAGNESIUM-1.6 URIC ACID-2.3* [**2185-3-9**] 09:00AM HBsAg-NEGATIVE [**2185-3-9**] 09:00AM WBC-7.9 RBC-3.57* HGB-11.5* HCT-34.6* MCV-97 MCH-32.2* MCHC-33.2 RDW-14.2 [**2185-3-9**] 09:00AM NEUTS-81.9* LYMPHS-13.0* MONOS-4.7 EOS-0.4 BASOS-0 [**2185-3-9**] 09:00AM PLT COUNT-182 [**2185-3-9**] 09:00AM PT-13.0 PTT-36.1* INR(PT)-1.1 . [**2185-3-10**] Pathology: SPECIMEN SUBMITTED: terminal illium, placenta: DIAGNOSIS: 1. Terminal ileum (A - C): Recent hemorrhage and mucosal necrosis consistent with ischemic type injury. The changes extend to the margins of resection focally. 2. [**Doctor Last Name 11468**] placenta (156 grams) D - G: A. Umbilical cord with three vessels. B. Fetal membranes: No evidence of chorioamnionitis. C. A thrombus is noted in a vessel beneath the amniotic surface of the placenta. Clinical: Fetal demise/? bowel obstruction. Small bowel volvulus/fetal demise. 38 year old IU FD at 25 weeks. Hysterotomy for delivery. Gross: The specimen is received fresh, in two parts, each labeled with the patient's name "[**Known firstname 1154**] [**Known lastname 11469**]" and the medical record number. Part 1 is additionally labeled "terminal ileum", and consists of an unoriented segment of small intestine measuring 44 cm in length x 3.5 cm in diameter. The two stapled ends each measure 3.0 cm in length. The serosa of the entire specimen appears dark red to black. The specimen is opened along the antimesenteric side to reveal a dark red to black lumen filled with blood. The attached mesentery measures 9.5 x 4.5 x 0.5 cm, pink to red in color. The specimen is sectioned to reveal dark red to black cut surfaces. The specimen is represented as follows: A=stapled margins, B=representative sections of mucosa, C=section of mucosa with adjacent mesentery. Part 2 is additionally labeled "placenta", and consists of a [**Doctor Last Name **] placenta. The umbilical cord has three vessels, is 8.0 cm in length and 1.0 cm in average diameter and has a normal insertion. The umbilical cord has no twists and is otherwise unremarkable. The fetal membranes have a 100% marginal insertion, are normal in color and do not have attached granular deposits of decidua. The point of rupture is not identified. The trimmed disc weighs 156 grams and measures 18 x 17.5 x 1.3 cm. The fetal identified shows patchy subchorionic fibrin and a normal arborizing fetal vascular pattern without thrombosis. The maternal surface is complete and does not have adherent blood clot or decidual hemorrhage. On cut sections, the placenta is unremarkable. The specimen is represented as follows: D=cross sections of the vocal cord, E=sections of placental membrane, F-G=sections of placental disc. . [**2185-3-9**] Abdominal MRI: 1. Pancreas divisum anatomy. The pancreas otherwise appears normal. 2. Small amount of free fluid in the abdomen and pelvis. 3. Moderate amount of stool throughout the colon. The patient may be constipated, worsened by compressive effect of the gravid uterus on the sigmoid colon. No evidence of bowel obstruction. 4. No anterior abdominal wall hernia is identified. Brief Hospital Course: She was admitted to labor and delivery for evaluation and management of abdominal pain. General sugery consult was obtained. Initial workup included an MRI on HD#1 which did not report any significant findings. Her pain persisted and on the morning of hospital day 2 her clinical picture changed with the development of oliguria, leukocytosis, change in hematocrit, and change in abdominal exam. In addition, sadly at this time an intrauterine fetal demise was diagnosed. The decision was made to proceed to the operating room for exploratory laparotomy by the general surgeons as well as cesarean delivery for the intrauterine fetal demise. Intraoperatively, the demised fetus was delivered by primary classical cesarean section and found to be grossly normal. Please see Dr.[**Name (NI) 11470**] (obstetrics) and Dr.[**Name (NI) 11471**] (surgery) operative notes for full details. [**3-10**]: exploratory laparotomy, c-section, resection 10cm TI, abdomen remained open, continued on pressors, given prbc for low hematocrit, remained intubated [**3-11**]: returned to the operating room for a second look, bowel looked better, abdomen still open to suction, remained intubated, weaned off pressors; given 4units albumin, 1u prbc [**3-12**]: remained intubated, on vasopressors [**3-14**]: returned to the operating room for end-ileostomy, closure, started cipro/vanc/flagyl, TPN [**3-15**]: remained intubated, back on pressors, bladder pressures okay, hct falling, kept paralzyed, started diflucan for candidiasis, got 1 upRBC [**3-16**] off pressors, cont TPN, remained intubated [**3-17**] 1 u pRBC, autodiuresing, still on vent, no pressors, TPN [**3-18**] febrile, TPN, autodiuresing, pan cultured, on CPAP [**Date range (1) 11472**] extubated, autodiuresing, discontinued vancomycin, ciprofloxacin and flagyl, started meropenem [**3-21**] continued ICU care, episodes of emesis, NGT replaced [**3-22**] bolused for high NGT output, pain control, transferred to floor for continued monitoring, continued meropenem and fluconazole [**3-23**] foley catheter removed [**3-24**] NGT clamping trials started, discontinued meropenem and fluconazole [**3-25**] NGT removed, diet advanced to clears [**3-27**] diet advanced to fulls, seen by PT, ostomy care [**3-28**] - [**3-30**] regular diet, increased loperamide for high ostomy output; TPN cycled, TPN fat taken out, cycled, volume halved [**3-31**] ostomy leaking [**4-1**] hydrocort for benzoin reaction, started hydrocort [**4-2**] -[**4-7**] continued cycled TPN, monitor ostomy output and adjust medications as needed; Calorie counts performed x 3days with results as follows: [**4-4**] cal counts = 880 cal, 24g fat, 18.5g prot, [**4-5**] cal counts = 1000cal, [**4-6**] cal counts = 1236 cal, 24.5g protein. [**4-7**] no events [**4-8**] started tincture of opium [**Date range (1) 11473**] No events [**4-13**] advanced to clears. [**4-14**] TPN returned to 24 hour infusion from cycled. Continued on clears and IV fluids. No events. [**Date range (1) 11474**] continued clears and IVF; no major events [**4-17**] decreased IVF, but still thirsty. No leakage from ostomy. Complaint of migraine; started on fioricet prn with good effect. [**4-19**] On clears/TPN. No events. At the time of discharge on [**2185-4-20**], the patient was doing well, afebrile with stable viral signs. The patient was tolerating a clear/full diet, ambulating, voiding without assistance, and pain was well controlled. The patient was dischaged home with VNA for ostomy care and infusion services for TPN. The patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. Medications on Admission: Flonase Prilosec 20mg [**Hospital1 **] Sucralfate 1g QID Creon 20 3 capsules TID Metamucil 2 caplets [**Hospital1 **] Colace 100mg [**Hospital1 **] Folic acid 400 mcg daily Demerol prn Darvocet N100 [**Hospital1 **]-TID Zofran 8mg QD-TID PRN Fioricet PRN migraine [**Doctor First Name **] 180mg PRN Vitamin B-6 Vitamin B-12 Discharge Medications: 1. White Petrolatum-Mineral Oil 42.5-56.8 % Ointment Sig: One (1) Appl Ophthalmic PRN (as needed). 2. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO BID (2 times a day). Disp:*60 Capsule, Delayed Release(E.C.)(s)* Refills:*2* 3. Loperamide 2 mg Capsule Sig: [**12-10**] Capsules PO Q4H (every 4 hours) as needed for excessive ostomy output. Disp:*120 Capsule(s)* Refills:*2* 4. ZOFRAN ODT 8 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO Q4-8HOURS as needed for nausea. Disp:*120 Tablet, Rapid Dissolve(s)* Refills:*2* 5. Psyllium Packet Sig: One (1) packet PO TID (3 times a day). 6. Butalbital-Acetaminophen-Caff 50-325-40 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for migraine. 7. Morphine 15 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. Disp:*40 Tablet(s)* Refills:*0* 8. Propoxyphene N-Acetaminophen 100-650 mg Tablet Sig: [**12-10**] Tablets PO Q6H (every 6 hours) as needed. Disp:*120 Tablet(s)* Refills:*2* 9. Opium Tincture 10 mg/mL Tincture Sig: Ten (10) Drop PO Q6HOURS (). Disp:*QS - 1 month mL* Refills:*0* 10. Sucralfate 1 gram Tablet Sig: One (1) Tablet PO TID (3 times a day). 11. Promethazine 25 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. 12. Xanax 0.25 mg Tablet Sig: One (1) Tablet PO at bedtime as needed for insomnia. Disp:*30 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Primary: 1. Small bowel mesenteric volvulus around a fixed point of a former jejunostomy tube 2. 25-week fetal demise. Discharge Condition: Good Discharge Instructions: Please call your doctor or return to the ER for any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. *Avoid lifting objects > 5lbs until your follow-up appointment with the surgeon. *Avoid driving or operating heavy machinery while taking pain medications. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. * Please resume all regular home medications and take any new meds as ordered. * Continue to ambulate several times per day. . Incision Care: -Your steri-strips will fall off on their own. Please remove any remaining strips 7-10 days after surgery. -You may shower, and wash surgical incisions. -Avoid swimming and baths until your follow-up appointment. -Please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. Monitoring Ostomy output/Prevention of Dehydration: -Keep well hydrated. -Replace fluid loss from ostomy daily. -Avoid only drinking plain water. Include Gatorade and/or other vitamin drinks to replace fluid. -Try to maintain ostomy output between 1000mL to 1500mL per day. -If Ostomy output >1 liter, take 4mg of Imodium, repeat 2mg with each episode of loose stool. Do not exceed 16mg/24 hours. . TPN Instruction: -Continue to cycle TPN for 12 hours overnight. -Weekly Labwork: Your electrolytes will be checked weekly per the VNA. Adjustments to your TPN formula will be made accordingly [**First Name8 (NamePattern2) **] [**First Name5 (NamePattern1) 553**] [**Last Name (NamePattern1) 11475**](Home Hyperal Service Coordinator), [**Telephone/Fax (1) 11476**], FAX: [**Telephone/Fax (1) 11477**]. -Check you blood sugars 4 times per day, at the same time each day. -Treat with insulin injections as indicated. Followup Instructions: Please call the office of Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2819**] to arrange a follow up appointment in [**1-11**] weeks at ([**Telephone/Fax (1) 6347**] Please call the office of Dr. [**Last Name (STitle) **] (Obstetrics) to arrange a follow up appointment in 2 weeks at ([**Telephone/Fax (1) 11478**] Completed by:[**2185-4-20**]
Discharge summary
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Chief Complaint: 24 Hour Events: TRANSTHORACIC ECHO - At [**2196-1-13**] 09:00 AM - ENT deferred inpatient consult and recommended that patient follow-up as an oupatient for work-up of hoarseness, should be arranged when he is closer to discharge (clinic x27500) - Morphine 2 mg iv x1 and q6 h prn for resipratory anxiety ; Deferred fentanyl patch until am - restarted klonipin - TTE -(LVEF>55%). Increased left ventricular filling pressure (PCWP>18mmHg). The right ventricular cavity is moderately dilated with moderate global free [**Known lastname **] hypokinesis. There is abnormal septal motion/position consistent with right ventricular pressure/volume overload. Mild (1+) mitral regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. - LEFT LENI - no dvt - RUQ u/s - PENDING - updated code status to DNR/DNI - Hct - 22.7 > 22.7 > 25.2 Allergies: No Known Drug Allergies Last dose of Antibiotics: Levofloxacin - [**2196-1-13**] 04:00 AM Ceftriaxone - [**2196-1-14**] 05:00 AM Infusions: Other ICU medications: Other medications: Review of systems is unchanged from admission except as noted below Review of systems: pt sleeping Flowsheet Data as of [**2196-1-14**] 07:05 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37 C (98.6 Tcurrent: 36.3 C (97.4 HR: 103 (90 - 113) bpm BP: 109/53(64) {101/53(64) - 128/74(84)} mmHg RR: 29 (20 - 32) insp/min SpO2: 93% Heart rhythm: ST (Sinus Tachycardia) Height: 71 Inch Total In: 1,228 mL 50 mL PO: 250 mL TF: IVF: 623 mL 50 mL Blood products: 355 mL Total out: 3,850 mL 1,050 mL Urine: 3,850 mL 1,050 mL NG: Stool: Drains: Balance: -2,622 mL -1,000 mL Respiratory support O2 Delivery Device: Non-rebreather SpO2: 93% ABG: ///25/ Physical Examination General Appearance: Well nourished, tachypnec, HEENT: : Normocephalic, eyes closed Cardiovascular: mildly tachy, ns1/ Prominent p2, Respiratory / Chest: recruitment of extra-respiratory muscles, bibasilar rales, Abdominal: Soft, Non-tender, Bowel sounds present Extremities: minimal peripheral edema; 2+ distal pulses, no cyanosis Neurologic: sleeping Labs / Radiology 26 K/uL 9.0 g/dL 157 mg/dL 1.1 mg/dL 25 mEq/L 3.5 mEq/L 46 mg/dL 108 mEq/L 142 mEq/L 26.3 % 7.4 K/uL [image002.jpg] [**2196-1-13**] 12:44 AM [**2196-1-13**] 11:36 AM [**2196-1-13**] 05:11 PM [**2196-1-14**] 04:45 AM WBC 4.3 4.1 5.0 7.4 Hct 22.7 22.7 25.2 26.3 Plt 20 21 25 26 Cr 3.1 1.8 1.1 Glucose 122 148 157 Other labs: ALT / AST:1092/765, Alk Phos / T Bili:92/0.6, Differential-Neuts:79.1 %, Band:0.0 %, Lymph:16.7 %, Mono:3.0 %, Eos:0.1 %, D-dimer:150 ng/mL, Fibrinogen:499 mg/dL, LDH:747 IU/L, Ca++:8.3 mg/dL, Mg++:1.9 mg/dL, PO4:2.8 mg/dL Assessment and Plan HYPOTENSION (NOT SHOCK) RENAL FAILURE, ACUTE (ACUTE RENAL FAILURE, ARF) RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name 11**]) ANXIETY 1. Hypoxia: Known metastatic lung cancer, but presents with change in sputum with occasional hypoxia. Given CXR and recent chemo, infection likely. Thus have started on broad spectrum antibiotics and sputum cultures are sent. Other potential infections include fungal and viral. Non infectious etiologies include pulmonary embolism and progression of his cancer. Given acute renal failure and abnormal chest x-ray, both CTA and V/Q scan are suboptimal choices. Though getting a Q scan to assess solely perfusion could be considered. Having progression of his know metastatic disease especially in the form of lymphangitic spread could explain current hypoxia, though the progression may be somewhat acute. - Vanc, ceftriaxone, levofloxacin - Repeat CXR in AM - Consider non-contrast CT versus perfusion scan - follow up viral and sputum cultures - urine legionella antigen 2. Hypotension Acute Renal failure: Patient presents with acute renal failure in the setting of hypotension, NSAID use, and hypovolemia. Thus cause for renal failure is likely multifactorial. Will evaluate with u/a, urine culture, will need to evaluate urine sediment. As well will give aggressive IVF. Concern with AMS, hypotension, ARF and LFT abnormalities, that patient could have tamponade. Pulsus 6 on initial eval but will recheck. - IVF - urine studies - renally dose meds 3. Thrombocytopenia: Unclear etiology, concerning for TTP, DIC or consumption in the setting of occult bleeding. Will repeat diff in AM and hct. If persistent low plt with schistocytes and no signs of DIC will contact heme for phasmaphoresis. - Tx plt if <20 - [**Last Name (un) 4201**] hct/plt - consider heme c/s if still low and concern for TTP 4. Acute hepatitis: Given hypotension, potentially ischemic secondary to poor perfusion. Will also send off hepatitis serologies as could have reactivation of Hep B in the setting of chemotherapy. Additionally could be infection or metatastases. - hepatitis serologies - repeat LFTs - Likely do CT torso - echo ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2196-1-12**] 10:17 PM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: DNR / DNI Disposition:
Physician
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[**2170-6-26**] 12:02 AM CT CHEST W/CONTRAST; CT ABDOMEN W/CONTRAST Clip # [**Clip Number (Radiology) 77183**] CT PELVIS W/CONTRAST Reason: fx, solid organ injury Field of view: 44 Contrast: OPTIRAY Amt: 130 ______________________________________________________________________________ [**Hospital 2**] MEDICAL CONDITION: 83 year old man with found down, unk mech REASON FOR THIS EXAMINATION: fx, solid organ injury No contraindications for IV contrast ______________________________________________________________________________ WET READ: JMGw TUE [**2170-6-26**] 12:55 AM no traumatic injury. prostate seeds. diffuse bony sclerotic changes compatible with metastatic dz or post radiation changes. emphysema. probable aspiration PNA at the right base. ______________________________________________________________________________ FINAL REPORT HISTORY: 83-year-old man found down. CT TORSO: Helical imaging was performed from the thoracic inlet to the pubic symphysis after uneventful administration of intravenous contrast. Sagittal and coronal reformatted images were prepared. COMPARISON: None. CT CHEST: There is biapical emphysema. Bibasilar consolidations, more pronounced on the right are concerning for aspiration pneumonia. The left atrium of the heart is enlarged and the main pulmonary artery is enlarged. There is atherosclerotic calcification of the thoracic aorta and coronary vessels. There is no hilar, axillary, or mediastinal lymphadenopathy. Tip of an ET tube is positioned 3.2 cm from the carina. Lobes of the thyroid appear normal. CT ABDOMEN: There is heterogeneous perfusion to the spleen likely due to phase of contrast timing. There are dense calcifications within the spleen which may represent granulomas. The adrenals appear unremarkable. The pancreas, gallbladder, and liver all appear within normal limits. The kidneys enhance and excrete contrast symmetrically without hydronephrosis. There is slight cortical defect along the interpolar region of the right kidney (2:67), which may be related to a site of prior infarction. There is a gastric tube within the stomach which extends into the duodenum. Abdominal loops of small bowel appear normal. The stomach appears normal. There is no free air or free fluid. There is no significant retroperitoneal or mesenteric lymphadenopathy. CT PELVIS: There are radiation seeds within the prostate, but also the seminal vessicles. There is a Foley within a decompressed bladder. Pelvic loops of small and large bowel appear normal in caliber. There is no free air or free fluid. There is a stent within the distal aorta just proximal to the bifurcation. There is no pelvic or inguinal lymphadenopathy. There is right flank edema. (Over) [**2170-6-26**] 12:02 AM CT CHEST W/CONTRAST; CT ABDOMEN W/CONTRAST Clip # [**Clip Number (Radiology) 77183**] CT PELVIS W/CONTRAST Reason: fx, solid organ injury Field of view: 44 Contrast: OPTIRAY Amt: 130 ______________________________________________________________________________ FINAL REPORT (Cont) BONE WINDOWS: Particularly within the left hemipelvis are diffuse sclerotic changes. The T10 vertebral body exhibits diffuse sclerotic changes without bone expansion. There are no fractures. IMPRESSION: 1. No evidence for traumatic injury in the chest, abdomen or pelvis. 2. Prostate brachytherapy seeds. 3. Left hemipelvis Paget disease. Sclerotic T10 vertebral body likely reflects earlier Paget disease, but metastatic disease cannot be excluded. 3. Ground-glass opacity in bilateral bases, concerning for aspiration pneumonia, more pronounced on the right where there is high density material that could be barium aspirtated in the past or calcification. 4. Extensive atherosclerotic disease including coronary calcifications. Distal aortic stent graft. Possible pulmonary hypertension. 5. ET tube 3.5 cm from the carina.
