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Admission Date : [ * * 2117 - 9 - 11 * * ] Discharge Date : [ * * 2117 - 9 - 17 * * ] Date Birth : [ * * 2082 - 3 - 21 * * ] sex : F Service : MEDICINE allergy : Levaquin attending:[**first Name3 ( LF ) 2195 * * ] Chief Complaint : nausea , vomit Major Surgical Invasive Procedure : none history Present Illness : 35f w/ poorly control Type 1 diabetes mellitus w/ neuropathy , nephropathy , HTN , gastroparesis , CKD retinopathy , recently hospitalize orthostatic hypotension [ * * 2 - 3 * * ] autonomic neuropathy [ * * Date range ( 1 ) 25088 * * ] ; dka hospitalization [ * * 6 - 12 * * ] [ * * 7 - 12 * * ] , return w/ 5d history worsen nausea , vomit coffee - ground emesis , chill , dyspnea exertion . last week fall hit right face . also 1 day diarrhea , resolve early last week . find DKA AG 30 bicarb 11 . . ED inital vital 09:00 0 98.2 113 181/99 22 100 % RA . K 4.7 , HCO3 11 , Anion Gap 30 , Cr . 2.7 ( baseline 1.6 - 2.0 ) 3rd L NS . insulin srip 5 unit / hr . home 22 levemir 12 difficult control sugar . bp high . give 30 mtroprolol tartrate ED . start insulin drip 5 unit / hr 3L NS bolus . also aspirin 325 mg PO Morphine 4 mg ivx1 pain . CXr clear . EKG NAD . . Review system : otherwise negative . Past Medical history : type 1 diabetes mellitis w/ neuropathy , nephropathy , retinopathy - 2 episode dka [ * * 6 - 12 * * ] [ * * 7 - 12 * * ] HTN - 5 year gastroparesis - 1.5 year ckd - stage III , baseline Cr 2.4 - 2.5 , proteinuria L1 vertebral fracture - [ * * 2117 - 7 - 17 * * ] Systolic ejection murmur Social History : Patient live home [ * * Location ( un ) * * ] 8 / daughter boyfriend . history EtOH , tobacco , illicit drug use . currently unemployed seek disability . Family history : parent HTN T2DM . Grandfather mi 40 . Physical Exam : GEN : awake , alert , orient HEENT : PERRLA . MMM . JVD . neck supple . cervical LAD card : RRR , S1 / S2 normal . II / VI systolic ejection murmur hear good L upper sternal border . Pulm : ctabl crackle wheeze . Abd : BS+ , soft , NT , rebound / guarding , HSM , [ * * Doctor Last Name 515 * * ] sign extremity : wwp , edema . radial , dp , PTs 2 + . skin : rash bruising . skin tenting . Neuro : cns II - XII intact . upper extremity : Power [ * * 5 - 6 * * ] bilaterally . le : leave power : 4.5/5 right : power [ * * 3 - 6 * * ] . bilateral symmetric , reduced sensation distal LE ankle . pertinent result : Admission Labs : [ * * 2117 - 9 - 11 * * ] 09:22AM WBC-11.9 * RBC-4.58 HGB-13.0 HCT-36.5 MCV-80 * PLT count-466 * lipase-22 ALT(SGPT)-10 AST(SGOT)-16 ALK PHOS-105 TOT BILI-0.5 GLUCOSE-260 * UREA N-48 * CREAT-2.7 * SODIUM-137 POTASSIUM-4.9 CL-101 CO2 - 11 * LACTATE-1.9 Discharge Labs : [ * * 2117 - 9 - 16 * * ] 07:10am wbc-6.8 rbc-3.67 * Hgb-10.4 * hct-30.2 * MCV-82 Plt ct-298 Glucose-118 * UreaN-20 creat-2.3 * Na-137 K-3.7 cl-104 HCO3 - 23 angap-14 calcium-8.7 Phos-3.5 Mg-2.0 radiology : CXR : evidence pneumonia pathological abnormality . pleural effusion . pulmonary edema . normal size cardiac silhouette . microbiology : Urine culture negative , blood culture growth date , stool C.difficile negative Brief Hospital Course : 35 yo F HTN & poorly control type DM , c / b neuropathy , gastroparesis , nephropathy ? ? ? ? ? ? CKD , retinopathy present DKA hypertension SBP 200s . . # diabetic ketoacidosis : patient control diabete home Humalog SS long act Levemir . Sugars home recently 250s . ED , glucose 466 . UA + ketone ? ? ? ? ? ? correct 200s , rise 300s . treat insulin drip transition subq tolerate pos . electrolyte replete receive aggressive volume resuscitation . [ * * last Name ( un ) * * ] see give slide scale recommendation implement . source DKA find , beleive [ * * 2 - 3 * * ] gastroparesis . nausea manage ativan , compazine , promethazine . discharge home Insulin slide scale instruction follow - [ * * last Name ( un ) * * ] . # HTN : Hypertensive SBP 190s initially , attribute DKA , experience past . improve blood pressure normalize - start home Lopressor Midodrine regimen . # Coffee ground emesis : Emesis start clear , prolong wretching , start coffee - ground vomiting . also occur prior admission DKA associate vomiting . hematocrit remain stable hematemesis self - resolve , work - defer outpatient setting . # Acute chronic kidney disease , Stage III : Patient 's Cr admission 2.7 , trend 2.1 - 2.3 following fluid , consistent know ckd secondary diabetic nephropathy . medication admission : 1 . citalopram 20 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 2 . Levemir 100 unit / mL Solution Sig : twenty two ( 22 ) unit Subcutaneous every . 3 . Levemir 100 unit / mL Solution Sig : twelve ( 12 ) unit Subcutaneous bedtime . 4 . humalog 100 unit / mL Solution Sig : slide scale direct Subcutaneous four time day : please use slide scale direct MD [ * * First Name8 ( NamePattern2 ) 767 * * ] [ * * last Name ( Titles ) * * ] . 5 . metoprolol tartrate 50 mg Tablet Sig : 1.5 Tablets po DAILY ( Daily ): take evening . 6 . promethazine 25 mg Tablet Sig : 0.5 Tablet po Q8H ( every 8 hour ) need nausea . 7 . gabapentin 300 mg Capsule Sig : one ( 1 ) Capsule po Q12H ( every 12 hour ) . Disp:*60 Capsule(s ) * Refills:*2 * 8 . duloxetine 30 mg Capsule , Delayed Release(E.C. ) Sig : two ( 2 ) Capsule , Delayed Release(E.C. ) PO DAILY ( Daily ): please take 1 capsule daily ( 30 mg ) first 2 week treatment . disp:*60 Capsule , delayed Release(E.C.)(s ) * Refills:*2 * 9 . oxycodone 5 mg Capsule Sig : one ( 1 ) Capsule po every eight ( 8) hour need pain . 10 . midodrine 5 mg Tablet Sig : 1.5 tablet po every four ( 4 ) hour : hold sleep . Disp:*270 Tablet(s ) * Refills:*2 * Discharge medication : 1 . citalopram 20 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 2 . gabapentin 300 mg Capsule Sig : one ( 1 ) Capsule po Q12H ( every 12 hour ) . 3 . duloxetine 30 mg Capsule , Delayed Release(E.C. ) Sig : one ( 1 ) Capsule , Delayed Release(E.C. ) PO DAILY ( Daily ) . 4 . metoprolol tartrate 25 mg Tablet Sig : three ( 3 ) Tablet PO Daily 6 pm . 5 . midodrine 2.5 mg Tablet Sig : three ( 3 ) Tablet PO DAILY ( Daily ) . 6 . Levemir 100 unit / mL Solution Sig : direct [ * * last Name ( un ) * * ] unit Subcutaneous direct . discharge Disposition : home discharge diagnosis : diabetic keotacidosis hematemesis ( blood vomit ) Hypertension Chronic renal insufficiency discharge condition : Mental Status : clear coherent . Level consciousness : alert interactive . Activity Status : Ambulatory - Independent . Discharge instruction : admit hospital DKA , hypertension , blood vomit . initially treat ICU insulin drip , blood sugar improve . blood pressure medication adjust well control blood pressure DKA , - start home regimen discharge . blood vomit likely secondary mechanical trauma repeat wretching , follow - primary care doctor discuss whether undergo evaluation upper endoscopy . give complaint chronic cough heartburn , also discuss begin trial proton pump inhibitor Nexium Prilosec see help symptom . insulin regimen adjust [ * * last Name ( un ) * * ] team . continue follow - question concern regard insulin management . Followup Instructions : please call dr.[**last Name ( STitle ) 805 * * ] ' office schedule follow - appointment within 7 - 10 day discharge . office number [ * * telephone / Fax ( 1 ) 85219 * * ] . also continue follow - [ * * last Name ( un ) * * ] doctor need .
[ "5849" ]
Admission Date : [ * * 2150 - 4 - 17 * * ] Discharge Date : [ * * 2150 - 4 - 21 * * ] Date Birth : [ * * 2090 - 5 - 19 * * ] sex : Service : MEDICINE allergy : Patient record known allergy drug attending:[**first Name3 ( LF ) 12174 * * ] Chief Complaint : coffee ground emesis Major Surgical Invasive Procedure : egd Right IJ CVL history Present Illness : Mr. [ * * know lastname 52368 * * ] 59 w HepC cirrhosis c / b grade / II esophageal varix portal gastropathy ( last egd [ * * 3-/2150 * * ] ) , p / w coffee - ground emesis melena x2 day . . Pt USOH 2 - 3 day PTA , begin experience intermittent nausea . 2 - 3 episode coffee - ground emesis 1 episode tarry black stool morning admission . report lightheadedness new , deny frank hematemesis , BRBPR , abdominal pain , fever , chill , significant increase abdominal girth . deny drinking medication non - compliance . also report take naproxen back pain 2 - 3 time day recent past . . ed , vital 97.4 , 93/41 , 69 , 18 , 100 % RA . give 4L NS IV , protonix 40 mg IV , start octreotide drip . guaiac positive brown stool rectal exam . see liver fellow ED feel unlikely variceal bleed recommend work infection . NG tube attempt , however , patient unable tolerate ED . abdominal ultrasound do show patent portal vein , scant ascite enough tap . BP drop 80/34 , pt transfer MICU hemodynamic monitoring . . MICU , pt give 3 prbc , Hct bump 21.3 28 . start norepinephrine gtt hour , bp stabilize . transfer floor , remain hemodynamically stable . feel good , deny tarry bloody bm , emesis . Past Medical history : HCV Cirrhosis ( tx interferon x2 response ) Portal Gastropathy Grade II Esophageal varix HTN Social History : live alone . drink alcohol , usually one session per week . four five drink per session . tell completely abstain alcohol , effective today . smoke 20 cigarette per day . Family history : NC Physical Exam : admission : vs : T95.9 hr 71 BP 83/36 RR 11 96 % 2L NC Gen : somnolent , orient x 3 , unable assess asterixis give somnolence HEENT : PERRLA , EOMI Neck : supple , JVP angle jaw ( fluid bolus run wide open ) CV : rrr s1 s2 appreciable murmur Lungs : CTAB Abd : distend , non tender , rebound guarding , bowel sound positive Ext : 1 + pit edema bilaterally skin : warm , diaphoretic , rash lesion note pertinent result : LABS admission : [ * * 2150 - 4 - 17 * * ] 01:30PM blood wbc-17.9 * # RBC-2.78 * Hgb-8.5 * Hct-26.0 * MCV-94 MCH-30.6 mchc-32.7 RDW-20.6 * Plt ct-186 [ * * 2150 - 4 - 17 * * ] 01:30PM blood Neuts-61.2 Lymphs-28.8 Monos-6.9 Eos-2.2 Baso-0.9 [ * * 2150 - 4 - 17 * * ] 02:13PM blood pt-17.7 * PTT-34.5 INR(PT)-1.6 * [ * * 2150 - 4 - 17 * * ] 01:30PM blood Glucose-92 UreaN-51 * Creat-1.3 * Na-131 * K-5.7 * Cl-104 HCO3 - 21 * AnGap-12 [ * * 2150 - 4 - 17 * * ] 01:30PM blood ALT-126 * AST-260 * ld(ldh)-426 * AlkPhos-157 * TotBili-3.3 * [ * * 2150 - 4 - 17 * * ] 06:41pm blood calcium-7.5 * Phos-3.8 Mg-1.9 . LABS discharge : [ * * 2150 - 4 - 21 * * ] 05:00am blood WBC-10.7 RBC-2.94 * Hgb-9.6 * Hct-27.0 * MCV-92 MCH-32.6 * mchc-35.6 * RDW-21.2 * Plt Ct-110 * [ * * 2150 - 4 - 21 * * ] 05:00am blood pt-17.4 * PTT-35.6 * INR(PT)-1.6 * [ * * 2150 - 4 - 21 * * ] 05:00am blood Glucose-84 UreaN-15 Creat-1.0 Na-132 * K-4.4 Cl-99 HCO3 - 25 AnGap-12 [ * * 2150 - 4 - 21 * * ] 05:00am blood alt-113 * AST-210 * AlkPhos-111 TotBili-3.6 * [ * * 2150 - 4 - 21 * * ] 05:00am blood Calcium-8.1 * Phos-3.8 Mg-1.7 . LABS : [ * * 2150 - 4 - 18 * * ] 06:25AM blood CK - MB-9 cTropnT-<0.01 [ * * 2150 - 4 - 17 * * ] 06:41pm blood CK - MB-11 * MB Indx-4.9 cTropnT-<0.01 [ * * 2150 - 4 - 17 * * ] 01:30PM blood Lipase-85 * . URINE : [ * * 2150 - 4 - 17 * * ] 11:01PM URINE Color - Yellow Appear - Clear Sp [ * * last Name ( un ) * * ] -1.016 [ * * 2150 - 4 - 17 * * ] 11:01PM URINE Blood - LG Nitrite - NEG Protein - NEG Glucose - NEG Ketone - NEG Bilirub - NEG Urobiln-2 * pH-5.5 Leuks - NEG [ * * 2150 - 4 - 17 * * ] 11:01PM URINE RBC-63 * WBC-7 * Bacteri - none yeast - none epi-<1 . MICROBIOLOGY : blood , urine culture - negative H.pylori serum antibody - negative . CARDIOLOGY : . TTE ( [ * * 4 - 18 * * ] ): Conclusions left atrium dilate . leave ventricular wall thickness cavity size normal . leave ventricular systolic function hyperdynamic ( EF>75 % ) . right ventricular chamber size free wall motion normal . aortic valve leaflet ( 3 ) mildly thicken aortic stenosis present . aortic regurgitation see . mitral valve leaflet mildly thicken . mild ( 1 + ) mitral regurgitation see . moderate pulmonary artery systolic hypertension . pericardial effusion . IMPRESSION : Hyperdynamic LV systolic function . mild mitral regurgitation . moderate pulmonary artery systolic hypertension . . EKG ( [ * * 4 - 17 * * ] ): Sinus rhythm prolong QT interval nonspecific clinical correlation suggest previous tracing available comparison Intervals Axes Rate PR QRS QT / QTc P QRS 70 160 96 462/479 70 55 52 . GI : EGD ( [ * * 4 - 20 * * ] ): 1 . varix low third esophagus middle third esophagus . 2 . erythema erosion antrum pylorus compatible non - steroidal induce gastritis . 3 . bleed pyloric ulcer pylorus compatible non - steroidal induce ulcer ( injection , thermal therapy ) . 4 . normal mucosa duodenum . 5 . otherwise normal egd third part duodenum . RADIOLOGY : . CXR ( [ * * 4 - 17 * * ] ): prominent bulge right heart border could due pericardial effusion , _ _ _ _ _ cyst , enlarge right atrium . mediastinal vascular engorgement suggest cardiac tamponade . Pulmonary vasculature normal . lung clear pleural effusion . overall heart size normal . right jugular line end junction brachiocephalic vein . pneumothorax pleural effusion . . ABD U / ( [ * * 4 - 17 * * ] ): IMPRESSION : 1 . son[**name ( NI ) 493 * * ] evidence portal venous thrombosis . portal vein flow hepatopetal wall - - wall . 2 . significant ascite . sliver perihepatic ascite . 3 . persistent coarsen echotexture liver consistent know history cirrhosis . 4 . Splenomegaly Brief Hospital course : Mr [ * * know lastname 52368 * * ] 59 w HCV cirrhosis w grade ii esophageal varix admit w coffee - ground emesis melena concern ugib , / p MICU stay hypotension . . # ugib : Pt bleed hospital . egd reveal erythema erosion antrum pylorus compatible non - steroidal induce gastritis . Pt remember take increase dose naproxen backache . start pantoprazole 40 mg po BID one week repeat endoscopy schedule one week ( [ * * 4 - 30 * * ] ) . recommend take tylenol ( max daily dose 2gm ) pain instead nsaid . blood pressure med hold first , give MICU admission hypotension , restart discharge . . # HCV cirrhosis : appear progress liver failure , elevated INR 1.6 , decrease albumin 2.6 , tbili slightly elevate 3.6 , chronic LE edema . Pt continue prophylactic medication . . # full code Medications admission : FUROSEMIDE 20 mg daily LISINOPRIL 10 mg daily SPIRONOLACTONE 100 mg daily Discharge medication : 1 . phenol 1.4 % Aerosol , Spray Sig : one ( 1 ) spray mucous membrane PRN ( need ) . 2 . Lactulose 10 gram/15 ml Syrup Sig : thirty ( 30 ) ML po TID ( 3 time day ) . 3 . thiamine HCl 100 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 4 . Folic Acid 1 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 5 . spironolactone 100 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 6 . furosemide 40 mg Tablet Sig : one ( 1 ) Tablet po day . 7 . Acetaminophen 325 mg Tablet Sig : 1 - 2 tablet po every [ * * 6 - 15 * * ] hour need : 6 tablet regular strength tylenol per day . 8 . terbinafine 1 % Cream Sig : one ( 1 ) Appl Topical [ * * hospital1 * * ] ( 2 time day ) 1 week . Disp:*qs * Refills:*0 * 9 . Nadolol 20 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 10 . Pantoprazole 40 mg Tablet , Delayed Release ( E.C. ) Sig : one ( 1 ) Tablet , Delayed Release ( E.C. ) po twice day 1 week : take 1 tablet daily . Disp:*60 Tablet , Delayed Release ( e.c.)(s ) * Refills:*2 * 11 . Camphor - Menthol 0.5 - 0.5 % Lotion Sig : one ( 1 ) Appl Topical QID ( 4 time day ) need itching . Disp:*qs * Refills:*0 * 12 . lisinopril 10 mg Tablet Sig : one ( 1 ) Tablet po day . discharge Disposition : home discharge Diagnosis : peptic ulcer gi bleed discharge condition : asymptomatic Discharge instruction : admit bleed ulcer stomach . ulcer least partially cause naproxen . stop take naproxen take tylenol pain . take NSAIDS pain include ibuprofen , naproxen , aleve , motrin , aspirin , toradol , advil . okay take tylenol take 4 extra strength tylenol day ( 2gram daily maximum ) . . follow medication change make : take naproxen take pantoprazole 40 mg twice daily one week . take 40 mg daily . . schedule get repeat endoscopy next week . prior procedure anything drink eat midnight . . please return er chest pain , lightheadeness , fever , chill , bloody black stool concern symptom . Followup Instructions : Provider : [ * * Name10 ( NameIs ) * * ] [ * * apartment address(1 ) * * ] ( ST-3 ) GI ROOMS Date / time:[**2150 - 4 - 30 * * ] 1:30 Provider : [ * * First Name11 ( Name Pattern1 ) * * ] [ * * last Name ( NamePattern1 ) 7290 * * ] , MD phone:[**telephone / fax ( 1 ) 463 * * ] Date / time:[**2150 - 4 - 30 * * ] 1:30 Provider : [ * * Name10 ( NameIs ) * * ] [ * * last Name ( namepattern4 ) 2424 * * ] , MD phone:[**telephone / fax ( 1 ) 2422 * * ] Date / time:[**2150 - 5 - 7 * * ] 11:00 complete by:[**2150 - 4 - 24 * * ]
[ "2851", "5715", "4019" ]
Admission Date : [ * * 2108 - 4 - 6 * * ] Discharge Date : [ * * 2081 - 4 - 7 * * ] Date Birth : [ * * 2059 - 5 - 7 * * ] sex : F Service : MED CHIEF COMPLAINT : Dyspnea . history PRESENT ILLNESS : 48 year old african american female history multiple myeloma admit respiratory distress . patient recently discharge one week ago outside hospital ( [ * * Hospital3 7900 * * ] ) respiratory distress . back [ * * hospital3 7362 * * ] , give nebulizer , antibiotic steroid . also elevate INR give medication lower INR although evidence bleeding . last night , report increase difficulty breathing . also cough . deny fever chill . patient admit decrease p.o . intake recently sedimentary . deny swelling leg . patient note wheezing take Albuterol inhaler without effect . Prednisone taper report cough thick sputum . go primary care provider today could say sentence send Emergency Department . Emergency Department , tachypneic wheeze heart 120 blood pressure 127/82 . receive Solu - Medrol continue nebulizer treatment . improve , seem tire . abg do show ph 7.41 ; PCO2 , 40 ; PO2 , 92 . speak full sentence still make wheezing . require continue nebulizer treatment deny chest pain , nausea , vomiting , diarrhea abdominal pain . feel weak general . PAST MEDICAL history : 1 . multiple myeloma diagnose [ * * 2107 - 12 - 9 * * ] , increase protein bone marrow biopsy . receive Decadron 40 mg q every week . 2 . Pulmonary embolism , [ * * 2108 - 1 - 2 * * ] . 3 . Asthma . pft ..................... 4 . history steroid psychosis . 5 . Pneumonia require intubation [ * * 2107 - 12 - 9 * * ] . MEDICATIONS UPON admission : 1 . Coumadin 2.5 mg p.o . q d. 2 . Serevent two puff q.i.d . 3 . Albuterol inhaler one two puff q 6 hour prn . 4 . dexamethasone 10 mg p.o . q d. allergy : know drug allergy . SOCIAL history : socially , live child work home home health aid . twenty year two pack day smoking history quit [ * * 2107 - 12 - 9 * * ] . drink occasional alcohol . FAMILY history : family history show father die myocardial infarction . Sister ovarian cancer . PHYSICAL EXAMINATION UPON admission : Temperature , 96.6 ; heart rate , 122 ; blood pressure , 127/82 ; respiratory rate , 24 ; O2 saturation , 99 % . Head , eye , ear , nose throat , pupil equal , round , reactive light accommodation extraocular movement intact . accessory muscle use . Neck supple without lymphadenopathy . Pulmonary , diffuse wheezing bibasilar crackle left great right . Cardiac , regular rate rhythm normal S1 S2 . murmur thrill note . Abdomen soft , nontender , nondistende normal active bowel sound . extremity , edema , cyanosis club note . neurologically , patient somnolent orient x 3 . focal defect note . laboratorie UPON admission : white count , 9.6 ; neutrophil , 66 % ; lymphocyte , 5 % ; bandemia , 21 % ; monocyte , 1 % . Sodium , 131 ; potassium , 4.4 ; chloride , 92 ; bicarbonate , 24 . BUN , 14 ; creatinine , 0.8 . Glucose , 131 . INR , 1.3 . PTT , 29.1 . ABG , 7.41 ; PCO2 , 40 ; PO2 , 92 . HOSPITAL COURSE : 1 . Pulmonary - Dyspnea secondary chronic obstructive pulmonary disease / emphysema hospital course . Briefly , patient receive BIPAP , .................... , intravenous Solu - Medrol , nebulizer treatment inhaler treatment Intensive Care Unit . able wean oxygen back room air , sate 93 94 percent . though chest x - ray show hyperinflation sign infection , give five day worth Zithromax . echocardiogram rule cardiac wheeze show ejection fraction great 55 % , mild right ventricular dilation mild pulmonary arterial pressure . Pulmonary function test perform show obstructive pattern FEC 2.56 93 % predict FEV1 0.9 43 % predict FEV1 FEC ratio 46 % . patient transfer Medical Floor , CT perform show evidence pulmonary embolism show sign emphysema . Sputum culture send show growth organism . Alpha antitrypsin send still pende . 2 . Pulmonary Embolism - patient continue Coumadin INR 2 3 . since subtherapeutic , start Lovenox become therapeutic Coumadin . 3 . Psychiatry - Anxiety . patient quite anxious hospital course . Psychiatry call consult recommend Risperidone 0.25 mg q hs . patient well medication . 4 . Oncology - Multiple myeloma . protein electrophoresis do show monoclonal IGG capa gammaglobulinopathy ( 60 % total protein [ * * 2108 - 1 - 8 * * ] , 66 % total protein [ * * 2108 - 4 - 9 * * ] , despite q weekly dexamethasone treatment . bone marrow biopsy do reveal 70 80 percent plasma cell . give finding , patient transfer [ * * Hospital Ward Name 516 * * ] start chemotherapy Vincristine , ................... Decadron preparation bone marrow transplant do . [ * * Name6 ( MD ) * * ] [ * * last Name ( namepattern4 ) 5837 * * ] , M.D. [ * * MD Number(1 ) 8285 * * ] dictate by:[**first Name3 ( LF ) 30667 * * ] medquist36 : [ * * 2108 - 4 - 17 * * ] 15:47 : [ * * 2108 - 4 - 17 * * ] 15:46 JOB # : [ * * Job number 30668 * * ]