Radiology
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` Pt 55 y/o m who presented from [**Hospital 108**] Hospital with mental status changes, lethargy, Tmax of 103, and hyperglycemia FS 560. Pt went unresponsive while at [**Name (NI) 108**], pt was nasally intubated and Tx to [**Hospital1 54**]. [**9-15**]: PT had MRI/MRA of head, neck and pelvis. PT was noted to have clear carotids, 3 small vessel infarcts 1 in the cerebal peduncle and 2 located in bilateral thalamus, ? septic arthritis in pelvis. Pt was extubated on [**9-16**]. Found to have new bilat opacities on cxr [**9-20**]. Started on Vanco and zosyn. Bs trending up despite [**Hospital1 **] nph increased doses. Started on insulin drip [**9-21**] and Sliding scale. obtructive sleep apnea (OSA) Assessment: Tolerating cpap at night on autset Action: When patient falls asleep and is snoring cpap placed on patient. Wears 3l nc when awake Response: Sats 92% or greater on cpap and 3l nc. Resp 18-22. bs clear upper. Di minished at the bases. Plan: Cpap at night or when he is sleeping and snoring. Transfers, Impaired Assessment: Inability to be pivoted to the chair. Action: Using hovercraft to move patient from bed to chair. Response: Sits up for 3 or more hours at a time in stretcher chair. Plan: Oob to chair once a day. Pneumonia, bacterial, ventilator acquired (VAP) Assessment: Fever curve improved on iv antibiodics. Action: On vanco and zosyn iv. Response: Wbc down to 10.6 from 12.7. Temp max 99.9. Vanco level 28.9 this am. Plan: Cont antibiodics till 8/18 per micu team. Monitor cult results. Trough level of vanco drawn prior to 1600 dose. Awaiting level to come back prior to giving dose. Will need to let micu resident know level to decide if med to be given. Constipation (Obstipation, FOS) Assessment: No stool since [**9-20**]. Action: Was receiving colace and senna. Given lactulose and ducolax today. Response: Had one large brown soft guiac neg stool. Plan: Cont bowel regimen Altered mental status (not Delirium) Assessment: S/p 3 small vessel infarcts that effect his alertness. Action: Neuro assessment q 4hours while in icu. On asa and lipitor Response: More awake in chair. Speech slurred. Right side weak. Will at times squeeze your hand with his right hand at other times will not. Wiggles toes on right foot at times. At other times does not. Left side beys commands consistently. Very lethargic after he has been up in chair and put back to bed. Then will only nod when asked a question. Pearl . Opens right eye. Left eye remains closed most of the time. Plan: Cont to monitor neuro status. .H/O hypertension, benign Assessment: Bp I mproved on increased doses of captopril and lopressor Action: On lisinopril 40mg qd. . Lopressor increased today to 25mg per ft [**Hospital1 **]. Response: Sbp 100-140 Plan: Cont current antihypertensive regimen. ``` Hyperglycemia Assessment: Bs 200-300 range despite high doses of nph [**Hospital1 **] and humologess Action: Seen by [**Last Name (un) **]. Changed to [**Hospital1 **] glargine dosing, increased ss humalog, and [**Hospital1 **] metformin dosing. Response: Will watch bs qid as ordered to see results of increased dosage of insulin Plan: Monitor bs as ordered. Insulin and metafromin as ordered. Hypotension (not Shock) Assessment: Episode of hypotension related to antihypertensives, diuresis and sleep. Sbp down to 78 Action: Dr [**First Name (STitle) **] made aware and 500cc fluid bolus given Response: Sbp up to 100-120 Plan: Cont to monitor bp.
Nursing
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Chief Complaint: shortness of breath, hypoxia HPI: This is a 56 yo F with h/o metastatic melanoma who was admitted on [**2187-7-9**] for IL-2 therapy and now is transferred to the [**Hospital Unit Name 4**] in the setting of shortness of breath and hypoxia. Began IL-2 in PM of [**7-9**] and has since gotten a total of 8 doses. Course has been complicated by intermittent rigors, n/v/diarrhea, and hypotension responsive to IVF boluses. Weight is 5% up from baseline. Initially began to complain shortness of breath yesterday afternoon when she triggered for RR 24, O2 sat 85% RA, increased to 93% on 50% shovel [**Date Range 1269**]. Remained hypoxic throughout the evening and IVFs stopped, IL-2 held, and given albuterol nebs for reported wheezing. Awoke at 1 am acutely short of breath and gasping for air with O2 sats 76% on 2L NC --> 92 % on NRB with RR 40. Other vitals notable for BP 120/60 (had previously been running SBPs in 80-90s), HR 112. CXR revealed marked bilateral interstitial markings with blurring of the heart border concerning for pulmonary edema vs. ARDS. Given lasix 12 mg IV X 1 with only 100 ccs of urine output and then given lasix 20 mg IV X 1 and started on dopamine gtt at 2 mcg/kg/hr per biologics attending with subsequent 600 ccs in urine output. ABG 7.39/37/62/23. Given another lasix 20 mg IV and transferred to [**Hospital Unit Name 4**] for ongoing respiratory distress and hypoxia. . Upon arrival to the [**Hospital Unit Name 4**], the patient feels her breathing is slightly improved but still labored. Denies chest pain/pressure, lightheadedness, nausea, confusion, fevers. Intermittent chills. Placed on BIPAP [**Hospital Unit Name 1269**] at 5/5 FiO2 70% with O2 sats 97-99%, given morphine 1 mg IV X 1. Urine output in past hour 1L. Switched dopamine to neosynephrine for HR 150s. Patient admitted from: [**Hospital1 5**] [**Hospital1 **], 7 [**Hospital Ward Name 200**] History obtained from [**Hospital 19**] Medical records Allergies: No Known Drug Allergies Last dose of Antibiotics: Infusions: Phenylephrine - 1 mcg/Kg/min Other ICU medications: Lorazepam (Ativan) - [**2187-7-13**] 06:00 AM Morphine Sulfate - [**2187-7-13**] 06:05 AM Other medications: IL-2 (last dose [**2187-7-12**] at 9am) Lasix 20 mg IV X 1, Lasix 10 mg IV X 1 Dopamine gtt at 2 mcg/kg/min Neosynephrine gtt Cephalexin 500 mg po bid Tylenol 975 mg q6h Naproxen 375 mg q12h Gelclair 15 ml tid prn Ranitidine 150 mg [**Hospital1 **] Ativan 1-2 mg q4h prn Albuterol neb q6h prn Loperamide prn Benadryl 25-50 mg q6h prn Sarna qid prn Compazine q6h prn Meperidine 50-100 IV q2h prn Nystatin qhs HISS Past medical history: Family history: Social History: - Metastatic Melanoma - s/p R total maxillectomy with resection of the pterygopalatine fossa as well as resection of tumor at the skull base foramina at [**Hospital 7022**] in [**4-9**]. PET scan [**5-10**] with increased uptake in lungs (multiple pulm nodules), left hilar and subcarinal LAD. Admitted for IL-2 therapy on [**2187-7-9**], s/p 8 doses - DM II, insulin dependent - HTN - Hypercholesterolemia - h/o cervical CA s/p radical hysterectomy, XRT/chemo in [**2173**] No family history of melanoma. Occupation: Worked as part owner of seafood distributing company in [**Location (un) 7023**] Drugs: denies Tobacco: quit 5 years ago Alcohol: denies Other: Recently widowed, husband passed from bladder CA 8 mos ago. Has 2 daughters. Review of systems: Constitutional: Fatigue Ear, Nose, Throat: Dry mouth Cardiovascular: No(t) Chest pain, No(t) Palpitations, Tachycardia, Orthopnea Respiratory: Dyspnea, Tachypnea Gastrointestinal: No(t) Abdominal pain, Nausea, loose BMs Genitourinary: Foley Integumentary (skin): no rash Flowsheet Data as of [**2187-7-13**] 06:26 AM Vital Signs Hemodynamic monitoring Fluid Balance 24 hours Since 12 AM Tmax: 35.9 C (96.6 Tcurrent: 35.9 C (96.6 HR: 126 (124 - 126) bpm BP: 108/70(79) {83/44(53) - 108/70(79)} mmHg RR: 30 (29 - 32) insp/min SpO2: 95% Heart rhythm: ST (Sinus Tachycardia) Total In: 13 mL PO: TF: IVF: 13 mL Blood products: Total out: 0 mL 1,000 mL Urine: 200 mL NG: Stool: Drains: Balance: 0 mL -987 mL Respiratory O2 Delivery Device: Bipap [**Year (4 digits) 1269**] Ventilator mode: CPAP/PSV Vt (Spontaneous): 790 (790 - 790) mL PS : 5 cmH2O RR (Spontaneous): 28 PEEP: 5 cmH2O FiO2: 70% PIP: 11 cmH2O SpO2: 95% Ve: 21.2 L/min Physical Examination General Appearance: Thin, Anxious, moderate amt of distress due to tachypnea, speaking in short sentences due to shortness of breath Eyes / Conjunctiva: PERRL, slightly dry MM Head, Ears, Nose, Throat: Normocephalic, Poor dentition, has upper palate prosthesis Cardiovascular: (PMI Hyperdynamic), (S1: Normal), (S2: Normal), II/VI systolic flow murmur over LUSB Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Crackles : throughout lung fields b/l up to apices, anterior crackles also appreciated, No(t) Wheezes : no wheezes appreciated, Diminished: diminished at bases b/l) Abdominal: Soft, Non-tender, Bowel sounds present Extremities: Right: Trace, Left: Trace Skin: Warm, no rashes Neurologic: Attentive, Follows simple commands, Responds to: Verbal stimuli, Oriented (to): person, place, Movement: Purposeful, Tone: Not assessed Labs / Radiology 103 10.3 180 0.5 27 20 114 3.9 147 30.7 7.7 [image002.jpg] Other labs: PT / PTT / INR://1.1, ALT / AST:32/30, Alk Phos / T Bili:/2.0, Ca++:7.9, Mg++:2.6, PO4:3.5 CXR (my read) - marked increased in interstitial lung markings (R > L) without significant blunting of costophrenic angles but blurring of entire heart border compared to prior CXR on [**2187-7-9**] Assessment and Plan 56 yo F with h/o metastatic melanoma on IL-2 therapy being transferred to [**Hospital Unit Name 4**] in setting of shortness of breath and hypoxia. . #) Hypoxia - In setting of recent IL-2 therapy. CXR with increased interstitial markings bilaterally concerning for pulmonary edema vs. increased capillary leakage leaking to ARDS-type picture vs. pulmonary hemorrhage. Has been given lasix with 600 ccs of urine output, but minimal improvement in overall respiratory status. Acuity of onset of symptoms, lack of fevers do not fit with multi-focal PNA as being primary cause of pt's respiratory distress, but remains in the differential. Lastly, PE is a consideration, but less likely given hypoxia can be explained by pt's worsening interstitial lung markings. ABG with significant A-a gradient (PaO2 62, FiO2 100). - Continue diuresis with lasix IV. Seems to be putting out well to 20 mg IV that she received prior to leaving floor. - Closely monitor I/Os. - BIPAP for now until achieve further diuresis. If worsening MS, starts tiring in spite of BIPAP with increased work of breathing, unable to further diurese, or unable to tolerate [**Last Name (LF) 1269**], [**First Name3 (LF) 124**] need to intubate. - Recheck ABG in [**2-2**] hour. - Daily CXRs. - Hold on empiric abxs for now. - Hold IL-2. - Per biologics attending, would consider use of renal doses of dopamine gtt. However, given HR to 150s on dopamine gtt, will switch over to neosynephrine for BP support. - Consider use of steroids to dampen inflammatory response to IL-2 if respiratory status does not clearly improve with further diuresis. Will need to speak with biologics attending first. . #) Hypotension - Ongoing issue for past 48 hours, again likely related to IL-2. Has been getting maintenance IVFs as well as intermittent IVF boluses. - Will switch to neosynephrine gtt as above given HR 150s on dopamine gtt. - Maintain MAPs > 65. - Hold on IVFs for now given respiratory distress. - If has fever, will panculture, start on broad spectrum abxs. - [**Month (only) 8**] be limited in terms of diuresis due to hypotension. . #) Non anion gap metabolic acidosis - AG 13. [**Month (only) 8**] also be secondary to IL-2. Has had several loose stools thought to be related to IL-2 and has been receiving maintanence NS, which may also be contributing. - Holding IL-2 for now. - Closely monitor acid-base status. . #) Hypernatremia Appears total body fluid overloaded although may be intravascularly deplete due to ongoing capillary leak from IL-2. Suspect that hyponatremia will improve with diuresis with lasix. - Monitor serum Na. - Hold on giving back free H2O for now. . #) Anemia Hct 32.8 on admission, currently 30.7. Likely related to anemia of chronic disease. - Guaiac stools. - Maintain active T&S. - Transfuse for Hct < 24 (onc pt). . #) Thrombocytopenia Plts downtrending since admission. Receiving heparin through central line although time course for fall in plts is fast for HIT. No signs of active bleeding. INR wnl. - Continue to closely monitor plts. - If continues to fall without clear precipitating factor, will hold heparin and check PF-4 Ab. - Review med list for other possible offending agents. . #) Metastatic melanoma - Current respiratory compromise likely [**3-5**] IL-2 related toxicity. - Holding further IL-2 for now. - Further management per primary oncology team. . #) DM II - As NPO for now given BIPAP, will give only [**2-2**] of standing insulin dose and continue to cover with HISS. . #) FEN/GI - NPO for now as on BIPAP, replete lytes prn #) Ppx - hep SQ,H2 blocker,holding bowel regimen given recent loose stools #) Code - Full, confirmed with patient #) Access - R subclavian TLC #) Communication - with patient and daughter [**Name (NI) 7024**] [**Name (NI) 7025**] [**Telephone/Fax (1) 7026**] #) Dispo - ICU level of care ICU Care Nutrition: Comments: NPO for now as on BiPAP Glycemic Control: Comments: halve insulin dosing while NPO Lines: Multi Lumen - [**2187-7-13**] 05:27 AM Prophylaxis: DVT: SQ UF Heparin Stress ulcer: H2 blocker VAP: Comments: Communication: ICU consent signed Comments: Daughter [**Name (NI) 161**], left message. Discussed pt with Dr. [**Last Name (STitle) 2958**], biologics attending, and briefly with Dr. [**Last Name (STitle) 911**], overnight ICU intensivist. Code status: Full code Disposition: ICU
Physician
Classify the following medical document.
Chief Complaint: 24 Hour Events: INVASIVE VENTILATION - STOP [**2124-9-14**] 05:23 PM - recieved 1uPRBC and 1u PLT - CBI for hematuria - ambisome decresed to 250 q24 (from 400) given concern for hematuria - ID: check stool for c diff - CXR: Dense right upper lobe consolidation with volume loss, new since the [**2124-9-13**] study. Allergies: Bactrim (Oral) (Sulfamethoxazole/Trimethoprim) Rash; Last dose of Antibiotics: Ambisome - [**2124-9-14**] 09:24 PM Linezolid - [**2124-9-15**] 03:51 AM Meropenem - [**2124-9-15**] 07:53 AM Infusions: Other ICU medications: Fentanyl - [**2124-9-15**] 05:26 AM Pantoprazole (Protonix) - [**2124-9-15**] 07:53 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2124-9-15**] 08:22 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36.4 C (97.6 Tcurrent: 36.4 C (97.6 HR: 105 (90 - 105) bpm BP: 137/81(93) {77/57(62) - 151/110(117)} mmHg RR: 22 (15 - 24) insp/min SpO2: 99% Heart rhythm: ST (Sinus Tachycardia) Wgt (current): 113.7 kg (admission): 125 kg Total In: 3,049 mL 1,296 mL PO: TF: IVF: 1,826 mL 1,296 mL Blood products: 481 mL Total out: 1,645 mL 400 mL Urine: 1,645 mL 400 mL NG: Stool: Drains: Balance: 1,404 mL 896 mL Respiratory support O2 Delivery Device: None, Venti mask Ventilator mode: CPAP/PSV Vt (Spontaneous): 488 (445 - 518) mL PS : 5 cmH2O RR (Spontaneous): 20 PEEP: 5 cmH2O FiO2: 50% PIP: 11 cmH2O SpO2: 99% ABG: ///24/ Ve: 9 L/min Physical Examination General Appearance: No acute distress Eyes / Conjunctiva: Sclera edema Head, Ears, Nose, Throat: Normocephalic, Poor dentition Cardiovascular: (S1: Normal), (S2: Normal) Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Rhonchorous: BL) Abdominal: Soft, Non-tender, Bowel sounds present Extremities: Right lower extremity edema: 3+, Left lower extremity edema: 3+ Musculoskeletal: Muscle wasting Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 71 K/uL 8.2 g/dL 140 mg/dL 0.7 mg/dL 24 mEq/L 3.5 mEq/L 58 mg/dL 108 mEq/L 140 mEq/L 23.0 % 2.7 K/uL [image002.jpg] [**2124-9-12**] 03:50 AM [**2124-9-12**] 03:48 PM [**2124-9-12**] 08:00 PM [**2124-9-13**] 03:42 AM [**2124-9-13**] 05:18 AM [**2124-9-13**] 03:40 PM [**2124-9-14**] 03:49 AM [**2124-9-14**] 06:15 PM [**2124-9-15**] 12:10 AM [**2124-9-15**] 04:30 AM WBC 1.0 1.8 2.0 2.0 1.8 2.2 2.5 2.7 Hct 20.6 22.8 24.4 24.3 24.3 24.0 23.8 24.7 23.0 Plt 10 107 112 101 91 72 66 49 85 71 Cr 0.5 0.8 0.8 0.7 0.7 Glucose 111 107 113 167 140 Other labs: PT / PTT / INR:11.6/30.4/1.0, ALT / AST:94/93, Alk Phos / T Bili:503/7.4, Differential-Neuts:78.3 %, Band:0.0 %, Lymph:14.0 %, Mono:6.9 %, Eos:0.7 %, Fibrinogen:404 mg/dL, Lactic Acid:2.5 mmol/L, Albumin:2.1 g/dL, LDH:390 IU/L, Ca++:8.2 mg/dL, Mg++:1.9 mg/dL, PO4:3.8 mg/dL Imaging: Provisional Findings Impression: [**First Name9 (NamePattern2) **] [**Doctor First Name **] [**2124-9-14**] 4:54 PM 1. Dense right upper lobe consolidation with volume loss, new since the [**2124-9-13**] study. 2. Worsening of already very low lung volumes. 3. ET and left subclavian central venous catheter, unchanged in position. Microbiology: [**9-12**] EBV viral load: non-detected B glucan, galactomanin pending. . [**2124-9-14**] 6:53 pm SPUTUM Site: INDUCED Source: Induced. GRAM STAIN (Final [**2124-9-15**]): >25 PMNs and <10 epithelial cells/100X field. 2+ (1-5 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS AND CLUSTERS. . CMV pending. Assessment and Plan 57-year-old gentleman with CLL and [**Doctor Last Name **] s transformation (aggressive large B-cell lymphoma) s/p allo SCT in [**2-24**] w/ AMS and hypothermia in the setting of BK viremia, transferred to MICU after PEA arrest on [**9-10**], with apical infiltrates on CXR (as of [**9-11**]) concerning for possible aspiration PNA and pancytopenia. # Worsening AMS: No significant change from yesterday, but overall improvement compared to several days ago. Underlying etiology of AMS is unclear. Represents the main obstacle to extubation of this patient. Could be infectious, including fungemia in his setting with so many risk factors and an elevated beta glucan. CSF studies all negative including BK/[**Male First Name (un) 561**] and adenovirus. Patient received two doses of cidofovir so far, first on [**8-25**] and [**9-1**], (was pretreated in ICU with probenecid and IVF). EEG negative for seizures. Hepatic encephalopathy less likely given EEG pattern and waxing and [**Doctor Last Name 533**] mental status not correlating with LFTs prior to arrival. -D/c Benadryl -Attempt to extubate today as the pt. seems to reached a stable level of improvement in AMS after discussing re-intubation plans with pt. wife. # Pancytopenia: Most likely due to immunosuppression/infection/GVHD. HCT goal >25, plt goal > 50. Linezolid is currently day 4 which was added for his PNA. Patient continues to be having melanic stools, but Hct has remained stable at this time. - transfuse 1 units pRBCs. The patient remains hemodynamically stable and has not required any pressors. - Continue to check HCT [**Hospital1 **], if unstable, dropping GI consult- stress ulceration vs. GVHD - Continue broad Abx coverage with Meropenem, Linezolid (day 4 of 10 day course for PNA) and ambisome 400mg IV q24h - continue neutropenic precautions - T&C 2 units - Restraints for now in setting of agitation - follow up BK virus load and Bcx, CMV and EBV PCR, pending Blood Cx - amio held as pt in sinus . # PNA- bilateral apical infiltrates could be [**12-20**] aspiration PNA (although RUL infiltrates are abormal for aspiration PNA could be possible in this patient due to positioning during code and recumbent position). Started on Linezolid (currently day 4 of a 10 day total course). Plt have been slowly trending down, so continue to monitor [**Hospital1 **]. - continue linezolid IV 600mg q12h as per ID recs -F/u CXR today - monitor Plts and transfuse for Plt < 50 . # CLL with BMT c/b GVHD: - Continue immunosuppressant and prophylactic regimens - appreciate Dr. [**Last Name (STitle) 21**] s recs - follow-up any pending heme/onc recs # Melena GVHD vs. stress ulcer; Hct has been stable -Continue to follow HCt [**Hospital1 **] - If trending down, GI consult - Transfuse pRBCs for Hct < 25 (1 unit pRBCs today to assist with # Hematuria Etiology is BK cystitis vs. secondary to Ambisome. - Bladder scan - Replace with triple lumen catheter - Manual irrigation, consider CBI if not resolved -Consider decreasing Ambisome dose or switching to another antifungal [**Doctor Last Name **] . # Nutrition The patient can get TPN via double lumen -TPN via double lumen ICU Care Nutrition: Glycemic Control: Lines: PICC Line - [**2124-9-10**] 07:31 AM Prophylaxis: DVT: Boots Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition:
Physician
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[**2156-6-14**] 2:16 PM CT CHEST W/O CONTRAST Clip # [**Clip Number (Radiology) 81612**] Reason: Pls eval for interval change, possible same-time interventio Admitting Diagnosis: S/P PEDESTRIAN STRUCK ______________________________________________________________________________ [**Hospital 2**] MEDICAL CONDITION: 38 year old man with multitrauma intubated right hemothorax REASON FOR THIS EXAMINATION: Pls eval for interval change, possible same-time interventional CT-guided drainage/chest tube? Will call to discuss. No contraindications for IV contrast ______________________________________________________________________________ FINAL REPORT PROCEDURE: CT chest without contrast. REASON FOR EXAM: Trauma with right hemothorax. Assess for interval change. TECHNIQUE: MDCT chest performed without IV contrast. 5-mm and 1.25-mm axial slices were acquired with coronal and sagittal reformats. Comparison was made to the previous study on [**2156-6-11**]. FINDINGS: A moderately large right hemothorax persists athough there has been interval improvement in the degree of aeration in the lower lobes bilaterally with a slight decrease in the left pleural effusion. The remaining lungs are unchanged and a chest drain, which enters the anterior chest wall has been slightly withdrawn since the previous study with no appreciable pneumothorax. The patient remains intubated and the tip of the ET tube high in the trachea and approximately 9 cm above the carina with overinflation of the cuff and requires repositioning. The NG tube passes into the stomach. The aorta, pulmonary artery and heart size is normal. No pericardial effusion. This examination was not designed for subdiaphragmatic evaluation, which is unremarkable. Posterior rib fractures are unchanged in position, a number of which are displaced and overriding in the upper posterior hemithorax in addition to a nondisplaced scapular fracture. Impression: 1) Proximal position ET tube and apparent overdistention of cuff. Recommend readjusting the ET tube to a lower in position and decreasing the volume of air within the cuff. 2)Stable moderately large organizing right hemothorax with improved aeration in both lower lungs bilaterally and decreasing left pleural effusion. 3)Multiple rib fractures are predominantly right-sided, a number of which are displaced and overriding in the upper chest wall in addition to a stable nondisplaced left scapular fracture. (Over) [**2156-6-14**] 2:16 PM CT CHEST W/O CONTRAST Clip # [**Clip Number (Radiology) 81612**] Reason: Pls eval for interval change, possible same-time interventio Admitting Diagnosis: S/P PEDESTRIAN STRUCK ______________________________________________________________________________ FINAL REPORT (Cont) The TICU nurse [**First Name (Titles) 3450**] [**Name (NI) 14921**] at the time of reporting regarding the position of the ET tube which had been already adjusted.
Radiology
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[**2108-9-18**] 10:25 AM CT CHEST W&W/O C ; CTA ABD W&W/O C & RECONS Clip # [**Clip Number (Radiology) 26518**] Reason: evidence of pancreatic mass/insulinoma Admitting Diagnosis: RULE OUT INSULINOMA Contrast: OPTIRAY Amt: 200 ______________________________________________________________________________ [**Hospital 2**] MEDICAL CONDITION: 67 year old woman with morbid obesity and episodes of hypoglycemia concering for insulinoma REASON FOR THIS EXAMINATION: evidence of pancreatic mass/insulinoma No contraindications for IV contrast ______________________________________________________________________________ WET READ: JKSd TUE [**2108-9-18**] 3:20 PM Extremely limited evaluation of the chest and abdomen given patient's body habitus. Complete collapse of the left upper lobe and partial collapse of the left lower lobe. Cause of obstruction is not seen on this study. Leftward shift of midline structures. Patchy opacity in the right upper lobe, nonspecific, may be infectious of inflammatory in nature. Diffuse mosaic pattern in the right lung is consistent with air-trapping and may represent small airways disease. Pancreas barely visible; however, no gross mass identified. Possible left adrenal nodule measuring up to 1.5 cm (however, not entirely clear this is part of the adrenal gland given very low quality study). Cholelithiasis. WET READ VERSION #1 ______________________________________________________________________________ FINAL REPORT INDICATION: 67-year-old woman with morbid obesity and episodes of hypoglycemia, concerning for insulinoma. Please assess for evidence of pancreatic mass/insulinoma. In addition, chest x-ray demonstrates opacification of the left hemithorax. TECHNIQUE: MDCT-acquired images were obtained from the lung apices through the abdomen prior to and after the administration of 200 cc of Optiray intravenous contrast. Arterial and venous phase images were obtained. Coronal and sagittal reformatted images were also displayed. FINDINGS: Please note that evaluation is extremely limited given patient's body habitus. CT CHEST: There is complete collapse of the left upper lobe and partial collapse of the left lower lobe with leftward shift of mediastinal structures. The obstructing cause is not seen on this study. This is new when compared to the chest radiograph of [**2105-3-18**]. There are patchy opacities in the right lung apex, nonspecific, but may be (Over) [**2108-9-18**] 10:25 AM CT CHEST W&W/O C ; CTA ABD W&W/O C & RECONS Clip # [**Clip Number (Radiology) 26518**] Reason: evidence of pancreatic mass/insulinoma Admitting Diagnosis: RULE OUT INSULINOMA Contrast: OPTIRAY Amt: 200 ______________________________________________________________________________ FINAL REPORT (Cont) infectious or inflammatory in nature. Mosaic pattern of ground-glass opacity within the right lung is consistent with air trapping, and may represent underlying small airways disease. There is a small right-sided pleural effusion and adjacent compressive atelectasis. There is cardiomegaly without pericardial effusion. No definite mediastinal, hilar, or axillary lymphadenopathy is seen, although again, evaluation is extremely limited. CT ABDOMEN: The spleen, stomach, and liver are within normal limits. Multiple small calcified gallstones are present within the gallbladder. Evaluation of the kidneys is limited, although they do appear grossly normal. There may be a left adrenal nodule measuring up to 1.5 cm, although it is unclear whether this is definitively part of the left adrenal gland. Unfortunately, further assessment of this nodule cannot be made on this study. The right adrenal gland appears normal. The pancreas is markedly atrophic and extremely difficult to see on this study. However, no gross mass within the pancreas is identified. BONE WINDOWS: No concerning osseous lesions are identified. IMPRESSION: Extremely limited evaluation given patient's body habitus. 1. Complete collapse of the left upper lobe and partial collapse of the left lower lobe. An obstructing cause is not seen. Leftward shift of midline structures. Small right-sided pleural effusion. 2. Patchy opacities in the right lung apex are nonspecific, but may be infectious or inflammatory in nature. Mosaic ground-glass pattern to the right lung is most consistent with air trapping and may reflect underlying small airways disease. 3. Cardiomegaly. 4. The pancreas is not well seen given limitations of the examination and is also likely atrophic. However, no gross mass identified. 5. Possible left adrenal nodule measuring up to 1.5 cm. However, it is unclear whether this actually part of the left adrenal gland or adjacent to it and further characterization cannot be made on this study. 6. Cholelithiasis. (Over) [**2108-9-18**] 10:25 AM CT CHEST W&W/O C ; CTA ABD W&W/O C & RECONS Clip # [**Clip Number (Radiology) 26518**] Reason: evidence of pancreatic mass/insulinoma Admitting Diagnosis: RULE OUT INSULINOMA Contrast: OPTIRAY Amt: 200 ______________________________________________________________________________ FINAL REPORT (Cont) Findings were discussed with Dr. [**First Name8 (NamePattern2) 26519**] [**Name (STitle) 26520**] at approximately 2:30 p.m. on [**2108-9-18**] in person.
Radiology
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Attending Physician: [**Name10 (NameIs) 449**] Referral date: [**2110-12-6**] Medical Diagnosis / ICD 9: [**Last Name (un) 10353**] / 959.9 Reason of referral: eval and treat, CPT, risk to fall History of Present Illness / Subjective Complaint: 79F adm to outside hospital s/p fall down flight of stairs with R pelvic fx (comminuted iliac [**Doctor First Name **] to acetabulum), R scapula fx, multiple rib fractures. Transferred to [**Hospital1 5**] [**2110-12-5**]. patient also hypertensive and Hct dropped; now s/p ORIF R acetabulum [**2110-12-5**] Past Medical / Surgical History: hep A, R LE fracture, sexual reassignment surgery (M to F) 30 years ago Medications: insulin, Glucagon, Percocet, Dilaudid, Albuterol Radiology: small R hydropneumothorax; rib fractures R [**4-13**]; fracture of R scapular spine; R T7 transverse process fx; fracture sup post endplate T12; extensive comminuted fracture R iliac bone extending into acetabulum with large hematoma Labs: 25.2 8.8 142 7.0 [image002.jpg] Other labs: Activity Orders: R LE NWB, R UE NWB with sling for OOB Social / Occupational History: baseline lives with partner in [**Name2 (NI) 10354**]-- they own a business together and have multiple dogs (poodles) Living Environment: raised ranch-- level to enter but steps up to second part of house Prior Functional Status / Activity Level: baseline completely independent without AD, no other h/o falls Objective Test Arousal / Attention / Cognition / Communication: pt A and Ox3, pleasant and cooperative, consistently follows all commands Hemodynamic Response Aerobic Capacity HR BP RR O[2 ]sat HR BP RR O[2] sat RPE Supine 102 160/63 30 100 % (50% face tent) Rest / Sit 110 152/58 31 87 % (RA) Activity / Stand / Recovery / Total distance walked: Minutes: Pulmonary Status: BS: diminished t/o but moving air in all fields; cough weak, congested, non-productive; breathing pattern shallow and rapid Integumentary / Vascular: R chest tube to suction; R A line, foley cath, epidural in place; incision not visualized Sensory Integrity: grossly intact to LT Pain / Limiting Symptoms: c/o upper R back and R hip pain [**6-11**] at rest, [**8-11**] with activity/ sitting EOB Posture: received in sling RUE; bilat fwd shoulders in sitting, fwd head Range of Motion Muscle Performance R shoulder flexion to 80 with empty end feel, limited by pain; R hip flexion to 90, limited by pain, abd/add WNL; otherwise WNL t/o R shoulder flex [**1-6**], elbow flex 3+, elbow ext 3+, good grip, R hip flexion [**1-6**], knee ext 3-/5, ankle [**5-6**]; L UE and LE grossly 4-5/5 t/o Functional Status: Activity Clarification I S CG Min Mod Max Gait, Locomotion: rolls to L with modA, rolls to R with maxA; sup to sit with maxAx2 dependent slide transfer to stretcher chair Rolling: T Supine / Sidelying to Sit: Tk Transfer: Dependent slide to stretcher chair Sit to Stand: NA Ambulation: NA Stairs: NA Balance: able to sit at edge of bed for 7 minutes initially requiring hand held assist but quickly weaned to S using R UE to support self-- pt reports severe pain seated at edge of bed Education / Communication: pt ed: role of PT, plan of care; communication with RN re: patient status Intervention: DB &C Diagnosis: 1. Ventilation, Impaired 2. Transfers, Impaired 3. Range of Motion, Impaired 4. Muscle Performace, Impaired 5. Respiration / Gas Exchange, Impaired 6. Knowledge, Impaired Clinical impression / Prognosis: 79f s/p fall with multiple fractures p/w above impairments c/w fracture as well as vent pump dysfunction as patient is limited in her chest excursion and secretion clearance by pain. Patient is well below her baseline and would benefit from d/c to rehab once medically stable. Patient has a very high baseline, excellent support and good potential to recover from her injuries. Her functional status may be limited until she can increase weight bearing through either RUE or RLE but she should be able to become independent at wheelchair level at this current functional status. Goals Time frame: 1 week 1. SpO2 >92 % on RA with all activities 2. I secretion clearance 3. increase ROM R shoulder flexion to 110, R hip flexion to 110 4. increase strength 1/3 ms [**Last Name (Titles) 10355**] t/o 5. sup to sit with [**Female First Name (un) 332**] 6. sit to stand with modA Anticipated Discharge: Rehab Treatment Plan: Frequency / Duration: 3-5x/week x1 week Pt ed, functional mob training-- sup to sit, sit to stand, stand pivot transfers, therex/ROM, d/c planning Recommend up with nursing daily via stretcher chair slide T Patient agrees with the above goals and is willing to participate in the rehabilitation program.
Rehab Services
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Chief Complaint: fevers, leukocytosis I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 53M severe COPD - fractured his right elbow [**9-18**] and underwent external fixation. Returns to the hospital because of persistent vomiting and diarrhea at rehab. Has been on gent and PO vanco for recent pseudomonas pneumonia and CDiff. Also concern about a broken external fixation devise. In ER Temp was 102.3 and WBC count 26. Pins were noted to be missing from his right arm and ortho is taking him back to the OR to replace these. A CXR showed stable effusions and opacities. History obtained from housestaff Patient unable to provide history: on vent Allergies: Codeine Unknown; Compazine (Oral) (Prochlorperazine Maleate) Unknown; Penicillins Rash; itchiness Metformin Nausea/Vomiting Heparin Agents Unknown; Last dose of Antibiotics: Vancomycin - [**2126-11-10**] 06:00 PM Infusions: Other ICU medications: Other medications: Changes to medical and family history: PMH, SH, FH and ROS are unchanged from Admission except where noted above and below Review of systems is unchanged from admission except as noted below Review of systems: Constitutional: Fever Flowsheet Data as of [**2126-11-10**] 11:58 PM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.6 C (99.7 Tcurrent: 37.2 C (98.9 HR: 109 (98 - 112) bpm BP: 107/70(78) {92/59(64) - 107/71(78)} mmHg RR: 18 (18 - 30) insp/min SpO2: 100% Heart rhythm: ST (Sinus Tachycardia) Height: 66 Inch Total In: 1,768 mL PO: TF: IVF: 768 mL Blood products: Total out: 0 mL 650 mL Urine: 250 mL NG: 400 mL Stool: Drains: Balance: 0 mL 1,118 mL Respiratory support O2 Delivery Device: Tracheostomy tube Ventilator mode: CMV/ASSIST Vt (Set): 500 (500 - 500) mL RR (Set): 16 RR (Spontaneous): 0 PEEP: 5 cmH2O FiO2: 50% PIP: 26 cmH2O Plateau: 19 cmH2O SpO2: 100% ABG: 7.41/52/112/33/7 Ve: 8.3 L/min PaO2 / FiO2: 224 Physical Examination General Appearance: Thin Head, Ears, Nose, Throat: Normocephalic, trach Cardiovascular: (S1: Normal), (S2: Normal) Respiratory / Chest: (Percussion: Dullness : bases), (Breath Sounds: Rhonchorous: ) Abdominal: Soft, Non-tender, Bowel sounds present Musculoskeletal: right arm external fixation Neurologic: Responds to simple questions Labs / Radiology 8.7 g/dL 354 K/uL 86 mg/dL 0.6 mg/dL 33 mEq/L 3.4 mEq/L 8 mg/dL 102 mEq/L 141 mEq/L 29.2 % 21.3 K/uL [image002.jpg] [**2126-11-10**] 07:17 PM [**2126-11-10**] 11:17 PM WBC 21.3 Hct 29.2 Plt 354 Cr 0.6 TCO2 34 Glucose 86 Other labs: PT / PTT / INR:16.0/32.7/1.4, ALT / AST:[**11-23**], Alk Phos / T Bili:96/0.3, Differential-Neuts:87.4 %, Lymph:7.1 %, Mono:5.3 %, Eos:0.2 %, Lactic Acid:0.7 mmol/L, Ca++:8.5 mg/dL, Mg++:1.4 mg/dL, PO4:3.5 mg/dL Imaging: CXR bilateral effusions, basilar opacities, no change elbow x-ray - Stable position of external fixator without evidence of hardware complication Microbiology: awaiting cultures ECG: NSR 100, no ischemia Assessment and Plan fever, leukocytosis - likely sites of infection include resp tract, UTI, CDiff, line infection. Right arm fracture seems less likely. Will continue abx . Consider replacing lines once fever clears. Await micro studies. broken external fixator - to OR tomorrow vomiting, diarrhea, possible ileus - continue PEG drainage for now, will retry TFs once surgery complete, treat CDiff as above resp failure - cont current vent settings ICU Care Nutrition: NPO Glycemic Control: Lines: Midline - [**2126-11-10**] 07:00 PM Prophylaxis: DVT: SQ UF Heparin Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition :ICU Total time spent: 35 minutes Patient is critically ill
Physician
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Chief Complaint: 79M with CHF, afib, Alzheimer's admitted with influenza 24 Hour Events: On pressure support most of day; did well but switched back to AC in evening Held coumadin, will need to be started on heparin gtt once INR no longer supratherapeutic Started on tube feeds; will watch lytes closely per nutrition Had episode of ?rigors around 8pm, VSS, was able to pull away from noxious stimuli DDx was undersedation vs seizure vs bacteremia Sent blood cultures and stat labs; increased sedation; gave ativan 2mg IV x 1 with resolution Blood pressures dropped about one hour later into SBP 80s; responded to IV fluids and weaning sedation Cardiac enzymes came back with troponin 0.13; EKG unchanged apart from RVR Started metoprolol 12.5 TID, increased simvastatin to 80, already on ASA Patient unable to provide history: Sedated Allergies: No Known Drug Allergies Antibiotics: Oseltamivir 75mg PO BID Levofloxacin 750mg IV daily Vancomycin 1g IV BID Infusions: Midazolam (Versed) - 0.5 mg/hour Fentanyl - 12.5 mcg/hour Other medications: ASA 325 daily, Simvastatin 80 daily, Metoprolol 12.5mg PO TID Famotidine Flowsheet Data as of [**2151-2-7**] 07:34 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 37.2 C (98.9 Tcurrent: 37.2 C (98.9 HR: 131 (96 - 131) bpm BP: 136/85(104){79/52(62) - 136/85(104)} mmHg RR: 18 (6 - 20) insp/min SpO2: 98% Heart rhythm: AF (Atrial Fibrillation) Height: 68 Inch CVP: 11 (6 - 14)mmHg Total In: 3,727 mL 542 mL PO: TF: 100 mL 111 mL IVF: 3,512 mL 312 mL Blood products: Total out: 771 mL 325 mL Urine: 766 mL 325 mL NG: 5 mL Stool: Drains: Balance: 2,956 mL 217 mL Respiratory support Ventilator mode: CMV/ASSIST/AutoFlow Vt (Set): 550 (550 - 550) mL Vt (Spontaneous): 748 (748 - 960) mL PS : 12 cmH2O RR (Set): 14 PEEP: 8 cmH2O FiO2: 40% RSBI: 17 PIP: 24 cmH2O Plateau: 18 cmH2O SpO2: 98% ABG: 7.34/27/155/17/-9 Ve: 7.8 L/min PaO2 / FiO2: 388 Physical Examination Eyes / Conjunctiva: PERRL Head, Ears, Nose, Throat: Endotracheal tube Cardiovascular: (S1: Normal), (S2: Normal), No(t) S3, No(t) S4, No(t) Rub, (Murmur: No(t) Systolic, No(t) Diastolic), irregularly irregular tachycardic Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Breath Sounds: Bronchial: bilateral) Abdominal: Soft, Non-tender, Bowel sounds present Extremities: Right: Absent, Left: Absent Skin: Warm Neurologic: Responds to: Not assessed, Movement: Not assessed, Sedated, Tone: Not assessed Labs / Radiology 128 K/uL 11.3 g/dL 102 mg/dL 0.7 mg/dL 17 mEq/L 4.0 mEq/L 14 mg/dL 111 mEq/L 136 mEq/L 32.2 % 10.5 K/uL [image002.jpg] Micro 2/8,[**2-6**] blood cx NGTD [**2-5**] urine cx negative [**2-5**] urine legionella antigen negative [**2-5**] sputum >25 polys no organisms on gram, culture NGTD legionella cx NGTD CXR: read pending, L lower lung field opacity sm L effusion [**2151-2-5**] 05:47 PM [**2151-2-6**] 04:21 AM [**2151-2-6**] 04:39 AM [**2151-2-6**] 05:37 AM [**2151-2-6**] 08:49 AM [**2151-2-6**] 01:46 PM [**2151-2-6**] 08:14 PM [**2151-2-6**] 08:18 PM [**2151-2-7**] 05:02 AM [**2151-2-7**] 05:14 AM WBC 6.6 10.5 Hct 32.9 32.2 Plt 113 128 Cr 0.7 0.8 0.7 TropT 0.13 0.13 TCO2 22 20 20 21 21 21 15 Glucose 91 117 102 Other labs: PT / PTT / INR:63.0/70.3/7.6, CK / CKMB / Troponin-T:213/12/0.13, Differential-Neuts:91.8 %, Band:Units: % Range: 0-5 %, Lymph:5.0 %, Mono:2.9 %, Eos:0.1 %, D-dimer:3745 ng/mL, Lactic Acid:1.2 mmol/L, Albumin:2.3 g/dL, Ca++:7.2 mg/dL, Mg++:2.0 mg/dL, PO4:1.2 mg/dL Assessment and Plan RESPIRATORY FAILURE, ACUTE (NOT ARDS/[**Doctor Last Name **]) Oxygenating adequately with good RSBI this AM, wean PSV as tolerated ?exubate today PNEUMONIA, VIRAL Bandemia improved, afebrile Continue oseltamivir for influenza currently day 3 Pt. had pus from LLL on [**2-5**] bronch so continue levofloxacin for ?bacterial superinfection. Consider d/c vancomycin. Followup cultures and reculture if febrile SEPSIS, SEVERE (WITH ORGAN DYSFUNCTION) Off of pressors, making adequate urine. Hypotensive yesterday in setting of ativan, now with improved BP. Continue antibiotics as above. MYOCARDIAL INFARCTION, ACUTE (AMI, STEMI, NSTEMI) Enzymes elevated yesterday in setting of RVR, suspect demand ischemia. CK s trending down with flat tropn, continue to trend. Continue medical management with aspirin, statin, beta blocker; will titrate beta blocker upward for further rate control today. ATRIAL FIBRILLATION (AFIB) Still tachycardic, increase metoprolol. Holding anticoagulation [**1-30**] supratherapeutic INR. Will restart heparin drip when INR <2. INR elevated Patient on coumadin at home, held here. No evidence of active bleeding with stable Hct. Consider PO vitamin K. Will repeat DIC labs. HEART FAILURE (CHF), SYSTOLIC, CHRONIC Clinically ~euvolemic, goal net even today. Consider checking TTE to assess pump function (no echo on file here) ICU Care Nutrition: Replete with Fiber (Full) - [**2151-2-6**] 02:00 PM 20 mL/hour Glycemic Control: Regular insulin sliding scale Lines: 18 Gauge - [**2151-2-5**] 06:00 AM Multi Lumen - [**2151-2-5**] 12:21 PM Arterial Line - [**2151-2-5**] 02:37 PM Prophylaxis: DVT: Boots Stress ulcer: H2 blocker VAP: HOB elevation, Mouth care, Daily wake up, RSBI Comments: Communication: Comments: Code status: Full code Disposition:ICU