[ "486", "2761" ]
Admission Date : [ * * 2145 - 3 - 31 * * ] Discharge Date : [ * * 2145 - 4 - 7 * * ] Date Birth : [ * * 2071 - 6 - 4 * * ] sex : F Service : SURGERY allergy : Penicillins / Dilantin attending:[**first Name3 ( LF ) 301 * * ] Chief Complaint : severe abdominal back pain unable take oral intake . flatus bowel movement . abdominal distention . Major Surgical Invasive Procedure : Exploratory Laparotomy Lysis adhesion Small Bowel Resection Jejunosotomy history Present Illness : Ms [ * * know lastname * * ] 73 year old female history multiple abdominal surgery , pancreatitis previous SBO . present Emergency Department [ * * 2145 - 3 - 30 * * ] complaint [ * * 11 - 10 * * ] abdominal pain , radiate back begin morning . complain distention , inability bowel movement , inability take oral intake , fever , chill diarrhea . Past Medical history : Chronic Pancreatitis Migraines surgical history : pancreatic diversion , cholecystectomy , appendectomy , small bowel obstruction . Social History : marry , live husband retire pediatric infectious disease doctor . Family history : Father : deceased , leukemia Brother : colon cancer Physical Exam : : 97.9 hr : 79 bp : 153/60 RR : 22 spo2 100 % RA Constitutional : pain Head / eye : mucous membrane dry ENT / Neck : neck supple Chest / Respiratory : clear auscultation Bilaterally GI / abdominal : Tender light palpation . multiple well heal scar + guard , hypoactive bowel sound GU : costovertebral angle tenderness Musculoskeletal : WNL Skin : Dry Neuro : alert & oriented Pertinent result : [ * * 2145 - 3 - 30 * * ] 09:15pm blood Glucose-116 * UreaN-16 Creat-0.8 Na-139 K-3.8 Cl-103 HCO3 - 25 angap-15 [ * * 2145 - 3 - 31 * * ] 10:26am blood wbc-12.3 * # rbc-4.01 * Hgb-12.3 Hct-37.1 MCV-93 MCH-30.6 MCHC-33.0 RDW-14.2 Plt Ct-259 [ * * 2145 - 3 - 30 * * ] 09:15pm blood ALT-12 AST-22 AlkPhos-89 amylase-169 * TotBili-0.3 [ * * 2145 - 4 - 2 * * ] 06:15AM blood Amylase-107 * [ * * 2145 - 3 - 31 * * ] 10:26am blood Calcium-8.9 Phos-4.2 Mg-1.6 [ * * 2145 - 3 - 31 * * ] 12:44AM blood lactate-3.1 * [ * * 2145 - 4 - 2 * * ] 02:10PM blood lactate-1.9 [ * * 2145 - 3 - 30 * * ] 11:35PM urine blood - NEG Nitrite - NEG Protein - NEG Glucose - NEG Ketone - NEG Bilirub - NEG Urobiln - NEG pH-8.0 Leuks - NEG . ABDOMEN ( SUPINE & ERECT ) impression : nonspecific bowel gas pattern without evidence obstruction . . CT ABDOMEN W / CONTRAST ; CT PELVIS W / CONTRAST IMPRESSION : 1 . high grade small - bowel obstruction . unusual configuration loop small bowel mid abdomen concern close loop obstruction . moderate amount free fluid within abdoman . 2 . ill - define opacity right middle lobe represent infection BAC evaluate PET CT . 3 . thickening first portion duodenum , uncertain clinical significance . . CHEST ( portable AP ) [ * * 2145 - 4 - 2 * * ] 1:51 pm impression : right low lobe airspace opacity , could represent pneumonia appropriate clinical setting . small bilateral pleural effusion . followup assure resolution recommend . . CT Chest [ * * 2145 - 4 - 2 * * ] IMPRESSION : 1 . new right low lobe pneumonia . small bilateral pleural effusion leave basilar atelectasis . 2 . ill - define opacity right middle lobe represent either infection BAC evaluate acute issue resolve . 3 . evidence pulmonary embolus aortic dissection . 4 . small mediastinal axillary lymph node , meet CT criterion pathologically enlargement . CXR [ * * 2145 - 4 - 6 * * ] IMPRESSION : 1 . improve airspace consolidation right low lung field consistent resolve pneumonia . 2 . small bilateral pleural effusion . Brief Hospital course : Ms [ * * know lastname * * ] admit emergency room [ * * 2145 - 3 - 31 * * ] take operating room . undergo uncomplicated exploratory laparatomy small bowel resection , jejunosotomy lysis adhesion , see op report detail . stabilize PACU , transfer sicu POD#1 . extubate , pain well control morphine PCA , remain NPO NGT foley catheter . initiate Cefazolin / Flagyl x 24 hour . POD#2 develop confusion decrease oxygen saturation , require 3L nasal cannula . narcotic stop , CXR CT chest obtain reveal right low lobe pneumonia , see pertinent result detail . Vanc / Levo / Flagyl initiate well ID medicine consult . transfer SICU . pod#[**4 - 4 * * ] remain SICU , mental status respiratory status improve . POD#4 NGT remove transfer [ * * Hospital Ward Name 121 * * ] 9 , wean room air . pain well control tylenol small dose oxycodone . POD#5 report flatus follow multiple loose stool . stool C diff negative . start sip , tolerate easily . POD#6 tolerate clear liquid long want take antibiotic due frequent stool . CXR repeat show resolve pneumonia . tolerate regular diet evening without difficulty . infectious disease team recommend completion 7 day Levofloxacin . clip remove POD#7 , discharge home stable condition antibiotic , pain medication appropriate follow appointment . medication admission : Ramipril 1.25 mg Capsule Sig : two ( 2 ) Capsule po DAILY ( Daily ) . Trazodone 50 mg Tablet Sig : three ( 3 ) Tablet PO HS ( bedtime ) need . Gabapentin 400 mg Capsule Sig : one ( 1 ) Capsule PO Q6H ( every 6 hour ) . 6 . Trileptal resume home dose trileptal Discharge medication : 1 . oxycodone - Acetaminophen 5 - 325 mg Tablet Sig : 0.5 - 1 Tablet PO Q4 - 6h ( every 4 6 hour ) need . disp:*30 Tablet(s ) * Refills:*0 * 2 . Ramipril 1.25 mg Capsule Sig : two ( 2 ) Capsule po DAILY ( Daily ) . 3 . trazodone 50 mg Tablet Sig : three ( 3 ) Tablet PO HS ( bedtime ) need . 4 . Acetaminophen 325 mg Tablet Sig : 1 - 2 tablet PO q4 - 6h ( every 4 6 hour ) need . 5 . 7 . Levaquin 500 mg Tablet Sig : one ( 1 ) Tablet po day . Disp:*7 Tablet(s ) * Refills:*0 * Gabapentin 400 mg Capsule Sig : one ( 1 ) Capsule PO Q6H ( every 6 hour ) . 6 . Trileptal resume home dose trileptal Discharge Disposition : home discharge diagnosis : small bowel obstruction internal hernia necrotic jejunum Pneumonia Discharge condition : good Discharge instruction : please call surgeon develop chest pain , shortness breath , fever great 101.5 , foul smelling colorful drainage incision , redness swelling , severe abdominal pain distention , persistent nausea vomiting , inability eat drink , symptom concern . tub bath swimming . may shower . clear drainage incision , cover dry dressing . leave white strip incision place , allow fall . activity : heavy lifting item [ * * 11 - 15 * * ] pound follow appointment doctor . medication : resume home medication . problem constipation , take stool softener , Colace 100 mg twice daily need . give pain medication may make drowsy . driving take pain medicine . Followup Instructions : Provider : [ * * Name10 ( NameIs ) 4267 * * ] [ * * last Name ( namepattern4 ) 4268 * * ] , MD , PHD[**MD Number(3 ) 708**]:[**telephone / Fax ( 1 ) 657 * * ] Date / Time:[**2145 - 4 - 20 * * ] 2:00 appointment see Dr. [ * * last Name ( STitle ) * * ] Friday , [ * * 2145 - 4 - 23 * * ] 3:30 . phone # : [ * * telephone / Fax ( 1 ) 2723 * * ] . please see primary care physician regard follow CT scan within 1 month . CT result discharge summary fax . complete by:[**2145 - 4 - 7 * * ]
[ "486", "4019" ]
Admission Date : [ * * 2162 - 5 - 16 * * ] Discharge Date : [ * * 2162 - 5 - 21 * * ] Date Birth : [ * * 2101 - 7 - 30 * * ] sex : Service : CARDIOTHORACIC allergy : Known Allergies / Adverse Drug reaction attending:[**first Name3 ( LF ) 1505 * * ] Chief Complaint : Angina Major Surgical Invasive Procedure : [ * * 2162 - 5 - 17 * * ] : CABGx4 LIMA- > LAD , RSVG- > Diagonal , Posterior Descending Artery , Obtuse marginal [ * * 2162 - 5 - 19 * * ] : right atrial lead placement history Present Illness : 60yo man know coronary disease ( AMI [ * * 2143 * * ] [ * * Name Prefix ( Prefixes ) * * ] [ * * last Name ( Prefixes ) * * ] LCx [ * * 2155 * * ] ) . well last week develop angina initially exertion progress rest angina . episode releive SL NTG , episode last 5 minute . present cardiologist treatment . admit MWMC , cardiac catheterization reveal 3 vessel disease . transfer [ * * Hospital1 18 * * ] coronary bypass grafting . Cardiac Catheterization : date : [ * * 2162 - 5 - 11 * * ] Place : MWMC -LAD- chronic total occlusion proximally(distal fill via collateral ) -rca- chronic total occlusion non - dominant RCA 90 % -LCx- new complex 90 % stenosis prox LCx involve bifurcation LCx proper large OM2 . old stent LCx widely patent -mod LV systolic dysfx , anterior , apical , infero - apical AK reduce EF 30 % LVEDP 36mmhg valvular dz Past Medical History : CAD-(AMI [ * * 2143 - 7 - 3 * * ] , [ * * Name Prefix ( Prefixes ) * * ] [ * * last Name ( Prefixes ) * * ] LCx [ * * 6-/2155 * * ] ) Cardiomyopathy- EF 35 - 45 % depend study Ventricular tachycardia / p AICD [ * * 8-/2155 * * ] Atrial flutter / p ablation [ * * 8-/2155 * * ] Hypertension Dyslipidemia Insulin dependent diabete Mellitus Obesity Conduction disease - LAFB Peripheral vascular disease / p right fem-[**doctor last Name * * ] bypa [ * * 3-/2161 * * ] leave leg claudication Right thigh tumor / p radiation excision [ * * 2141 * * ] 's Social History : race : caucasian Last Dental Exam : live : wife Occupation : [ * * name2 ( NI ) 56028 * * ] own company tobacco : 2ppd x20 yrs quit [ * * 2143 * * ] ETOH : occaisional Family history : Father die 50yo cirrhosis , mother die 42yo MI Physical Exam : pulse : 58 Resp : 16 O2 sit : 97%-ra B / p right : 124/76 leave : height : 5'[**62 * * ] " Weight : 259 lbs General : skin : Dry [ x ] intact [ x ] HEENT : PERRLA [ x ] EOMI [ x ] Neck : Supple [ x ] full rom [ x ] chest : lung clear bilaterally [ x ] heart : rrr [ x ] Irregular [ ] Murmur Abdomen : Soft [ x ] non - distended [ x ] non - tender [ x ] bowel sound + [ x ] extremity : Warm [ x ] , well - perfuse [ x ] Edema -none varicosity : None [ x ] . well heal right vein harvest site . Neuro : grossly intact pulse : Femoral right : +2 Left:+2 dp Right:+2 Left:+2 PT [ * * Name ( NI ) 167 * * ] : +2 Left:+2 Radial right : +2 Left:+2 Carotid Bruit none right : +2 Left:+2 pertinent result : [ * * 2162 - 5 - 17 * * ] : Prebypass left atrium dilate . spontaneous echo contrast see body left atrium leave atrial appendage . spontaneous echo contrast see body right atrium . atrial septal defect see 2D color Doppler . leave ventricular wall thickness normal . left ventricular cavity severely dilate . moderate regional left ventricular systolic dysfunction hypokinesis apex septum . overall left ventricular systolic function mildly depressed ( LVEF=30 - 35 % ) . estimate cardiac index depressed ( < 2.0l / min / m2 ) . focal abnormality see mid apical anteroseptal wall , apical anterior wall , mid apical inferoseptal wall , apical inferior wall . thrombus see LV apex . right ventricular chamber size free wall motion normal . descending thoracic aorta mildly dilate . aortic valve leaflet ( 3 ) mildly thicken focal calcification non - coronary cusp move poorly . minimally increase gradient consistent minimal aortic valve stenosis . aortic regurgitation see . mitral valve leaflet mildly thicken . mild moderate ( [ * * 1 - 3**]+ ) mitral regurgitation see . mitral valve prolapse flail segment . pericardial effusion . Postbypass patient - pace phenylephrine infusion . biventricular systolic function unchanged . mitral regurgitation remain mild - - moderate . thoracic aorta intact post decannulation . [ * * 2162 - 5 - 20 * * ] 05:00am blood wbc-10.9 RBC-3.73 * Hgb-11.2 * Hct-31.7 * MCV-85 MCH-30.1 MCHC-35.4 * RDW-13.9 Plt ct-114 * [ * * 2162 - 5 - 20 * * ] 05:00am blood Glucose-151 * UreaN-19 Creat-0.7 Na-135 k-3.9 cl-100 HCO3 - 28 AnGap-11 [ * * 2162 - 5 - 16 * * ] 05:00pm blood ALT-66 * AST-55 * LD(LDH)-206 AlkPhos-73 TotBili-0.3 Brief Hospital course : patient admit hospital bring operating room [ * * 2162 - 5 - 17 * * ] patient undergo Coronary artery bypass graft x 4 . see operative note detail . overall patient tolerate procedure well post - operatively transfer CVICU stable condition recovery invasive monitoring . POD 1 find patient extubate , alert oriented breathe comfortably . electrophysiology team consult due non capturing atrial lead permanent pacemaker initially interrogate epicardial wire remove . ventricular lead ICD function appropriately . right atrial lead revise [ * * 5 - 19 * * ] without complication . follow device clinic [ * * hospital1 * * ] 2 week - operative note give patient bring follow appointment . patient neurologically intact hemodynamically stable inotropic vasopressor support . beta blocker initiate patient gently diurese toward preoperative weight . Lisinopril restart well blood pressure . patient transfer telemetry floor recovery . Chest tube discontinue without complication post operative day 3 . patient evaluate physical therapy service assistance strength mobility . time discharge POD 4 patient ambulate freely , sternal pacer pocket wound heal pain control oral analgesic . continue 1 week antibiotic per EP / p atrial lead placement . patient discharge home vna service good condition appropriate follow instruction . follow appointment arrange . medication admission : Lisinopril 20 ' Atenolol 100 ' Vytorin [ * * 10/2131 * * ] QHS fenofibrate 200 ' ASA 325 ' NTG - sl / PRN Insulin - NPH 22u QAM/24u qpm- follow [ * * last Name ( un ) * * ] Insulin- humalog SS MVI Calcium 600 ' plavix - last dose:[**2162 - 5 - 12 * * ] allergy : NKDA Discharge medication : 1 . fenofibrate 160 mg Tablet Sig : one ( 1 ) Tablet po day . disp:*30 Tablet(s ) * Refills:*0 * 2 . simvastatin 80 mg Tablet Sig : one ( 1 ) Tablet po day . disp:*30 Tablet(s ) * Refills:*2 * 3 . ezetimibe 10 mg Tablet Sig : one ( 1 ) Tablet PO HS ( bedtime ) . disp:*30 Tablet(s ) * Refills:*1 * 4 . multivitamin Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . disp:*100 Tablet(s ) * Refills:*0 * 5 . docusate sodium 100 mg Capsule Sig : one ( 1 ) Capsule po BID ( 2 time day ) . 6 . magnesium hydroxide 400 mg/5 ml Suspension Sig : thirty ( 30 ) ML po HS ( bedtime ) need constipation . 7 . ranitidine HCl 150 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) . Disp:*60 Tablet(s ) * Refills:*2 * 8 . oxycodone - acetaminophen 5 - 325 mg Tablet Sig : 1 - 2 tablet po Q4H ( every 4 hour ) need pain . Disp:*65 Tablet(s ) * Refills:*0 * 9 . aspirin 81 mg Tablet , Delayed Release ( E.C. ) Sig : one ( 1 ) Tablet , Delayed Release ( E.C. ) PO DAILY ( Daily ) . disp:*100 Tablet , Delayed Release ( e.c.)(s ) * Refills:*2 * 10 . cephalexin 500 mg Capsule Sig : one ( 1 ) Capsule PO Q6H ( every 6 hour ) 7 day . Disp:*28 Capsule(s ) * Refills:*0 * 11 . Lasix 40 mg Tablet Sig : one ( 1 ) Tablet po day 7 day . Disp:*7 Tablet(s ) * Refills:*0 * 12 . potassium chloride 20 meq Tablet , ER Particles / Crystals Sig : one ( 1 ) Tablet , ER Particles / Crystals PO day 7 day . Disp:*7 Tablet , ER Particles / Crystals(s ) * Refills:*0 * 13 . metoprolol tartrate 25 mg Tablet Sig : one ( 1 ) Tablet PO BID ( 2 time day ) . Disp:*60 Tablet(s ) * Refills:*2 * 14 . acetaminophen 325 mg Tablet Sig : two ( 2 ) Tablet PO Q4H ( every 4 hour ) need pain . 15 . nph insulin human recomb 100 unit / mL Suspension Sig : one ( 1 ) Subcutaneous twice day : take 22 unit 24 unit PM . disp:*q 1 month * Refills:*0 * 16 . lisinopril 5 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . disp:*30 Tablet(s ) * Refills:*2 * discharge Disposition : Home Service Facility : [ * * Location ( un ) 1110 * * ] VNA Discharge Diagnosis : Coronary Artery Disease CAD-(AMI [ * * 2143 - 7 - 3 * * ] , [ * * Name Prefix ( Prefixes ) * * ] [ * * last Name ( Prefixes ) * * ] LCx [ * * 6-/2155**]),cardiomyopathy- EF 35 - 45 % Ventricular tachycardia / p AICD [ * * 8-/2155 * * ] , atrial flutter / p ablation [ * * 8-/2155 * * ] , Hypertension , Dyslipidemia , insulin dependent diabete Mellitus , Obesity , Conduction disease - LAFB , Peripheral vascular disease / p right fem-[**doctor last Name * * ] bypa [ * * 3-/2161 * * ] , leave leg claudication , right thigh tumor / p radiation excision [ * * 2141 * * ] 's discharge condition : alert orient x3 nonfocal ambulate steady gait incisional pain manage Percocet incision : Sternal - heal well , erythema drainage Leg Left - heal well , erythema drainage . 1 + Edema discharge instruction : please shower daily include wash incision gently mild soap , bath swimming clear surgeon . look incision daily redness drainage please lotion , cream , powder , ointment incision morning weigh evening take temperature , write chart drive approximately one month take narcotic , discuss follow appointment surgeon able drive lifting 10 pound 10 week please call question concern [ * * telephone / Fax ( 1 ) 170 * * ] * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * Followup Instructions : schedule follow appointment surgeon : Dr [ * * last Name ( STitle ) * * ] [ * * 6 - 10 * * ] 1:45pm [ * * telephone / Fax ( 1 ) 170 * * ] Cardiologist : Dr. [ * * last Name ( STitle ) 1295 * * ] [ * * 6 - 14 * * ] 3:30pm EP [ * * Hospital 19721 * * ] Clinic [ * * hospital1 * * ] [ * * 1 - 3 * * ] week : call appointment - [ * * telephone / Fax ( 1 ) 6256 * * ] Wound check appointment [ * * Hospital * * ] medical office building [ * * telephone / Fax ( 1 ) 170 * * ] Date / Time:[**2162 - 5 - 26 * * ] 12:00 please call schedule appointment Primary Care Dr. [ * * last Name ( STitle ) 27187 * * ] [ * * 4 - 6 * * ] week [ * * telephone / Fax ( 1 ) 3658 * * ] follow [ * * Hospital * * ] [ * * Hospital 982 * * ] Clinic arrange patient * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * complete by:[**2162 - 5 - 24 * * ]
[ "4111", "2859", "4019", "2720" ]