Physician
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CVICU HPI: 86yoM s/p CABG/MVR [**4-19**] EF 70 Cr 1.8 Wt 68.5K HgbA1c 6.3 [**Last Name (un) **]: ASA 325', Diltiazem SR 240', Furosemide 80", Metolazone 2.5 Q M-W-F, Metoprolol 25', Warfarin 2alt4mg, Potassium 20''' Coumadin - atrial fibrillation - started [**5-13**] (1), On Fondaparinux sq due to HITT until INR theraputic trach collar started [**5-13**] tolerating (speech ordered for passy muir) Rehab screen started [**5-13**] - plan for dc [**5-19**] or after with chole tube Follow up with Dr [**Last Name (STitle) **] in [**5-27**] weeks to evaluate GB D5w for free water deficit lopressor resumed [**5-13**], no statin due to previous ^lft when started EP to do 1 week pacer check [**5-13**] (spoke with fellow [**5-13**]) PMHx: PMH: ^lipids, AFib, TURP, Ing Hernia repair, Sleep Apnea-CPAP -home, CRI(1.8), Ascites, Squamous Cell CA-excision groin, Lower Back Arthritis, depression Current medications: Albuterol 0.083% Neb Soln 4. Artificial Tears Preserv. Free 5. Aspirin 6. Bisacodyl 7. Chlorhexidine Gluconate 0.12% Oral Rinse 8. Ciprofloxacin 9. Dextrose 50% 10. Erythromycin 0.5% Ophth Oint 11. Fondaparinux Sodium 12. Hydrocortisone Na Succ. 13. Hydrocortisone Na Succ. 14. Insulin 15. Insulin 16. Ipratropium Bromide Neb 17. Lansoprazole Oral Disintegrating Tab 18. Lactulose 19. Magnesium Sulfate 20. Metoclopramide 21. Metoprolol Tartrate 22. MetRONIDAZOLE (FLagyl) . Potassium Chloride TraMADOL (Ultram) 28. Warfarin 24 Hour Events: coumadin started for AFib Post operative day: [**5-12**] perc trach, lap->open J-tube, chole tube, incidental gangren GB [**5-9**] R BKA [**4-28**] R leg thrombectomy, peroneal/BK [**Doctor Last Name 1539**] stent, fem-[**Doctor Last Name 1539**] bpg [**4-26**] PPM [**4-23**] RLE [**Doctor Last Name **] Stent, AT Aplasty/Stent [**4-19**] CABGx3 (LIMA to LAD, SVG to OM, SVG to Dx)/MVR(29tissue) Allergies: Heparin Agents Thrombocytopeni Last dose of Antibiotics: Ciprofloxacin - [**2154-5-13**] 05:00 PM Metronidazole - [**2154-5-14**] 02:00 AM Other ICU medications: Metoprolol - [**2154-5-14**] 06:29 AM Flowsheet Data as of [**2154-5-14**] 09:46 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**56**] a.m. Tmax: 36.6 C (97.9 T current: 36.3 C (97.3 HR: 82 (80 - 83) bpm BP: 133/55(78) {113/46(67) - 143/60(84)} mmHg RR: 22 (20 - 35) insp/min SPO2: 96% Heart rhythm: V Paced Wgt (current): 71.7 kg (admission): 61.3 kg Height: 67 Inch CVP: 17 (8 - 18) mmHg Total In: 2,477 mL 843 mL PO: Tube feeding: 727 mL 579 mL IV Fluid: 1,750 mL 234 mL Blood products: Total out: 1,100 mL 595 mL Urine: 900 mL 320 mL NG: 25 mL Stool: Drains: 175 mL 275 mL Balance: 1,377 mL 249 mL Respiratory support O2 Delivery Device: Trach mask SPO2: 96% ABG: 7.47/37/84.[**Numeric Identifier 1000**]/23/3 PaO2 / FiO2: 168 Physical Examination General Appearance: No acute distress, Cachectic, trached and open J tube/chole tube HEENT: PERRL Cardiovascular: (Rhythm: Regular), Vpaced Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: CTA bilateral : , Diminished: bases), (Sternum: Stable ) Abdominal: Soft, Bowel sounds present Left Extremities: (Edema: Trace), (Temperature: Warm), (Pulse - Dorsalis pedis: Present), (Pulse - Posterior tibial: Diminished) Neurologic: Follows simple commands, (Responds to: Verbal stimuli), Moves all extremities, opens eyes responds appropriately to questions Labs / Radiology 249 K/uL 9.0 g/dL 141 mg/dL 1.4 mg/dL 23 mEq/L 4.0 mEq/L 66 mg/dL 111 mEq/L 144 mEq/L 27.8 % 20.6 K/uL [image002.jpg] [**2154-5-12**] 12:55 AM [**2154-5-12**] 04:24 PM [**2154-5-12**] 04:56 PM [**2154-5-12**] 09:51 PM [**2154-5-13**] 04:16 AM [**2154-5-13**] 04:24 AM [**2154-5-13**] 05:52 AM [**2154-5-13**] 10:34 AM [**2154-5-13**] 02:11 PM [**2154-5-14**] 04:19 AM WBC 26.8 24.7 19.5 20.6 Hct 32.0 30.0 28 26.5 27.2 27.8 Plt [**Telephone/Fax (3) 7767**]49 Creatinine 1.6 1.3 1.3 1.4 TCO2 31 28 27 28 28 Glucose 156 90 111 121 109 141 Other labs: PT / PTT / INR:19.1/30.7/1.8, CK / CK-MB / Troponin T:139/8/0.61, ALT / AST:55/72, Alk-Phos / T bili:91/5.2, Amylase / Lipase:108/54, Differential-Neuts:95.0 %, Band:0.0 %, Lymph:3.0 %, Mono:2.0 %, Eos:0.0 %, Fibrinogen:242 mg/dL, Lactic Acid:2.1 mmol/L, Albumin:2.7 g/dL, LDH:348 IU/L, Ca:8.1 mg/dL, Mg:3.0 mg/dL, PO4:3.1 mg/dL Assessment and Plan PAIN CONTROL (ACUTE PAIN, CHRONIC PAIN), ALTERATION IN NUTRITION, IMPAIRED SKIN INTEGRITY, PERIPHERAL VASCULAR DISEASE (PVD) WITH CRITICAL LIMB ISCHEMIA Assessment and Plan: 86yo man s/p CABG/MVR. post-op course c/b ARF, resp failure, LE thrombosis Neurologic: Pain controlled, tylenol and ultram Cardiovascular: Aspirin, Beta-blocker, Statins, plavix, change Bblockers to oral dosing Pulmonary: Trach, (Ventilator mode: Other), Trach collar trials Gastrointestinal / Abdomen: Nutrition: Tube feeding, advancew tube feedings to goal rate Renal: Foley, Adequate UO, monitor I/O, BUN/Cr hypernatremic over past weekend, received 1.5L free water. now normalized will give free water vis feeding tube Hematology: stable hct Endocrine: Regular insulin, on iv steroids x 7 days will stop today elevated FSBS will add lantus today Infectious Disease: gm neg in sputum/urine. WBC elevated at 20.6, no fevers currently on cipro/flagyl Lines / Tubes / Drains: Foley, J-Tube, Trach, Surgical drains (hemovac, JP) Wounds: Dry dressings Imaging: CXR from [**5-12**] with mod left effusion Consults: General surgery, Vascular surgery, CT surgery, Hem / Onc , Nephrology, P.T. ICU Care Nutrition: Nutren 2.0 (Full) - [**2154-5-14**] 07:17 AM 35 mL/hour Glycemic Control: Regular insulin sliding scale, Comments: add Lantus today Lines: Arterial Line - [**2154-5-1**] 02:30 PM Multi Lumen - [**2154-5-9**] 02:53 PM Prophylaxis: DVT: (Systemic anticoagulation: Fondaparinux Sodium) Stress ulcer: PPI VAP bundle: HOB elevation, Mouth care Communication: Patient discussed on interdisciplinary rounds , ICU Code status: Full code Disposition: ICU
Physician
Classify the following medical document.
Admission Date: [**2141-11-5**] Discharge Date: [**2142-2-18**] Date of Birth: [**2141-11-5**] Sex: M Service: Neonatology HISTORY OF PRESENT ILLNESS: Baby [**Name (NI) **] [**Name2 (NI) 4027**] #2, is the former 1070 gm male newborn Twin B who was admitted to the Neonatal Intensive Care Unit for management of prematurity. The baby was [**Name2 (NI) **] to a 36 year old gravida 3, para 1 mother. Prenatal screens - A positive, antibody negative, hepatitis B Streptococcus unknown. Also cystic fibrosis was negative, Chlamydia, gonorrhea culture negative. Maternal history - Hypothyroidism, pregnancy notable for spontaneous dichorionic/diamniotic twins. Pregnancy complicated by preterm labor and cervical shortening noted during routine examination at 23 5/7 weeks. Mother was was placed on bedrest and was treated with magnesium sulfate. Betamethasone. On the day of delivery, [**11-5**], mother presented in active labor despite high doses of magnesium. Delivery was by cesarean section. This infant emerged floppy without spontaneous respirations. The infant was dried, bulb suctioned and stimulated. Poor respiratory effort continued and positive pressure was begun with some improvement. Was intubated in the Delivery Room, Apgars 1 at one minute and 6 at five minutes. The baby was shown to the parents and then transferred to the Newborn Intensive Care Unit. HOSPITAL COURSE: (By systems) Respiratory - The baby received three doses of Surfactant and was on the conventional ventilator with pressures of 22/5 and a rate of 18. Weaned by day of life #24 to nasopharyngeal CPAP which he required until nasal cannula oxygen on day of life #51. He transitioned to room air on day of life 64 and remained in room air until day of life 76 where he had an increase in apnea and bradycardia. He was on CPAP for approximately 24 hours. He was also noted to have spits at this time. Sepsis evaluation was negative, and ultimately this episode was thought to be related to reflux. He was then again transitioned to room air where he remained. The baby was loaded with caffeine citrate on day of life #4. He remained on caffeine citrate until day of life #63. At the time of discharge he has been without significant apnea, bradycardia or desaturation for greater than five days. Cardiovascular - The patient had a presumed patent ductus arteriosus which was treated with one course of Indomethacin on day of life 3 to 4. He had an echocardiogram on [**11-10**] after treatment with Indomethacin which showed no patent ductus arteriosus. The baby's baseline heartrate is 130s to 160s. He is cardiovascularly stable with blood pressures with systolics in the 60s to 80s, diastolics 30s to 40s and mean blood pressure 40s to 50s. Fluids, electrolytes and nutrition - The patient initially had an umbilical artery catheter but was unable to have an access to umbilical venous catheter. The umbilical artery catheter was removed on day of life #3. He had a PICC line inserted which remained in place for several weeks. He was started on enteral feedings on day of life #7 and was advanced to full strength breastmilk 32 with ProMod, demonstrated some initial spits, ultimately was thought to have reflux. He was started on Reglan and Zantac on day of life #60 and had rice cereal added to his breastmilk 32 with ProMod. The Reglan and Zantac were discontinued on [**1-31**] and he was transitioned to Enfamil AR which he is currently feeding all p.o. He is receiving supplemental iron, Ferrous Sulfate .3 cc p.o. q.d. which equals 2 mg/kg/day of 25 mg/cc. The baby is taking in greater than 170 cc/kg/day. His birthweight was 1070 gm, 50th percentile, discharge weight 4160, 50th percentile. Admission length 37 cm, 50th percentile, discharge length 52 cm, 25th to 50th percentile. Admission head circumference, 20.5 less than 10th percentile, question accuracy of this measurement as at one week of age his head circumference was 24 cm, 10th percentile. Discharge head circumference 35 cm, 75th percentile. Gastrointestinal - He had a bilirubin on day of life #4 of 5, .4, .3. He responded to single phototherapy and had a rebound bilirubin of 1.8, 0.4, 1.4. Hematology - Baby is A positive, Coomb's negative, received four transfusions of red blood cells during this admission, last one being on [**2142-1-21**] for a hematocrit of 24. He has not had a repeat hematocrit since then, he is pink and well perfused. Infectious disease - The baby had a sepsis evaluation on admission because of prematurity and presentation at birth, he had a white count of 7.3, 38 polys, 0 bands, 57 lymphs, platelets of 299,000. Admission hematocrit of 54%. He was started on Ampicillin and gentamicin. He had adequate gentamicin levels of 1.3, 1.1 and a trough of 5.5. Antibiotics were discontinued as the baby was clinically doing well for gestational age. He then had a sepsis evaluation on day of life #30 for increased apnea and bradycardia. At that time his blood count was 18 wit 51 polys, 0 bands, platelet count of 645,000, hematocrit 41. He was not started on antibiotics and clinically improved. On day of life #38 he again had a sepsis evaluation for increased apnea and bradycardia. The complete blood count was also within normal limits. Blood culture was negative and the baby received 48 hours of Vancomycin and was clinically improved. On day of life #75 again he had increased apnea and bradycardia. He had a blood culture and complete blood count sent. His complete blood count had a white count of 11.8 with 14 polys, 0 bands, platelets 383 and his blood culture remained negative. He did have a urine catheter specimen sent that was positive for enterococcus, and klebsiella. He had a repeat complete blood count after starting on Vancomycin and Gentamicin that was within normal limits. His antibiotics were continued for five days and after being off of antibiotics for one week he had a repeat urine culture sent that showed no growth. To follow up on this presumed urinary tract infection, he had a renal ultrasound which showed nephrocalcinosis on [**1-31**] and then [**2-8**] he had a vesicoureterogram done at [**Hospital3 1810**] that was within normal limits. He has had no further issues. Neurological - The baby had an initial head ultrasound on day of life #3 which was within normal limits with no evidence of intraventricular hemorrhage. On day of life #10 he had another head ultrasound which showed a Grade 3 bilateral intraventricular hemorrhage. He had serial head ultrasounds after this to follow his ventriculomegaly that was noted on this ultrasound also and these were improving, until [**2-1**] when his ventriculomegaly was mildly increased from his previous scan. He had his last scan on [**2-12**] which showed a resolving clot with ventricular size stable. Plan is to do an outpatient head ultrasound at the [**Hospital3 1810**] in the next week or two and certainly prior to being followed up in the Neonatal Neurology follow up program at the [**Hospital3 18242**]. Dr. [**Last Name (STitle) 37122**] has seen [**Known lastname **] here at the [**Hospital6 1760**] and has also met with the parents, his phone #[**Telephone/Fax (1) 47462**]. Baby's neurological examination is appropriate for gestational age. Sensory - Audiology, hearing screen as passed. Ophthalmology, the baby has had serial eye examinations which showed some mild retinopathy of prematurity with his last examination being on [**2142-2-7**] which showed Stage 1 retinopathy of prematurity, both eyes, 2 to 3 clock hours with a plan to follow up in three to four weeks with Dr. [**Last Name (STitle) 36137**] from ophthalmology at [**Hospital3 1810**], phone [**Telephone/Fax (1) 36249**]. Psychosocial - Parents have been visiting daily, are optimistic about [**Known lastname **] outcome. They have been appropriately grieving [**Known lastname **] twin, [**Known lastname **] who died of pulmonary hemorrhage and shock on day of life #2. They had a [**Hospital1 **] service for him about one week after his death and met with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] on [**2142-2-17**] regarding autopsy results and a bereavement meeting. They look forward to transitioning home and are appropriately anxious about this transition. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: Home with family. PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 47463**], phone [**Telephone/Fax (1) 37304**], fax [**0-0-**]. CARE RECOMMENDATIONS: Continue Enfamil AR adlib, minimum of 130 cc/kg. Medications - Ferrous Sulfate .3 cc p.o. q.d. which equals 2 mg/kg/day of 25 mg/cc. Car seat screening passed on [**2142-2-17**]. State newborn screen, baby had serial newborn screen, the last one being on [**12-29**] that was within range. Immunizations received - Hepatitis B vaccine [**12-25**] and [**1-26**]. DTAP [**1-5**], HIB [**1-5**], IPV [**1-5**], pneumococcal 7 valiant conjugate vaccine [**1-5**], Synagis [**2-8**]. Immunizations recommended - Synagis respiratory syncytial virus prophylaxis should be considered from [**Month (only) 359**] through [**Month (only) 547**] for infants who meet any of the following three criteria: 1. [**Month (only) **] at less than 32 weeks; 2. [**Month (only) **] between 32 and 35 weeks with plans for daycare during respiratory syncytial virus season, with a smoker in the household or with preschool siblings; or 3. With chronic lung disease. Influenza immunization should be considered annually in the fall for preterm infants with chronic lung disease once they reach six months of age. Before this age the family and other caregivers should be considered for immunization against influenza to protect the infant. FOLLOW UP: Follow up appointments recommended with primary care physician, [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 47463**], parents plan to call on [**2-18**] and will be seen during the first week of discharge. Neonatal Neurology Program, [**Telephone/Fax (1) 47462**]. Follow up head ultrasound the week of [**2-19**] at [**Hospital3 1810**], [**Telephone/Fax (1) 47462**]. Ophthalmology, Dr. [**Last Name (STitle) 36137**] [**Telephone/Fax (1) 36249**], last examination on [**2142-2-7**], plan to follow up in three to four weeks, [**2-28**] to [**3-7**]. Mother will call for an appointment. [**First Name (Titles) 407**] [**Last Name (Titles) **] Group, [**Telephone/Fax (1) 37503**] and Infant Follow Up Program at [**Hospital3 18242**] will contact the family. Follow-up renal ultrasound suggested for several monthsa time to evaluate resolution of stones,, or need for further evaluation. DISCHARGE DIAGNOSIS: 1. Former 27 [**2-16**] week premature male 2. Status post respiratory distress syndrome 3. Status post rule out sepsis 4. Status post presumed urinary tract infection 5. Status post intraventricular hemorrhage 6. Mild retinopathy of prematurity 7. Gastrointestinal reflux 8. Status post apnea and bradycardia of prematurity 9. Renal calcifications [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 36142**], M.D. [**MD Number(1) 36143**] Dictated By:[**Last Name (NamePattern1) 36144**] MEDQUIST36 D: [**2142-2-18**] 15:52 T: [**2142-2-18**] 16:05 JOB#: [**Job Number 47464**]
Discharge summary
Classify the following medical document.