Admission Date : [ * * 2177 - 8 - 29 * * ] Discharge Date : [ * * 2177 - 9 - 12 * * ] Date Birth : [ * * 2156 - 2 - 27 * * ] sex : Service : SURGERY allergy : Patient record known allergy drug attending:[**first Name3 ( LF ) 2534 * * ] Chief Complaint : helmete motocyclist hit tree Major Surgical Invasive Procedure : [ * * 2177 - 8 - 29 * * ] 1 . irrigation debridement inclusive bone , right open femur fracture . 2 . Retrograde intramedullary nailing Synthes 11 x 360 nail . 3 . open reduction internal fixation patella fracture k - wire figure - of-8 tension band construct . [ * * 2177 - 9 - 4 * * ] Tracheostomy IVC filter [ * * 2177 - 9 - 12 * * ] PICC right bascilic vein history Present Illness : 21 y.o . male helmete moped rider strike tree report GCS 6 scene . Patient transport OSH note right side open femur fracture . receive antibiotic intubate prior transfer . Patient transport radiographic study perform show right femur fracture , SAH , grade II liver lac , pulmonary contusion , small PTX . Patient reportedly receive 1 unit prbcs ED place traction splint RLE . Past Medical history : none Social History : tobacco none ETOH none family history : Non - contributory . Physical Exam : 96.9 130 150/97 20 100 % intubated sedate HEENT - L eye abrasion , pupil nonreactive bilaterally CTA b / l rapid HR , regular rhythm SNDNT pelvic fracture + palpable distal pulse pertinent result : [ * * 2177 - 8 - 29 * * ] 04:35am blood WBC-17.7 * RBC-4.76 Hgb-15.2 Hct-45.5 MCV-96 MCH-32.0 mchc-33.5 RDW-13.2 Plt ct-314 [ * * 2177 - 8 - 30 * * ] 12:50AM blood wbc-7.6 RBC-2.73 * hgb-9.0 * hct-25.0 * MCV-92 MCH-32.8 * MCHC-35.9 * RDW-13.5 Plt ct-188 [ * * 2177 - 8 - 31 * * ] 01:49AM blood wbc-9.4 RBC-2.42 * Hgb-7.8 * Hct-21.7 * MCV-89 MCH-32.1 * MCHC-35.9 * RDW-14.5 Plt Ct-148 * [ * * 2177 - 9 - 1 * * ] 03:13AM blood WBC-9.2 RBC-2.87 * hgb-9.0 * hct-25.6 * MCV-90 MCH-31.6 MCHC-35.3 * RDW-15.0 Plt ct-128 * [ * * 2177 - 9 - 2 * * ] 01:40am blood WBC-7.7 RBC-2.78 * Hgb-8.8 * hct-24.6 * MCV-88 MCH-31.5 MCHC-35.7 * RDW-15.4 Plt ct-164 [ * * 2177 - 9 - 3 * * ] 12:53am blood WBC-8.9 RBC-2.94 * Hgb-9.3 * Hct-26.2 * MCV-89 MCH-31.8 mchc-35.6 * RDW-15.7 * Plt ct-220 [ * * 2177 - 9 - 4 * * ] 01:08am blood WBC-7.7 rbc-2.99 * Hgb-9.5 * hct-27.3 * MCV-91 MCH-31.7 mchc-34.7 RDW-15.5 Plt Ct-313 [ * * 2177 - 9 - 5 * * ] 02:32AM blood wbc-8.4 RBC-2.91 * Hgb-9.0 * hct-26.9 * MCV-92 MCH-30.9 mchc-33.5 RDW-15.6 * Plt ct-412 [ * * 2177 - 9 - 6 * * ] 01:58am blood WBC-12.1 * RBC-2.86 * hgb-9.0 * Hct-26.5 * MCV-93 MCH-31.6 MCHC-34.0 RDW-15.2 Plt ct-418 [ * * 2177 - 9 - 7 * * ] 02:12AM blood WBC-14.4 * RBC-3.00 * Hgb-9.3 * Hct-27.6 * MCV-92 MCH-30.9 MCHC-33.7 RDW-14.7 Plt ct-556 * [ * * 2177 - 9 - 8 * * ] 01:59am blood WBC-14.7 * RBC-3.25 * Hgb-10.0 * Hct-29.7 * MCV-91 MCH-30.6 MCHC-33.6 RDW-14.5 Plt Ct-748 * [ * * 8 - 29 * * ] CT head - multiple foci parenchymal hemorrhage well small amount likely subarachnoid hemorrhage . location foci [ * * Doctor Last Name 352**]-white matter interface concern diffuse axonal injury CT Cspine - fracture traumatic malalignment cervical spine CT torso - extensive pulmonary contusion , bad right left . hepatic laceration small amount abdominal pelvic free fluid intermittent density . Bilateral rib fracture . right femur / knee xray - mid shaft femoral fracture mild varus angulation distal fragment relative proximal . also medial subluxation ~ 1 cortical width . [ * * 9 - 2 * * ] MRI cspine - Edema interspinous ligament C3 - c4 C7 - T1 , without evidence distraction . lobal central canal narrowing due congenital short pedicle . slightly exacerbate disc bulge C3 - 4 . cord signal abnormality . moderate right C4 - 5 neural foraman narrow due uncovertebral osteophyte . [ * * 9 - 3 * * ] Bilateral LE leni - deep venous thrombosis involve right leave low extremity . LUE LENI - deep venous thrombosis left upper extremity . [ * * 9 - 7 * * ] CT Abdomen / Pelvis - right pleural effusion associate compressive atelectasis . considerable improvement appearance right lobe liver laceration . small amount free fluid pelvis . fracture left first right fourth fifth rib . fracture right transverse process T1 . Brief Hospital course : patient admit trauma ICU . [ * * 8 - 29 * * ] - Patient admittd ICU . take operation room ortho ORIF right femur ( see operative report full detail ) . Neurosurgery consult ICP place . start dilantin q1 hour neurocheck . [ * * date range ( 1 ) 58392 * * ] - patient transfuse 4u PRBC decrease Hct . right femur hematoma expand limb soft fear compartment symdrome . Hct stabilize . Head CT stable . [ * * 9 - 1 * * ] - ICP discontinue neurosurgery sign . Head CT stable . [ * * 9 - 2 * * ] - MR head c - spine perform . [ * * 9 - 3 * * ] - Bilateral LE LUE leni perform demonstrate DVT . [ * * 9 - 4 * * ] - patient go acute care service tracheostomy IVC filter placement . [ * * 9 - 6 * * ] - Patient dc'e dophoff tube twice . [ * * 9 - 7 * * ] - CT / p do persistent fever rise white count . source fever identify . Patient put trach collar . [ * * 9 - 8 * * ] : awake , - verse , follow command . pass S&S regular diet Passy [ * * last Name ( un ) 87596 * * ] valve . BAL culture grow MRSA , keep Vanc . patient ready transfer floor , wait bed . ` follow transfer surgical floor continue make slow progress . trach tube plug PMV tolerate well . confirm aspiration video swallow tolerate regular diet thin liquid . Physical Therapy Occupational Therapy service follow daily basis increase mobility increase cognitive ability . memory decrease occasionally confusion improve day . PICC line place [ * * 2177 - 9 - 12 * * ] IV antibiotic require Vancomycin thru [ * * 2177 - 9 - 16 * * ] MRSA pneumonia . minimal secretion undergo nebulizer treatment . potentially IVC filter remove Dr. [ * * last Name ( STitle ) * * ] evaluate week therefore need return [ * * Hospital 2536 * * ] Clinic . also follow Neuro cognitive clinic Dr. [ * * First Name ( STitle ) * * ] follow discharge rehab . lonfg hospitalization transfer rehab [ * * 2177 - 9 - 12 * * ] therapy goal return home soon . medication admission : none Discharge medication : 1 . Acetaminophen 325 mg Tablet Sig : two ( 2 ) Tablet PO Q6H ( every 6 hour ) need temp > 101.5 . 2 . Bisacodyl 10 mg Suppository Sig : one ( 1 ) Suppository Rectal HS ( bedtime ) need constipation . 3 . Docusate Sodium 50 mg/5 ml Liquid Sig : ten ( 10 ) ml po BID ( 2 time day ) . 4 . Bacitracin Zinc 500 unit / g Ointment Sig : one ( 1 ) Appl Topical QID ( 4 time day ) need abrasion . 5 . Heparin ( Porcine ) 5,000 unit / mL Solution Sig : 5000 ( 5000 ) unit Injection TID ( 3 time day ) . 6 . Albuterol Sulfate 2.5 mg /3 mL ( 0.083 % ) solution Nebulization Sig : one ( 1 ) neb Inhalation Q6H ( every 6 hour ) . 7 . Ipratropium Bromide 0.02 % solution Sig : one ( 1 ) neb Inhalation Q6H ( every 6 hour ) . 8 . aspirin 325 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 9 . Vancomycin 1,000 mg Recon Soln Sig : 1500 ( 1500 ) mg Intravenous every eight ( 8) hour : thru [ * * 2177 - 9 - 16 * * ] . 10 . Morphine Concentrate 20 mg / mL Solution Sig : fifteen ( 15 ) mg PO Q2H ( every 2 hour ) need pain . 11 . HYDROmorphone ( Dilaudid ) 1 - 2 mg IV Q2H : PRN pain please use breakthrough PO / NG MSIR . 12 . Heparin Flush ( 10 unit / ml ) 2 ml IV PRN line flush PICC , heparin dependent : flush 10ml Normal Saline follow Heparin daily PRN per luman . discharge Disposition : Extended Care Facility : [ * * hospital3 1107 * * ] [ * * Hospital * * ] Hospital - [ * * Location ( un ) 38 * * ] discharge diagnosis : / P scooter v tree 1 . leave eye abrasion 2 . rib fracture right [ * * 5 - 5 * * ] , leave 1 3 . bilat pulmonary contusion 4 . grade 2 liverlaceration 5 . open right femur fracture 6 . right thigh laceration 7 . right patellar fracture 8 . right metatarsal neck fracture [ * * 3 - 7 * * ] 9 . small SAH 10.right tp fracture T1 11.[**doctor First Name * * ] 12.acute blood loss anemia Discharge condition : Mental Status : clear coherent . Level consciousness : alert interactive . Activity Status : Bed assistance chair wheelchair . Discharge instruction : * admit hospital multiple injury follow accident include head trauma , rib fracture , knee fracture liver laceration . * make alot progress need rehabilitation return home . * breathe well trach tube plug hopefully remove improve . * continue work physical therapy increase mobility . Followup Instructions : please follow [ * * First Name8 ( NamePattern2 ) * * ] [ * * last Name ( NamePattern1 ) * * ] , NP orthopaedic 1 month , please call [ * * telephone / Fax ( 1 ) 1228 * * ] schedule appointment . call [ * * Hospital 2536 * * ] Clinic [ * * telephone / Fax ( 1 ) 600 * * ] follow appointment [ * * 3 - 5 * * ] week call Vascular Surgery Clinic [ * * telephone / Fax ( 1 ) 1237 * * ] appointment 2 week Dr. [ * * last Name ( STitle ) * * ] . call [ * * hospital 4695 * * ] Clinic [ * * telephone / Fax ( 1 ) 1669 * * ] follow appointment 6 week Dr. [ * * First Name ( STitle ) * * ] . need Head CT prior appointment . secretary book . call Dr. [ * * First Name ( STitle ) * * ] Neuro cognitive Clinic [ * * telephone / Fax ( 1 ) 1690 * * ] appointment discharge rehab complete by:[**2177 - 9 - 12 * * ]
[ "2851" ]
Admission Date : [ * * 2177 - 3 - 12 * * ] Discharge Date : [ * * 2177 - 3 - 22 * * ] Date Birth : [ * * 2109 - 6 - 26 * * ] sex : Service : CARDIOTHORACIC allergy : Shellfish attending:[**first Name3 ( LF ) 1505 * * ] Chief Complaint : exertional angina Major Surgical Invasive Procedure : [ * * 2177 - 3 - 14 * * ] Coronary artery bypass GRAFTING x3 : Left Internal Mammary Artery left Anterior Descending Artery , Saphenous Vein Graft Obtuse Marginal Artery , Saphenous Vein Graft Posterior Descending Artery history Present Illness : 67 year old man know coronary artery disease - / p stent x 6(2004x5 [ * * 11 - 21 * * ] ) develop exertional angina walk [ * * 3 - 9 * * ] . Angina resolve w/ rest minute . Angina recur [ * * 3 - 11 * * ] , patient bring [ * * Hospital * * ] Med Ctr enzyme negative . cardiac catheterization show : taper distal lm,70 % osteal lad,90 % mid RCA . LVEF 60 % LVgram . transfer [ * * Hospital1 18 * * ] surgical management coronary artery disease . time transfer pain free . Past Medical history : Coronary artery disease(PCI / stent x6 ) , Hypertension , HYPERCHOLESTEROLEMIA , CA- leave vocal cord(RT / chemo)[**3 - 20 * * ] PSH : leave knee arthroscopy , leave chest Portacath Social History : work administrator [ * * University / College 33918 * * ] . marry , 2 child . Tob : former smoker , quit 30 yrs ago . ETOH : drink beer cocktail per night . drug family history : brother : mi 60 , uncle : mi 50 mother : htn Physical Exam : pulse : Resp : O2 sit : B / P Right:130/72 leave : 128/72 Height : 70 " Weight:175 # General : WDWN , NAD skin : Dry [ ] intact [ x ] HEENT : PERRLA [ x ] EOMI [ x]glasses neck : Supple [ x ] full rom [ x ] chest : lung clear bilaterally [ x ] heart : rrr [ x ] Irregular [ ] Murmur n Abdomen : Soft [ x ] non - distended [ x ] non - tender [ x ] bowel sound + [ x ] extremity : Warm [ x ] , well - perfuse [ x ] Edema varicosity : None [ x ] Neuro : grossly intact pulse : Femoral Right:2 Left:2 dp Right:2 Left:2 PT [ * * Name ( NI ) 167**]:2 Left:2 Radial Right:2 Left:2 Carotid Bruit right : n leave : n pertinent result : Admission Labs : [ * * 2177 - 3 - 12 * * ] 04:05PM pt-11.7 PTT-23.8 INR(PT)-1.0 [ * * 2177 - 3 - 12 * * ] 04:05PM PLT count-199 [ * * 2177 - 3 - 12 * * ] 04:05PM neuts-78.7 * LYMPHS-9.6 * MONOS-5.6 EOS-5.6 * basos-0.5 [ * * 2177 - 3 - 12 * * ] 04:05PM WBC-6.9 rbc-3.93 * HGB-14.0 HCT-38.2 * MCV-97 # mch-35.6 * MCHC-36.6 * RDW-13.5 [ * * 2177 - 3 - 12 * * ] 04:05PM % HbA1c-5.2 eag-103 [ * * 2177 - 3 - 12 * * ] 04:05PM ALBUMIN-4.1 MAGNESIUM-1.7 [ * * 2177 - 3 - 12 * * ] 04:05PM ALT(SGPT)-36 AST(SGOT)-24 LD(LDH)-148 ALK phos-100 TOT BILI-2.0 * [ * * 2177 - 3 - 12 * * ] 04:05PM GLUCOSE-123 * UREA N-14 CREAT-1.0 SODIUM-137 POTASSIUM-4.2 chloride-100 TOTAL CO2 - 27 anion gap-14 [ * * 2177 - 3 - 12 * * ] 04:33PM URINE blood - NEG NITRITE - NEG protein - NEG GLUCOSE - NEG KETONE - NEG BILIRUBIN - NEG UROBILNGN - NEG ph-6.0 LEUK - NEG [ * * 2177 - 3 - 12 * * ] 04:33PM URINE COLOR - Yellow APPEAR - Clear SP [ * * last Name ( un ) 155**]-1.020 Discharge Labs : Radiology Report CHEST ( PORTABLE AP ) Study Date [ * * 2177 - 3 - 17 * * ] 7:29 Final Report : comparison study [ * * 3 - 15 * * ] , monitoring support device remove except leave subclavian catheter right IJ sheath . chest tube remove , evidence pneumothorax . residual opacification left base consistent atelectasis effusion . [ * * Hospital1 18 * * ] echocardiography REPORT Echocardiographic measurement result measurement Normal Range Left Ventricle - Ejection Fraction : 55 % > = 55 % finding right ATRIUM / INTERATRIAL SEPTUM : color - flow imaging interatrial septum raise suspicion atrial septal defect , could confirm basis study . LEFT VENTRICLE : normal regional LV systolic function . overall normal LVEF ( > 55 % ) . right ventricle : borderline normal RV systolic function . AORTIC VALVE : three aortic valve leaflet . . Trace AR . MITRAL VALVE : MS . mild ( 1 + ) MR . TRICUSPID VALVE : Physiologic TR . PULMONIC VALVE / PULMONARY ARTERY : pulmonic valve well see . PERICARDIUM : small pericardial effusion . GENERAL comment : tee perform location list . certify present compliance HCFA regulation . patient general anesthesia throughout procedure . tee relate complication . patient appear sinus rhythm . result personally review MD care patient . Conclusions focus intraoperative TEE chest exploration post - operative bleeding . color - flow imaging interatrial septum raise suspicion atrial septal defect , could confirm basis study . regional left ventricular wall motion normal . overall left ventricular systolic function normal ( lvef>55 % ) . borderline normal RV free wall function . three aortic valve leaflet . aortic valve stenosis . trace aortic regurgitation see . Mild ( 1 + ) mitral regurgitation see . small pericardial effusion . Dr. [ * * last Name ( STitle ) * * ] notify person result . Brief Hospital course : Mr [ * * know lastname 732 * * ] transfer fro [ * * Hospital * * ] Med Ctr surgical management coronary artery disease . usual pre - operative workup bring operating room coronary artery bypass graft [ * * 2177 - 3 - 14 * * ] . please see operative report detail . summmary : Coronary Artery Bypass Grafting x3 Lwft Internal Mammary Artery leave Anterior Descending Artery , Saphenous Vein Graft Obtuse Marginal Artery , Saphenous Vein Graft Posterior Descending Artery . cardiopulmonary bypass time 51 minute crossclamp time 39 minute . tolerate operation well post - operatively transfer cardiac surgery ICU stable conditio . remain hemodynamically stable immediate post - op period . wake anesthesia neurologically intact extubate operative day . POD1 continue significant drainage chest tube bring back operating room mediastinal exploration - source bleeding find . tolerate procedure well return cardiac surgery ICU stable condition . recover anesthesia extubate shortly surgery complete . remain hemodynamically stable throughout period . tube line drain remove per cardiac surgery protocol . POD 3 transfer ICU stepdown floor continued post - op care recovery . physical therapy work patient advance activity daily living improve strength endurance . POD # 4 , Pt develope drainage sternal incision . start IV Vancomycin . betadine cleanse TID start . POD # [ * * 4 - 19 * * ] , pt wound improve . discharge PO keflex x 10 day . wound DC without drainage . POD 10 discharge home visit nurse . follow Dr [ * * last Name ( STitle ) * * ] 3 week , sternal check [ * * 3 - 26 * * ] [ * * Hospital Ward Name * * ] 6 . follow cardiologist , appt make , also instruct follow PCP . medication admission : Lisinopril 20 mg daily , Lipitor 80 mg daily , Plavix 75 mg [ * * last Name ( LF ) * * ] , [ * * first Name3 ( LF ) * * ] 325 mg daily , Discharge medication : 1 . 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 * 2 . docusate sodium 100 mg Capsule Sig : one ( 1 ) Capsule po BID ( 2 time day ) . Disp:*60 Capsule(s ) * Refills:*2 * 3 . atorvastatin 80 mg Tablet Sig : one ( 1 ) Tablet PO HS ( bedtime ) . disp:*30 Tablet(s ) * Refills:*2 * 4 . [ * * last Name ( un ) 1724 * * ] Lisinopril 20 mg daily , EcASA 325 mg daily , Lopressor 25 mg [ * * hospital1 * * ] , Plavix 75 mg daily , NTG prn , lipitor 80 mg daily 5 . lisinopril 5 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . disp:*30 Tablet(s ) * Refills:*2 * 6 . metoprolol tartrate 25 mg Tablet Sig : three ( 3 ) Tablet PO BID ( 2 time day ) . Disp:*180 Tablet(s ) * Refills:*2 * 7 . furosemide 20 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) 7 day . Disp:*14 Tablet(s ) * Refills:*0 * 8 . potassium chloride 8 meq Tablet Extended Release Sig : one ( 1 ) Tablet Extended Release po twice day 7 day . disp:*14 Tablet Extended release(s ) * Refills:*0 * 9 . Keflex 250 mg Capsule Sig : one ( 1 ) Capsule po four time day 10 day . Disp:*40 capsule(s ) * Refills:*0 * discharge Disposition : Home Service Facility : [ * * Location ( un ) 1110 * * ] VNA Discharge Diagnosis : Coronary Artery Disease / p Coronary Bypass Grafting x3 PCI / stents(6 ) PMH : Hypertension , HYPERCHOLESTEROLEMIA , CA- leave vocal cord(RT / chemo)[**3 - 20 * * ] PSH : lt knee arthroscopy , LT chest portacath Discharge condition : alert orient x3 nonfocal ambulate steady gait incisional pain manage incision : Sternal - heal well , erythema drainage Leg Right / left - heal well , erythema drainage . Edema discharge instruction : please shower daily include wash incision gently mild soap , bath swimming clear surgeon . look incision daily redness drainage please lotion , cream , powder , ointment incision morning weigh evening take temperature , write chart drive approximately one month take narcotic , discuss follow appointment surgeon able drive lifting 10 pound 10 week please call question concern [ * * telephone / Fax ( 1 ) 170 * * ] * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * Followup Instructions : schedule follow appointment surgeon : Dr [ * * First Name ( STitle ) * * ] [ * * Name ( STitle ) * * ] [ * * 2177 - 4 - 10 * * ] 9am [ * * hospital1 * * ] Cardiologist : [ * * first Name8 ( NamePattern2 ) * * ] [ * * last Name ( NamePattern1 ) 5874 * * ] [ * * 2177 - 4 - 16 * * ] 3PM please call schedule appointment Primary Care Dr [ * * last Name ( STitle ) * * ] , [ * * first Name3 ( LF ) 488 * * ] J. [ * * telephone / Fax ( 1 ) 8036 * * ] [ * * 4 - 15 * * ] week wound check schedule [ * * 5 - 26 * * ] 1000 hrs , please come [ * * Hospital Ward Name * * ] 6 scheduled time . thw midleveler look wound see stable . * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * Labs : PT / INR Coumadin ? ? ? ? ? ? indication Goal INR first draw result phone fax complete by:[**2177 - 3 - 22 * * ]
[ "4019", "2720" ]
Admission Date : [ * * 2188 - 5 - 24 * * ] Discharge Date : [ * * 2188 - 5 - 30 * * ] Date Birth : [ * * 2132 - 11 - 19 * * ] sex : Service : MEDICINE allergy : Ampicillin / Thorazine Attending:[**Last Name ( NamePattern4 ) 290 * * ] Chief Complaint : Respiratory Failure Major Surgical Invasive Procedure : Trach change mechanical ventilation history Present Illness : Mr. [ * * know lastname 89172 * * ] 55 yo man PMH significant Downs Syndrome , MRSA pneumonia respiratory failure [ * * 10/2187 * * ] result tracheostomy reverse [ * * 2188 - 5 - 13 * * ] , transfer / p intubation [ * * hospital1 * * ] [ * * Location ( un ) 1110 * * ] today . Patient predominantly rehab since develop MRSA pneumonia [ * * 10/2187 * * ] ( first [ * * last Name ( un ) * * ] [ * * Hospital 5279 * * ] Rehab Centers ) present [ * * hospital1 * * ] rehab respiratory distress . start Rocephin [ * * 5 - 22 * * ] presume pneumonia Rehab setting labored breathing . Patient intubate [ * * hospital1 * * ] labored breathing , accessory muscle use . per report , may fail attempt OSH ED - open tracheostomy prior intubation . . OSH , patient receive , levoquin 750 mg @ 03:25 , Vancomycin 1 g @ 5:09 pneumonia . order 4L NS receive least 2.5L. CXR CT Chest appear show fluid overload . Patient difficult maintain sedation ; blood pressure drop propofol , patient briefly dopamine sedation switch verse bolus prn , tolerate well . Trach site serosanguinous fluid leakage , cover guaze tegaderm . respiratory therapist ED confirm air leakage ventilator . Patient transfered [ * * Hospital1 18 * * ] management . . ED , initial VS follow : 99.9 ( rectal temp ) 101 174/100 22 98 % ventilator 100%fio2 . give 1amp D50 blood sugar 69 . also receive 250cc IVF 2.5 mg bolus IV verse sedation ventilate . EKG show sinus tach rate 103 . CXR show fluid overload possible consolidation , CTA chest do characterize ? consolidation rule PE . CTA show sign PE confirm RUL RML pneumonia , well fluid fill esophagus , suggest aspiration . CT also show moderate left small right effusion , pulmonary edema . vital ED prior transfer ICU follow : 99.8F hr 91 BP 92/53 rr 16 o2sat100 % cpap FIO2 60 % , PS 10 , PEEP 5 . . arrival unit , patient mechanically ventilate appear comfortable . accompany sister able corroborate story . note , patient non - verbal baseline make sign , eat icecream [ * * last Name ( un ) * * ] tea mouth ( pleasure ) otherwise feed tube feed . . Past Medical History : - Downs Syndrome - MRSA Pneumonia complicate tracheostomy [ * * 10/2187 * * ] - reverse [ * * 2188 - 5 - 13 * * ] - C Diff Colitis - [ * * 2188 * * ] - Pseudomonas Colitis - [ * * 2188 * * ] - dx colonoscopy , tx w cipro g - tube - Adrenal Insufficiency - Seizure history , per sister [ * * name2 ( NI ) 89173 * * ] hospitalization [ * * 11 - 3 * * ] - keppra - Hx transaminitis - presume secondary antiepileptic - Hx HBV - Membranoproliferative Glomerulonephritis Social History : live Group Home , spend significant amount time Rehab since [ * * 10/2187 * * ] present [ * * first Name4 ( NamePattern1 ) 5279 * * ] [ * * last Name ( NamePattern1 ) * * ] . [ * * last Name ( NamePattern1 ) 6961 * * ] guardian , sister [ * * Name ( NI ) * * ] also involved care finance . Family history : NC Physical Exam : admission exam : GEN : comfortable appear , open eye command HEENT : ett place . neck : Tegaderm place anterior neck ; difficult assess opening skin . drainage erythema . CV : RRR , murmur lung : Rhonchi anteriorly R > l , CTAB laterally side ABD : soft , non - tender distend . central g - tube cover gauze tube feed drain around opening . ostomy erythematous , raw . erythema surround skin . EXT : LE cachectic , LE edema . DISCHARGE EXAM : GEN : comfortable appear , open eye command , distress HEENT / Neck : EOMI , trach place sputum surrounding , mild erythema around site CV : RRR , murmur lung : Rhonchi anteriorly , CTAB laterally side ABD : soft , non - tender distend . central g - tube cover gauze . mildly erythematous around opening . EXT : LE cachectic , LE edema . pertinent result : ADMISSION labs : . [ * * 2188 - 5 - 24 * * ] 11:50am pt-18.8 * PTT-31.4 INR(PT)-1.7 * [ * * 2188 - 5 - 24 * * ] 11:50am urine RBC-28 * WBC-7 * BACTERIA - yeast - NONE EPI-0 TRANS EPI-<1 [ * * 2188 - 5 - 24 * * ] 11:50am urine BLOOD - MOD NITRITE - NEG PROTEIN-30 GLUCOSE - NEG KETONE - NEG BILIRUBIN - NEG UROBILNGN - NEG PH-6.0 LEUK - SM [ * * 2188 - 5 - 24 * * ] 11:50AM WBC-11.7 * RBC-2.84 * HGB-10.5 * HCT-31.6 * MCV-111 * MCH-37.1 * mchc-33.4 RDW-18.9 * [ * * 2188 - 5 - 24 * * ] 11:50am GLUCOSE-69 * UREA N-54 * CREAT-1.0 sodium-136 POTASSIUM-5.0 chloride-107 total CO2 - 24 anion GAP-10 [ * * 2188 - 5 - 24 * * ] 12:00PM LACTATE-2.0 . DISCHARGE LABS : . [ * * 2188 - 5 - 30 * * ] 03:56am blood wbc-8.1 RBC-2.32 * Hgb-8.9 * hct-26.7 * MCV-115 * MCH-38.5 * mchc-33.5 RDW-17.4 * Plt ct-130 * [ * * 2188 - 5 - 30 * * ] 03:56am blood Glucose-83 UreaN-29 * Creat-1.1 Na-135 K-3.7 Cl-108 HCO3 - 24 AnGap-7 * [ * * 2188 - 5 - 30 * * ] 03:56am blood Calcium-7.3 * Phos-2.5 * Mg-1.5 * [ * * 2188 - 5 - 30 * * ] 03:56am blood vanco-25.0 * . MICRO : C. diff negative Urine culture - growth blood culture x2 - growth date IMAGING : CXR [ * * 2188 - 5 - 24 * * ] : 1 . endotracheal tube terminate carina . 2 . mild pulmonary interstitial edema . 3 . right upper zone opacity may reflect aspiration pneumonitis develop pneumonia . CT - [ * * 2188 - 5 - 24 * * ] : impression : 1 . rul RML pneumonia , possible due aspiration since esophagus fluid fill dilate . 2 . PE . 3 . moderate left small right effusion , pulmonary edema . 4 . mediastinal lymphadenopathy 5 . Acute leave 7th rib fracture . G / GJ / GI TUBE check finding : supine radiograph demonstrate jejunostomy tube tip junction distal duodenum proximal jejunum . contrast see pass distally jejunum without evidence leak . Bowel gas pattern normal without evidence leak . image portion lung clear . surgical clip note overlie base heart . IMPRESSION : jejunostomy tube appropriate position normal passage contrast without evidence leak . Brief Hospital Course : 55 hx Downs Syndrome , MRSA pneumonia c / b respiratory failure tracheostomy , / p tracheostomy reversal 10d prior admission , transfer [ * * Hospital1 18 * * ] hypoxic respiratory failure [ * * 2 - 27 * * ] RUL / RML aspiration PNA . # Aspiration PNA / respiratory distress : PE rule potential cause respiratory distress . Imaging demonstrate RUL / RML pneumonia secondary aspiration , well airway narrowing site prior tracheostomy . likely secondary aspiration , patient also note fluid fill esophagus CT scan . Patient treat hospital acquire community acquire pneumonia Vancomycin , Levoquin Cefepime ( 8 - day course ) . culture urine blood OSH show growth . aspiration may relate overflow g - tube site . Tube feed initially hold , G tube study order show jejunostomy tube appropriate position normal passage contrast without evidence leak . patient steroid home adrenal insufficiency , PCP prophylaxis home bactrim daily start . Patient arrange transfer [ * * Hospital Ward Name 517 * * ] ICU service extubation potential IP intervention site airway narrowing . IP find 0.8 cm focal area stenosis dynamic collapse 2nd tracheal ring . granulation tissue debride IP replace percutaneous trach exist stoma . Patient need evaluation tracheal resection / reconstruction IP / p f / u 2 week . post - procedure CXR show multifocal PNA , unchanged bilateral effusion , trach appropriate position . Patient remain stable new trach place well prior discharge . last day levaquin cefepime [ * * 2188 - 5 - 31 * * ] . . # recent history colitis : report recent history C.diff Pseudomembranous colitis . Patient several episode lose stool . C. diff check negative . . # syndrome / anxiety : baseline , pt nonverbal . Pt restart home dose ativan give evidence anxiety aggitation w / group people intubate . . # Adrenal Insufficiency : history unclear patient currently prednisone 20 daily - patient outpatient endocrine evaluation . per [ * * Hospital 228 * * ] rehab facility steroid start treat low sodium . Patient currently normal blood pressure . Steroid dose taper 10 mg daily 1 week outpatient follow electrolyte . Patient start PCP prophylaxis , remain go continue steroid long term . patient follow - endocrinology work - possible renal insufficiency . osh record fax endocrinology department appointment make . . # Hx seizure disorder : reportedly first seizure [ * * 11 - 3 * * ] time hospitalization MRSA pneumonia . continue home dose Keppra . . # FEN : concern leak J tube site . Tube feed hold concern leak feeding tube . Surgery consult suture tube place clamp . dress place tube site . . # Prophylaxis : SubQ heparin , Famotidine . # contact : [ * * Name ( NI ) 6961 * * ] = guardian , [ * * Name ( NI ) 449 * * ] [ * * Name ( NI ) * * ] ( [ * * 0 - 0- * * ] ) , Sister [ * * Name ( NI ) * * ] [ * * telephone / Fax ( 1 ) 89174 * * ] . . # Code Status : full code ( confirm family ) medication admission : Prednisone 20 mg daily Omeprazole 20 mg [ * * hospital1 * * ] Keppra 500 mg [ * * hospital1 * * ] ( crush ) Ativan 0.25 - 0.5 mg via PEG Q8h PRN ( moderate severe anxiety ) Duonebs prn wheezing oxycodone Zinc Bacitracin ointment Bowel Regimen prn discharge disposition : Extended Care Facility : [ * * Hospital * * ] Healthcare Center - [ * * Location ( un ) 1110 * * ] discharge diagnosis : primary diagnosis : subglottic stenosis Hosptial acquire pneumonia . secondary diagnosis : ? adrenal insufficiency 's syndrome Seizure disorder Discharge condition : level consciousness : alert interactive . Activity Status : Bedbound . Mental Status : Confused - sometimes . ( baseline ) Discharge instruction : pleasure participate care Mr. [ * * know lastname 89172 * * ] . admit [ * * Hospital1 18 * * ] evaluation respiratory failure . find narrowing trachea . take procedure replace tracheostomy . also treat pneumonia . . concern g tube work appropriately . Surgery evaluate fix J tube . . start steroid outpatient facility low sodium . decrease dose steroid start Bactrim prevent type lung infection call PCP . [ * * Name10 ( NameIs ) * * ] follow - endocrinology evaluate need take steroid . . medication change : start Cefepime 2gm Q24 one day start Levofloxacin 750 mg daily one day START Bactrim SS daily prophylaxis PCP DECREASE Prednisone 10 mg daily Followup Instructions : department : Thoracic Multi [ * * hospital 4094 * * ] Clinic : TUESDAY [ * * 2188 - 6 - 10 * * ] 2:30 pm : [ * * first Name8 ( NamePattern2 ) * * ] [ * * Name8 ( MD ) * * ] , MD [ * * 0 - 0- * * ] building : SC [ * * Hospital Ward Name 23 * * ] Clinical Ctr [ * * Location ( un ) 24 * * ] campus : EAST good parking : [ * * Hospital Ward Name 23 * * ] Garage Department : Thoracic Multi [ * * hospital 4094 * * ] Clinic : TUESDAY [ * * 2188 - 6 - 10 * * ] 3:00 pm : [ * * Name6 ( MD ) 1532 * * ] [ * * Name8 ( MD ) 1533 * * ] , MD [ * * 0 - 0- * * ] building : SC [ * * Hospital Ward Name 23 * * ] Clinical Ctr [ * * Location ( un ) 24 * * ] campus : EAST good parking : [ * * Hospital Ward Name 23 * * ] Garage Department : MEDICAL SPECIALTIES - Endocrinology : WEDNESDAY [ * * 2188 - 6 - 11 * * ] 3:15 pm : MALA [ * * last Name ( namepattern4 ) 16956 * * ] , MD [ * * telephone / Fax ( 1 ) 1803 * * ] building : SC [ * * Hospital Ward Name 23 * * ] Clinical Ctr [ * * Location ( un ) * * ] campus : EAST good parking : [ * * Hospital Ward Name 23 * * ] Garage Department : HEMATOLOGY / ONCOLOGY : TUESDAY [ * * 2188 - 6 - 10 * * ] 2:30 pm : [ * * first Name8 ( NamePattern2 ) * * ] [ * * Name8 ( MD ) * * ] , MD [ * * 0 - 0- * * ] building : SC [ * * Hospital Ward Name 23 * * ] Clinical Ctr [ * * Location ( un ) 24 * * ] campus : EAST good parking : [ * * Hospital Ward Name 23 * * ] Garage Department : HEMATOLOGY / ONCOLOGY : TUESDAY [ * * 2188 - 6 - 10 * * ] 3:00 pm : [ * * Name6 ( MD ) 1532 * * ] [ * * Name8 ( MD ) 1533 * * ] , MD [ * * 0 - 0- * * ] building : SC [ * * Hospital Ward Name 23 * * ] Clinical Ctr [ * * Location ( un ) 24 * * ] campus : EAST good parking : [ * * Hospital Ward Name 23 * * ] Garage Department : MEDICAL specialty : WEDNESDAY [ * * 2188 - 6 - 11 * * ] 3:15 pm : MALA [ * * last Name ( namepattern4 ) 16956 * * ] , MD [ * * telephone / Fax ( 1 ) 1803 * * ] building : SC [ * * Hospital Ward Name 23 * * ] Clinical Ctr [ * * Location ( un ) * * ] campus : EAST good parking : [ * * Hospital Ward Name 23 * * ] garage [ * * initial ( namepattern4 ) * * ] [ * * last Name ( namepattern4 ) * * ] [ * * Name8 ( MD ) * * ] MD [ * * MD Number(1 ) 292 * * ] complete by:[**2188 - 5 - 30 * * ]
[ "5070" ]
Admission Date : [ * * 2176 - 8 - 29 * * ] Discharge Date : [ * * 2176 - 9 - 6 * * ] Date Birth : [ * * 2121 - 2 - 13 * * ] sex : Service : MEDICINE allergy : Penicillins / Keflex attending:[**first Name3 ( LF ) 1928 * * ] Chief Complaint : upper extremity weakness Major Surgical Invasive Procedure : C5 - C6 anterior cervical decompression fusion , C1 tumor removal history Present Illness : 55 - year - old man diabetes mellitus type 2 , hypertension , severe peripheral [ * * first Name3 ( LF ) 1106 * * ] disease / p r SFA stent angioplasty L SFA stent placement , congenital pulmonic valve stenosis , CAD / p BMS stent , diastolic CHF , atrial fibrillation / p ablation warfarin , stage 3 diabetic nephropathy , intradural tumor compress spinal cord C1 / C2 , admit [ * * 2176 - 8 - 29 * * ] neurosurgery anterior cervical decompression c5/6 fusion ( [ * * 8 - 29 * * ] ) extradural tumor removal C1 intradural tumor ( [ * * 8 - 30 * * ] ) . patient post - operatively manage ICU dexamethasone taper . develop small subdural hematoma ( [ * * 8 - 30 * * ] ) new neurologic symptom . aspirin heparin SC restart . Clopidogrel , L SFA stent , schedule restart POD#5 , [ * * 2176 - 9 - 4 * * ] , warfarin , atrial fibrillation , restart [ * * 2176 - 9 - 9 * * ] . Patient extubate [ * * 9 - 1 * * ] , come furosemide drip dchf . [ * * Month / Day ( 4 ) * * ] follow patient mottled right foot recent [ * * Month / Day ( 4 ) 1106 * * ] procedure . Patient 's medical issue diabetes , HTN , CKD ( Cr 1.1 ) , atrial fibrillation ( hrs 70s-80s ) , CAD / p stent " chronic hyponatremia " ( Na 138 ) stable . transfer request ongoing management diastolic CHF . evaluation SICU transfer , patient sleep arousable , complain old back pain constipation . vital sign stable O2 saturation 98 % 3l. Past Medical History : ( 1 ) type 2 diabetes mellitus , require insulin , complication year poor glycemic control : -hypertension -severe peripheral [ * * Month / Day ( 4 ) 1106 * * ] disease -peripheral neuropathy -pressure , venous stasis , neuropathic ulcer right leave low extremity -stage 3 diabetic nephropathy -renal insufficiency ( baseline creatinine 1.5 1.7 ) ( 2 ) atrial fibrillation status post ablation [ * * 2169 * * ] [ * * 2174 * * ] , coumadin ( 3 ) congenital pulmonic valve stenosis status post two childhood surgery -history RV failure -history peripheral edema anasarca ( 4 ) chronic hyponatremia ( 5 ) chronic low back pain status post car accident ( 6 ) spinal cord meningioma compress spinal cord C1 / C2 ( 7 ) COPD ( 8) Coronary artery disease status post stente [ * * 2169 * * ] ( bare metal stent Dr. [ * * first Name4 ( NamePattern1 ) * * ] [ * * last Name ( NamePattern1 ) 7047 * * ] ( [ * * telephone / Fax ( 1 ) 8725 * * ] ) ) repeat stente [ * * Hospital1 18 * * ] [ * * 2174 * * ] ( bare metal stent - see / c summary [ * * 2175 - 2 - 7 * * ] ) ( 9 ) mi [ * * 2161 * * ] Social History : patient married two adult son live home . live [ * * Hospital1 1474 * * ] , . wife work 60 hour week , leave home day . bedbound several year . visit nurse come week change dressing low extremity ulcer . son struggle alcoholism heroin abuse . young son recently threaten suicide homicide ( patient 's wife ) , source much stress home . use work " bouncer " construction , enjoy ride motorcycle . patient say try keep positive attitude condition . say feel depressed , say interested therapy medication depression . see primary care physician [ * * last Name ( namepattern4 ) * * ] 2 year travel ambulance PCP 's office touch patient wife weekly . -[**Name2 ( NI ) * * ] 2 pack per year smoke history " several year " -He drink alcohol occasionally , never problem alcoholism -He deny recreational IV drug use Family history : heart disease unspecificed family member . Physical Exam : physical exam admission : Gen : obese , deconditioned , pain movement extremity . Extrem : B LE edema Neuro : mental status : awake alert , cooperative exam . language : speech fluent good comprehension repetition . name intact . dysarthria paraphasic error . motor : patient severe bilateral wasting muscle hand . UE 's : fi's:[**2 - 1 * * ] 4+/5 Grip 4+/5 Bi4+/5 Tri 4+/5 . RLE : [ * * 1 - 4 * * ] pf / df 0/5 LLE : IP3/5 PF / df 0/5 pertinent result : [ * * 2176 - 8 - 29 * * ] 12:10PM GLUCOSE-94 UREA N-42 * creat-1.2 SODIUM-133 POTASSIUM-4.4 CHLORIDE-95 * TOTAL CO2 - 28 anion gap-14 [ * * 2176 - 8 - 29 * * ] 12:10PM estGFR - use [ * * 2176 - 8 - 29 * * ] 12:10PM wbc-7.6 RBC-3.91 * HGB-9.7 * hct-30.5 * MCV-78 * MCH-24.9 * MCHC-31.9 RDW-13.6 [ * * 2176 - 8 - 29 * * ] 12:10PM PLT count-206 IMAGING study : # c - spine Xray [ * * 8 - 29 * * ] : single lateral view cervical spine obtain portably , label # 1 . c1 c4/5 disc space visualize . C5 vertebral body faintly see -- bony structure low obscure overlying soft tissue . however , surgical marker see overlie anterior aspect C4 - 5 C5 - 6 disc space , anterior approach . support tubing temperature proble note . # c - spine CT [ * * 2176 - 8 - 29 * * ] : 1 . new interval C5 - C6 anterior fusion intervertebral disc spacer , immediate hardware complication . post - surgical change soft tissue subcutaneous emphysema mostly right submandibular region . 2 . Mass C1 level associated cord compression consistent know meningioma well describe recent MRI . 3 . soft tissue thicken right lung apex , fully characterize current CT . comparison CT neck [ * * 2176 - 8 - 9 * * ] , increase size . CT chest recommend evaluate , clinically warrant . # head CT [ * * 2176 - 8 - 30 * * ] : 1 . new interval leave frontal subdural hyperdense extra - axial fluid collection new interval subdural subfalcine extra - axial hyperdense fluid collection , indicate subdural hemorrhage , likely post - surgical clinical correlation recommend . 2 . pneumocephalus distribution basilar cistern , mostly leave sylvian fissure , bifrontally falx , likely post - surgical , additionally posterior fossa near site occipital craniotomy . 3 . post - surgical change left craniotomy occipital bone laminectomy C1 subcutaneous emphysema hyperdense product , likely post - surgical . 4 . soft tissue hyperdensity posterior parietal , occipital soft tissue region , could small post - surgical hematoma . . # c - spine MRI [ * * 2176 - 8 - 31 * * ] : status post resection C1 extradural tumor , likely meningioma expectorated postoperative change . large intraspinal hematoma see . remain persistent narrowing spinal canal C1 level indentation posterior aspect spinal cord . continue followup recommend . mild spinal cord atrophy could secondary chronic myelomalacia . . # LE arterial Duplex [ * * 2176 - 9 - 3 * * ] : peak systolic velocity involve native right common femoral artery 104 cm / sec . velocity within superficial femoral artery range 85 234 cm / sec within popliteal artery right , 25 cm / sec . left , peak systolic velocity within common femoral artery 132 cm / sec , SFA , velocity range 146 - 75 cm / sec within popliteal artery 85 cm / sec . IMPRESSION : finding state indicate widely patent common femoral , superficial femoral popliteal artery bilaterally . . PATHOLOGY : # c1 tumor [ * * 2176 - 8 - 30 * * ] : cervical medullary junction tumor : Meningioma , psammomatous subtype ( Grade ) . tumor compose meningothelial cell numerous psammoma body collagen deposition typical feature mitotic activity . Brief Hospital Course : 55 - year - old man diabetes mellitus type 2 , severe peripheral [ * * Month / Day / Year 1106 * * ] disease , CAD , diastolic CHF , atrial fibrillation , present plan anterior cervical decompression C5 - 6 removal C1 meningioma . # cervical myelopathy meningioma : Patient underwent anterior cervical decompression c5/6 fusion [ * * 2176 - 8 - 29 * * ] removal C1 meningioma [ * * 2176 - 8 - 30 * * ] . patient post - operatively manage ICU dexamethasone taper . develop small subdural hematoma [ * * 2176 - 8 - 30 * * ] new neurologic symptom . per neurosurgery recommendation , aspirin heparin SC restart . Clopidogrel , recent left SFA stent , restart POD#5 , [ * * 2176 - 9 - 4 * * ] , warfarin , atrial fibrillation , restart [ * * 2176 - 9 - 9 * * ] . note , concern develop LE weakness procedure , - evaluation neurosurgery team feel strength leg baseline change . continue work PT hospitalization . # diastolic heart failure : patient experience acute exacerbation diastolic heart failure likely secondary significant fluid administration surgery . place furosemide gtt SICU , transition home dose lasix floor . discharge slightly admission weight 115 kg O2 sat mid 90 's room air . # Peripheral [ * * Date Range * * ] disease . patient recently underwent bilateral SFA angioplasty leave SFA stente . preparation neurosurgery , plavix hold pre - procedure subsequently - start [ * * 2176 - 9 - 4 * * ] . undergo bilateral arterial ultrasound [ * * 2176 - 9 - 3 * * ] demonstrate patent SFA femoral artery . # atrial fibrillation : patient atrial fibrillation hospitalization . give need neurosurgery coumadin hold . schedule restart 10 day post - procedure ( [ * * 2176 - 9 - 9 * * ] ) . well rate control time discharge . # DM II . patient 's insulin regimin adjust 50 unit insulin glargine nightly humalog insulin slide scale achieve good control blood sugar ( FSBS 100 - 180 ) . # pressure ulcer . patient 2x2 cm right heel full thickness ulcer without odor drainage . right dorsum small 1x1 cm partial thickness ulcer . wound care nursing consult obtain . pressure ulcer care perform repositioning , skin cleansing conditioner application , cover ABD kerlex . # cope . pt express staff member mood poor cope well surgery . never express suicidal ideation . express extremely frustrated hospitalization inability walk function independently . discuss possibility talk psychiatrist hospital , decline . feel feeling persist would pursue psychiatric care . number psychiatric service provide discharge . # Chronic pain syndrome : patient continue home regiman dilaudid 4 mg PO Q3H : prn # chronic hyponatremia . patient history chronic hyponatremia although sodium remain 130 - 140 admission . medication admission : 1 . Docusate Sodium 100 mg Capsule Sig : one ( 1 ) Capsule po BID : PRN need constipation . 2 . furosemide 10 mg / mL Solution Sig : Sixty ( 60 ) mg Injection [ * * hospital1 * * ] ( 2 time day ): hold sbp<100 . 3 . Ascorbic Acid 500 mg Tablet Sig : one ( 1 ) Tablet po twice day . 4 . pantoprazole 40 mg Tablet , Delayed Release ( E.C. ) Sig : one ( 1 ) Tablet , Delayed Release ( E.C. ) PO Q24H ( every 24 hour ) . 5 . Metoprolol Tartrate 25 mg Tablet Sig : one ( 1 ) Tablet PO BID ( 2 time day ): hold sbp<100 HR<60 . 6 . trazodone 50 mg Tablet Sig : one ( 1 ) Tablet PO HS ( bedtime ) need insomnia . 7 . Acetaminophen 325 mg Tablet Sig : 1 - 2 tablet po Q6H ( every 6 hour ) need fever . 8 . Petrolatum Ointment Sig : one ( 1 ) Appl Topical DAILY ( Daily ): please apply leg wound per wound care order . thank ! . 9 . Methocarbamol 500 mg Tablet Sig : two ( 2 ) Tablet PO QID ( 4 time day ) . 10 . albuterol Sulfate 90 mcg / actuation HFA Aerosol Inhaler Sig : two ( 2 ) Puff Inhalation q6H : PRN need shortness breath wheezing . 11 . hydromorphone 4 mg Tablet Sig : one ( 1 ) Tablet PO Q3H ( every 3 hour ) need pain : hold rr<12 sedation . 12 . Simvastatin 10 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 13 . senna 8.6 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) . 14 . hydroxyzine HCl 25 mg Tablet Sig : one ( 1 ) Tablet PO q6H : PRN need itching . 15 . Polyethylene Glycol 3350 17 gram / dose Powder Sig : seventeen ( 17 ) g po BID : PRN need constipation . 16 . Bisacodyl 5 mg Tablet , Delayed Release ( E.C. ) Sig : two ( 2 ) Tablet , Delayed Release ( E.C. ) PO DAILY ( Daily ) need constipation : hold diarrhea . 