Admission Date: [**2159-3-4**] Discharge Date: [**2159-3-8**] Date of Birth: [**2115-11-6**] Sex: M Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern1) 13561**] Chief Complaint: left upper and lower extremity numbness/tingling Major Surgical or Invasive Procedure: Intubation CT Scan MRI/MRA CTA Lumbar Puncture History of Present Illness: ID/CC: Loss of strength and sensation in lower extremities HPI: Pt is a 43 year old male with hx of lumbar disc disease, s/p L4-L5 laminectomy at [**Hospital3 15054**] in [**2156**], with residual R leg numbness and foot drop from surgery, who presents with acute onset of L leg plegia and sensory loss. He says that at baseline he walks with a cane because of a foot drop on the R and also has some sensory loss in the R leg. He also at baseline has severe pain over his spine in the L4 area that he has had since the surgery. He says that last night (midnight 24 hours prior to presentation to the ED) he was sleeping and awoke because he thought his dog was sitting on his L leg (it felt heavy and numb). He awoke and saw that his dog was not on his leg. He tried to move his leg and could not. It was numb and completely plegic. He says he felt very scared and therefore did not tell anyone aobut this for the entire day. Around 8 pm, however, he realized he had to be evaluated and he presented to the [**Hospital6 **], who then sent him to the [**Hospital1 18**] for further evaluation. He denies any recent back trauma. Past Medical History: spinal disease operated on [**2156**] at [**Hospital6 **] chronic pain Social History: Denies tobacco, ETOH, drugs. Used to work as a UPS supervisor, fired 2 yrs ago when got back injury at work. Has not worked since. Lives at home with wife and 3 kids, says situation at home has been stressful since he has been out of work. Is currently involved in at least one lawsuit (his former neurosurgeon) as well as a sticky financial/worker's compensation situation. Family History: no h/o seizures, neurological problems Physical Exam: Exam findings have fluctuated throughout his hospital course. On admission to neuro: VS: T 98.6 HR77 BP 148/87 RR18 Sat 95% on room air PE: overweight male, very distressed and tearful. HEENT OP benign, head atraumatic Neck Supple, full ROM, no carotid bruits Chest CTA B CVS RRR w/o MGR ABD soft, NTND, + BS EXT no C/C/E, distal pulses full, no rashes or petechiae Neuro: MS: AA&Ox3, appropriately interactive, normal affect Attention: WORLD backwards Speech: fluent w/o paraphasic error, repetition, naming intact L/R confusion: No L/R confusion Praxis: Able to mimic saluting the flag, rolling dice, brushing teeth with either hand. CN: I--not tested; II,III--PERRLA, VFF by confrontation, visual acuity 20/X, optic discs sharp; III,IV,VI-EOMI w/o nystagmus, no ptosis; V--sensation intact to LT/PP, masseters strong symmetrically; VII--face symmetric without weakness; VIII--hears finger rub bilaterally; IX,X--voice normal, palate elevates symmetrically, gag intact; [**Doctor First Name 81**]--SCM/trapezii [**5-17**]; XII--tongue protrudes midline, no atrophy or fasciculation. Of note, tongue at times is protruded far to the left, usually when the patient is questioned about his symptoms. Motor: normal bulk and tone, no tremor, rigidity or bradykinesia, no pronator drift. Strength: Upper extremities [**5-17**] throughout. In the lower extremities pt has no spontaneous movement, able to wiggle R toes and slide R leg along the bed, no withdrawal to pain in the LLE. Of note, motor strength returned to R leg then slowly to L leg, moving toes only on command at discharge but able to walk with nurses and get out of bed on his own at times. Refl: |[**Hospital1 **] |tri |bra |pat |[**Doctor First Name **] |toe | L | 1 | 2 | 2 | 1 | 0 | dn | R | 1 | 2 | 2 | 1 | 0 | dn | [**Last Name (un) **]: Diminished sensation to light touch, pin prick, temperature, vibration to T8 anteriorly and posteriorly, but no saddle anesthesia. No joint position in L foot. In R foot able to detect movement of toes, but not the direction. This sensation defect improved over the next few days and resolved by discharge. Pertinent Results: [**2159-3-5**] 02:52AM BLOOD WBC-10.4 RBC-4.89 Hgb-14.7 Hct-41.6 MCV-85 MCH-30.0 MCHC-35.3* RDW-13.8 Plt Ct-268 [**2159-3-4**] 12:25AM BLOOD Neuts-82.6* Lymphs-13.5* Monos-3.1 Eos-0.7 Baso-0.2 [**2159-3-5**] 02:52AM BLOOD Plt Ct-268 [**2159-3-5**] 02:52AM BLOOD PT-13.2 PTT-25.2 INR(PT)-1.1 [**2159-3-4**] 12:25AM BLOOD ESR-4 [**2159-3-5**] 02:52AM BLOOD Glucose-104 UreaN-16 Creat-0.9 Na-146* K-3.4 Cl-110* HCO3-27 AnGap-12 [**2159-3-5**] 02:52AM BLOOD ALT-74* AST-24 AlkPhos-79 TotBili-0.7 [**2159-3-5**] 02:52AM BLOOD Calcium-8.8 Phos-4.8* Mg-1.9 Cholest-211* [**2159-3-5**] 02:52AM BLOOD Triglyc-594* HDL-35 CHOL/HD-6.0 LDLmeas-107 [**2159-3-4**] 12:25AM BLOOD CRP-0.67* [**2159-3-4**] 09:30AM BLOOD IgG-1149 [**2159-3-4**] 09:33AM CEREBROSPINAL FLUID (CSF) WBC-1 RBC-0 Polys-0 Lymphs-92 Monos-8 [**2159-3-4**] 09:33AM CEREBROSPINAL FLUID (CSF) TotProt-53* Glucose-91 [**2159-3-4**] 09:33AM CEREBROSPINAL FLUID (CSF) CSF-PEP-NO OLIGOCL MRI/MRA BRAIN: Mild sinus disease. There are a few nonspecific T2 high-signal-intensity foci. No definite evidence of acute infarction, mass effect, or hemorrhage. Normal MRA of intracranial circulation MRI SPINE There are degenerative changes in the cervical spine with osteophyte formation producing mild canal narrowing at C3-C4, C5-C6, and C6-C7, and T8-T9. These do not appear to produce spinal cord compression. No definite contrast enhancement XRAY-L-Spine with oblique Five views of the lumbosacral spine, including oblique projections show no fracture or spondylolisthesis. The height of the vertebral bodies is normal. The intervertebral disc spaces are normal. The SI joints are normal and the visualized hip joints are normal. There is no evidence for bony destruction. The visualized soft tissue structures are normal Brief Hospital Course: The patient was initially thought to be in acute need of neursurgery per his reported symptoms of paraparesis and h/o back surgery, but spine imaging proved negative for cord compression or major pathology (past scarring from surgery was visualized.) The following differential was considered: 1. Cord compression/infarct: Decadron was started in the ICU due to acute symptoms. However, nonrevealing imaging made surgical treatment less likely. In addition, the patient's neurological symptoms were also inconsistent with a cord compression as he complained of L arm paresis and some sensory loss as well as a paraparesis and some sensory loss that did not correspond to a level. [**Doctor Last Name 60437**] sign was positive. He also demonstrated an unusual cranial nerve exam consisting of a tongue that occasioanlly protrudes far to the left when he is asked about his symptoms, as well as a [**Doctor Last Name 11586**] and Rinne test that he localized to the right side of his head only. 2. Infection. The pt reported severe tenderness on exam as well as paresis but epidural abscess was not found on imaging. He was empirically started on IV abx in the ICU which were subsequently d/ced when the LP was done and was negative. 3. Demyelinating disease. LP and head/spine imaging negative for MS, GB. On the neurology floor, a differential including conversion vs. malingering evolved due to inconsistent physical exam as well as the following: 1. Social stressors. Extensive discussions with the patient regarding his social situation revealed several social stressors. The patient is involved in a sticky worker's compensation situation after he was fired from his job several years ago for back injury. He has been bed-ridden and depressed since his operation 2 yrs ago which was apparently not done correctly. He has also had [**10-22**] chronic pain for which he has been taking 80mg oxycontin TID for several months. He believes he is addicted. 2. Inconsistent history. Several aspects of his medical course were not correctly relayed to us, per his father's report as well as his neurosurgeon's report at the [**Hospital3 **] (pt states he has an appt [**3-15**] with Dr. [**Last Name (STitle) **] who reports no such appt.) 3. Secondary gain. He reported to the team that his worker's comp would end once he received back surgery but that he wanted to get the surgery even if he had to pay for it himself. However, his father reported that the situation is reversed: that the patient cannot get worker's comp UNTIL he received back surgery and that therefore he is very anxious to be operated on. 4. Lawsuits. He is also involved in at least one lawsuit against his former neurosurgeon. Given the above factors and the apparent volitional aspect of his symptoms, malingering seemed more likely than a conversion disorder. A psychiatry consult was called and gave the unequivocal diagnosis of malingering. The patient was informed that he has no neurological diagnosis and that his transient weakness may be evoked by stress and will resolve on its own. The patient's symptoms continued to resolve over the next few days as PT attempted to get him out of bed to clear him for home discharge. He was D/Ced home feeling much better. Medications on Admission: oxycontin 80mg PO TID Discharge Medications: 1. Oxycodone HCl 40 mg Tablet Sustained Release 12HR Sig: Two (2) Tablet Sustained Release 12HR PO Q8H (every 8 hours) for 4 days. Disp:*20 Tablet Sustained Release 12HR(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: transient left-sided weakness Discharge Condition: stable Discharge Instructions: Continue to take your medications as prescribed by Dr. [**Last Name (STitle) 5263**]. You should follow up with her in the next week. Please follow up with Dr. [**Last Name (STitle) **] as previously scheduled on [**3-15**] for neurosurgical evaluation. Followup Instructions: If your symptoms recur contact your PCP for advice or come directly to the emergency room. Follow up with Dr. [**Last Name (STitle) **] as well for neurosurgery evaluation.
Discharge summary
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TITLE: Chief Complaint: 24 Hour Events: Pt. started on standing haldol as per neuroloy recs, but patient had QT prolongation to 0.49, so patient was changed to zyprexa 5mg QID. Treatment with cidofovir was initiated yesterday, with probenecid for renal protection Patient to get an EEG today Allergies: Bactrim (Oral) (Sulfamethoxazole/Trimethoprim) Rash; Last dose of Antibiotics: Daptomycin - [**2124-8-25**] 10:20 PM Micafungin - [**2124-8-26**] 01:38 AM Meropenem - [**2124-8-26**] 04:00 AM Infusions: Other ICU medications: Haloperidol (Haldol) - [**2124-8-25**] 10:36 PM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2124-8-26**] 06:37 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 36 C (96.8 Tcurrent: 35.6 C (96.1 HR: 114 (108 - 126) bpm BP: 114/73(84) {76/44(32) - 154/114(151)} mmHg RR: 29 (15 - 29) insp/min SpO2: 97% Heart rhythm: ST (Sinus Tachycardia) Total In: 3,820 mL 1,853 mL PO: TF: IVF: 3,620 mL 1,743 mL [**Year (4 digits) **] products: Total out: 485 mL 345 mL Urine: 485 mL 345 mL NG: Stool: Drains: Balance: 3,335 mL 1,508 mL Respiratory support O2 Delivery Device: Nasal cannula SpO2: 97% ABG: ///17/ Physical Examination gen-altered, moving around in bed, moaning HEENT-nc/at, PERRL but slightly sluggish, +conjunctival and scleral edema, +scleral icterus, dry MM, NGT in place neck-supple, no LAD chest-b/l slight expiratory wheezes,bibasilar crackles heart- s1s2 tachycardic, +systolic flow murmur throughout precordium abd-+hypoactive bs, soft, NT, ND ext-no c/c/ 2+edema. R.knee and dorsal surface of hand with slight erythema. neuro-AAOx0, moving all 4 extremities, no noticeable tremor. Labs / Radiology 41 K/uL 6.6 g/dL 110 mg/dL 0.5 mg/dL 17 mEq/L 3.2 mEq/L 16 mg/dL 112 mEq/L 137 mEq/L 19.6 % 6.2 K/uL [image002.jpg] [**2124-8-26**] 04:40 AM WBC 6.2 Hct 19.6 Plt 41 Cr 0.5 Glucose 110 Other labs: PT / PTT / INR:17.2/32.5/1.5, ALT / AST:141/97, Alk Phos / T Bili:391/6.3, Differential-Neuts:88.0 %, Lymph:8.2 %, Mono:3.5 %, Eos:0.2 %, Lactic Acid:1.4 mmol/L, Albumin:2.0 g/dL, LDH:597 IU/L, Ca++:7.5 mg/dL, Mg++:1.6 mg/dL, PO4:2.2 mg/dL Assessment and Plan This is a 57-year-old gentleman with CLL and large cell transformation s/p MURD SCT on [**3-10**], recently discharged from [**Hospital1 19**] to rehab, now readmitted for increased diarrhea, abdominal pain, and waxing/[**Doctor Last Name 533**] mental status. #AMS-Likely etiology is thought to be infectious due to adenovirus and BK virus being detected in the [**Doctor Last Name 573**], but <500 copies of adenovirus and BK being very highly positive in the [**Last Name (LF) 573**], [**First Name3 (LF) **] thought to be due to BK encephalitis. Due to deterioration in mental status and persistent altered state, ID has recommended adding viral studies to the CSF and to start empiric treatment with IV cidofovir at 5mg/kg IV weekly. In addition, he will need IV hydration with NS and he must receive oral probenecid (as this does not come IV) for renal protection. Other etiologies of AMS could include toxic metabolic or medication effect given recent recent ativan and morphine for pain control. In addition, malignant process such as return of cancer could be possible but CSF did not show malignant cells. In addition, MRI, though a poor study did not show any other possible explanations. -Started treatment with cidofovir, patient tolerated probenecid and IVF hydration very well - Changed standing haldol to Zyprexa due to QTc prolongation, will continue to monitor QTc - ID and neuro following, appreciate recs -f/u CSF viral PCRs and well as pending cxs -started cidofovir 400mg and probenacid as directed by protocol -avoid mind alternating medications ativan, morphine, etc. -started thiamine IV x 5 days and po folate, -will f/u EEG from today -continue broad antibiotic coverage with daptomycin and meropenem pending further culture data -continue micafungin for fungal ppx while on heavy immunosuppression . #Hypothermia-has been improving with warming blankets, thought to be secondary to infection. Pt apparently displayed this physiology with his prior viral infectious. Could also be secondary to an endocrine source. -thyroid studies: TSH and T4 mildly decreased, but in the context of an acute illness are difficult to assess. Could consider cortisol stim test if he remains hypothermic and no infectious etiology is found -warming blankets. -on daptomycin and meropenem in case of bacterial sepsis, as per ID team . # s/p CLL with BMT c/b GVHD -care per BMT team, discuss immunosuppressant and prophylactic regimens. -can d/c acyclovir with initiation of cidofovir . #GI:diarrhea, could be related to immunosuppression/medication effect, GVHD. - stool cultures NG thus far. - iv fluids PRN - replete lytes. . #Elevated LFTs/bili-chronic since around [**4-25**], per BMT thought to be mainly due to GVHD, could be acutely worsened by viral infection. Will continue to monitor and continue immune suppression regimen as per BMT team. -If worsens, consider RUQ u/s . #Anemia-baseline is chronic likely secondary to immunosuppresion/infection/GVHD, but acute drop in HCT today likely due to IVF administration, HCT fell below 21 today. -Check a type and screen since he does not have an active one. F/U transfusion threshold with BMT but will likely transfuse 1 unit PRBC -Continue to monitor . #Thrombocytopenia-chronic as with anemia. Continue to monitor. . #Non gap metabolic acidosis-based on VBG looks like a primary respiratory alkalemia likely due to hyperventilation from agitation, and compensatory metabolic academia -could also be related to diarrhea and IVF . #HTN-currently normotensive, will hold outpatient medications . #HL-currently holding statin given transaminitis ICU Care Nutrition: Glycemic Control: Lines: PICC Line - [**2124-8-25**] 01:20 PM Prophylaxis: DVT: pneumo boots Stress ulcer: IV PPI VAP: Comments: Communication: Comments: Code status: Full code Disposition: ICU pending decreased nursing needs now that NGT is in place ------ Protected Section ------ MICU Attending Addendum: I examined the patient today, reviewed the history and laboratory data and was present for the key portion of the services provided. I have also reviewed Dr [**Last Name (STitle) 10627**] s note above and largely agree with the findings and plan of care. I have also discussed the patient s status with Dr [**Last Name (STitle) 383**]. Over the morning the patient has continued to be unresponsive and yet is now starting to look agitated again. Furthermore he has a rising lactate and a metabolic acidosis (7.27 on VBG, compared to 7.42 earlier today). The possibility of sepsis is high, including intra-abdominal with his GVHD. Given acidemia and severely altered mental status, we feel intubation is in order, and Dr [**Last Name (STitle) 383**] agrees and pt s wife consents. If hemodynamically stable I concur with abd CT later today. Overall prognosis is very guarded, but for now we will continue max care. [**First Name8 (NamePattern2) 1620**] [**Last Name (NamePattern1) 1621**], MD 45 min spent in the care of this critically ill pt. ------ Protected Section Addendum Entered By:[**Name (NI) 1620**] [**Last Name (NamePattern1) 1621**], MD on:[**2124-8-26**] 13:55 ------ Additional MICU Attending Addendum 15:00hr Repeat [**Year (4 digits) 573**] gases (abg s) now show pH 7.42 and arterial lactate is only 1+. Now that haldol, Zyprexa, and benadryl stopped, patient has times when he follows simple commands. We will follow his clinical trajectory closely and for now hold off on intubation though if he becomes progressively acidotic or deeply obtunded we will have low threshold for intubation then. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1621**], MD ------ Protected Section Addendum Entered By:[**Name (NI) 1620**] [**Last Name (NamePattern1) 1621**], MD on:[**2124-8-26**] 15:28 ------
Physician
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Trauma, s/p multiple stab wounds to head, chest, right arm & axilla, abdomen, and right buttocks. Pt is s/p Exp Lap with repair of liver laceration & repair of gastrotomy; and repair RUE brachial vein. Assessment: Pt sedated on propofol and Fentanyl infusion- not responding to noxious stimulation, no cough, gag, corneal; PERRL @ 2mm. C-collar in place; logroll precautions in effect. Vital signs stable and urine output adequate. Impaired gas exchange per ABG; breath sounds clear & diminished R>L. Bilateral chest tube in place without fluctuation or leak & negative for crepitus; serosanginous drainage from both. Abdominal incision is open with transparent dressing intact & 2 JP drains with large s/s output. Bear hugger for temp of 96.9. Groin lines for access placed in ED. Warm extremities with palpable pulses. +CSM in UE which is more edematous than left. Action: Propofol lightened for neuro assessments and titrated for adequate sedation; Fentanyl titrated for analgesia per nonverbal & vital sign responses. Neuro checks Q 4 hours & prn. CT of head and neck done. Neurosurgical consult obtained. Repeat head CT @ 1800 for reported right temporal pneumocephalous &? bleed vs. artifact Vent changes made PEEP increased to 10cm, see metavision; ABG assessed. ETT position adjusted per CXR findings; now at 23cm at teeth. Access changed: LSC MLC placed & confirmed by CXR, and left radial arterial line placed; groin lines removed with adequate hemostasis achieved. RUE wounds examined by ortho resident for reported tendon damage; dressings changed. X-rays of right humerus were done. RUE elevated on pillow. Right 5^th digit stab laceration was cleaned & sutured by trauma resident. Abdominal JPs placed to low constant wall suction for large output. Serial HCTs Q 4 hours Q 6 hour blood sugars monitored. amp of D50W for blood sugar of 69. Serum K+ 3.3: repleted. Logroll status discontinued per trauma team. Pt now normothermic @ 99.9 Response: Pt MAE s when light from sedation, but does not follow commands. Pt appeared to nod his head to confirm that his name was [**Known firstname 4211**]. Cough, gag, and corneal reflexes present but impaired, and pt localizes to nail bed pressure. PERRL @ 2mm; sclera edema bilaterally. Pt also becomes dysynchronous with vent, with RR>40 and clamping down on ETT; generalized shaking observed each time sedation was lightened. Repeat head CT results pending. Breath sounds remain decreased R>L, clear & with scant secretions. ABG and O2 saturations reveal adequate oxygenation improved on current O2 support. Mild permissive hypercapnea noted with pH wnl. Both chest tubes continue to drain s/s fluid that is becoming more serous; no fluctuations or air leaks noted. ? Crepitus on right where greater edema is notable in right upper chest, shoulder, and arm. Also new is air collecting under transparent dressing of upper arm laceration (ICU resident notified). Right axillary JP drain has moderate s/s output. RUE remains warm with palpable peripheral pulses; all stab lacerations of RUE are stapled & clean with small to moderate s/s drainage. Spontaneous movement of RUE noted against gravity with sedation suspended; no grasp noted. Abdominal drainage >500cc this shift, s/s fluid. HCT stable @ 35-36; vital signs remain stable see Metavision; urine output remains adequate. C-collar remains in place; pt has been position with HOB @20 degrees and is tolerating side to side positioning Bear hugger removed; now with temp spike to 102 @ 1900; ICU resident aware. Pt is to receive Tylenol. Blood sugars 79-97. Left hand noted to be cooler following placement of arterial line; + but weaker radial pulse and normal skin coloring; ICU resident notified. Plan: Continue with all above actions and monitoring. Follow neuro exam Q 4 hours & prn Wean sedation as tolerated. Monitor ABG to assess pH; follow saturations, breath sounds, and airway pressure/plateau for developing respiratory distress associated with injuries and multiple blood products transfused. Follow CSM of UEs; elevate RUE. Cont serial HCTs follow drainage of JP and wound sites. Recheck serum K+; follow blood sugars & treat per sliding scale order. Follow temps and culture for >102. Pt remains unidentified at this time; their have been no inquiries made. Police investigators called earlier today asking to speak with patient if able. T/SICU social worker, [**Name (NI) 1746**] [**Name (NI) 363**] spoke with police detective; little information was forwarded to us by police as their investigation is ongoing at this time. Police have all pt belongings, obtained in ED (see chain of custody papers). ED MDs came by at end of this shift to see pt; they reported that pt was alert on admission to ED but c/o of not being able to breathe. He had minimal breath sounds. It was related that he was able to confirm he had no allergies and no PMH. There was not time for additional inquiries and his name or NOK contact information was not obtained.