17 . Clonazepam 0.5 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) need anxiety . 18 . Menthol - Cetylpyridinium 3 mg Lozenge Sig : one ( 1 ) Lozenge mucous membrane PRN ( need ) need dry mouth , sore throat . 19 . Ketoconazole 2 % Cream Sig : one ( 1 ) Appl Topical [ * * hospital1 * * ] ( 2 time day ): please apply upper forehead scalp seborrheic dermatitis ( day 1 = [ * * 2176 - 8 - 11 * * ] ) . also , please apply wound leave shin overlie fungal infection(day 1 = [ * * 2176 - 8 - 15 * * ] ) . thank ! . 20 . Glycerin ( Adult ) Suppository Sig : one ( 1 ) Suppository Rectal PRN ( need ) need constipation . 21 . Hydrocodone - Acetaminophen 5 - 500 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) need headache : hold somnolence . 22 . Heparin drip Heparin IV Sliding Scale ( please see include scale ): diagnosis : DVT / - fib , Patient Weight : 114.76 kg , Initial Bolus : 0 unit ivp , Initial Infusion Rate : 1450 unit / hr , Target PTT : 60 - 100 second , . PTT < 40 : 4600 unit Bolus increase infusion rate 450 unit / hr , PTT 40 - 59 : 2300 unit Bolus increase infusion rate 250 unit / hr , PTT 60 - 100 * : , PTT 101 - 120 : reduce infusion rate 250 unit / hr , PTT > 120 : hold 60 min reduce infusion rate 450 unit / hr , 23 . insulin slide scale glargine 46 unit bedtime ; humalog slide scale per include slide scale . Discharge medication : 1 . hydroxyzine HCl 25 mg / mL Solution Sig : one ( 1 ) Intramuscular Q6H ( every 6 hour ) need pruritis . 2 . Clonazepam 0.5 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) . 3 . furosemide 40 mg Tablet Sig : 2.5 tablets po BID ( 2 time day ) . 4 . clopidogrel 75 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 5 . senna 8.6 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) need constipation . 6 . famotidine 20 mg Tablet Sig : one ( 1 ) Tablet po Q12H ( every 12 hour ) . 7 . Metoprolol Tartrate 50 mg Tablet Sig : one ( 1 ) Tablet PO BID ( 2 time day ) . 8 . ascorbic Acid 500 mg Tablet Sig : one ( 1 ) Tablet po twice day . 9 . Methocarbamol 500 mg Tablet Sig : 1.5 tablet po Q4H ( every 4 hour ) . 10 . albuterol Sulfate 90 mcg / actuation HFA Aerosol Inhaler Sig : [ * * 12 - 1 * * ] Inhalation every 4 - 6 hour need shortness breath wheezing . 11 . Docusate Sodium 100 mg Capsule Sig : one ( 1 ) Capsule po BID ( 2 time day ) . 12 . dilaudid 4 mg Tablet Sig : one ( 1 ) Tablet PO Q3hr : prn . 13 . simvistatin 10 mg Qday 14 . Petrolatum Ointment Sig : one ( 1 ) Appl Topical DAILY ( Daily ) . 15 . Ketoconazole 2 % Cream Sig : one ( 1 ) Appl Topical [ * * hospital1 * * ] ( 2 time day ) . 16 . outpatient lab Work Chem 10 monitor electrolyte creatinine take lasix 17 . turn reposition back prn limit sit time 1hour time use pressure redistribution cushion . cleanse skin wound cleanser NS pat dry nad apply aquafor gluteal leg foot daily 18 . heel lateral foot ulcer apply thin layer duoderm wound gel , cover dorsum lateral wound adaptic heel gauze follow ABD pad , wrap iwth kerlix change daily 19 . headr occiput frequent repositioning 20 . please remove suture posterior neck tuesday [ * * 9 - 10 * * ] [ * * 2175 * * ] 21 . please start warfarin [ * * 2176 - 9 - 9 * * ] ( post op day 10 ) monitor INR prn 22 . check weight Qday Discharge Disposition : Extended Care Facility : [ * * Hospital3 105 * * ] Northeast - [ * * Location ( un ) 701 * * ] discharge diagnosis : cervical myelopathy C1 tumor cervical myelopathy Acute chronic diastolic heart failure discharge condition : stable , afebrile Discharge instruction : admit [ * * Hospital1 18 * * ] [ * * 2176 - 8 - 29 * * ] worsen upper extremity weakness due spinal tumor . undergo operation remove tumor . also undergo operation decrease pressure spinal cord neck . need staple surgical site [ * * 2176 - 9 - 10 * * ] , rehab facility . appointment make follow Dr. [ * * last Name ( STitle ) * * ] 6 week . please return Emergency department fever , chill , difficulty breathing , worsen upper extremity weakness , worsen symptom . Followup Instructions : 1 . [ * * last Name ( STitle ) * * ] LAB [ * * Hospital1 18 * * ] [ * * Hospital Unit Name * * ] , [ * * Location ( un ) * * ] [ * * Location ( un ) * * ] surgery phone:[**telephone / fax ( 1 ) 1237 * * ] Date / Time:[**2176 - 9 - 26 * * ] 3:15 2 [ * * First Name11 ( Name Pattern1 ) * * ] [ * * last Name ( NamePattern4 ) 3469 * * ] , MD LM [ * * Hospital Unit Name * * ] , [ * * Location ( un ) * * ] [ * * Location ( un ) * * ] surgery phone:[**telephone / fax ( 1 ) 2625 * * ] Date / Time:[**2176 - 9 - 26 * * ] 4:15 3 . Dr. [ * * last Name ( STitle ) 47032 * * ] [ * * Name ( STitle ) * * ] address : [ * * Doctor First Name * * ] [ * * Hospital Unit Name * * ] [ * * Location ( un ) 470 * * ] [ * * Hospital Unit Name * * ] phone : [ * * telephone / Fax ( 1 ) * * ] appointment : [ * * 2176 - 10 - 8 * * ] 1:15pm 4 . Psychiatry Clinic [ * * Hospital1 18 * * ] Psychiatry Clinic please call bottom number schedule appointment mood sad take pleasure life : [ * * telephone / Fax ( 1 ) * * ]
[ "2761", "5119", "4280", "3572", "496", "412" ]
Admission Date : [ * * 2138 - 6 - 9 * * ] Discharge Date : [ * * 2138 - 6 - 12 * * ] Date Birth : [ * * 2111 - 2 - 28 * * ] sex : Service : Cardiothoracic Surgery PREOPERATIVE DIAGNOSIS : 1 . Bicuspid aortic valve . 2 . dilate aorta . 3 . Aortic insufficiency . history PRESENT ILLNESS : patient heart murmur since childhood find bicuspid aortic valve echocardiogram , recently increase size ascending aorta . otherwise , patient deny medical problem . [ * * Name ( NI ) * * ] surgery [ * * 2124 * * ] undescended testicle . SOCIAL history : deny smoking history . occasional alcohol , maybe per week . FAMILY history : Noncontributory . medication admission : prophylactic antibiotic . allergy : know drug allergy . LABORATORY ADMISSION : preoperative vital sign heart rate 78 , blood pressure 102/68 , respiratory rate 18 . healthy , 27 - year - old male . lung clear . Heart 3/6 systolic ejection murmur . otherwise , examination within normal limit . HOSPITAL COURSE : , [ * * 2138 - 6 - 9 * * ] , patient underwent homograft aortic root replacement , resection , graft proximal aortic arch . undergo general anesthesia . intraoperative complication . postoperatively , patient transfer recovery room nitroglycerin drip normal sinus rhythm . transfer recovery room Intensive Care Unit , postoperative day one transfer floor , continue uncomplicated postoperative course . patient experience tachycardia heart rate around 117 . tachycardia patient 's beta blocker increase , respond . beta blocker increase 75 mg p.o . b.i.d . Potassium replete . patient diurese 4 liter per day . patient good pain control . ambulate around hall without difficulty . condition discharge : Stable . DISCHARGE STATUS : discharge home prescription . service need . medication DISCHARGE : 1 . Lopressor 75 mg p.o . b.i.d . 2 . [ * * first name5 ( NamePattern1 ) 233 * * ] [ * * last Name ( NamePattern1 ) 1002 * * ] 40 meq p.o . q.d . times five day . 3 . iron sulfate 325 mg p.o . t.i.d . 4 . Percocet 5 one two tablet p.o . q.6h . p.r.n . 5 . Aspirin 81 mg p.o . q.d . [ * * Doctor Last Name 412 * * ] [ * * last Name ( Prefixes ) 413 * * ] , M.D. [ * * MD Number(1 ) 414 * * ] dictate by:[**last Name ( NamePattern1 ) 8344 * * ] medquist36 : [ * * 2138 - 6 - 12 * * ] 23:01 : [ * * 2138 - 6 - 13 * * ] 18:17 JOB # : [ * * Job number 13750 * * ]
[ "4241" ]
Admission Date : [ * * 2142 - 11 - 30 * * ] Discharge Date : [ * * 2142 - 12 - 10 * * ] Date Birth : [ * * 2084 - 5 - 2 * * ] sex : Service : MEDICINE allergy : Percocet / Bactrim Ds / Lisinopril attending:[**first Name3 ( LF ) 898 * * ] Chief Complaint : hypotension Major Surgical Invasive Procedure : none history Present Illness : Mr. [ * * know lastname 25925 * * ] 58 yo w/ multiple sclerosis seizure disorder present OSH delusion ams x 2 day . OSH , note Na 124 . history hyponatremia ; Na 117 [ * * 2 - 27 * * ] mid 130s since . see nephrology . OSH , approx 45sec generalize tonic clonic seizure , receive 1 mg Ativan , transfer ED [ * * Hospital1 18 * * ] . also history seizure especially setting infection hyponatremia . unclear seizure without incite event . currently wean Keppra Gabapentin start Tegretol . er , VS : 97.5 ; 189/105 ; 78 ; 16 ; 95 % 3l. give 2L NS . give ams setting infection know chronic uti [ * * 12 - 24 * * ] indwelling suprapubic catheter neurogenic bladder , blood urine culture obtain well CXR . urine culture [ * * 11 - 28 * * ] grow pseudomona CXR show possible infiltrate treat vancomycin cefepime . head CT negative . Past Medical history : MS - since [ * * 2119 * * ] , progressive , quadriplegic , neurogenic bladder suprapubic catheter , restrictive PFT 's history Aspiration PNAs Esophageal Ulcer - [ * * 12 - 24 * * ] nsaid , [ * * 2139 * * ] , small bowel bx negative recurrent uti CHF ( EF > 65 % moderate LVH ' [ * * 39 * * ] ) HTN legally blind Social History : marry 32 year live wife home . three child three grandchild . professor [ * * First Name ( Titles ) * * ] [ * * last Name ( Titles ) 25949 * * ] engineering [ * * University / College 25932 * * ] , retire disability [ * * 2128 * * ] spring semester due MS . [ * * Name13 ( STitle ) * * ] wheelchair - bind . deny tobacco , alcohol , recreational drug use . personal care assistant . Family history : Father CAD CVA . Mother [ * * Name ( NI ) 2481 * * ] disease . Brother diabete . Physical Exam : general : Alert , oriented , acute distress HEENT : Sclera anicteric , MMM , oropharynx clear Neck : supple , JVP elevate , LAD lung : clear auscultation bilaterally , wheeze , rale , ronchi CV : regular rate rhythm , normal S1 + S2 , murmur , rub , gallop Abdomen : soft , non - tender , non - distended , bowel sound present , rebound tenderness guarding , organomegaly Ext : warm , well perfuse , 2 + pulse , club , cyanosis edema pertinent result : [ * * 2142 - 11 - 29 * * ] 10:47PM BLOOD wbc-6.4 rbc-3.99 * # hgb-11.8 * # hct-33.1 * MCV-83 # MCH-29.7 MCHC-35.7 * RDW-15.0 Plt ct-235 # [ * * 2142 - 12 - 10 * * ] 05:50AM blood wbc-8.8 RBC-3.54 * Hgb-10.8 * Hct-31.0 * MCV-88 MCH-30.5 mchc-34.7 RDW-15.3 Plt ct-424 [ * * 2142 - 12 - 7 * * ] 05:50AM blood PT-13.6 * PTT-34.1 INR(PT)-1.2 * [ * * 2142 - 11 - 29 * * ] 10:47PM blood Glucose-102 UreaN-11 Creat-0.6 Na-126 * K-4.5 Cl-88 * HCO3 - 29 angap-14 [ * * 2142 - 11 - 30 * * ] 06:58AM blood Glucose-89 UreaN-11 Creat-0.7 na-125 * K-4.6 Cl-90 * HCO3 - 28 AnGap-12 [ * * 2142 - 11 - 30 * * ] 12:40pm blood na-128 * [ * * 2142 - 11 - 30 * * ] 09:45PM blood na-127 * [ * * 2142 - 12 - 1 * * ] 07:40AM blood Glucose-79 UreaN-11 Creat-0.7 Na-131 * K-4.0 Cl-93 * HCO3 - 29 angap-13 [ * * 2142 - 12 - 1 * * ] 03:00pm blood glucose-101 UreaN-16 Creat-0.8 Na-131 * K-4.5 cl-94 * HCO3 - 30 AnGap-12 [ * * 2142 - 12 - 2 * * ] 05:45am blood Glucose-81 urean-15 creat-0.7 Na-133 K-4.6 cl-95 * HCO3 - 28 angap-15 [ * * 2142 - 12 - 2 * * ] 04:10PM blood Glucose-98 urean-15 Creat-1.0 Na-131 * K-4.9 Cl-93 * HCO3 - 27 AnGap-16 [ * * 2142 - 12 - 3 * * ] 06:20AM blood glucose-121 * UreaN-21 * creat-1.2 Na-131 * K-4.3 Cl-93 * HCO3 - 28 angap-14 [ * * 2142 - 12 - 3 * * ] 05:40PM blood Glucose-115 * UreaN-25 * Creat-1.3 * Na-134 K-4.4 Cl-96 HCO3 - 27 angap-15 [ * * 2142 - 12 - 4 * * ] 07:18AM blood glucose-101 urean-23 * Creat-0.8 Na-135 K-4.0 Cl-98 HCO3 - 27 angap-14 [ * * 2142 - 12 - 5 * * ] 05:30AM blood Glucose-83 UreaN-21 * Creat-0.7 Na-135 K-3.9 Cl-96 HCO3 - 26 AnGap-17 [ * * 2142 - 12 - 6 * * ] 05:30AM blood Glucose-96 UreaN-19 Creat-0.8 na-134 K-4.2 Cl-97 HCO3 - 28 angap-13 [ * * 2142 - 12 - 7 * * ] 05:50am blood Glucose-102 UreaN-21 * Creat-0.8 na-137 K-4.2 Cl-97 HCO3 - 26 angap-18 [ * * 2142 - 12 - 8 * * ] 07:00AM blood Glucose-89 urean-15 Creat-0.9 Na-136 K-3.9 Cl-99 HCO3 - 27 angap-14 [ * * 2142 - 12 - 9 * * ] 06:30AM blood Glucose-96 UreaN-14 Creat-0.9 Na-140 K-4.0 cl-101 HCO3 - 28 angap-15 [ * * 2142 - 12 - 10 * * ] 05:50am blood Glucose-99 UreaN-18 Creat-1.0 Na-140 K-4.5 Cl-102 HCO3 - 26 AnGap-17 [ * * 2142 - 11 - 29 * * ] 10:47PM blood Osmolal-260 * [ * * 2142 - 11 - 30 * * ] 12:40pm blood osmolal-264 * [ * * 2142 - 12 - 8 * * ] 07:00AM blood alt-23 AST-16 LD(LDH)-213 AlkPhos-87 totbili-0.2 [ * * 2142 - 12 - 10 * * ] 05:50AM blood Calcium-9.3 Phos-2.8 Mg-2.4 u / [ * * 11 - 28 * * ] : nit + , LE + , WBC 55 , RBC 6 , Epi 1 , bact u / [ * * 11 - 29 * * ] : sm bld , 100 prot / gluc ; WBC [ * * 1 - 24 * * ] , RBC [ * * 1 - 24 * * ] , Epi [ * * 1 - 24 * * ] , bact mod u / [ * * 12 - 2 * * ] : sm LE , WBC 10 , RBC 2 , Epi 1 , bact none u / [ * * 12 - 5 * * ] : 30 prot , 10 ket , lg LE ; WBC 99 , RBC 11 , Epi 1 , bact u / [ * * 12 - 6 * * ] : 30 prot , mod LE ; WBC 22 , RBC 8 , Epi 3 , bact none u / [ * * 12 - 8 * * ] : neg leuk CULTURES : BCx [ * * 11 - 29 * * ] x2 : neg BCx [ * * 12 - 2 * * ] x2 : neg UCx [ * * 11 - 28 * * ] : pseudomona AERUGINOSA . > 100,000 ORGANISMS / ML UCx [ * * 11 - 29 * * ] pseudomona UCx [ * * 12 - 2 * * ] yeast Ucx [ * * 12 - 5 * * ] neg Ucx [ * * 12 - 6 * * ] yeast Ucx [ * * 12 - 8 * * ] neg c.diff neg x 2 - CXR [ * * 12 - 2 * * ] : patchy opacity left base note , significance setting low inspiratory volume uncertain . - CTA [ * * 12 - 2 * * ] : pe . scatter patchy ground - glass opacity may represent expiratory state air trapping . - Renal u / [ * * 12 - 2 * * ] : evidence abscess , hydronephrosis mass - abd xray [ * * 12 - 3 * * ] : non - specific bowel gas pattern , stool throughout colon , free air - abd xray [ * * 12 - 4 * * ] : Stool- air - fill loop large small bowel consistent ileus . - Liver u / [ * * 12 - 5 * * ] : hypoechoic right hepatic mass , measure 4.2 cm size - CT abd : prelim read : arterially enhance liver lesion fully characterize , may represent adenoma , FNH , less likely HCC . Brief Hospital Course : 58 yo male w/ progressive multiple sclerosis admit ams seizure 45 GTC OSH respond 1 mg Ativan . negative head CT find Na level 126 . hyponatremic past often cause change mental status . ed , treat 2L NS concern hypovolemic hyponatremia . time , urine osm 423 serum osm 263 . also CXR prelim concern pneumonia cause ADH like effect ( final read neagtive ) . Neurology consult ams seizure feel hyponatremia likely relate recent initiation carbamezapine sensory illusion . Carbamezapine know ADH like effect cause hyponatremia . follow discontinuation carbamezapine along fluid restriction , Na increase . several day , pt appear slightly dehydrate fluid restriction lift . time discharge , serum Na 140 . . past , seizure instigate underlying infection . however , upon admission afebrile leukocystosis . likely source either pneumonia UTI . suprapubic catheter [ * * 12 - 24 * * ] neurogenic bladder day prior admission , urine sample grow pseudomona , bacteria past . also several pneumonia past , likely [ * * 12 - 24 * * ] frequent aspiration first CXR concern lung infiltrate . treat one dose vancomycin cefepime pneumonia . ultimately , repeat CXR CTA negative pneumonia . . pseudomonal bacteriuria , start ciprofloxacin . urine culture draw prior abx inititian also grow pseudomona . afebrile leukocytosis think may actually colonization oppose infection . however , treat full course cipro complicated UTI . catheter change culture remain negative . . admission , pt afebrile hypertensive 180 - 200 . however , shortly arrive floor , episode hypotension 70 's systolic . time mentate well , complaint , deny chest pain , headache , visual change . ivf give , however hypotension initially respond , however come eventually prior get ICU . labile blood pressure likely secondary patient 's autonomic dysfunction secondary SPMS . consideration infection possible sepsis , however patient continue afebrile . blood urine culture negative . monitor ICU 24 hour stable swing BP asymptomatic consistent autonomic dysfunction . change clonidine dose 0.2 mg [ * * hospital1 * * ] 0.1 mg TID . maintain blood pressure medication home dose . . next day , transfer MICU return floor . shortly arrival , develop fever . blood urine culture send negative . Pneumonia rule UTI treat medication appropriate per sensitivity . CTA negative PE . however , start meropenem treat 2 day . still slightly febrile meropenem discontinue concern drug fever . defervesce without treatment . . however , mental status continue fluctuate despite afebrile , obvious source infection , eunatremic . occasionally aggressive would say murder kidnap . Neurology reconsulte feel symptom relate keppra think subclinical seizure . continue repetitive shake move head conscious able speak episode . also , despite Keppra , continue sensory illusion , mostly center around feeling bowel movement ( actually ) . . work source infection source AMS , CTA reveal liver lesion . ultrasound multiphase liver CT describe lesion MRI [ * * 12 - 24 * * ] implanted baclofen pump . Mr [ * * know lastname 25925 * * ] family decide biopsy lesion time rule completely malignancy , although unlikely . work also KUB concern ileus continue bm keep regular diet . . prior discharge , mental status completely return baseline alert orient x 3 long aggressive towards staff . definite etiology elucidated hypothesize could result progression establish disease . medication admission : BACLOFEN 2,000 mcg / mL Kit -pump BRIMONIDINE Dosage uncertain CARVEDILOL - 25 mg Tablet [ * * hospital1 * * ] CARBAMEZAPINE - 100 mg [ * * hospital1 * * ] CLONIDINE - 0.2 mg Tablet [ * * hospital1 * * ] CLOTRIMAZOLE - BETAMETHASONE - 1 % -0.05 % Cream tid FENTANYL - 12 mcg / hour patch 72 hr FUROSEMIDE - 40 mg Tablet qd IPRATROPIUM - ALBUTEROL prn LACTULOSE prn MINOCYCLINE - 100 mg Tablet [ * * hospital1 * * ] MODAFINIL [ provigil ] 50 [ * * hospital1 * * ] OMEPRAZOLE 20 [ * * hospital1 * * ] OXYBUTYNIN CHLORIDE - 15 mg qhs SIMVASTATIN - 40 mg qd TRAVOPROST1 drop l eye day ACETAMINOPHEN prn ASCORBIC ACID 500 [ * * hospital1 * * ] BISACODYL hs CALCIUM 500 mg Tid CRANBERRY 475 mg Capsule [ * * hospital1 * * ] ERGOCALCIFEROL ( VITAMIN D2)400 [ * * hospital1 * * ] MINERAL OIL prn omega-3 FATTY ACIDS [ * * hospital1 * * ] PSYLLIUM [ METAMUCIL ] prn senna - 8.6 mg Tablet prn Discharge medication : 1 . Carvedilol 12.5 mg Tablet Sig : two ( 2 ) Tablet po BID ( 2 time day ) . 2 . fentanyl 12 mcg / hr Patch 72 hr Sig : one ( 1 ) patch 72 hr Transdermal Q72H ( every 72 hour ) . 3 . furosemide 40 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . 4 . Lactulose 10 gram/15 ml Syrup Sig : thirty ( 30 ) ML PO Q8H ( every 8 hour ) need . 5 . Acetaminophen 325 mg Tablet Sig : 1 - 2 tablet po Q6H ( every 6 hour ) need . 6 . Oxybutynin Chloride 5 mg Tablet Sig : three ( 3 ) Tablet po QHS ( day ( bedtime ) ) . 7 . Ascorbic Acid 500 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) . 8 . Docusate Sodium 100 mg Capsule Sig : one ( 1 ) Capsule po BID ( 2 time day ) need . 9 . Senna 8.6 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) need . 10 . calcium Carbonate 500 mg Tablet , Chewable Sig : one ( 1 ) Tablet , Chewable PO TID ( 3 time day ) . 11 . omeprazole 20 mg Capsule , Delayed Release(E.C. ) Sig : one ( 1 ) Capsule , Delayed Release(E.C. ) PO BID ( 2 time day ) . 12 . Simvastatin 10 mg Tablet Sig : four ( 4 ) Tablet PO DAILY ( Daily ) . 13 . brimonidine 0.15 % drop Sig : one ( 1 ) Drop Ophthalmic [ * * hospital1 * * ] ( 2 time day ) . 14 . Modafinil 100 mg Tablet Sig : 0.5 Tablet po BID ( 2 time day ) . 15 . Ciprofloxacin 500 mg Tablet Sig : one ( 1 ) Tablet po Q12H ( every 12 hour ) 6 day : [ * * 2142 - 12 - 13 * * ] . 16 . clonidine 0.1 mg Tablet Sig : one ( 1 ) Tablet PO TID ( 3 time day ) . 17 . Bisacodyl 5 mg Tablet , Delayed Release ( E.C. ) Sig : two ( 2 ) Tablet , Delayed Release ( E.C. ) PO DAILY ( Daily ) need . 18 . Levetiracetam 250 mg Tablet Sig : two ( 2 ) Tablet po BID ( 2 time day ) . 19 . combivent 18 - 103 mcg / Actuation Aerosol Sig : one ( 1 ) inh Inhalation twice day need . 20 . travatan z 0.004 % drop Sig : one ( 1 ) ophthalmic day : left eye . 21 . cranberry 475 mg Capsule Sig : one ( 1 ) Capsule po twice day . 22 . omega-3 Fatty Acids Capsule Sig : one ( 1 ) Capsule po twice day . 23 . ergocalciferol ( Vitamin D2 ) 400 unit Tablet Sig : one ( 1 ) Tablet PO twice day . patient allergy list ACE Inhibitors , therefore discharge ACE Inhibitor . communicate PCP . discharge Disposition : Home Service Facility : [ * * Hospital * * ] Home Health Care discharge Diagnosis : 1 . Multiple Sclerosis 2 . Urinary Tract Infection , complicated 3 . Hyponatremia . secondary : 1 . Chronic Diastolic CHF discharge condition : stable vital sign . Discharge instruction : admit altered mental status find low sodium urinary tract infection . start antibiotic urinary tract infection ( cipro ) complete 2 week course . sodium correct adjust medication reduce water intake . . find abnormality liver . CT scan result pende final interpretation . provide phone number schedule appointment [ * * Hospital * * ] clinic . may necessary reimage liver take biopsy lesion see CT scan . . medication change . switch tegratol keppra . please review recent medication list take medication , discard old medication list . . please return hospital develop fever , chill , worsen symptom . Followup Instructions : 1 . [ * * First Name8 ( NamePattern2 ) * * ] [ * * first Name8 ( NamePattern2 ) 1575 * * ] [ * * last Name ( NamePattern1 ) * * ] , MD phone:[**telephone / fax ( 1 ) 8645 * * ] Date / Time:[**2143 - 1 - 8 * * ] 1:30 . 2 . [ * * First Name11 ( Name Pattern1 ) 1037 * * ] [ * * last Name ( namepattern4 ) 2335 * * ] , MD phone:[**telephone / fax ( 1 ) 457 * * ] Date / time:[**2143 - 1 - 15 * * ] 4:00 . 3 . [ * * Hospital * * ] CLINIC [ * * Hospital1 18 * * ] : ( [ * * telephone / Fax ( 1 ) 2233 * * ] complete by:[**2142 - 12 - 13 * * ]