Nursing
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ADMISSION NOTE: The patient is a 64-year-old female who began having crampy spasmodic abdominal pain accompanied by nausea and dry heaves about three days ago. She denies passage of flatus for 2-3 days, last BM was 3 days ago. She denies fever and chills. The pain is remniscent of an episode of food poisoning she had remotely. Pt was transferred from [**Hospital 713**] to [**Hospital1 1**]. Taken to OR for LOA and gastric tube placement. +closed loop obstruction and peritonitis. Large amounts of foul smelling gastric contents via g tube. Pt brought to T/SICU intubated post op for further monitoring. PSH: s/p lap gastric bypass [**2160-5-27**] complicated by a bile leak at the [**Hospital 714**] Hospital Group. She was taken back to the operating room for a exploratory laparotomy which did not identify source of the bile leak and a right colectomy and gastrostomy tube was performed. Her continued to have biliary drainage from her peritoneal JP drains and she was transferred to the [**Hospital1 715**] for further management of her bilary leak. + open cholecystectomy, colonoscopy (negative, [**2148**]) PMH: morbid obesity (BMI 49), CHF, EBV syndrome, Bipolar disorder/depression (followed by Dr. [**Last Name (STitle) 716**] in [**Location (un) 717**]), hypertension, arthritis, chronic dyspnea on exertion, asthma, bronchiti, DJD, plantar fasciitis, , obstructive sleep apnea (on CPAP at home), urinary incontinence, chronic back/leg pain SOCIAL HISTORY: Smoked 1 PPD, quit in [**2148**]. Admits to [**7-9**] drinks per day, occasional marijuana, and lives alone in a [**Hospital3 718**] in [**Location (un) 717**]. She is a retired nurse and has two children in [**Location (un) **]. *please see nursing admission sheet for further details re: medications, contact info etc.* Bowel obstruction (intestinal obstruction, including volvulus, adhesions) Assessment: Abdominal cramps, nausea and dry heaving, constipation at admission Action: Pt taken to OR for LOA due to closed loop obstruction and gastric tube placement Response: Pt hemodynamically stable, active fluid recesitation and electrolyte repletion, moderate amounts of foul smelling g tube contents after placement Plan: Continue to monitor labs and fluid balance, abdominal assessments and g tube monitoring .H/O alcohol abuse Assessment: Pt stated she drinks 6-12 drinks/daily, family reinforced the fact that pt has a high ETOH intake Action: Pt started on Midazolam infusion Response: No s/s of etoh w/d, pt calm when awake, vss Plan: Continue Midazolam gtt and monitor for s/s of withdrawal Acute Pain Assessment: Pt nods to pain when asked, points to abdomen (incision) Action: Pt started on Fentanyl gtt at 50mcgs/hr, titrating to effect Response: Pt nods to pain when asked Plan: Continue Fentanyl gtt and titrate to effect Respiratory failure, acute (not ARDS/[**Doctor Last Name 2**]) Assessment: Pt intubated on CMV, abg wnl with POA2 300 s, lung sounds clear, adequate TV. Pt on CMV TV 550 R 14 P5 100% Action: Weaned to PSV 10 peep 5 50% Response: Sats 100%, tidal volumes 400-500, rr low to mid teens Plan: Continue to wean vent as tolerated for extubation Hypovolemia (Volume Depletion - without shock) Assessment: Sbp 90 s, low uop 20-30cc/hr Action: LR bolus 1 liter x2 Response: Increase in UOP and SBP back to 120-130 Plan: Continue to monitor fluid status
Nursing
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Chief Complaint: hypoxia, change in mental status I saw and examined the patient, and was physically present with the ICU Resident for key portions of the services provided. I agree with his / her note above, including assessment and plan. HPI: 66F with small cell lung ca diagnosed by biopsy of neck soft tissue lesion with lesions in T7, with malignant lymphadenompathy, admitted electively for chemo on [**6-29**]. initally did well but developed neutrotpenic fever, started on abx broad spectrum. For thrombocytopenia, received a plt transfusion developed hypoxia and fever in the setting of plt transfusion. Some concern for TRALI, treated with supportive care. Pt did a little better, but last night pt became hypoxic; treated with lasix but persistent O2 requrirment. Also reports small amount of hemoptysis intermittent with normal sputum. furthermore, worsening anemia in the last few days. ddx on the floor included trali, pe (less likley given prophylaxis). transferred to the icu for further work-up monitoring. Patient admitted from: [**Hospital1 54**] [**Hospital1 55**] History obtained from Patient Allergies: Penicillins Hives; Demerol (Injection) (Meperidine Hcl) Hives; Iodine itching; Latex itching; Betadine (Topical) (Povidone-Iodine) Unknown; Last dose of Antibiotics: Vancomycin - [**2102-7-14**] 10:15 AM Infusions: Other ICU medications: Other medications: vanco 1g q12, cefepime, flagyl; nebs; fondaparinux Past medical history: Family history: Social History: small cell lung ca - [**2101**] paraneoplastic syndrome resulting in blurry vision and leg weakness thrombocytopenia: h/o possibly hit, now post-chemo copd, h/o heavy tob use pvd, s/p aaa with stent; chronic stable angina father died from stroke; sonw with dvt; mother with cad Occupation: Drugs: none Tobacco: h/o tob use many yeasr Alcohol: none Other: Review of systems: Constitutional: No(t) Fatigue, Fever, No(t) Weight loss Eyes: No(t) Blurry vision, No(t) Conjunctival edema Ear, Nose, Throat: No(t) Dry mouth Cardiovascular: Chest pain, No(t) Palpitations, No(t) Edema, No(t) Tachycardia, No(t) Orthopnea, relieved with nitro this am Nutritional Support: No(t) NPO, No(t) Tube feeds, No(t) Parenteral nutrition Respiratory: Cough, No(t) Dyspnea, No(t) Tachypnea, No(t) Wheeze Gastrointestinal: No(t) Abdominal pain, No(t) Nausea, No(t) Emesis, No(t) Diarrhea, No(t) Constipation Genitourinary: No(t) Dysuria, No(t) Dialysis Integumentary (skin): No(t) Jaundice, No(t) Rash Heme / Lymph: No(t) Lymphadenopathy, No(t) Anemia, No(t) Coagulopathy Neurologic: No(t) Numbness / tingling, No(t) Headache, No(t) Seizure Psychiatric / Sleep: No(t) Agitated, No(t) Suicidal, No(t) Delirious, No(t) Daytime somnolence Allergy / Immunology: No(t) Immunocompromised, No(t) Influenza vaccine Signs or concerns for abuse : No Pain: No pain / appears comfortable Flowsheet Data as of [**2102-7-14**] 01:02 PM Vital Signs Hemodynamic monitoring Fluid Balance 24 hours Since 12 AM Tmax: 37.5 C (99.5 Tcurrent: 37.5 C (99.5 HR: 105 (105 - 114) bpm BP: 114/57(68) {94/47(58) - 114/57(68)} mmHg RR: 18 (18 - 21) insp/min SpO2: 98% Heart rhythm: ST (Sinus Tachycardia) Height: 61 Inch Total In: 213 mL PO: TF: IVF: 213 mL Blood products: Total out: 0 mL 250 mL Urine: 250 mL NG: Stool: Drains: Balance: 0 mL -37 mL Respiratory O2 Delivery Device: Aerosol-cool SpO2: 98% ABG: 7.4/40/53 on ? Physical Examination General Appearance: Well nourished, No acute distress, No(t) Overweight / Obese, No(t) Thin, No(t) Anxious, No(t) Diaphoretic Head, Ears, Nose, Throat: Normocephalic, No(t) Poor dentition, No(t) Endotracheal tube, No(t) NG tube, No(t) OG tube Lymphatic: No(t) Cervical WNL, No(t) Supraclavicular WNL, No(t) Cervical adenopathy Cardiovascular: (PMI Normal, No(t) Hyperdynamic), (S1: Normal, No(t) Absent), (S2: Normal, No(t) Distant, No(t) Loud, No(t) Widely split , No(t) Fixed), No(t) S3, No(t) S4, No(t) Rub, (Murmur: Systolic, No(t) Diastolic) Peripheral Vascular: (Right radial pulse: Present), (Left radial pulse: Present), (Right DP pulse: Present), (Left DP pulse: Present) Respiratory / Chest: (Expansion: Symmetric), (Percussion: Resonant : ), (Breath Sounds: Crackles : insp and exp) Abdominal: Soft, Non-tender, No(t) Bowel sounds present, Distended, No(t) Tender: , No(t) Obese Extremities: Right: Trace, Left: Trace Musculoskeletal: No(t) Muscle wasting, No(t) Unable to stand Skin: Not assessed Neurologic: Attentive, Responds to: Not assessed, Movement: Not assessed, No(t) Sedated, No(t) Paralyzed, Tone: Not assessed Labs / Radiology 32 22 8 1.2 28 24 106 4 139 9 [image002.jpg] Other labs: PT / PTT / INR:1.3/31, Differential-Neuts:92, Band:0, Lymph:6.3 Imaging: cxr: left perihilar consolidation; interstitial opacities Microbiology: GRAM STAIN (Final [**2102-7-4**]): <10 PMNs and <10 epithelial cells/100X field. 4+ (>10 per 1000X FIELD): PLEOMORPHIC GRAM NEGATIVE ROD(S). 2+ (1-5 per 1000X FIELD): GRAM POSITIVE ROD(S). 2+ (1-5 per 1000X FIELD): BUDDING YEAST WITH PSEUDOHYPHAE. 2+ (1-5 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS. ECG: sinus tach, no [**Last Name (un) **] changes Assessment and Plan 66F with small cell lung ca, admitted for chemo, with hospital course complicated by neurtopenic fever, now with new interstitial lung infiltreates and worsening oxygenation despite broad-spectrum antibiotics, with minimal response to lasix, and now with hemoptysis. etiology of the infiltrates and hypoxia remains unclear. bacterial pna seem unlikely given lack of response to antibiotics. however, patient may be at risk for atypical infections, including pcp, [**Name10 (NameIs) **] well as fungal infections (yeast in sputum). PE is much less likely given thrombocytopenia, dvt ppx, and clear infiltrates on the cxr giving an alternative explanation to the hypoxia. ANCA-associated vasculitis as part of a paraneoplasic syndrome has been reported as well. TRALI from platelet transfusion is possible: hypoxia and interstitial infiltrates: with hemoptysis; maybe trali; focal cancer may be contributing to the picture -check anca -continue to treat for bacterial infection for now -expand coverage to include atypicals and pcp with azithromycin and bactrim -continue diuresis as tolerated; holding for now given incr creatinine -cont suppl O2 -hold off on additional imaging for now thrombocytopenia and anemia: due to recent chemo; possible HIT dx in the past -prn transfusion -holding heparin acute renal failure: in the setting of lasix use -renal dose meds -hold nephrotoxics and lasix; hold off on fluid challenge given tenuous repospiratory status cad/pvd: -holding asa/plavix in the setting of hemoptysis and thrombocytopenia goals of care -dnr/dni ICU Care Nutrition: Glycemic Control: Blood sugar well controlled Lines / Intubation: PICC Line - [**2102-7-14**] 10:30 AM Comments: Prophylaxis: DVT: (fondaparinux) Stress ulcer: PPI VAP: Comments: Communication: Family meeting held , ICU consent signed Comments: daughter [**Name (NI) 2123**] is the HCP [**Name (NI) 66**] status: DNR / DNI Disposition: ICU Total time spent: 45 minutes Patient is critically ill
Physician
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Chief Complaint: 24 Hour Events: - LDH at 700 - PM Lytes: Lactate 3.4 (from 1.1), K 3.2, P 1.0 - HCT 33.6 from 38.1 - UOP to 30/hr from 60/hr - Received 4 L of fluids - Received: 14 g CaGluc, 60 KPhos, 2 Pkt Neutra Phos, 54 oral K Meq Allergies: No Known Drug Allergies Last dose of Antibiotics: Infusions: Other ICU medications: Morphine Sulfate - [**2141-5-23**] 07:20 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2141-5-23**] 07:53 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**43**] AM Tmax: 37.5 C (99.5 Tcurrent: 37.2 C (98.9 HR: 122 (106 - 131) bpm BP: 121/87(94) {88/54(63) - 154/101(112)} mmHg RR: 24 (19 - 28) insp/min SpO2: 96% Heart rhythm: ST (Sinus Tachycardia) Height: 63 Inch Total In: 7,602 mL 1,144 mL PO: TF: IVF: 4,602 mL 634 mL Blood products: Total out: 1,553 mL 380 mL Urine: 1,018 mL 380 mL NG: Stool: Drains: Balance: 6,049 mL 764 mL Respiratory support O2 Delivery Device: Nasal cannula SpO2: 96% ABG: ///19/ Physical Examination Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Tone: Not assessed Labs / Radiology 88 K/uL 9.7 g/dL 95 mg/dL 0.4 mg/dL 19 mEq/L 4.1 mEq/L 4 mg/dL 103 mEq/L 130 mEq/L 30.7 % 12.3 K/uL [image002.jpg] [**2141-5-22**] 04:30 AM [**2141-5-22**] 06:56 AM [**2141-5-22**] 02:55 PM [**2141-5-22**] 09:13 PM [**2141-5-23**] 03:59 AM WBC 13.2 12.3 Hct 38.1 33.6 33.7 30.7 Plt 108 88 Cr 0.4 0.5 0.4 0.4 TCO2 14 Glucose 116 163 117 95 Other labs: PT / PTT / INR:11.8/29.5/1.0, Amylase / Lipase:/372, Differential-Neuts:86.5 %, Lymph:10.5 %, Mono:2.5 %, Eos:0.4 %, Lactic Acid:3.4 mmol/L, Albumin:2.5 g/dL, LDH:722 IU/L, Ca++:5.7 mg/dL, Mg++:1.9 mg/dL, PO4:2.5 mg/dL Assessment and Plan PANCREATITIS, ACUTE ALCOHOL WITHDRAWAL (INCLUDING DELIRIUM TREMENS, DTS, SEIZURES) ICU Care Nutrition: Glycemic Control: Lines: 22 Gauge - [**2141-5-23**] 01:00 AM 20 Gauge - [**2141-5-23**] 01:00 AM Prophylaxis: DVT: Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full code Disposition:
Physician
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Mrs [**Last Name (STitle) 12830**] is an 88 yr. old woman, who fell at home on [**1-14**]. she underwent hip surgery on [**1-16**]. pt. also broke her humerous and uses a sling when oob. Pt. is very HOH and hears best from her left ear. Pt. is alert and orientated. She was sent to [**Hospital3 **] for rehab. Today she was found to be hypoxic with sat in the 80 s. pt. also found to be diaph. Brought to the ed and 02 sats 88-89% on RA. Placed on NRB with o2 sats in high 90 Placed on np at 6L. sats 95-97%. Given nebs in the ed. Pt. very wheezy on adm. Lactate 1.6. cxr showed pneumonia and bil pleural effusions. Pt. denies sob. Given levoquin and vanco prior to transfer to the micu. Foley placed. u/a sent. Pt. never hypotensive. Pt. slightly tachy in low 100 Pain control (acute pain, chronic pain) Assessment: Pt with recent l femur fx and l humerus fx . had surgical orif l hip. Drsg [**Name5 (PTitle) **] [**Name5 (PTitle) **] hip d&i. l arm in splint. Denies pain when at rest and but with any repositioning of pt she does yell out in pain. Action: Physical therapy consulted and worked with pt at the bedside. Pt received Tylenol 1000mg po atc. Pt also medicated with 0.5 mg ivp morphine . repositioned from side to side. Response: Pt continues to experience pt with any movement of left extremities but pain free when left alone. Plan: Continue with Tylenol and prn morphine as needed for pain management . continue to support l hip and arm with any repositioning Diabetes Mellitus (DM), Type II Assessment: Pt with hx of t ype 2 dm and recently on metformin 500mg [**Hospital1 **]. Blood sugars elevated as high as 200 Action: Blood sugars cheked q 6 hrs as ordered ad treated with ssi as needed. Medicated x1 with 4 units humalog insulin at 1230. pt ordered for heart healthy diet but pt s dentures are at [**Hospital3 **] so will need family to pick them up when possible. Tolerating liqs and pill well but aspiration precautions maintained. Response: As above Plan: Follow blood sugars as ordered and tx with ssi as needed. Maintain aspiration precautions and advance diet when pt s dentures are available Respiratory failure, acute (not ARDS/[**Doctor Last Name 11**]) Assessment: Cxr concerning for bil pleural effusions and underlying infiltrate though pt without leukocytosis or fever. Pt initially covered for cap with vancomycin and levofloxacin but antibiotics d/c d today. Received pt on 70% face tent o2 but then changed TO 4L/M NC. L ungs essentially clear on auscultation but diminished at the bases. her resp distress aprrear predominantly due to mild chf . we suspect that her underlying physiology limited bu kyphosis and lg intrathoracic hiatal hernia may be contributing to her dyspnea though pt denies being sob. Pt diuresed overnoc with a total of 40 mg iv lasix none given today . rr in the high teens to low 20 s and o2 sats> 95% Action: Resp status monitored closely. Fluid balance monitored as well. Given nebs as ordered. Tte done at bedside Response: Pt needs less amt of o2 with adequate diuresis results of tte pending Plan: Antibiotics d/c d. continue to follw pt s resp status and fluid balance. Goal for i%o is to be neg 1-2 liters and if necessary will administer additional diuretics. Demographics Attending MD: [**Doctor Last Name 1111**] [**Location (un) **] Admit diagnosis: PNEUMONIA Code status: Height: Admission weight: 46.9 kg Daily weight: 47.6 kg Allergies/Reactions: No Known Drug Allergies Precautions: PMH: Diabetes - Oral [**Doctor Last Name 121**] CV-PMH: CHF Additional history: pt. is HOH. hx of diverticulosis hx of anxiety. , hx of dyslipdiemia. osteroporosis, hx of aortic insufficiency hx of benign cystic pancreatic lesion. hx of spinal stenosis s/p fx of left hip ( with surgery on [**1-14**]). also fx of left humerous on [**1-14**] (using sling). Surgery / Procedure and date: [**1-16**] open reduction with internal fixation of the left hip. Latest Vital Signs and I/O Non-invasive BP: S:108 D:67 Temperature: 97.3 Arterial BP: S: D: Respiratory rate: 20 insp/min Heart Rate: 92 bpm Heart rhythm: SR (Sinus Rhythm) O2 delivery device: Nasal cannula O2 saturation: 98% % O2 flow: 4 L/min FiO2 set: 70% % 24h total in: 550 mL 24h total out: 1,765 mL Pertinent Lab Results: Sodium: 135 mEq/L [**2187-1-23**] 03:03 AM Potassium: 4.0 mEq/L [**2187-1-23**] 03:03 AM Chloride: 98 mEq/L [**2187-1-23**] 03:03 AM CO2: 28 mEq/L [**2187-1-23**] 03:03 AM BUN: 41 mg/dL [**2187-1-23**] 03:03 AM Creatinine: 0.6 mg/dL [**2187-1-23**] 03:03 AM Glucose: 165 mg/dL [**2187-1-23**] 03:03 AM Hematocrit: 32.2 % [**2187-1-23**] 03:03 AM Finger Stick Glucose: 200 [**2187-1-23**] 12:00 PM Valuables / Signature Patient valuables: none Other valuables: Clothes: Sent home with: Wallet / Money: No money / wallet Cash / Credit cards sent home with: Jewelry: none Transferred from: [**Hospital Ward Name **] 409 Transferred to: 11 [**Hospital Ward Name **] Date & time of Transfer: [**2187-1-23**] 1600
Nursing
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TITLE: History of Present Illness - gave 2 units PRBC, IVF (750 cc) - held all antii-hypertensives - HR initially 110s atrial tachycardia, fell to 70s and sinus with fluids, alternating between these two rhythms with stable BP Medications Unchanged Physical Exam BP 90-112/53-82, HR 69-134, RR 13, O2 Sat 100% on 4L by NC Tmax C last 24 hours: 36.3 C Tmax F last 24 hours: 97.3 F T current C: 35.6 C T current F: [**Age over 90 **] F Previous day: Intake: 3,500 mL Output: 1,400 mL Fluid balance: 2,100 mL Today: Intake: 1,608 mL Output: 150 mL Fluid balance: 1,458 mL Gen: elderly woman lying in bed, appears uncomfortable HEENT: dry mucous membranes Neck: could not visualize neck veins Cardiac: tachycardic, irregular, no audible murmur Lungs: clear anteriorly Ext: DP and PT pulses dopplerable bilaterally, R femoral site without hematoma, bruit, or tenderness, L femoral site with ~8 cm diameter hematoma exapanded by ~1 cm since last marking 2 hours previously Neuro: A&O x 3 Skin: no rashes Labs 267 9.1 169 0.6 26 4.4 14 104 136 26.8 9.4 [image002.jpg] [**2155-2-26**] 11:20 PM WBC 9.4 Hgb 9.1 Hct (Serum) 26.8 Plt 267 INR 1.7 PTT 43.6 Na+ 136 K + (Serum) 4.4 Cl 104 HCO3 26 BUN 14 Creatinine 0.6 Glucose 169 ABG: / / / 26 / Values as of [**2155-2-26**] 11:20 PM Assessment and Plan HEMORRHAGE/HEMATOMA, PROCEDURE-RELATED (E.G., CATH, PACEMAKER, ICD BLEED) 77 year old woman with paroxysmal atrial fibrillation/flutter and atrial tachycardia admitted to the ccu after an ablation procedure for monitoring of a groin hematoma. . #. Hematoma: Iatrogenic after catheterization. Apparently still increasing in size. Hct has now fallen from 34.7 to 26.8, albeit with 5+ L crystalloid. No sign of arterial compromise or fistula. CT shows no extension intra- or retro-peritoneally. - 2 units pRBC - aggressive fluid resuscitation - serial Hct - maintain active clot - hold coumadin - hold sotalol, losartan, HCTZ . #. Atrial tachycardia: patient has a history of afib/flutter, and recently diagnosed atrial tachycardia. Now s/p ablation procedure and alternating between sinus and atrial tachycardia. Currently, she is hemodynamically stable and asymptomatic. - holding sotalol until acute bleeding stops - no anticoagulation for now; will restart after bleeding . #. Hypotension: Patient was hypotensive to SBP 90 after procedure, responded to IVF. Likely secondary to blood loss and general anesthesia with possible additional contribution from arrhythmia (although pt has apparently been hemodynamically stable while in and out of this rhythm for at least the past month.) - aggressive fluid resusucitation. - blood - hold antihypertensives . FEN: cardiac diet, replete lytes PRN ACCESS: PIV's PROPHYLAXIS: - CODE: full . DISPO: CCU . Contact: [**Name (NI) 160**] [**Name (NI) 5221**] (brother): [**Telephone/Fax (1) 5222**] (notified of ccu admission [**2-26**])
Physician
Classify the following medical document.
Admission Date: [**2128-3-19**] Discharge Date: [**2128-4-9**] Date of Birth: [**2050-6-4**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2597**] Chief Complaint: 77 y.o. male with two weeks of RLE claudication, Two days of RLE rest pain, with a feeling of colness in his RLE. Major Surgical or Invasive Procedure: RLE angiography Revision of right femoral to peroneal bypass graft using vein graft Angioplasty from left cephalic vein Exploration of distal GSV Cardiac Catherization with stenting of left main Intubation post op for resp failure PA catheter placed echocardiogram EF 35-40% History of Present Illness: 77 y.o. male with two weeks of RLE claudication, Two days of RLE rest pain, with a feeling of colness in his RLE. Pt has a hx of a fem - peroneal bypass graft [**Last Name (un) **] a vein graft. On [**8-19**] pt had a percutaneous revision of the graft site for stenosis. Pt re-evaluated for graft patency on [**11-19**]. The graft was found to patent at that time. Past Medical History: L AKA s/p failed LE bypass s/p R fem peroneal bypass HTN CAD Social History: Herbal therapies neg smoker, quit in past 15 yrs ago neg alcohol neg recreational drugs OTC meds - sinus allergy medicine, ES tylenol Family History: non contributory Physical Exam: AFVSS HEENT - NCAT, PERRL Neg lesions nares, oral pharnyx, auditory Supple, FAROM Neg lymphandopathy LUNGS - CTA B/L with sligtht crackles bases CARDIAC - RRR without murmers, Palpable PMI ABD - Soft, Pos BS, NTTP, neg Bruits, neg organomegaly, neg AAA NUERO - A/O x3 NAD EXT - LLE AKA / palpable femoral pulse RLE Slight edema noted Graft 2 plus Pertinent Results: [**2128-4-8**] 04:01AM BLOOD WBC-12.1* RBC-3.38* Hgb-9.5* Hct-29.5* MCV-87 MCH- [**2128-3-27**] 02:24AM URINE Color-Amber Appear-Clear Sp [**Last Name (un) **]-1.021 [**2128-3-19**] 06:00PM BLOOD Neuts-60.9 Lymphs-29.6 Monos-5.9 Eos-3.2 Baso-0.4 [**2128-4-8**] 04:01AM BLOOD Plt Ct-437 [**2128-4-8**] 04:01AM BLOOD Calcium-8.6 Phos-3.2 Mg-2.1 [**2128-4-3**] 03:19AM BLOOD freeCa-1.17 Brief Hospital Course: Pt had a difficult hospital stay Pt admitted on [**2128-3-19**] for a right leg ischemia Pt underwent the following procedures on [**2128-3-19**] 1. Thrombectomy of right femoral to peroneal artery in-situ saphenous vein graft. 2. Revision vein graft with vein patch angioplasty using left arm cephalic vein. 3. Harvest of upper arm extremity vein. After procedure pt admitted to PACU then VICU, early post up pt experienced EKG changes, specifically for ST depression V3-V5, had Brief runs NSVT and also complained of some chest pain. A cardiology consult was obtained. Pt R/I for NSTEMI. On [**2128-3-21**] Pt experienced with resp. failure. Pt was transferd to the SICU for observation. Later in the day pt condition became worse. Pt had to intubated and at this time pt recieved a R IJ CVL. A chest X-Ray showed resp. failure. Pt dalso experienced ARF secondary to hypotensive episode experienced with his NSTEMI. During this time pt was aggressively treated for both CHF and ARF, both which resolved during his stay in the SICU. On [**3-22**] pt underwent Cardiac catherization. The catherization showed: 1. Selective coronary angiography revealed a right-dominant system with left-main and 3-vessel coronary disease. 2. The LMCA had a hazy proximal 95% stenosis and a distal tapering 50% stenosis. 3. The LAD was diffusely diseased with serial proximal and mid-vessel 60% stenoses and an 80% long tubular stenosis in the distal vessel. 4. The LCx had severe diffuse disease and a 70% stenosis in the mid-vessel involving the origin of the OM1 branch. The RCA had severe diffuse disease up to 50-60% throughout with a focal 80% stenosis of the RPL branch. 5. Echo showed an ejection fraction of 35% with anterior hypokinesis. He is thus referred for cardiac catheterization for evaluation of coronary anatomy Cardiology decided to do an intervention which consisted: 1. Successful stenting of the ostial Left Main with a 3.5x13mm Cypher [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 7930**] with a 4.5x12mm Quantum MAverick at 16 atms. Pt remained intubated, tolerated the procedure and transfered back to the SICU in stable condition On [**3-25**] pt experienced new onset A-Fib. Pt was treated aggressively, the A-Fib has resolved. Pt extubated the same day. Pt remained in the SICU untill [**2128-4-1**]. During this time frame he was treated for the variety of ailments mentioned above. On 3 /18 pt transeferd back to the VICU in stable condition. Pt remianed in the VICU untill [**4-7**], then transfered to the floor. Pt screened by PT / Case management. Pt discharged from the hospital in stable condition. Medications on Admission: Captopril Atenolol Paxil Lipitor Colace Nueurontin Aprazolam Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 2. Captopril 12.5 mg Tablet Sig: 0.5 Tablet PO TID (3 times a day). 3. Lansoprazole 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 4. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 5. Clopidogrel Bisulfate 75 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily) for 30 days: after thirty days, decrease plavix to 75 mg for 9 months. 6. Gabapentin 100 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 7. Paroxetine HCl 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 8. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily) as needed. 9. Tamsulosin HCl 0.4 mg Capsule, Sust. Release 24HR Sig: One (1) Capsule, Sust. Release 24HR PO HS (at bedtime). 10. Atorvastatin Calcium 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Docusate Sodium 150 mg/15 mL Liquid Sig: One (1) PO BID (2 times a day). 12. Amlodipine Besylate 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q6H (every 6 hours) as needed. 14. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 15. Clonidine HCl 0.2 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 16. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical DAILY (Daily) as needed. 17. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 18. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**1-18**] Drops Ophthalmic PRN (as needed). Discharge Disposition: Extended Care Facility: Life Care Center of [**Location (un) 5165**] Discharge Diagnosis: Occluded Right femoral peroneal graft, had revision to correct Respiratory failure p/o requiring intubation Non Specific Ventricular Tachycardia - R/I for MI - requiring left main stent Afib post op, now RRR Acute Renal Failure post op EF 35-40% HTN Hypercholesteralemia LAKA Failed Left LE bypass Known L CIA/EIA occlusion CAD LBP S?P laminectomy Discharge Condition: stable Discharge Instructions: Check for fevers and chills - if have evaluate Look at surgical wounds - if drainage, erythematous or swelling please call Dr [**Last Name (STitle) 22423**] office F/U cardiology as directed F/U Dr [**Last Name (STitle) **] as directed below Per PT OOB with asst [**Hospital1 **] Ambulate pt PRN Followup Instructions: Follow up with Cardiology in 12 weeks from the date of stent [**2128-3-23**] Please call [**Telephone/Fax (1) 22424**] Follow up with Dr [**Last Name (STitle) **] in two weeks, please call [**Telephone/Fax (1) 22425**] Completed by:[**2128-4-9**]
Discharge summary
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[**2151-2-2**] 2:32 PM ABDOMINAL AORTA Clip # [**Clip Number (Radiology) 56800**] Reason: SMA aneurysm identified in the CT angio of abdomen.For coil Contrast: OPTIRAY Amt: 55 ********************************* CPT Codes ******************************** * [**Numeric Identifier 39**] EMBO NON NEURO -59 DISTINCT PROCEDURAL SERVICE * * [**Numeric Identifier 2871**] INITAL 2ND ORDER ABD/PEL/LOWER -59 DISTINCT PROCEDURAL SERVICE * * [**Numeric Identifier 43**] TRANCATHETER EMBOLIZATION -59 DISTINCT PROCEDURAL SERVICE * * [**Numeric Identifier 822**] F/U STATUS INFUSION/EMBO -59 DISTINCT PROCEDURAL SERVICE * * [**Numeric Identifier 1044**] VISERAL SEL/SUPERSEL A-GRAM -59 DISTINCT PROCEDURAL SERVICE * * [**Numeric Identifier 55610**] IV CONSCIOUTIOUS SEDATION PRO -59 DISTINCT PROCEDURAL SERVICE * **************************************************************************** ______________________________________________________________________________ [**Hospital 2**] MEDICAL CONDITION: 54 year old man with REASON FOR THIS EXAMINATION: SMA aneurysm identified in the CT angio of abdomen.For coil embolization. ______________________________________________________________________________ FINAL REPORT INDICATION: A 54-YEAR-OLD MALE WITH PSEUDOANEURYSM ADJACENT TO THE SUPERIOR MESENTERIC ARTERY SEEN ON CONTRAST CT SCAN. PLEASE EMBOLIZE. RADIOLOGISTS: ATTENDING RADIOLOGIST: Dr. [**First Name (STitle) 34437**] [**Name (STitle) 34432**]. INTERVENTIONAL RADIOLOGY FELLOW: Dr. [**First Name (STitle) 35591**] [**Name (STitle) **]. TECHNIQUE: Informed consent was obtained prior to the procedure. Dr. [**Last Name (STitle) 34432**] was present for the entirety of the procedure. The right common femoral artery was accessed using a micropuncture access system and a 5 Fr. vascular sheath was placed into the common femoral artery. The SMA was catheterized with a 5 FR Cobra glide catheter and a superior mesenteric angiogram was performed. The catheter was withdrawn into the ostium of the superior mesenteric artery, and another superior mesenteric artery angiogram was performed. A .035 angled Glidewire was used to place the catheter into the pseudoaneurysm under fluoroscopic guidance. Multiple macro coils were placed under fluoroscopic observation including 10 mm x 5 cm coils, and 10 mm x 8 cm coils. Subsequently, due to residual flow in the pseudoaneursym, 1500 units of thrombin mixed with saline and contrast were injected slowly under fluoroscopic control into the pseudoaneurysm while the catheter was pulled back from the apex of the aneurysm to the neck of the aneurysm very slowly. When the catheter tip was in the SMA, it was aspirated. The catheter was positioned again in the origin of the superior mesenteric artery and a superior mesenteric artery angiogram was performed. The sheath and catheter were removed and manual pressure applied at the right groin though hemostasis was achieved. Sterile dressing was applied. MEDICATIONS: Local anesthesia consist of 1% Lidocaine. Under continuous monitoring, small divided doses of Fentanyl totaling 200 mcg was administered. COMPLICATIONS: No complications were evident. (Over) [**2151-2-2**] 2:32 PM ABDOMINAL AORTA Clip # [**Clip Number (Radiology) 56800**] Reason: SMA aneurysm identified in the CT angio of abdomen.For coil Contrast: OPTIRAY Amt: 55 ______________________________________________________________________________ FINAL REPORT (Cont) FINDINGS: Superior mesenteric artery angiogram with the tip of the catheter approximately 3 cm from the origin demonstrate a normal superior mesenteric angiogram. However, when the catheter was retracted to the origin of the superior mesenteric artery, an angiogram performed, an approximately 3 x 2 cm pseudoaneurysm was seen arising from the proximal superior mesenteric artery just to the right side of the origin. Post procedure angiogram after embolization and thrombin injection demonstrated no flow within the pseudoaneurysm and patent SMA. IMPRESSION: 1. Successful coil and thrombin embolization of superior mesenteric artery pseudoaneurysm.