[ "5990", "2761", "5849", "4280", "2930", "4019" ]
Admission Date : [ * * 2109 - 8 - 17 * * ] Discharge Date : [ * * 2109 - 10 - 16 * * ] Date Birth : [ * * 2054 - 10 - 24 * * ] sex : Service : MEDICINE allergy : Patient record known allergy drug attending:[**first Name3 ( LF ) 759 * * ] Chief Complaint : B / l ankle fracture , / p fall Major Surgical Invasive Procedure : [ * * 8 - 18 * * ] . 1 . closed reduction left pilon fracture . 2 . Application multi - planar external fixator leave low extremity . 3 . Closed treatment calcaneus fracture mild amount manipulation . 4 . external fixation right Pilon fracture . [ * * 8 - 30 * * ] adjustment external fixator r pilon fracture . [ * * 9 - 17 * * ] ORIF right intra - articular distal tib - fib fracture r history Present Illness : 54 year old spanish speak male , US vacation , questionable pmh liver disease present jumping?falle ? window . per daughter drink alcohol son report feel someone kill . lock second - story bedroom later find daughter crawl outside . initially see [ * * hospital3 * * ] find opiate cocaine UA emergency department . transport [ * * Hospital1 18 * * ] b / l ankle fracture . per family , pt confuse home . [ * * Name ( NI ) * * ] , pt aggitate receive haldol ativan . later somnolent . EKG demonstrate atrial flutter hrs 110 - 140 's , rate control ED IV diltiazem . Patient poor historian , information obtain daughter ROS : + b / l ankle pain , -CP , -SOB , -abdominal pain Past Medical history : " get yellow " high ammonia HTN questionable anginal history depression , family state see psychiatrist Social History : EtOH abuse , polysubstance abuse , one ppd mayn year Urine positive cocaine opiate ED marry daughter involve care Family history : Noncontributory Physical Exam : vital : 96.7 140/90 76 16 99 % 2L NPO/1000 Physical Exam : general : sleepy arousable , orient place person , able name month year forwards , backwards , orient current month / year HEENT : icteric sclerae , dry MM , + c - collar CVS : irregular rate , tachy , murmur / rub / gallop appreciate Pulm : CTA b / l , wheeze , rale rhonchi Abd : soft , NT , mild hepatosplenomegaly , + BS Ext : b / l ankle splint , mild bruise b / l knee , - asterixis GU : + foley pertinent result : CT C - Spine : negative fracture Left tib / fib : Comminuted fracture calcaneus . dense sliver bone along medial aspect proximal fibula , see single view . could represent additional calcification intraosseous ligament , small cortical fracture fragment , foreign body . right tib / fib : Comminuted , intraarticular , impact , displace fracture distal tibia well fracture distal fibula detail . . CT bilat LE 1 . Comminuted intra - articular distal right tibial fracture . 2 . comminuted distal right fibular fracture displacement . 3 . Comminuted leave calcaneal fracture . . RUQ U / : finding : liver coarse echotexture without evidence focal lesion . gallbladder distend due nonfaste stage . evidence gallstone . evidence intra- extra - hepatic biliary ductal dilatation common duct measure 3 mm . pancrea well visualize due bowel gas . evidence free fluid . main portal vein patent antegrade flow . impression : evidence cholecystitis . . head CT ( [ * * 8 - 21 * * ] ) impression : evidence acute intracranial pathology , include sign intracranial hemorrhage . . CXR ( [ * * 8 - 21 * * ] ) previous study comparison . low lung volume . heart size difficult evaluate semi - upright AP film . could LVH evidence CHF lung clear . questionable slight impression right margin tracheal air column well evaluate standard PA lateral chest film condition permit . . Chest CT ( [ * * 8 - 23 * * ] ): 1 . juxtatracheal mass leave upper lobe lesion question chest radiograph report . 2 . three foci ground glass , right upper lobe , detectable routine radiograph , nonspecific finding . six- month CT follow recommend look change , bronchoalveolar cell carcinoma , though unlikely , exclude . 3 . borderline size mediastinal hilar lymph node check followup CT . 4 . mild atherosclerotic coronary artery calcification . Chest CTA ( [ * * 8 - 24 * * ] ): 1 . pulmonary embolism . 2 . relatively unchanged appearance multiple ill - define opacity tiny nodule right upper lobe . follow - state examination 1 day prior recommend . 3 . new foci opacification present lung basis compare examination one day prior likely relate aspiration . Layering debris present within right main stem bronchus suggestive aspiration well . clinical correlation recommend . 4 . recommend advance NG tube least 4 - 5 cm . current position elevate risk aspiration . . CT RLE contrast ( [ * * 8 - 24 * * ] ): impression : comminuted distal tibial fibular fracture intra- articular involvement tibial plafond lateral displacement talus respect tibia . posterior displacement distal fibular fragment . . CT LLE without contrast ( [ * * 8 - 24 * * ] ) Comminuted leave calcaneal fracture . Lentiform area fluid attenuation skin posterolateral aspect left foot . significance latter finding uncertain , may due skin blister possibly dress material within cast . clinical correlation request . . CXR ( [ * * 8 - 26 * * ] ) 1 . NG tube could advanced several centimeter standard positioning , describe prior exam . 2 . new perihilar opacity , likely due acute aspiration superior segment . . head CT ( [ * * 9 - 3 * * ] ) impression : evidence hemorrhage CT evidence acute infarct . . CT abd / pelvis ( [ * * 9 - 22 * * ] ): impression : CT evidence pyelonephritis abscess within abdomen / pelvis . . CT LLE without contrast ( [ * * 9 - 26 * * ] ) 1 . markedly comminute fracture calcaneus wide distraction dispersal fracture fragment . 2 . non - displace fracture sustentaculum tali middle facet talus . 3 . fracture identify medial malleolus . 4 . non - displace fracture anterior aspect inferior aspect lateral malleolus . 5 . non - displace fracture cuboid . 6 . fracture identify navicular . 7 . fracture identify within remainder mid foot forefoot . 8 . lateral subluxation peroneal tendon respect fibula . 9 . probable tear anterior talofibular ligament . . Echo ( [ * * 9 - 26 * * ] ): left atrium mildly dilate . leave ventricular wall thickness , cavity size regional / global systolic function normal ( LVEF > 55 % ) transmitral tissue Doppler imaging suggest normal diastolic function , normal leave ventricular filling pressure ( pcwp<12mmhg ) . right ventricular chamber size free wall motion normal . aortic valve leaflet ( 3 ) appear structurally normal good leaflet excursion aortic regurgitation . mitral valve appear structurally normal trivial mitral regurgitation . mitral valve prolapse . estimate pulmonary artery systolic pressure normal . pericardial effusion . IMPRESSION : normal global regional biventricular systolic function . Brief Hospital course : course hospitalization , pt put CIWA scale EtOH withdrawal give thiamine , folate multivitamin , AFib RVR initially treat metoprolol , diltiazem , high ammonia level treat lactulose . b / l ankle fracture follow orthopedic . patient severely agitate one occassion hospitalization , require three code puple call well require restraint protection patient staff . patient originally send floor MICU delirium unknown cause severe agititation . require increase amount sedation return floor NG tube place . return floor , patient require less sedation , take benzodiazipine intermittently need restraint . patient remain somnolent delerious . pull NG tube . also febrile rhoncorous floor . initially treat vancomycin flagyl , change azithro / ceftriaxone / flagyl . schedule return revision right external fixation . preop hold , find hypoxic send MICU . MICU COURSE : morning [ * * 8 - 28 * * ] , patient schedule return revision externally fixate RLE . upon transport PACU , patient become somnolent report " agonal breathing " . O2 sat 83 % 2lnc NRB apply O2 sat 100 % . BP 90s/60s , hr 80 , RR 17 - 19 . abg draw : 7.38/58/90 . stay MICU , patient cough large amount thick sputum improved respiratory status . Surgery postpone patient transfer MICU monitoring . MICU , respiratory status remain stable Sp02 high 90 room air . Pt hemodynamically stable chronic - flutter . call floor [ * * 8 - 29**]- intensive care need identify . MICU , patient start Zosyn restart Vancomycin wiht marked improvement respiratory status . within day return floor , Vancomycin zosyn stop CXR show resolution questionable aspiration pneumonia - feel likely pneuomonitis resolve . . MICU , patient 's delirium start improve , worsen return removal external fixation . develop fever 102F post - operatively likely worsen delirium . source fever unclear - note patient recently develop VRE urine infectious disease feel active infection . receive three day antibiotic ( daptomycin linezolid ) . stop become afebrile delirium begin lift . . # Aggitation mostly control haldol . Zyprexa try two week seem help acute aggitation . QTc monitor patient antipsychotic stable approximately 420 - 440msec . overall etiology delirium remain unclear think multifactorial due part chronic alcohol use , hepatic encephalopathy , benzodiazepine use , post - operative delririum . although spanish - speak 1:1 sitter interpreter employ much possible , language also likely contribute persistance delirium . Delirium completely resolve patient restraint sitter free . haldol stop . past period etoh withdrawal . recommend patient follow alcohol abuse counseling . . # afib / flutter febrile , afib / flutter complicate frequent episode rapid ventricular rate . control IV metoprolol need also increase po metoprolol diltiazem . treat fever tylenol also seem help . briefly put therapeutic lovenox atrial fibrillation , stop feel eligible CHADS criterion also high fall risk . Patient transition beta blocker place Diltiazem 120 mg daily . . # urinary retention patient fail several voiding trial . also pull foley several occasion , cause hematuria . Intermittent straight catheterization try reduce infection risk long - term indwelling foley . however give delirium aggitation untenable . resolve reduction haldol . patient able void freely . history VRE urine culture , sign infection , dyruria , increase urinary frequency . evidence base literature clinical indication treat asymptomatic bacteuria time . . # fracture patient follow orthopedic admission . L ankle fracture treat casting , however repeat plain film CT scan 4 - 6 week post - op show fracture initially visualize . orthopedic feel casting still appropriate indication surgery . r pilon fracture manage initially external fixation system skin breakdown make internal fixation difficult . one month hospitalization ex - fix removed tibial fibular plate place . remain non - weight bearing total one month hospital discharge . patient complete necessary course lovenox . follow appointment schedule orthopaedic surgeon Dr. [ * * last Name ( STitle ) * * ] [ * * 11 - 28 * * ] 1030am , [ * * hospital3 * * ] [ * * Hospital Ward Name * * ] , [ * * Location ( un ) 1385 * * ] [ * * Hospital Ward Name 23 * * ] building . . transfer [ * * Hospital * * ] Rehab Hospital . medication admission : Diltiazem 180 mg one daily Discharge medication : 1 . aspirin 81 mg Tablet , Chewable Sig : one ( 1 ) Tablet , Chewable po DAILY ( Daily ) . disp:*30 Tablet , Chewable(s ) * Refills:*0 * 2 . Folic Acid 1 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . disp:*30 Tablet(s ) * Refills:*1 * 3 . thiamine HCl 100 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . disp:*30 Tablet(s ) * Refills:*1 * 4 . calcium Carbonate 500 mg Tablet , Chewable Sig : one ( 1 ) Tablet , Chewable PO QID ( 4 time day ) need . Disp:*30 Tablet , Chewable(s ) * Refills:*0 * 5 . diltiazem HCl 120 mg Capsule , Sustained Release Sig : one ( 1 ) Capsule , Sustained Release po DAILY ( Daily ) . disp:*30 Capsule , sustained release(s ) * Refills:*1 * 6 . trazodone 50 mg Tablet Sig : 0.5 Tablet PO HS ( bedtime ) need . disp:*15 Tablet(s ) * Refills:*0 * discharge Disposition : Extended Care Facility : [ * * hospital6 2222 * * ] - [ * * Location ( un ) 538 * * ] discharge diagnosis : Primary : 1 ) Bilateral Lower Extremity fracture a. Closed leave tibial plafond fracture / pilon fracture . b. Dislocation leave tibiotalar joint . c. right calcaneus fracture , intra - articular 2 ) persistent agitated delirium ? ? ? ? ? ? resolve 3 ) Aspiration Pneumonitis - resolve 4 ) alcoholism ? ? ? ? ? ? continuous 5 ) Delirium Tremens 6 ) Polysubstance Abuse ( cocaine , opiate , alcohol ) 7 ) Atrial Fibrillation / Atrial Flutter 8) abnormal CT chest ? ? ? ? ? ? follow - ( [ * * 2111 - 1 - 5 * * ] ) recommend 9 ) Liver Failure ? ? ? ? ? ? presume secondary alcoholism ( evidence HBV HCV infection ) a. Thrombocytopenia presume secondary thrombopoitin deficiency . evidence splenomegaly imaging . 10 ) elevate AFP level ? ? ? ? ? ? etiology yet undetermined secondary : 1 ) Hypertension 2 ) urinary retention ? ? ? ? ? ? resolve 3 ) Bactiuria ? ? ? ? ? ? asymptomatic , colonize Vancomycin resistant enterococcus Contact information : [ * * first Name8 ( NamePattern2 ) * * ] [ * * know lastname 1794 * * ] ( daughter ): [ * * telephone / Fax ( 1 ) 74301 * * ] [ * * Female First Name ( un ) 74302 * * ] & [ * * first Name9 ( NamePattern2 ) 74303 * * ] [ * * know lastname 1794**](son ) cell [ * * telephone / Fax ( 1 ) 74304 * * ] follow - : 1 ) Repeat CT scan chest [ * * 2111 - 1 - 5 * * ] f / u 3 foci ground glass rul well borderline mediastinal hilar lymphadenopathy 2 ) Assess etiology elevated alpha - fetoprotein 3 ) evaluate etiology pancyctopenia ? ? ? ? ? ? consider bone marrow aspirate well HIV testing discharge condition : stable , Non - weight bearing leg one month start [ * * 10 - 15 * * ] Discharge instruction : transfer [ * * Hospital1 18 * * ] emergency room large fall . find bilateral ankle fracture . CT scan head show acute bleed . come emergency room heart rate fast , give medication help slow . . [ * * 8 - 18 * * ] operation left leg heel ankle fracture , several pin place left leg . left leg cast . . [ * * 8 - 30 * * ] operation r tibula fibula fracture stabilize leg externally . . [ * * 9 - 17 * * ] operation right tibula fibula screw place help leg heal . . hospital stay . confused place many psychiatric medication , become agitated time , restrain time . resolve long psychiatric medication . . hospital develop breathing problem . [ * * Name ( NI ) * * ] spend time intensive care unit , worry might pneumonia , start antibiotic , breathing problem improve , chest xray improve . think pneumonia antibiotic normal . . also find bacteria urine call VRE , , burning urination . infectious disease doctor think bacteria treat . . transfer rehab facility . important rehab facility , follow get counseling problem alcohol abuse . . follow appointment schedule orthopaedic new primary care physician . [ * * Name10 ( NameIs ) * * ] important follow appointment . . also important put weight leg next month . please return hospital emergency room condition worsen way . abnormal chest x - ray / CT scan repeat [ * * 2111 - 1 - 5 * * ] make sure not lung cancer . blood count low stable hospitalization . see Hematologist ( Blood Doctor ) consider test HIV . elevation marker blood call AFP ( alpha fetoprotein ) . significance know . may relate underlying liver disease evaluate specialist . absolutely refrain use alcohol , cocaine illicit drug explicitly prescribe physician . Ten??????as una exploraci??????n anormal [ * * Doctor First Name * * ] pecho x - ray / CT [ * * initial ( namepattern4 ) * * ] [ * * last Name ( namepattern4 ) * * ] [ * * last Name ( un ) 7214 * * ] esto repetido en diciembre de [ * * 2110 * * ] para cerciorarse de ? ? ? ? ? ? [ * * last Name ( un ) 7214 * * ] pulm??????n c??????ncer . Tus cuentas de sangre [ * * Doctor First Name * * ] [ * * first Name9 ( NamePattern2 ) 74305 * * ] [ * * last Name ( un ) * * ] [ * * first Name9 ( NamePattern2 ) 74306 * * ] [ * * last Name ( un ) 33761 * * ] tu hospitalizaci??????[**initial ( namepattern4 ) * * ] [ * * last Name ( namepattern4 ) 7213 * * ] [ * * last Name ( un ) * * ] un hemat??????logo ( el doctor [ * * last Name ( Titles ) * * ] [ * * last Name ( Prefixes ) 74307 * * ] ) sobre esto considerar el probar para el VIH . Ten??????as una elevaci??????n de un marcador en tu sangre llamada AFP ( alfa fetoprotein ) . [ * * Name Prefix ( Prefixes ) * * ] [ * * last Name ( Prefixes ) 74308**]??????n de esto es saber . puede ser relacionado con tu enfermedad [ * * Doctor First Name * * ] higado [ * * first Name9 ( NamePattern2 ) 74309 * * ] [ * * last Name ( un ) * * ] debe ser m??????s futuro evaluado por un especialista . [ * * last Name ( un ) 7213 * * ] refrenarse absolutamente [ * * Doctor First Name * * ] uso adicional [ * * Doctor First Name * * ] alcohol , de [ * * Name Prefix ( Prefixes ) * * ] [ * * last Name ( Prefixes ) * * ] ? ? ? ? ? ? na de cualquier droga il??????cita prescrito expl??????citamente ti por un m??????dico . Followup Instructions : Ten??????as una exploraci??????n anormal [ * * Doctor First Name * * ] pecho x - ray / CT [ * * initial ( namepattern4 ) * * ] [ * * last Name ( namepattern4 ) * * ] [ * * last Name ( un ) 7214 * * ] esto repetido en diciembre de [ * * 2110 * * ] para cerciorarse de ? ? ? ? ? ? [ * * last Name ( un ) 7214 * * ] pulm??????n c??????ncer . Tus cuentas de sangre [ * * Doctor First Name * * ] [ * * first Name9 ( NamePattern2 ) 74305 * * ] [ * * last Name ( un ) * * ] [ * * first Name9 ( NamePattern2 ) 74306 * * ] [ * * last Name ( un ) 33761 * * ] tu hospitalizaci??????[**initial ( namepattern4 ) * * ] [ * * last Name ( namepattern4 ) 7213 * * ] [ * * last Name ( un ) * * ] un hemat??????logo ( el doctor [ * * last Name ( Titles ) * * ] [ * * last Name ( Prefixes ) 74307 * * ] ) sobre esto considerar el probar para el VIH . Ten??????as una elevaci??????n de un marcador en tu sangre llamada AFP ( alfa fetoprotein ) . [ * * Name Prefix ( Prefixes ) * * ] [ * * last Name ( Prefixes ) 74308**]??????n de esto es saber . puede ser relacionado con tu enfermedad [ * * Doctor First Name * * ] higado [ * * first Name9 ( NamePattern2 ) 74309 * * ] [ * * last Name ( un ) * * ] debe ser m??????s futuro evaluado por un especialista . [ * * last Name ( un ) 7213 * * ] refrenarse absolutamente [ * * Doctor First Name * * ] uso adicional [ * * Doctor First Name * * ] alcohol , de [ * * Name Prefix ( Prefixes ) * * ] [ * * last Name ( Prefixes ) * * ] ? ? ? ? ? ? na de cualquier droga il??????cita prescrito expl??????citamente ti por un m??????dico . please follow Dr. [ * * last Name ( STitle ) * * ] orthopedic surgery appointment schedule [ * * 2112 - 11 - 28**]:30 , [ * * Location ( un ) 1385 * * ] [ * * Hospital Ward Name 23 * * ] build [ * * Hospital Ward Name * * ] [ * * hospital1 771 * * ] . please call [ * * telephone / Fax ( 1 ) 9769 * * ] would like change appointment . please follow new primary care physician [ * * last Name ( namepattern4 ) * * ] . [ * * last Name ( STitle ) 15259 * * ] [ * * 2109 - 11 - 19 * * ] 3 pm [ * * Hospital Ward Name 23 * * ] Center [ * * Location ( un ) * * ] [ * * Hospital Ward Name 516 * * ] [ * * Hospital1 1170 * * ] . abnormal chest x - ray / CT scan repeat [ * * 2111 - 1 - 5 * * ] make sure not lung cancer . blood count low stable hospitalization . see Hematologist ( Blood Doctor ) consider test HIV . elevation marker blood call AFP ( alpha fetoprotein ) . significance know . may relate underlying liver disease evaluate specialist .