Radiology
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[**2166-11-17**] 12:54 PM BILIARY CATH CHECK Clip # [**Clip Number (Radiology) 46741**] Reason: r/o biliary obstruction Admitting Diagnosis: ABDOMINAL AORTIC ANEURYSM Contrast: OPTIRAY Amt: 20 ********************************* CPT Codes ******************************** * [**Numeric Identifier 6610**] CHALNAGIOGRAPHY VIA EXISTING C -78 RELATED PROCEDURE DURING POSTOPE * * [**Numeric Identifier 6611**] TUBE CHOLANGIOGRAM * **************************************************************************** ______________________________________________________________________________ [**Hospital 2**] MEDICAL CONDITION: 70 year old man s/p PTC placement with rising bilirubins REASON FOR THIS EXAMINATION: r/o biliary obstruction ______________________________________________________________________________ PROVISIONAL FINDINGS IMPRESSION (PFI): ARHb MON [**2166-11-17**] 5:39 PM Percutaneous biliary drain well positioned and patent. ______________________________________________________________________________ FINAL REPORT INDICATION: 70-year-old male with pancreatic head mass and biliary obstruction, status post right percutaneous biliary drain placed on [**2166-10-24**]. Now has rising bilirubin, evaluate for biliary obstruction. COMPARISON: PTBD, [**2166-10-24**]. RADIOLOGISTS: Drs. [**Last Name (STitle) 517**] and [**Name5 (PTitle) 65**] performed the procedure. Dr. [**Last Name (STitle) 65**], attending radiologist, was present throughout the procedure. PROCEDURE/FINDINGS: After the risks, benefits, and alternatives of the procedure were explained to the patient, written informed consent was obtained. The patient was brought to the angiography suite and placed supine on the angiographic table. A timeout and huddle were performed to confirm patient identity and the procedure being performed. The indwelling right percutaneous biliary drain was prepped and draped in standard sterile fashion. A single supine scout view of the abdomen demonstrates a biliary drain to be well positioned, with the pigtail in the duodenum with multiple scattered surgical abdominal clips again identified. Contrast was slowly hand injected through the percutaneous biliary drain under constant fluoroscopic guidance. This demonstrated patency of the biliary drain without evidence for dilatation of the extra-hepatic ducts. [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 89**] and Glidewire were advanced through the catheter to confirm patency. The patient tolerated the procedure well, and there were no immediate complications. IMPRESSION: Percutaneous biliary drain well positioned and patent. (Over) [**2166-11-17**] 12:54 PM BILIARY CATH CHECK Clip # [**Clip Number (Radiology) 46741**] Reason: r/o biliary obstruction Admitting Diagnosis: ABDOMINAL AORTIC ANEURYSM Contrast: OPTIRAY Amt: 20 ______________________________________________________________________________ FINAL REPORT (Cont)
Radiology
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24 Hour Events: 79y F presenting with large L frontal and occipital intraparenchymal hemorrhage No major events overnight Allergies: No Known Drug Allergies Last dose of Antibiotics: Ciprofloxacin - [**2148-12-8**] 02:23 AM Vancomycin - [**2148-12-9**] 08:38 AM Infusions: Other ICU medications: Famotidine (Pepcid) - [**2148-12-9**] 07:28 PM Heparin Sodium (Prophylaxis) - [**2148-12-9**] 10:13 PM Other medications: Flowsheet Data as of [**2148-12-10**] 07:07 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since 12 AM Tmax: 38.1 C (100.5 Tcurrent: 37.1 C (98.7 HR: 80 (77 - 105) bpm BP: 126/92(96) {113/51(70) - 156/92(96)} mmHg RR: 12 (12 - 20) insp/min SpO2: 98% Heart rhythm: SR (Sinus Rhythm) Wgt (current): 65.2 kg (admission): 60 kg Height: 63 Inch Total In: 1,572 mL 440 mL PO: TF: 1,200 mL 354 mL IVF: 372 mL 85 mL Blood products: Total out: 1,975 mL 585 mL Urine: 1,975 mL 585 mL NG: Stool: Drains: Balance: -403 mL -145 mL Respiratory support O2 Delivery Device: Endotracheal tube Ventilator mode: CPAP/PSV Vt (Spontaneous): 476 (332 - 476) mL PS : 8 cmH2O RR (Spontaneous): 12 PEEP: 5 cmH2O FiO2: 40% RSBI: 45 PIP: 13 cmH2O SpO2: 98% ABG: ///30/ Ve: 4.6 L/min Physical Examination General Appearance: sedated, intubated Eyes / Conjunctiva: anicosocoria at baseline Head, Ears, Nose, Throat: Endotracheal tube, OG tube Peripheral Vascular: (Right radial pulse: Not assessed), (Left radial pulse: Not assessed), (Right DP pulse: Not assessed), (Left DP pulse: Not assessed) Respiratory / Chest: (Expansion: Symmetric), (Breath Sounds: Clear : , Diminished: at bases) Abdominal: Soft Extremities: Right lower extremity edema: Trace, Left lower extremity edema: Trace Skin: Not assessed Neurologic: Responds to: Not assessed, Movement: Not assessed, Sedated, Tone: Not assessed Labs / Radiology 313 K/uL 8.9 g/dL 127 mg/dL 0.5 mg/dL 30 mEq/L 4.0 mEq/L 19 mg/dL 103 mEq/L 140 mEq/L 27.5 % 9.4 K/uL [image002.jpg] [**2148-12-5**] 01:30 PM [**2148-12-5**] 07:26 PM [**2148-12-6**] 04:11 AM [**2148-12-6**] 04:01 PM [**2148-12-7**] 01:12 AM [**2148-12-7**] 02:17 PM [**2148-12-8**] 02:15 AM [**2148-12-8**] 02:07 PM [**2148-12-9**] 01:58 AM [**2148-12-10**] 03:17 AM WBC 11.6 8.7 8.1 8.3 9.4 Hct 27.2 26.8 27.1 27.3 27.5 Plt 152 184 185 236 313 Cr 0.5 0.5 0.5 0.5 0.5 0.4 0.4 0.4 0.4 0.5 Glucose 156 148 147 133 132 136 129 136 130 127 Other labs: PT / PTT / INR:11.3/24.2/0.9, Lactic Acid:0.9 mmol/L, Ca++:7.9 mg/dL, Mg++:1.9 mg/dL, PO4:3.5 mg/dL Assessment and Plan INTRACEREBRAL HEMORRHAGE (ICH) 79y F presenting with large L frontal and occipital intraparenchymal hemorrhage Neurologic: L Frontal/occipital IPH with poor prognosis for neurological recovery. On Propofol for sedation. Prn fentanyl. Not following commands. Moving bilat LE and LUE, withdraws to noxious stimuli. -weaning down on keppra Cardiovascular: Goal sbp 120-160. Prn hydralazine/lopressor. Autoregulating. Pulmonary: Intubated for airway protection. On CPAP/PS. Gastrointestinal/Abdomen: Full bowel regimen. PEG if family elects to continue care. Nutrition: NPO. TF at goal via OGT Renal: Foley in place. Auto-diuresing. UTI on UA , on vanc for enterococci and cont fever, await sensitivities. Hematology: Stable. Endocrine: RISS. Goal SBP < 150 ID: Enterococci UTI on vancomycin follow up sensitivities for abx. Lines / Tubes / Drains: PIV, foley, ETT, left subclavian TLC. Wounds: none Fluids: kvo Consults: neurosurg, neuro Communication: Family meeting on monday [**12-9**] - family requests another meeting for wed [**12-11**], this time with palliative care team present. Billing Diagnosis: IPH DVT: boots, HSQ Stress ulcer: h2b VAP bundle: + ICU Care Nutrition: Replete with Fiber (Full) - [**2148-12-10**] 05:59 AM 50 mL/hour Glycemic Control: Lines: Multi Lumen - [**2148-12-3**] 01:43 PM Code status: DNR Disposition:SICU Total time spent: 30 min
Physician
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Admission Date: [**2131-3-21**] Discharge Date: [**2131-4-12**] Date of Birth: [**2082-11-8**] Sex: F Service: PLASTIC Allergies: Sulfa(Sulfonamide Antibiotics) Attending:[**First Name3 (LF) 36263**] Chief Complaint: left thigh infection Major Surgical or Invasive Procedure: [**2131-3-21**] Debridement of left thigh necrotizing soft tissue infection. . [**2131-3-22**]: Incision and debridement 25 x 40 cm left thigh full-thickness skin, fat, fascia. Excision of the Sartorius muscle. . [**2131-3-24**]: 1. Incision and drainage of wound and change of wound V.A.C. of medial thigh. 2. Incision and drainage of the left lateral thigh. . [**2131-3-27**] Incision and drainage of necrotizing fasciitis with vacuum-assisted closure change, wound surface area 375 cm2 . [**2131-3-30**] Incision and drainage of necrotizing fasciitis and application of VAC dressing . [**2131-4-2**] 1. Irrigation and debridement of the skin, subcutaneous tissue of right groin (20 x 20 cm). 2. Delayed primary closure of left lateral thigh wound (10cm). 3. Application of a vacuum-assisted closure dressing (20 x 20 cm). . [**2131-4-5**] Split-thickness skin reconstruction of left groin (30x16cm) History of Present Illness: 48F with 4 days of left thigh erythema, induration, pain. Presented to [**Hospital3 **] 2 days prior. L thigh was observed, found to be getting worse. Was evaluated by surgery there (Dr [**Last Name (STitle) 110791**] who felt an emergent debridement was necessary but felt it should be done at a tertiary care center so transfer to the [**Hospital1 18**] MICU was arranged. On transport, she was hypotensive requiring a single pressor. On arrival, she was hemodynamically stable and quite fluid responsive and pressors were no longer needed. She was awake and alert on arrival, though confused about whether her leg has worsened or improved the past 48 hours. She has no other symptoms, just L thigh/hip pain. Past Medical History: PMH: hypertension tobacco abuse obesity alcohol abuse dyslipidemia hypothyroidism depression IBS . PSH: C-section Social History: - Tobacco: [**3-22**] cig/ day - Alcohol: daily, 4 drinks daily, last drink was on [**3-19**] - Illicits: patient denies Family History: non-contributory Physical Exam: Admission Exam (upon arrival/evaluation in MICU) Vitals: T 100.4 P 104 BP 98/46 RR 20 O2 98% 2L GEN: A&O, NAD, anxious HEENT: No scleral icterus, mucus membranes moist CV: RRR, No M/G/R PULM: Clear to auscultation b/l, No W/R/R ABD: Soft, obese, nondistended, nontender, no rebound or guarding, normoactive bowel sounds, no palpable masses Ext: right lower extremity normal. Left foot/leg normal with good pulses and normal sensation. L thigh with significant circumferential erythema. blistering on anteromedial proximal thigh. indurated primarily on lateral portion. moderate pain with flexing knee and hip joint. Pertinent Results: OSH: Na 133, K 3.6, CO2 15, BUN 323, Cr 1.7, Gluocse 187, WBC 17, Hgb 11, Hematocrit 31, Plt 185, Band 22, Bcx [**2131-3-19**]: no growth. Troponin 0.01, CK 105, 78, 91. Cortisol 31, AST 27, ALT 24. [**2131-3-21**] [**Hospital1 18**] Labs - CBC - 15.2 > 30.6 < 189 N:98 Band:0 L:1 M:1 E:0 Bas:0 137 112 34 ----------------< 161 3.4 14 1.4 Ca: 5.6 Mg: 1.3 P: 2.7 AST: 20 ALT: 27 AP: 84 Tbili: 0.7 Alb: 2.0 Vanco: <1.7 PT: 16.1 PTT: 29.6 INR: 1.5 Fibrinogen: 731 UA: mod positive . [**2131-4-3**] Creat-2.2* [**2131-4-9**] Creat-1.3* . IMAGING: CT LOW EXT W/O C BILAT [**2131-3-21**] IMPRESSION: Extensive changes of cellulitis and subcutaneous edema. No specific features to suggest necrotizing fasciitis such as soft tissue gas. . TTE (Portable) [**2131-3-22**] The left atrium is normal in size. Left ventricular wall thicknesses and cavity size are normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is mildly depressed (LVEF= 40-50%). The number of aortic valve leaflets cannot be determined. No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. Moderate [2+] tricuspid regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is an anterior space which most likely represents a prominent fat pad. IMPRESSION: Suboptimal image quality due to body habitus. Mild global LV systolic dysfunction. Moderate TR with normal PASP. RV function is difficult to evaluate on this study . Radiology Report RENAL U.S. Study Date of [**2131-4-4**] 8:43 AM IMPRESSION: 1. No hydronephrosis. 2. Difficult imaging of the left kidney with apparent greater than 3-cm size discrepancy. Correlate for details of prior medical history/reflux. . MICROBIOLOGY: [**2131-3-21**] 6:52 pm SWAB LEFT INNER THIGH. **FINAL REPORT [**2131-3-23**]** GRAM STAIN (Final [**2131-3-21**]): NO POLYMORPHONUCLEAR LEUKOCYTES SEEN. 3+ (5-10 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS AND IN SHORT CHAINS. WOUND CULTURE (Final [**2131-3-23**]): BETA STREPTOCOCCUS GROUP A. SPARSE GROWTH. Brief Hospital Course: [**Known firstname **] [**Known lastname 110792**] is a 48F which was transferred from [**Hospital3 **] after a left thigh was evaluated by surgery there (Dr. [**Last Name (STitle) 110791**] and felt an emergent debridement was necessary. Surgery was consulted upon arrival to the MICU. At that time she had an obvious severe left thigh infection. After obtaining an operative-planning CT scan, she was immediately taken to the operating room for debridement. Please see the operative report from [**3-21**] for further details. Patient had a large amount of necrotic tissue in the anterior and medial areas of her left thigh, not extending to the knee or up above the inguinal ligament. She was transferred to the ICU post-op and left intubated given her profound sepsis, tachypnea, and planned return to the operating room for further debridement the following day. Patient returned to the OR on 5 more occassions for further debridement and vac changes (see op note for [**3-22**], [**3-24**], [**3-30**], 4,16) and then finally for skin graft to her left thigh wound defect on [**2131-4-5**] with Plastic Surgery. . Her further course is outlined below by organ system: Neurologic: She was given intermittent Dilaudid IV for pain control, then was transferred to PO pain meds when tolerating diet. She was begun on Seroquel for agitation and delerium HD 3. She had been placed on a CIWA scale for concern for alcohol withdrawal but did not require significant doses of Ativan. Patient had occassional episodes of anxiety, relieved with redirection and treated with Ativan. . Cardiovascular: She was initially showing signs of hemodynamic instability but by HD 2 she had been weaned off pressors. She had an episode of chest pain HD 4 but EKG and enzymes showed no myocardial change. Her hematocrit decreased from baseline of 29 to 21 which was attributed to the repeated surgical explorations and she received 2 units RBCs on HD13 with adequate increase in hematocrit and again 2 units in HD 18. . Pulmonary: She has baseline OSA which was treated with CPAP at night. Narcotics were minimized when possible to sustain her respiratory drive. . Gastrointestinal: She was maintained on famotidine IV while intubated, then transitioned to oral Zantac for stress ulcer prophylaxis. . Nutrition: She was advanced to a regular diet [**3-25**] which she tolerated well. . Renal: She initially had acute kidney injury from sepsis, but that had resolved by HD 4. Patient had increased Cr again on HD17 and at first it was attribute to AIN from a betalactam as patient had +eos in urine and a morbilliform rash. The antibiotics were discontinued and patient Cr remained elevated. A Renal consult was placed and it was thought the [**Last Name (un) **] was secondary to a low flow state given fluid losses. Renal recommended Calcium Acetate 667 mg PO/NG TID. A foley catheter was used to monitor urine output until HD 13. Patient voided without difficulty. Foley was replaced on HD17 after grafting, given location of injury and concern for contamination of wound. Patient's foley was discontinued on HD21 after VAC dressing was removed and patient was able to get out of bed to use commode safely. Cr was monitored and by the time of discharge, patient's creatinine continued to recover and was 1.3. . Endocrine: Her blood sugar was controlled by an insulin sliding scale and she was maintained on her thyroid medication through an IV equivalent until tolerating POs. . Infectious Disease: She presented in septic shock from left thigh cellulitis. She was treated with broad spectrum antibiosis: Vanc, Clinda, Zosyn ([**Date range (1) 19644**]) then transitioned to Augmentin for 2 days. Her wound cultures from the first debridement showed Group A streptococcus. The antibiotics were then discontinued as the primary surgical team felt the debridement had been completed. Patient's blood cultures and urine cultures remained negative. . Patient was discharged to rehab facility on hospital day 23. The patient was doing well, afebrile with stable vital signs, tolerating a regular diet, voiding without assistance, and pain was well controlled. Medications on Admission: Synthroid 175mcg daily Diovan 360mg daily HCTZ 12.5mg daily Prozac 60 mg daily Discharge Medications: 1. heparin (porcine) 5,000 unit/mL Solution Sig: One (1) injection Injection TID (3 times a day). 2. diazepam 10 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for anxiety. 3. levothyroxine 175 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. 5. oxycodone 5 mg Tablet Sig: 2-3 Tablets PO Q3H (every 3 hours) as needed for pain. 6. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation. 8. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO Q6H (every 6 hours) as needed for constipation. 9. bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 10. cetirizine 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 12. camphor-menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical QID (4 times a day) as needed for pruritis. 13. nystatin 100,000 unit/g Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 14. diphenhydramine HCl 25 mg Capsule Sig: [**12-18**] Capsules PO Q6H (every 6 hours) as needed for pruritus. 15. Prozac 20 mg Capsule Sig: Three (3) Capsule PO DAILY (Daily). 16. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day): Hold for SBP < 110 or HR< 60 . 17. calcium acetate 667 mg Capsule Sig: One (1) Capsule PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 18. ranitidine HCl 150 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 19. ferrous sulfate 300 mg (60 mg iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 20. cyanocobalamin (vitamin B-12) 100 mcg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 21. Augmentin 875-125 mg Tablet Sig: One (1) Tablet PO twice a day. Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: 1. Necrotizing fasciitis of the left thigh 2. Septic shock 3. Acute renal insufficiency Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hospital with necrotizing fasciitis of your left thigh. You were taken to the operating room multiple times to have the area of infection debrided. The wound defect was then covered with a skin graft. Please follow these discharge instructions. . Followup Instructions: -You should continue taking your current medications. -If the area of your skin graft in your left groin/thigh area begins to worsen after discharge with an acute increase in swelling or pain or redness, please call Dr.[**Name (NI) 2989**] office at ([**Telephone/Fax (1) 36264**] - You should keep your right thigh donor site open to air and leave the yellow xeroform dressing in place to dry out. Do not get this area wet. - Your left groin/thigh skin graft and repair sites will be dressed with a xeroform dressing to graft areas, fluffed gauzes covered with kerlix and then ace wrap. - Continue on oral antibiotics until you are seen in [**Hospital 702**] clinic by Dr. [**First Name (STitle) 1022**] Followup Instructions: Please follow up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1022**]. Please call his office to schedule a follow up appointment in 1 week: ([**Telephone/Fax (1) 36264**]. . Please follow up with your PCP to review the details of your hospitalization. You were treated for necrotizing fasciitis (beta streptococcus group A), septic shock and acute renal insufficiency). You have completed your course of antibiotic therapy and your creatinine is normalizing. You should have a set of repeat electrolytes drawn at your PCP appointment to be sure your kidney function continues to improve. . You should also schedule a follow up appointment with Nephrology in [**12-18**] months after this hospitalization. Call for an appointment: ([**Telephone/Fax (1) 10135**] Completed by:[**2131-4-12**]
Discharge summary
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TITLE: Chief Complaint: 24 Hour Events: - three way foley placed for continuous bladder irrigation. Some clots came out, was pink tinged, then completely clear. - CT scan, got versed with it; somnolent afterwards; also got zyprexa yesterday am - Neuro feels large posterior infarct may be in last day or so; OK to restart heparin gtt if we really feel necessary - Delirium, waxing and [**Doctor Last Name 533**] mental status - UA sent --> positive -- starting ceftriaxone - had a few beats of NSVT, frequent ectopy - 17:40 wanted to have restraints taken off, became agitated ; given zyprexa-zydis 5mg x2; drawing lytes/cr b/c of decreased urine output - does not appear to have Left side neglect - holding heparin gtt ; started subq heparin - EKG showed worsening TWIs similar to EKG when he first presented, but cardiac enzymes showed CK [**Last Name (LF) 13334**], [**First Name3 (LF) **] did not restart heparin gtt ; redraw cardiac enzymes at midnight (added on to AM labs b/c difficult stick) - considered PE b/c of tachycardia and hypoxemia but EKG and Echo (from [**2-19**]) showed no signs of RH strain - gave 10mg IV lasix for hypoxia (to which he had responded very well in ED) ; put out about 400cc of urine Allergies: No Known Drug Allergies Last dose of Antibiotics: Ceftriaxone - [**2179-2-21**] 09:15 PM Infusions: Other ICU medications: Heparin Sodium (Prophylaxis) - [**2179-2-21**] 10:00 PM Furosemide (Lasix) - [**2179-2-21**] 10:00 PM Lorazepam (Ativan) - [**2179-2-22**] 06:30 AM Other medications: Changes to medical and family history: Review of systems is unchanged from admission except as noted below Review of systems: Flowsheet Data as of [**2179-2-22**] 06:54 AM Vital signs Hemodynamic monitoring Fluid balance 24 hours Since [**81**] AM Tmax: 38.2 C (100.7 Tcurrent: 37 C (98.6 HR: 115 (91 - 120) bpm BP: 137/84(94) {109/60(72) - 151/117(121)} mmHg RR: 30 (14 - 33) insp/min SpO2: 94% Heart rhythm: ST (Sinus Tachycardia) Total In: 1,100 mL 97 mL PO: 350 mL 30 mL TF: IVF: 750 mL 67 mL Blood products: Total out: 0 mL 420 mL Urine: 420 mL NG: Stool: Drains: Balance: 1,100 mL -323 mL Respiratory support O2 Delivery Device: Face tent SpO2: 94% ABG: ///27/ Physical Examination Gen: HEENT: Chest: Abd: Ext: Skin: Neuro: Labs / Radiology Head CT [**2179-2-21**] Large hypodensity in the right occipital lobe, of undetermined age, could be of subacute nature. Periventricular white matter densities, likely due to chronic small vessel ischemic changes. No acute hemorrhage. Please note that CT is not sensitive for acute ischemia, and if there is clinical concern, MRI can be done. 181 K/uL 10.5 g/dL 158 mg/dL 1.9 mg/dL 27 mEq/L 3.9 mEq/L 24 mg/dL 109 mEq/L 144 mEq/L 31.8 % 12.4 K/uL [image002.jpg] [**2179-2-20**] 09:13 PM [**2179-2-21**] 06:38 AM [**2179-2-21**] 05:57 PM [**2179-2-22**] 02:45 AM WBC 15.4 12.4 Hct 37.3 31.8 Plt 243 181 Cr 1.8 1.7 1.9 TropT 8.29 4.94 2.54 2.61 Glucose 156 158 Other labs: PT / PTT / INR:12.9/29.4/1.1, CK / CKMB / Troponin-T:357/10/2.61, ALT / AST:51/178, Alk Phos / T Bili:98/, Ca++:8.9 mg/dL, Mg++:2.1 mg/dL, PO4:2.3 mg/dL Microbiology: urine Eosinophils Negative Assessment and Plan 72 year old man with HTN, HL, DM, CKD, non-verbal from schitzophrenia and mental retardation presenting with NSTEMI and hyperglycemia. # Subacute Stroke: Large hypodense area on CT in Right occipital lobe. Neurology consulted and prefers not to use heparin gtt though states that it is OK if absolutely necessary for ACS. Patient appears to have some visual defects in Left eye; does not appear to have left-sided hemineglect. Neuro exam limited due to patient s schizophrenia and difficulty participating in exam. - Repeat Head CT if neuro exam changes - Holding heparin gtt for now # NSTEMI: EKG and cardiac enzymes consitent with NSTEMI on presentation. Difficult to assess patient in terms of pain, so checked EKG last night which showed larger T wave inversions, similar to on presentation; concern for restarting heparin gtt for coronary reperfusion, medical management of NSTEMI. Cardiac enzymes trending down, so heparin gtt not restarted. He is not consentable for cardiac catheterization, but presumably full code. He does not appear to have signs of cardiogenic shock, but will be gentle with beta-blockade for concern of worsening heart failure. Social work involved and found guardian s phone number; message left for guardian by social worker and CCU team. - continue ASA, plavix, statin, ACE - low-dose beta-blocker for HR goal < 90 - make all attempts to reach guardian again today - appreciate social work help in contacting guardian - appreciate ethics recommendations # HYPOXEMIA: [**Month (only) 51**] be secondary to fluid overload from MI. Less likely to have PE b/c no signs of RH strain on EKG or Echo. Attempted diuresis with lasix overnight, responded moderately well w urine output; difficult to assess whether oxygenation improved because he was on more O2 than required. Oxygenation worsens with agitation. - repeat cxr if not improving # HYPERTENSION: Weaned of nitroglycerin gtt yesterday and BPs stable on valsartan and beta blocker. - continue valsartan - beta blocker # UTI: Not using ciprofloxacin b/c getting antipsychotics as well which could prolong QT. - started Ceftriaxone last night # HYPERGLYCEMIA: Likely precipitated by NSTEMI and UTI on top of diabetes. - F/U HbA1c. - restart home regimen and start insulin gtt if not controlled - hold sulfonurea #Distended bowel on CXR: continue to follow clinically. #Hematuria continue continuous bladder irrigation. # SCHIZOPHRENIA: Unclear if home zyprexa dose is accurate. Will continue to try to confirm information; PCP will be in office today. - zyprexa 5mg daily for now # CHRONIC RENAL INSUFFICIENCY: at baseline Cr 1.8-2.0 ICU Care Nutrition: Glycemic Control: Lines: 20 Gauge - [**2179-2-20**] 05:45 PM Prophylaxis: DVT: subq heparin Stress ulcer: VAP: Comments: Communication: Comments: Code status: Full (Presumed) Disposition: CCU
Physician