[ "4019", "2875", "5990", "5070", "5180" ]
Admission Date : [ * * 2170 - 9 - 19 * * ] Discharge Date : [ * * 2170 - 9 - 25 * * ] Date Birth : [ * * 2099 - 5 - 27 * * ] sex : Service : CARDIOTHORACIC allergy : Known Allergies / Adverse Drug reaction attending:[**first Name3 ( LF ) 165 * * ] Chief Complaint : Dyspnea exertion fatigue Major Surgical Invasive Procedure : [ * * 2170 - 9 - 19 * * ] coronary artery bypass graft x 4 ( leave internal mammary artery diagonal , saphenous vein graft left anterior descending , saphenous vein graft obtuse marginal , saphenous vein graft posterior descend artery ) history Present Illness : 71 year old male present PCP [ * * Name Initial ( PRE ) * * ] routine visit complaint recent onset fatigue , dyspnea exertion , exertional throat discomfort leave arm . deny rest pain report discomfort dyspnea occur minimal activity shower . find hypertensive start Atenolol 25 mg daily . ekg normal send nuclear stress test . undergo nuclear stress test [ * * 2170 - 8 - 1 * * ] reveal inferolateral ischemia moderate inferior , inferolateral , posterolateral perfusion abnormality . refereed cardiac catheterization . refer cardiac surgery revascularization . Past Medical history : hypertension Right rotator cuff tear Compound fracture left arm / plate child Benign colon polyp Arthritis / p right rotator cuff repair / p repair leave arm fracture , plate Social History : race : caucasian last Dental Exam:"a long time ago " , recall live : Wife Contact:[**Name ( NI ) * * ] ( wife ) phone # [ * * telephone / Fax ( 3 ) 74913 * * ] Occupation : self employ painter cigarette : Smoked [ x ] Tobacco use : deny ETOH : stop drink [ * * 12 - 20 * * ] Illicit drug use : deny family history : premature coronary artery disease Physical Exam : pulse : 56 Resp:13 O2 sat:97 / RA B / p Right:173/82 left:164/76 Height:5'9 " Weight:200 lbs General : NAD , WG , WN skin : Dry [ x ] intact [ x ] HEENT : PERRLA [ x ] EOMI [ x ] Neck : Supple [ x ] full rom [ x ] chest : lung clear bilaterally [ x ] heart : rrr [ x ] Irregular [ ] Murmur [ ] grade _ _ _ _ _ _ abdoman : Soft [ x ] non - distended [ x ] non - tender [ x ] bowel sound + [ x ] extremity : Warm [ x ] , well - perfuse [ x ] Edema [ ] none _ varicosity : None [ x ] Neuro : grossly intact [ x ] pulse : Femoral Right : 2 + leave : 2 + dp right : 1 + leave : 1 + PT [ * * Name ( NI ) 167 * * ] : 1 + leave : 1 + Radial Right : 2 + leave : 2 + Carotid Bruit right : leave : bruit pertinent result : [ * * 2170 - 9 - 25 * * ] 06:35AM blood wbc-10.9 RBC-2.94 * Hgb-9.3 * Hct-26.3 * MCV-89 MCH-31.6 mchc-35.3 * RDW-13.5 Plt ct-261 [ * * 2170 - 9 - 24 * * ] 06:20AM blood WBC-13.4 * RBC-3.27 * Hgb-10.1 * Hct-28.7 * MCV-88 MCH-31.0 mchc-35.3 * RDW-14.2 Plt ct-197 [ * * 2170 - 9 - 25 * * ] 06:35AM blood Na-139 K-4.0 Cl-99 [ * * 2170 - 9 - 24 * * ] 06:20AM blood Glucose-118 * UreaN-26 * Creat-0.9 Na-139 K-4.0 Cl-98 HCO3 - 31 angap-14 [ * * 2170 - 9 - 23 * * ] 05:00am blood urean-25 * Creat-0.9 na-137 K-4.3 Cl-99 Brief Hospital course : Mr. [ * * know lastname * * ] day admit [ * * 9 - 19 * * ] bring operating room undergo Coronary artery bypass graft x4 ( leave internal mammary artery diagonal saphenous vein graft left anterior descending , obtuse marginal , posterior descend artery ) Dr.[**First Name ( STitle ) * * ] . CARDIOPULMONARY BYPASS TIME:104 minute . cross - CLAMP TIME:93 minute . please see operative report surgical detail . follow surgery transfer CVICU intubate sedate critical stable condition . later day wean sedation , awake neurologically intact extubate without incident . wean pressor support beta blocker / Statin / Aspirin diuresis initiate . chest tube epicardial pacing wire remove per protocol . pod#1 transfer step - unit monitoring . Physical Therapy consult evaluation strength mobility . postoperative course develop atrial fibrillation treat beta blocker amiodarone . anticoagulation initiate Coumadin . develop phlebitis IV Amio place course Keflex x 7 day . slowly improve . pulmonary status wax wane strong productive cough wheezing , improve time discharge . continue nebulizer treatment . CXR show small bilateral pleural effusion atelectasis , infiltrate density . pulmonary status slowly improve day discharge . POD 4 develop tender erythematous right knee treat colchicine presume gout . improve time discharge colchicine discontinue . POD 6 afebrile , ambulate assistance , tolerate full po diet wound heal well . POD 6 discharge Lifecare Center [ * * location 15289 * * ] stable condition . follow appointment advise . medication admission : ATENOLOL 25 mg Daily ASPIRIN 325 mg daily FISH OIL - DHA - EPA 1,200 mg-144 mg-216 mg Daily MV - FA - CA - FE - MIN - LYCOPEN - lutein [ THRU z high POTENCY ] 400 mcg-162 mg-18 mg-300 mcg-250 mcg Tablet Daily NAPROXEN SODIUM [ ALEVE]PRN Discharge medication : 1 . docusate sodium 100 mg Capsule Sig : one ( 1 ) Capsule po BID ( 2 time day ) . 2 . ranitidine HCl 150 mg Tablet Sig : one ( 1 ) Tablet po BID ( 2 time day ) . 3 . aspirin 81 mg Tablet , Delayed Release ( E.C. ) Sig : one ( 1 ) Tablet , Delayed Release ( E.C. ) PO DAILY ( Daily ) . 4 . bisacodyl 10 mg Suppository Sig : one ( 1 ) Suppository Rectal DAILY ( Daily ) need constipation . 5 . acetaminophen 325 mg Tablet Sig : two ( 2 ) Tablet po Q4H ( every 4 hour ) need pain / temp . 6 . hydromorphone 2 mg Tablet Sig : 1 - 2 tablet po every six ( 6 ) hour need pain . 7 . amiodarone 200 mg Tablet Sig : two ( 2 ) Tablet po BID ( 2 time day ): x 1 week 200 [ * * hospital1 * * ] x 1 week 200 mg daily direct caridologist . 8 . metoprolol tartrate 50 mg Tablet Sig : 1.5 tablet po TID ( 3 time day ) . 9 . magnesium hydroxide 400 mg/5 ml Suspension Sig : thirty ( 30 ) ML po HS ( bedtime ) need constipation . 10 . simvastatin 20 mg Tablet Sig : one ( 1 ) Tablet po day . 11 . albuterol sulfate 2.5 mg /3 mL ( 0.083 % ) solution Nebulization Sig : one ( 1 ) Inhalation Q6H ( every 6 hour ) . 12 . ipratropium bromide 0.02 % solution Sig : one ( 1 ) Inhalation Q6H ( every 6 hour ) . 13 . guaifenesin 100 mg/5 mL Syrup Sig : 5 - 10 ml po Q6H ( every 6 hour ) need cough . 14 . cephalexin 500 mg Capsule Sig : one ( 1 ) Capsule PO Q6H ( every 6 hour ) 7 day : right arm phlebitis . 15 . Lasix 40 mg Tablet Sig : one ( 1 ) Tablet po day 14 day . 16 . potassium chloride 20 meq Tablet , ER Particles / Crystals Sig : one ( 1 ) Tablet , ER Particles / Crystals PO day 14 day . 17 . warfarin 2 mg Tablet Sig : two ( 2 ) Tablet po ( ): give 4 mg [ * * 9 - 26 * * ] direct INR goal 2.0 - 2.5 fib . discharge Disposition : Extended Care Facility : Life Care Center [ * * location 15289 * * ] discharge diagnosis : Coronary artery disease / p coronary artery bypass graft x 4 past medical history : hypertension Right rotator cuff tear Compound fracture left arm / plate child Benign colon polyp Arthritis / p right rotator cuff repair / p repair leave arm fracture , plate discharge condition : alert orient x3 nonfocal ambulate steady gait incisional pain manage oral analgesia incision : Sternal - heal well , erythema drainage Leg Right / left - heal well , erythema drainage . Edema discharge instruction : please shower daily include wash incision gently mild soap , bath swimming clear surgeon . look incision daily redness drainage please lotion , cream , powder , ointment incision morning weigh evening take temperature , write chart drive approximately one month take narcotic , discuss follow appointment surgeon able drive lifting 10 pound 10 week please call question concern [ * * telephone / Fax ( 1 ) 170 * * ] female : please wear bra reduce pull incision , avoid rub low edge * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * Followup Instructions : schedule follow appointment surgeon : Dr. [ * * First Name ( STitle ) * * ] [ * * 10 - 29 * * ] 1:15pm , # [ * * telephone / Fax ( 1 ) 170 * * ] Cardiologist : Dr. [ * * first Name4 ( NamePattern1 ) * * ] [ * * last Name ( NamePattern1 ) 7047 * * ] [ * * 9 - 25 * * ] 2:00pm please call schedule appointment Primary Care Dr. [ * * last Name ( STitle ) * * ] . Nikolaos Michalacos [ * * 4 - 17 * * ] week * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * Labs : PT / INR Coumadin ? ? ? ? ? ? indication atrial fibrillation Patient give 4 mg Coumadin [ * * 2170 - 9 - 25 * * ] Goal INR 2.0 - 2.5 first draw [ * * 2170 - 9 - 26 * * ] please arrange follow PCP cardiologist prior discharge rehab [ * * Name6 ( MD ) * * ] [ * * Name8 ( MD ) * * ] MD [ * * MD Number(2 ) 173 * * ] complete by:[**2170 - 9 - 25 * * ]
[ "4111", "5119", "5180", "4019" ]
Admission Date : [ * * 2191 - 7 - 13 * * ] Discharge Date : [ * * 2191 - 7 - 15 * * ] Date Birth : [ * * 2191 - 7 - 13 * * ] sex : Service : NEONATOLOGY history : Baby [ * * Name ( NI ) * * ] [ * * know lastname 1661 * * ] bear 39 week gestation 32 - year - old gravida 1 , para 0 1 woman . mother 's prenatal screen blood type positive , antibody negative , rubella immune , RPR nonreactive , hepatitis surface antigen negative , group B strep negative . infant cry intubate meconium suction cord . give brief period bag mask ventilation good response . apgar 8 two minute 9 five minute . birth weight 3885 gram , birth length 20 [ * * 1 - 19 * * ] inch , birth head circumference 34 cm . transfer Newborn Intensive Care Unit four hour age hypoglycemia . blood dextrose stick 36 . PHYSICAL EXAMINATION : reveal vigorous , non - dysmorphic , term - appear infant . anterior fontanel open flat , cranial molding present , small caput posteriorly , palate intact . respiration unlabore , lung sound clear equal . Heart normal heart sound murmur . Femoral brachial pulse +2 equal . soft abdomen masse . normal external male genitalia testis descended . symmetric tone reflexe . HOSPITAL course system : 1 . Respiratory : infant remain room air throughout Newborn Intensive Care Unit stay . apnea , bradycardia desaturation . 2 . Cardiovascular : remain normotensive throughout Newborn Intensive Care Unit stay . cardiovascular issue . 3 . Fluids , electrolyte nutrition : infant require supplemental intravenous fluid , wean successfully 28 hour age , maintain euglycemia feeding Enfamil 20 ad lib schedule , take approximately one ounce every three four hour . last blood glucose four hour mark 59 . 4 . Gastrointestinal : infant pass meconium . 5 . Sensory : hearing screening perform automate auditory brain stem response , infant pass ear [ * * 2191 - 7 - 15 * * ] . 6 . Psychosocial : parent involve infant 's care Newborn Intensive Care Unit stay . DISCHARGE STATUS : infant discharge Newborn Nursery . condition discharge : condition good time discharge . primary PEDIATRIC CARE : provide Dr. [ * * last Name ( STitle ) 43003 * * ] [ * * Name ( STitle ) 17494 * * ] [ * * hospital3 * * ] Medical Center , telephone number [ * * telephone / Fax ( 1 ) 17663 * * ] . CARE recommendation : 1 . feeding : Enfamil 20 ad lib schedule . 2 . medication : infant discharge medication . 3 . state screening draw yet . 4 . infant yet receive hepatitis B vaccine . discharge DIAGNOSIS : 1 . resolve hypoglycemia 2 . Term male infant [ * * Name6 ( MD ) * * ] [ * * Name8 ( MD ) 38353 * * ] , M.D. [ * * MD Number(1 ) 38354 * * ] dictate by:[**last Name ( NamePattern1 ) 37333 * * ] medquist36 : [ * * 2191 - 7 - 15 * * ] 01:36 : [ * * 2191 - 7 - 15 * * ] 02:18 JOB # : [ * * Job number 43004 * * ]
[ "V053" ]
Admission Date : [ * * 2142 - 12 - 23 * * ] Discharge Date : [ * * 2142 - 12 - 30 * * ] Date Birth : [ * * 2070 - 6 - 15 * * ] sex : F Service : SURGERY allergy : Known Allergies / Adverse Drug reaction attending:[**first Name3 ( LF ) 371 * * ] Chief Complaint : right upper quadrant pain Major Surgical Invasive Procedure : [ * * 2142 - 12 - 23 * * ] : ERCP sphincterotomy stent placement [ * * 2142 - 12 - 28 * * ] : cholecystectomy history Present Illness : 72 year - old female history mild mental retardation , present RUQ start . Pt back pain . Pt go [ * * hospital1 * * ] find fever 102.9 elevated LFTs . RUQ u / concern stone CBD . WBC 9.4 56 % band , tbili 8.7 , dbili 5.3 give levo / flagyl , tylenol , IVF transfered [ * * Hospital1 18 * * ] presume cholangitis . orientate person " hospital " . life home . ed , VS arrival 97.3 82 132/74 20 96 % 2L NC . Pt give IVF , unasyn , zofran , morphine . Labs show WBC 31 , lactate 3.2 , bili 7.7 elevated LFTs . ERCP surgery consult . ERCP want pt [ * * Hospital Unit Name 153 * * ] ERCP tonight . Surgery request u / CT abd contrast . CXR concern LLL PNA , resp sx . RUQ u / prelim show : gallstone , evidence acute cholecystitis . Angiomyolipoma leave upper pole , 1.5 cm . CT prelim show : intrahep bil dil . slight enhancement normal caliber cbd , cbd raise possibility cholangitis . pulmonary bronchiectasis . Pt admit surgery [ * * Hospital Unit Name 153 * * ] . vs transfer 98 66 104/39 16 99 % 2lnc . Pt go ERCP show pus bile duct small stone cause obstruction . also stricture 1/3rd way CBD . Malignacy rule . stent place need removal 3 week . Pt give 3 liter LR time arrive post procedure [ * * Hospital Unit Name 153 * * ] include ER IVF . Past Medical History : -Mild mental retardation -arthoscopy knee -hysterectomy -Low plt [ * * Hospital1 2025 * * ] [ * * 2129 * * ] , dx ITP -cataract surgery -right 3rd nerve palsy -Esophageal web , food obstruction remove past Social History : live sister , brother - - law , mother . [ * * Name ( NI ) * * ] tobacco etoh use . ambulate independently . enjoy watch tv news today show . Family history : bleeding plt disorder Physical Exam : vital : 98.8 87 97/36 13 94%ra GEN : well - appear , acute distress HEENT : mild sclera ictericus , MMM , op Clear neck : jvp 5 - 6 cm , bruit , cervical lymphadenopathy , trachea midline COR : RRR , soft SEM Rt 2nd ICS , radial pulse +2 PULM : lung coarse crackle right bsea decrease bs left base crackle ABD : Soft , NT , ND , + BS , HSM , masse , neg Murphys EXT : C / C / e , palpable cord NEURO : alert , orient person time , " hospital " . move ext , right third nerve palsy ( abduction rest elevation past midline adduction ) pupil asymetric offcenter contract ; CN otherwise grossly intact . skin : mild jaundice Pertinent result : admission labs- [ * * 2142 - 12 - 23 * * ] 04:54PM blood WBC-31.3 * RBC-5.04 Hgb-13.2 Hct-38.0 MCV-75 * MCH-26.1 * mchc-34.7 RDW-13.9 Plt Ct-162 [ * * 2142 - 12 - 23 * * ] 04:54PM blood Neuts-57 Bands-30 * Lymphs-6 * Monos-2 Eos-0 baso-0 Atyps-2 * Metas-3 * Myelos-0 [ * * 2142 - 12 - 23 * * ] 04:54PM blood PT-16.0 * PTT-27.9 INR(PT)-1.4 * [ * * 2142 - 12 - 23 * * ] 04:54PM blood Glucose-106 * UreaN-18 Creat-0.8 Na-141 k-3.4 Cl-108 HCO3 - 20 * AnGap-16 [ * * 2142 - 12 - 23 * * ] 04:54PM blood alt-263 * AST-184 * AlkPhos-172 * TotBili-7.7 * [ * * 2142 - 12 - 23 * * ] 04:54PM blood Lipase-14 [ * * 2142 - 12 - 24 * * ] 12:08am blood calcium-7.7 * Phos-3.2 Mg-1.7 [ * * 2142 - 12 - 23 * * ] 05:08PM blood lactate-3.2 * [ * * 2142 - 12 - 23 * * ] Liver US : Gallstones , without gallbladder wall thickening pericholecystic fluid suggest acute cholecystitis . biliary dilation . [ * * 2142 - 12 - 23 * * ] CT Abd / pelvis : 1 . intrahepatic biliary ductal dilatation , gallstone , gallbladder normal appearance . 2 . slight mural hyperenhancement nondilated common hepatic common bile duct - see cholangitis . 2 . Diverticula , evidence diverticulitis . [ * * 2142 - 12 - 23 * * ] ERCP : Esophageal web periampullary diverticulum successful biliary cannulation . single stricture 6 mm long see middle third common bile duct . irregular appearance lining bile duct , likely secondary cholangitis . sucessful sphincterotomy perform small 4 mm stone extract . Pus see exit bile duct . successful plastic biliary stent placement otherwise normal ercp third part duodenum Possible Mirizzi 's versus tumor cause stricture . [ * * 2142 - 12 - 26 * * ] CXR ; 1 . new small - - moderate right - side pleural effusion parenchymal opacity could probably explain compressive atelectasis , although pneumonia additional differential consideration . 2 . similar leave low lung opacity chronic finding . [ * * 2142 - 12 - 28 * * ] : indication : cbd stricture unclear etiology . evaluate pancreatic mass . comparison : CT abdomen [ * * 2142 - 12 - 23 * * ] ERCP [ * * 12 - 23 * * ] , [ * * 2142 * * ] . TECHNIQUE : multidetector helical scanning abdoman perform prior follow administration 200 cc IV Optiray contrast . Coronal , sagittal , volume - render MIP reformat display . CTA ABDOMEN : leave low lobe bronchiectasis small bilateral pleural effusion unchanged prior exam . pneumobilia common bile duct stent place traverse mid cbd stricture see ERCP . soft tissue surround cbd definitively suggest biliary malignancy . mild intrahepatic biliary ductal dilation . 8 - mm low - density lesion within segment V / VI liver ( 3A:43 ) , small characterize likely cyst . intrahepatic lesion . portal vein patent . hepatic arterial anatomy conventional . pancreas enhance homogeneously evidence pancreatic mass . superior mesenteric artery vein patent normal caliber course . prominent 12 mm portal hilar lymph node ( 3B:110 ) , likely reactive . also 13 - mm precaval node ( 3B:119 ) . spleen , gallbladder , adrenal gland normal . kidney enhance excrete contrast symmetrically multiple subcentimeter hypoattenuate lesion small characterize likely cyst . 16 - mm exophytic fat - contain left renal lesion consistent angiomyolipoma ( 3a:66 ) . left extrarenal pelvis . ascite . mesenteric adenopathy . small bowel loop normal . moderately extensive colonic diverticula . bone mildly osteopenic degenerative change , however , concern lytic sclerotic lesion . IMPRESSION : mild biliary dilation stent within CBD , pancreatic biliary mass identify . study report review staff radiologist . DR . [ * * First Name ( STitle ) 18394 * * ] [ * * initial ( namepattern4 ) * * ] [ * * last Name ( namepattern4 ) 18395 * * ] DR . [ * * First Name ( STitle ) 8085 * * ] [ * * initial ( namepattern4 ) * * ] [ * * last Name ( namepattern4 ) 8086 * * ] approve : SAT [ * * 2142 - 12 - 29 * * ] 10:56 pm Brief Hospital course : 72 year - old female present acute cholangit transfer ERCP surgery evalaution . # Acute Cholangitis : Pt elevate lft bili RUQ pain fever 102.9 OSH . transfered ERCP surgery eval . Pt appearance sepsis due WBC 9.4 56 % band OSH WBC 31.3 30 % band [ * * Hospital1 18 * * ] ER fever . ERCP show stone obstruction drainage pus , stent place . Pt admit [ * * Hospital Unit Name 153 * * ] post procedure remain NPO . lft start trend post ERCP . 2 hour post ERCP develop hypotension BP dropping mid 90 70 . mentate make urine . give IVF bolus LR bp improve 90 - 100 . give IVF need maintain UO sbp>90 . abd pain post procedre . continue tx unasyn . [ * * 2142 - 12 - 23 * * ] osh blood cx grow GNR 2/4 bottle [ * * 2142 - 12 - 24 * * ] 9am . transferd sicu per request surgery team . # CBD stricture : ERCP pt find stricture unclear cause . pancreatic protocol CTA , show mild biliary dilation stent within CBD , pancreatic biliary mass identify . # cholelithiasis : follow ERCP sphincterotomy stone extraction , pt clincally stabilize lft gradually return [ * * Location 213 * * ] . point , take operating room definitive management cholelithiasis . Pt find acute suppurative cholecystitis laproscopic cholecystectomy perform . recover uneventfully procedure . # atrial fibrillation : develop RAF 150 [ * * 2142 - 12 - 25 * * ] give IV lopressor subsequently Diltiazem conversion NSR . episode . # Possibe PNA : clear resp sx hypoxia . CT Abd show low lung field pulm bronchiectasis , may expalin ER finding CXR . 3 liter oxygen requirment likely IVF give setting sepsis . follow transfer surgical floor continue make good progress . remain free arrhythmias gradually wean oxygen adequate saturation . ambulate independently void without difficulty . diet gradually advance regular well tolerate . medication admission : Multivitamin Discharge medication : 1 . Augmentin 500 - 125 mg Tablet Sig : one ( 1 ) Tablet PO three time day 2 day . Disp:*6 Tablet(s ) * Refills:*0 * 2 . metoprolol tartrate 25 mg Tablet Sig : 0.5 Tablet po BID ( 2 time day ) . disp:*30 Tablet(s ) * Refills:*0 * 3 . multivitamin Tablet Sig : one ( 1 ) Tablet po day . 4 . oxycodone 5 mg Tablet Sig : one ( 1 ) Tablet po every 4 - 6 hour need pain . disp:*25 Tablet(s ) * Refills:*0 * 5 . docusate sodium 100 mg Capsule Sig : one ( 1 ) Capsule po twice day : take use oxycodone avoid constipation . Disp:*60 Capsule(s ) * Refills:*2 * discharge disposition : home discharge diagnosis : cholangitis choledocholithiasis gram negative bacteremia paroxsymal atrial fibrillation discharge condition : Mental Status : clear coherent . Level consciousness : alert interactive . Activity Status : Ambulatory - Independent . Discharge instruction : * admit hospital abdominal pain due stone bile duct . undergo ERCP stent placement . * surgery gallbladder remove . * continue eat regular diet stay well hydrated . * take antibiotic prescribe . * irregular heartbeat short time ICU . normalize medication call lopressor . continue Dr. [ * * last Name ( STitle ) 39288 * * ] evaluate thge office . * develop abdominal pain symptom concern , please call doctor return Emergency Room . * need stent remove later . please call number schedule appointment . General Discharge instruction : please resume regular home medication , unless specifically advise take particular medication . please take new medication prescribe . please take prescribed analgesic medication need . may drive heavy machinery take narcotic analgesic medication . may also take acetaminophen ( tylenol ) direct , exceed 4000 mg one day . please get plenty rest , continue walk several time per day , drink adequate amount fluid . avoid strenuous physical activity refrain heavy lifting great 10 lbs . , follow - surgeon , instruct regard activity restriction . please also follow - primary care physician . Incision Care : * please call surgeon go emergency department increase pain , swelling , redness , drainage incision site . * avoid swimming bath clear surgeon . * may shower wash incision mild soap warm water . gently pat area dry . * staple , remove follow - appointment . * steri - strip , fall . please remove remain strip 7 - 10 day surgery . Followup Instructions : call Acute Care Clinic [ * * telephone / Fax ( 1 ) 600 * * ] follow appointment [ * * 12 - 27 * * ] week . call GI unit [ * * telephone / Fax ( 1 ) 1983 * * ] schedule appointment repeat ERCP stent removal 3 week . call Dr. [ * * last Name ( STitle ) 39288 * * ] follow appointment 2 week .
[ "0389", "2875" ]
Admission Date : [ * * 2185 - 4 - 17 * * ] Discharge Date : [ * * 2185 - 5 - 2 * * ] Date Birth : [ * * 2185 - 4 - 17 * * ] sex : F Service : neonatology history : [ * * first Name4 ( NamePattern1 ) 14552 * * ] [ * * know lastname * * ] , twin # 2 , bear 34 - 2/7 week gestation 40 - year - old gravida 3 , para 2 four woman spontaneous vaginal delivery . mother 's prenatal screen blood type O+ , antibody negative , rubella immune , RPR nonreactive , hepatitis surface antigen negative , group B Strep unknown . pregnancy achieve in-[**Last Name ( un ) 5153 * * ] fertilization result dichorionic - diamniotic twin . mother receive betamethasone 23 week gestation due cervical shortening . pregnancy also complicated hypertension urinary tract infection x2 unknown organism , mother also chronic smoker . labor ensue spontaneous rupture membrane 12 hour delivery twin # 1 . twin emerge vigorous . apgar eight one minute eight five minute . birth weight 2,125 gram , birth length 44.5 cm , birth head circumference 31.5 cm . parameter 25 - 50th percentile gestational age . ADMISSION PHYSICAL EXAM : reveal vigorous preterm infant . anterior fontanel soft flat . suture proximate . positive bilateral red reflex . mild subcostal - intercostal retraction , positive grunting . Breath sound equal . Heart regular , rate , rhythm , rhythm . pink well perfuse . soft abdoman positive bowel sound , three vessel umbilical cord . normal preterm female genitalia , femoral pulse +2 , nonfocal neurological examination . HOSPITAL COURSE systems : respiratory : infant initially grunt flaring retract resolve hour life . occasional episode desaturation first two day life , apnea , bradycardia , desaturation . examination , respiration comfortable . always remain room air throughout NICU stay . Cardiovascular : infant remain normotensive throughout nicu stay . cardiovascular issue . Fluids , electrolyte , nutrition : time discharge , weight 2,180 gram , length 45 cm , head circumference 31.5 cm . Enteral feed begin day life # 1 advance without difficulty full volume feed day life # 2 . time discharge , eat adlib schedule 24 calorie / ounce breast milk Enfamil breast feed mother present . Gastrointestinal : one bilirubin draw day life # 3 total 6.4 direct 0.3 . never require phototherapy . Hematology : time admission , hematocrit 46.8 . never receive blood product transfusion nicu stay . infectious disease : [ * * Doctor First Name 14552 * * ] start ampicillin gentamicin time admission sepsis risk factor . antibiotic discontinue 48 hour blood culture negative , infant clinically well . Neurology : neurological issue . Audiology : hearing screening perform automate auditory brain stem response , infant pass ear . Psychosocial : parent involved infant 's care throughout nicu stay . infant discharge good condition home parent . primary PEDIATRIC CARE : provide Dr. [ * * first Name4 ( NamePattern1 ) 2048 * * ] [ * * last Name ( NamePattern1 ) * * ] [ * * hospital1 1562 * * ] , telephone # [ * * telephone / Fax ( 1 ) 49156 * * ] . CARE recommendation discharge : 1 . feeding : 24 calorie / ounce breast milk Enfamil breast feed maintain consistent weight gain . medication : 1 . iron sulfate ( 25 mg / ml elemental iron ) 0.2 cc po q day . infant pass car seat oxygenation test . State newborn screen send [ * * 4 - 21 * * ] [ * * 2185 - 5 - 1 * * ] . infant yet receive immunization attempt keep twin immunization schedule twin yet reach 2 kg weight recommendation first hepatitis B vaccine . RECOMMENDED immunization : 1 . Synagis RSV prophylaxis consider [ * * Month ( ) 359 * * ] [ * * Month ( ) 547 * * ] infant meet follow three criterion : 1 ) bear less 32 week , 2 ) bear 32 35 week plan daycare RSV season , smoker household , preschool sibling , 3 ) chronic lung disease . 2 . influenza immunization consider annually fall preterm infant chronic lung disease reach six month age . age , family caregiver consider immunization influenza protect infant . FOLLOW - appointment INFANT : 1 . [ * * hospital6 407 * * ] [ * * hospital3 * * ] , telephone # 1-[**telephone / fax ( 1 ) 46331 * * ] . 2 . lactation consultant Learning Center [ * * hospital1 * * ] , telephone # [ * * telephone / Fax ( 1 ) 47507 * * ] . discharge diagnosis : 1 . prematurity 34 - 2/7 week . 2 . twin # 2 . 3 . status post transitional respiratory distress . 4 . sepsis rule . [ * * first Name8 ( NamePattern2 ) 36400 * * ] [ * * Name8 ( MD ) * * ] , M.D. [ * * MD Number(1 ) 37201 * * ] dictate by:[**last Name ( NamePattern1 ) 37333 * * ] medquist36 : [ * * 2185 - 5 - 2 * * ] 15:03 : [ * * 2185 - 5 - 2 * * ] 06:58 JOB # : [ * * Job number 49158 * * ]
[ "7742", "V290" ]
Admission Date : [ * * 2199 - 12 - 3 * * ] Discharge Date : [ * * 2199 - 12 - 19 * * ] Date Birth : sex : Service : CHIEF COMPLAINT : Hypoxia history PRESENT ILLNESS : 33 year old male significant past medical history initially present [ * * company 191 * * ] Outpatient Clinic [ * * 11 - 27 * * ] four day high fever ( 103 degree F ) , nonproductive cough , malaise , diffuse myalgias , mild resting dyspnea , exposure ill contact . [ * * 2199 - 11 - 27 * * ] vital sign office temperature 99.5 , blood pressure 120/85 , heartrate 113 respiratory rate 20 , oxygen saturation 89 % room air . Weight 238 lbs . nonspecific pulmonary examination appreciate time . prescribe Levaquin 500 mg p.o . q.d . discharge home . represent outpatient [ * * Hospital 191 * * ] Clinic [ * * 2199 - 12 - 3 * * ] complain persistent fever 102 degree f , weakness , bilious emesis , worsen dyspnea , nonproductive cough . vital sign office temperature 97.3 , blood pressure 108/70 , respiratory rate 20 , heartrate 108 , oxygen saturation 70 % room air . wheeze note examination . give 1 gm Ceftriaxone send Emergency Department receive normal saline 1 gm Vancomycin . deny pleuritic chest pain . risk factor human immunodeficiency virus . deny history seizure disorder , alcohol use , recent somnolence , symptom gastroesophageal reflux disease . transfer Intensive Care Unit arrival . PAST MEDICAL history : significant past medical history surgical history . allergy : know drug allergy . medication admission : Levofloxacin 500 mg p.o . q.d . SOCIAL history : originally [ * * Male First Name ( un ) 1056 * * ] . bus driver , live wife daughter , alcohol , elicit drug use . rare alcohol use . FAMILY history : Father diabetes mellitus . PHYSICAL EXAMINATION admission : General , moderately obese , sit bed , accessory muscle use . vital sign , temperature 99.0 , heartrate 92 , blood pressure 137/74 , respiratory rate 16 , oxygen saturation 100 % 100 % nonrebreather . Head , eye , ear , nose throat , pupil equal , round reactive light , extraocular muscle intact , anicteric , oropharynx clear , fair dentition . Neck , lymphadenopathy . Chest , rhonchi , right great leave , crackle , wheeze . Normal e ratio , egophony , fremitus , dullness percussion . Cardiac , regular rate rhythm , murmur , rub gallop . Abdomen , obese , normoactive bowel sound , nontender , nondistended , masse . Neurological , cranial nerve II XII grossly intact . alert oriented time three . Conversant appropriately . Strength 5/5 extremity . LABORATORY DATA : laboratory finding admission reveal white blood cell count 8.4 , 73 % neutrophil , 0 band , 19 lymphocyte , 6 monocyte , hematocrit 43.8 , platelet 104 , MCV 83 , RDW 13.0 , sodium 137 , potassium 3.4 , chloride 92 , bicarbonate 29 , BUN 13 , creatinine 0.8 , glucose 129 . arterial blood gas 100 % nonrebreather , PH 7.49 , carbon dioxide 39 , oxygen 77 . Imaging : [ * * 2199 - 11 - 27 * * ] , chest x - ray , normal , acute cardiopulmonary process . Chest x - ray [ * * 2199 - 12 - 3 * * ] , ( admission ) , patchy right upper lobe , right middle lobe infiltrate diffuse right great leave interstitial pattern , normal mediastinum , effusion . HOSPITAL COURSE : 33 year old male past medical history originally admit Intensive Care Unit hypoxia , bilateral pneumonia , receive Ceftriaxone Azithromycin , Doxycycline add since parakeet home ( also rat home ) . undergo bronchoscopy compute tomographic angiography thorax demonstrate right middle lobe right low lobe pulmonary embolus question infarction . subsequently heparinize . human immunodeficiency virus test negative . receive Bactrim steroid day stop human immunodeficiency virus test come back negative . hypercoagulability workup pende arrive floor stable condition . arrival floor clinically improve heparin drip , Ceftriaxone , Azithromycin , Doxycycline . study obtain Intensive Care Unit include [ * * First Name8 ( NamePattern2 ) * * ] [ * * Doctor First Name * * ] negative , ANCA negative , hepatitis panel negative . LENIS demonstrate deep vein thrombosis , thrombosis right lesser saphenous vein , echocardiogram obtain well [ * * 12 - 6 * * ] , demonstrate ejection fraction 50 % , mildly dilate right ventricle mild tricuspid regurgitation . chest computerized tomography scan mention [ * * 12 - 4 * * ] demonstrate multiple small pulmonary embolus ( right low lobe right middle lobe ) bilateral atypical pneumonia . Workup organism say pneumonia undertake . negative viral culture , negative Chlamydia , negative leptospirosis , negative C. Psittaci negative mycoplasma . blood culture negative well . maintain Azithromycin complete 14 day course pneumonia . Doxycycline withdraw . complete ten day course Ceftriaxone . regard pulmonary embolus , remain hemodynamically stable heparin drip throughout admission . repeat computerized tomography scan thorax demonstrate bilateral expand heterogenous soft tissue density within rectus abdominis muscle ? hematoma , partial resolution bilateral perihilar ground - glass opacity , leave SVC , however , pulmonary embolus . give discrepancy [ * * 12 - 4 * * ] [ * * 12 - 11 * * ] , computerized tomography scan , would difficult prove pulmonary embolus [ * * 12 - 4 * * ] film . decision anticoagulate three six month pursue evaluation make . regard anticoagulation workup , patient positive anticardiolipin IgM ( 46.9 ) . intermediate range value . IgG anticardiolipin value 1.6 . patient normal ptt admission . make diagnosis anticardiolipin syndrome single value , finding stand nonspecific , however , anticardiolipin panel repeat six week . patient subsequently continue anticoagulation pulmonary embolus . heparin drip discontinue discharge bridge Coumadin Lovenox . regard rectus hematoma note computerized axial tomography scan , finding commonly see setting anticoagulation . patient concurrently fever maximally 101 degree F. concern perhaps fever may attributable hematoma local infection thereabout . start Clindamycin conjunction infectious Disease Consult Service 's recommendation . complete ten day course Clindamycin . finally , patient note drop hematocrit anticoagulation . guaiac negative . source bleed identify . likely bleed abdominal hematoma attribute drop hematocrit . patient also intermittently hyponatremic stay , likely secondary syndrome inappropriate antidiuretic hormone secondary thoracic process ( namely bilateral pneumonia , pulmonary embolism ) admission . discharge DIAGNOSIS : 1 . Bilobar pneumonia atypical fever 2 . Pulmonary embolus 3 . Rectus hematoma 4 . Anticardiolipin antibody igm positive 5 . Hyponatremia 6 . anemia follow : patient follow primary provider , [ * * last Name ( namepattern4 ) * * ] . [ * * First Name8 ( NamePattern2 ) * * ] [ * * last Name ( NamePattern1 ) * * ] week follow discharge . medication DISCHARGE : discharge Lovenox bridge Coumadin . also discharge Clindamycin complete ten day course . [ * * Name6 ( MD ) 251 * * ] [ * * Name8 ( MD ) * * ] , M.D. [ * * MD Number(1 ) 1197 * * ] Dictated By:[**Name8 ( MD ) 17844 * * ] medquist36 : [ * * 2200 - 5 - 7 * * ] 17:14 : [ * * 2200 - 5 - 7 * * ] 19:08 JOB # : [ * * Job Number * * ]
[ "486", "2761", "2859" ]
Admission Date : [ * * 2140 - 11 - 11 * * ] Discharge Date : [ * * 2140 - 11 - 24 * * ] Service : cardiothoracic history PRESENT ILLNESS : patient schedule admission aortic aneurysm repair . 81 year old woman history hypertension , recurrent pericarditis pleuritis require percutaneous drainage [ * * 2137 * * ] . echocardiogram [ * * 2137 - 12 - 13 * * ] , show normal left ventricular function dilate aortic root 48 mm , mildly thicken aortic valve mild aortic regurgitation . Follow - [ * * 2140 - 9 - 12 * * ] , echocardiogram show ejection fraction 60 % dilate aortic root 55 mm , mild aortic sclerosis , mild aortic regurgitation , bilateral atrial enlargement . Cardiac catheterization do [ * * 2140 - 10 - 26 * * ] , show ejection fraction 80 % normal wall motion , severe aneurysmal dilatation ascending aorta arch , recurrent dilatation descending aorta dissection , 1 + aortic regurgitation , normal coronary . PAST MEDICAL history : 1 . Hypertension . 2 . Raynaud 's disease . 3 . Phlebitis . 4 . Osteoporosis . 5 . Tonsillectomy . 6 . spinal fusion . 7 . umbilical hernia repair . 8 . Appendectomy . 9 . Cholecystectomy . 10 . total abdominal hysterectomy . medication admission : 1 . Metoprolol 100 mg twice day . 2 . hydrochlorothiazide 25 mg daily . 3 . Lisinopril 10 mg daily . 4 . Enteric Coated Aspirin 81 mg daily . 5 . Centrum Silver one daily . 6 . Calcium 600 daily . 7 . Nexium 40 mg daily . allergy : state allergy Codeine cause bad abdominal cramp adhesive tape cause rash . SOCIAL history : patient live home husband . [ * * Name ( NI ) 1139 * * ] one half pack per day time eighteen year , quit forty - five year ago . Alcohol one drink per day , none time past four week . PHYSICAL EXAMINATION : time preadmission testing , heart rate 74 beat per minute , blood pressure 148/80 , respiratory rate 18 , oxygen saturation 96 % room air , height four foot eleven inch , weight 106 pound . general , appear young state age acute distress . skin - break rash . Head , eye , ear , nose throat - pupil equal , round , reactive light accommodation . extraocular movement intact . Pharynx clear . neck supple jugular venous distention , bruit , carotid pulse 2 + bilaterally . chest clear auscultation bilaterally . heart regular rate rhythm , murmur , rub gallop . abdoman soft , nontender , nondistended , positive bowel sound , hepatosplenomegaly , well heal surgical scar . extremity without cyanosis , club edema . leave upper extremity nodularity old intravenous site near left wrist . varicosity low extremity . neurologically , patient alert orient time three , grossly intact . Pulses - femoral indicate . Dorsalis pedi 1 + bilaterally . Posterior tibial detect . Radial 2 + bilaterally . carotid bruit bilaterally . HOSPITAL COURSE : state previously , patient direct admission operating room [ * * 2140 - 11 - 11 * * ] , time undergo supracoronary ascending aortic graft resuspension aortic valve . please see operative report full detail . patient tolerate operation well transfer operating room Cardiothoracic Intensive Care Unit . Circ arrest time eleven minute . time transfer , patient Milrinone 0.4 mcg / kg / minute , amiodarone 1 mg per minute , Neo - Synephrine dose indicate Propofol , also dose indicate . patient well immediate postoperative period . anesthesia reverse . wean ventilator . morning postoperative day one , successfully extubate . postoperative day number one , cardioactive medication begin wean begin Amiodarone Milrinone . postoperative day two , patient maintain minimal amount Amiodarone , Milrinone Nipride . postoperative day two , patient 's Milrinone discontinue . amiodarone change p.o . Nipride discontinue initiation beta blockade . chest tube remove . maintain Cardiothoracic Intensive Care Unit monitoring hemodynamic pulmonary status . postoperative day three , patient continue well . remain hemodynamically stable . transfer Cardiothoracic Intensive Care Unit [ * * Hospital Ward Name 121 * * ] two continue postoperative care cardiac rehabilitation . floor , note patient go sustain atrial fibrillation heart rate 100 110 , hemodynamically tolerate well . see electrophysiology service maintain p.o . Lopressor well p.o . amiodarone continue monitor floor . next two day , patient atrial fibrillation . remain hemodynamically stable throughout period . postoperative day five , note patient drop hematocrit guaiac positive stool . see gastroenterology service . time , also transfer back Cardiothoracic Intensive Care Unit close monitoring . patient undergo KUB read normal . also stool send Clostridium difficile negative . empirically start Flagyl time . patient remain Intensive Care Unit next several day monitor gastrointestinal status make sure guaiac positive stool . postoperative day seven , transfer floor continue postoperative care . prior transfer Intensive Care Unit , note patient left upper extremity swelling . undergo ultrasonography upper extremity time rule thrombosis . Ultrasound show right internal jugular cephalic thrombus . follow transfer , vascular service consult recommend oral anticoagulation Coumadin , begin time . next several day , exception intermittent atrial fibrillation , patient uneventful hospital course . see electrophysiology service give episode atrial fibrillation , last episode last great 24 hour . patient additionally begin Heparin give duration episode atrial fibrillation . patient schedule direct current cardioversion , however , prior cardioversion , patient spontaneously convert normal sinus rhythm . postoperative day twelve , decide patient remain rate control rhythm next 24 hour , would stable ready transfer rehabilitation . time dictation , patient 's physical examination follow ; vital sign reveal temperature 98.2 , heart rate 71 , sinus rhythm , blood pressure 147/68 , respiratory rate 20 , oxygen saturation 98 % room air . Weight preoperatively 50 kilogram transfer rehabilitation 53 kilogram . laboratory datum [ * * 2140 - 11 - 23 * * ] , white blood cell count 11.7 , hematocrit 34.5 , platelet count 219,000 . Prothrombin time 15.0 , partial thromboplastin time 25.0 Heparin . INR 1.5 . Sodium 129 , potassium 4.8 , chloride 95 , CO2 29 , blood urea nitrogen 16 , creatinine 0.8 , glucose 183 . patient alert orient time three , move extremity , follow command . Respiratory reveal scatter rhonchi . Cardiac regular rate rhythm murmur . sternum stable incision Steri - strip open air , clean dry . abdoman soft , nontender , nondistende positive bowel sound . extremity warm well perfuse edema . right upper arm minimal edema resolve last several day . medication DISCHARGE : 1 . Colace 100 mg p.o . twice day . 2 . amiodarone 200 mg p.o . three time day time one week 200 mg p.o . daily time one month . 3 . Metoprolol 100 mg twice day . 4 . Lasix 20 mg daily time ten day . 5 . Potassium Chloride 20 meq daily time ten day . 6 . Prilosec 40 mg p.o . daily . 7 . Heparin 600 unit per hour keep partial thromboplastin time 40 60 INR therapeutic . 8 . warfarin maintain INR 2.0 2.5 . patient receive 2 mg Coumadin two day prior discharge Coumadin one day prior discharge 2 mg Coumadin night discharge . check INR morning dose Coumadin day transfer rehabilitation center . condition DISCHARGE : good . discharge diagnosis : 1 . Status post supracoronary ascending aortic graft resuspension aortic valve . 2 . Hypertension . 3 . Raynaud 's disease . 4 . Phlebitis . 5 . Osteoporosis . 6 . Status post tonsillectomy . 7 . Status post spinal fusion . 8 . Status post umbilical hernia repair . 9 . Status post inguinal hernia repair . 10 . status post appendectomy . 11 . status post cholecystectomy . 12 . status post total abdominal hysterectomy . DISCHARGE STATUS : patient discharge [ * * Location 50742 * * ] . fo[**last Name ( STitle ) * * ] p : follow - Dr. [ * * First Name ( STitle ) * * ] two three week follow - Dr. [ * * last Name ( STitle ) 1159 * * ] one month follow - Dr. [ * * last Name ( Prefixes ) * * ] one month . [ * * Doctor Last Name 412 * * ] [ * * last Name ( Prefixes ) 413 * * ] , M.D. [ * * MD Number(1 ) 414 * * ] Dictated By:[**Name8 ( MD ) 415 * * ] medquist36 : [ * * 2140 - 11 - 23 * * ] 16:44 : [ * * 2140 - 11 - 23 * * ] 18:31 JOB # : [ * * Job Number 50743 * * ]
[ "4241", "4019" ]
Admission Date : [ * * 2164 - 4 - 23 * * ] Discharge Date : [ * * 2164 - 4 - 27 * * ] Date Birth : [ * * 2096 - 1 - 7 * * ] sex : Service : CARDIOTHORACIC allergy : Known Allergies / Adverse Drug reaction attending:[**first Name3 ( LF ) 1406 * * ] Chief Complaint : chest pain shortness breath Major Surgical Invasive Procedure : [ * * 2164 - 4 - 23 * * ] coronary artery bypass graft x3 left internal mammary artery left anterior descend artery reverse saphenous vein graft posterior descend artery obtuse marginal artery . history Present Illness : 68 year old male history mi 25 year ago . treat medication since . well year 3 week ago start notice diaphoresis , shortness breath right side chest discomfort occur exertion yard work take trash . symptom resolve rest . also one episode chest pain , diaphoresis back pain occur rest large meal . episode last little long episode prompt patient contact Dr. [ * * last Name ( STitle ) 1270 * * ] . send stress echo abnormal refer cardiac catheterization . find three vessel disease refer cardiac surgery revascularization . Past Medical History : diabete type II -diagnose [ * * 2160 * * ] ; control oral agent hyperlipidemia hypertension MI [ * * 2138 * * ] psoriasis Social History : race : caucasian last Dental exam:[**1-/2164 * * ] live : Wife Contact:[**Name ( NI ) * * ] ( wife ) phone # [ * * telephone / Fax ( 1 ) 90854 * * ] Occupation : retire FDA field investigator consultant cigarette : Smoked [ ] yes [ x ] Hx : smoke 2ppd 28 year quit [ * * 2138 * * ] Tobacco use : deny ETOH : < 1 drink / week [ x ] [ * * 12 - 27 * * ] drink / week [ ] > 8 drink / week [ ] Illicit drug use : deny family history : premature coronary artery disease- unknown - adopt Physical Exam : pulse:61 Resp:16 O2 sat:100 / RA B / p Right:138/86 Left:135/74 Height:6'2 " Weight:230 lbs General : skin : Dry [ x ] intact [ x ] HEENT : PERRLA [ x ] EOMI [ x ] neck : Supple [ x ] full rom [ x ] chest : lung clear bilaterally [ x ] heart : rrr [ x ] Irregular [ ] Murmur [ ] grade _ _ _ _ _ _ abdoman : Soft [ x ] non - distended [ x ] non - tender [ x ] bowel sound + [ x ] extremity : Warm [ x ] , well - perfuse [ x ] Edema [ x ] _ _ _ _ _ varicosity : ( L)LE superficial varicosities Neuro : grossly intact [ x ] pulse : Femoral Right : leave : dp Right:2 + Left:2 + PT [ * * Name ( NI ) 167 * * ] : leave : Radial right : leave : Carotid Bruit -none appreciate , pulse Right:2 + Left:2 + pertinent result : [ * * 2164 - 4 - 23 * * ] echo : PRE - bypass : spontaneous echo contrast see body left atrium leave atrial appendage . atrial septal defect see 2D color Doppler . leave ventricular wall thickness normal . left ventricular cavity size top normal / borderline dilate . mild regional left ventricular systolic dysfunction hypokinesis basal distal inferoseptal anteroseptal wall . overall left ventricular systolic function mildly depressed ( lvef= 50 - 55 % ) . right ventricular chamber size free wall motion normal . simple atheroma aortic arch . simple atheroma descending thoracic aorta . aortic valve leaflet ( 3 ) appear structurally normal good leaflet excursion aortic stenosis aortic regurgitation . mitral valve leaflet mildly thicken . mild ( 1 + ) mitral regurgitation see . pericardial effusion . Dr. [ * * last Name ( STitle ) * * ] notify person result time surgery . POST - BYPASS : patient sinus rhythm . patient inotrope . biventricular function unchanged . mitral regurgitation unchanged . aorta intact post - decannulation . [ * * 2164 - 4 - 27 * * ] 04:44AM blood WBC-11.7 * RBC-3.00 * Hgb-9.8 * hct-28.3 * MCV-94 MCH-32.5 * MCHC-34.5 RDW-14.0 Plt ct-323 [ * * 2164 - 4 - 27 * * ] 04:44AM blood Plt ct-323 [ * * 2164 - 4 - 27 * * ] 04:44AM blood Glucose-121 * UreaN-22 * Creat-1.0 Na-139 K-3.8 Cl-102 HCO3 - 28 angap-13 [ * * 2164 - 4 - 27 * * ] 04:44AM blood mg-2.3 comparison : [ * * 2164 - 4 - 25 * * ] 10:45 a.m. finding : note previously , similar - sized left apical pneumothorax . left chest tube remove interim . leave basilar atelectasis remain . cardiac silhouette mediastinal contour unchanged . median sternotomy wire unchanged . IMPRESSION : unchanged small leave apical pneumothorax , status post leave chest tube removal . Brief Hospital course : Mr. [ * * know lastname * * ] 68 yr old male history MI develop worsen chest pain , underwent cath reveal significnat CAD . see cardiac surgery service accept CABG . day admit [ * * 4 - 23 * * ] bring directly operating room undergo coronary artery bypass graft x 3 . please see operative note surgical detail . follow surgery transfer CVICU invasive monitoring stable condition . later day wean sedation , awake neurologically intact extubate . wean Neo overnight start beta - blocker POD#1 . diurese towards preoperative weight . POD#1 transfer step unit monitoring . continue progress well floor . Physical Therapy consult evaluation strength mobility . remainder postop course essentially uneventful . clear discharge home vna service POD#4 . follow - appt arrange . medication admission : ATENOLOL 50 mg Daily lipitor 20 mg Daily PLAVIX 75 mg Daily ( start [ * * 2164 - 4 - 14 * * ] ) , LD [ * * 4 - 17 * * ] DILTIAZEM HCL 240 mg Daily ENALAPRIL MALEATE take 10 mg qam , 5 mg qhs HYDROCHLOROTHIAZIDE 25 mg Daily METFORMIN 1,000 mg [ * * hospital1 * * ] NITROGLYCERIN 0.4 mg Tablet PRN Aspirin 325 mg Daily Centrum Silver Multivitamin 1 tablet daily Discharge medication : 1 . potassium chloride 10 meq Tablet Extended Release Sig : two ( 2 ) Tablet Extended Release po day 2 week . Disp:*60 Tablet Extended release(s ) * Refills:*2 * 2 . aspirin 81 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:*2 * 3 . atorvastatin 20 mg Tablet Sig : one ( 1 ) Tablet PO DAILY ( Daily ) . Disp:*60 Tablet(s ) * Refills:*2 * 4 . tramadol 50 mg Tablet Sig : one ( 1 ) Tablet PO Q6H ( every 6 hour ) need pain . Disp:*40 Tablet(s ) * Refills:*0 * 5 . fluticasone 50 mcg / actuation Spray , Suspension Sig : two ( 2 ) Spray Nasal DAILY ( Daily ) . Disp:*1 * Refills:*2 * 6 . metoprolol tartrate 50 mg Tablet Sig : one ( 1 ) Tablet PO TID ( 3 time day ) . Disp:*90 Tablet(s ) * Refills:*2 * 7 . metformin 500 mg Tablet Sig : two ( 2 ) Tablet po BID ( 2 time day ) . disp:*120 Tablet(s ) * Refills:*2 * 8 . docusate sodium 100 mg Capsule Sig : one ( 1 ) Capsule po BID ( 2 time day ) . Disp:*60 Capsule(s ) * Refills:*2 * 9 . Lasix 40 mg Tablet Sig : one ( 1 ) Tablet po day 2 week . Disp:*14 Tablet(s ) * Refills:*0 * discharge Disposition : Home Service Facility : [ * * Location ( un ) 86 * * ] VNA Discharge Diagnosis : Coronary artery disease / p Coronary artery bypass graft x 3 past medical history : diabete type II -diagnose [ * * 2160 * * ] ; control oral agent hyperlipidemia hypertension MI [ * * 2138 * * ] psoriasis discharge condition : alert orient x3 nonfocal ambulate steady gait incisional pain manage oral analgesia incision : Sternal - heal well , erythema drainage Leg Right / left - heal well , erythema drainage . Edema discharge instruction : please shower daily include wash incision gently mild soap , bath swimming clear surgeon . look incision daily redness drainage please lotion , cream , powder , ointment incision morning weigh evening take temperature , write chart drive approximately one month take narcotic , discuss follow appointment surgeon able drive lifting 10 pound 10 week please call question concern [ * * telephone / Fax ( 1 ) 170 * * ] female : please wear bra reduce pull incision , avoid rub low edge * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * Followup Instructions : schedule follow appointment Wound Check : [ * * 2164 - 5 - 8 * * ] 10:00 surgeon : Dr. [ * * last Name ( STitle ) * * ] [ * * 2164 - 5 - 31 * * ] @ 1 pm Cardiologist / PCP : [ * * last Name ( namepattern4 ) * * ] . [ * * last Name ( STitle ) 1270 * * ] [ * * telephone / Fax ( 1 ) 1144 * * ] Date / time:[**2164 - 5 - 15 * * ] 10:30 * * please call cardiac surgery office question concern [ * * telephone / Fax ( 1 ) 170 * * ] . answer service contact call person hour * * complete by:[**2164 - 4 - 27 * * ]
[ "2724", "4019", "412" ]
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