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<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
3. Guaifenesin ___ mL PO Q6H:PRN cough
4. Mylanta *NF* 1 tablet Oral daily prn gas
5. Tiotropium Bromide 1 CAP IH DAILY
6. Amlodipine 5 mg PO DAILY
7. Ibuprofen 400 mg PO Q6H:PRN pain
8. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY
9. Lorazepam 1 mg PO Q6H:PRN anxiety
10. OLANZapine 15 mg PO HS
11. TraZODone 50 mg PO HS:PRN insomnia
12. Haloperidol 5 mg PO TID:PRN agitation
13. Haloperidol 5 mg PO TID
14. Docusate Sodium 100 mg PO BID
15. Senna 1 TAB PO BID:PRN constipation
16. Lisinopril 10 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary diagnosis: Lithium toxicity
Secondary diagnoses: bipolar disorder, diabetes mellitus
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you during your hospitalization
at ___. You were admitted for altered mental status and
confusion which was due to an increased lithium level. You
likely became dehydrated, your kidneys got injured and you
developed a high level of the drug in your blood which caused
adverse effects. You were given fluids and your level decreased.
Your kidneys improved.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Ms. ___,
It was a privilege caring for you at ___.
Please see below for more information on your hospitalization.
WHY WERE YOU ADMITTED TO THE HOSPITAL?
- You were admitted to the hospital because you had chest pain.
You were found to have had a heart attack.
WHAT WAS DONE WHILE YOU WERE IN THE HOSPITAL?
- Your heart arteries were examined (cardiac catheterization)
which showed a blockage of one of the arteries. This was opened
by placing a tube called a stent in the artery. You were given
medications to prevent future blockages.
- We started you on medications to help your heart
- You had a low blood count (anemia) and we did imaging and the
GI team looked at your esophagus, stomach and first part of your
intestines with EGD. They saw some ulcers and changes in your
esophagus but no obvious signs of bleeding.
- We gave you blood to maintain your blood counts
- You blood counts remained stable and you were ready to go
home.
WHAT DO YOU NEED TO DO WHEN YOU LEAVE THE HOSPITAL?
- Take all of your medications as prescribed (listed below)
- It is very important to take your aspirin and clopidogrel
(also known as Plavix every day.
- These two medications keep the stents in the vessels of the
heart open and help reduce your risk of having a future heart
attack.
- If you stop these medications or miss ___ dose, you risk
causing a blood clot forming in your heart stents and having
another heart attack
- Please do not stop taking either medication without taking to
your heart doctor.
- You are also on other new medications for your atrial
fibrillation including Metoprolol and Digoxin to help control
your heart rate. You were also started on Rivaroxaban to help
prevent stroke.
- Weigh yourself every morning, seek medical attention if your
weight goes up more than 3 lbs from your discharge weight of
163.8 lbs.
- Seek medical attention if you have new or concerning symptoms
or you develop swelling in your legs, chest pain, abdominal
distention, or shortness of breath at night.
- Follow up with your doctors as listed below
It was a pleasure taking part in your care here at ___!
We wish you all the best!
- Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Apixaban 5 mg PO BID
RX *apixaban [Eliquis] 5 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
2. Multivitamins W/minerals 1 TAB PO DAILY
RX *multivitamin,tx-minerals [Vitamins and Minerals] 1
tablet(s) by mouth daily Disp #*30 Tablet Refills:*0
3. Zinc Sulfate 220 mg PO DAILY Duration: 10 Days
RX *zinc sulfate 220 mg (50 mg zinc) 1 capsule(s) by mouth daily
Disp #*3 Capsule Refills:*0
4. Metoprolol Succinate XL 25 mg PO DAILY
RX *metoprolol succinate 25 mg 1 tablet(s) by mouth daily Disp
#*30 Tablet Refills:*0
5. erenumab-aooe 70 mg/mL subcutaneous Monthly
6. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH QAM
7. HYDROmorphone (Dilaudid) ___ mg PO QID:PRN Pain - Moderate
8. ketamine (bulk) 100 % miscellaneous TID:PRN
9. Lidocaine 5% Ointment 1 Appl TP TID:PRN pain
10. Mirtazapine 45 mg PO QHS
11. Pregabalin 300 mg PO BID
12. Promethazine 12.5 mg PO BID:PRN nausea
13. Sumatriptan Succinate 6 mg SC ONCE:PRN migraine
14. Tizanidine 8 mg PO TID
15. HELD- amLODIPine 7.5 mg PO DAILY This medication was held.
Do not restart amLODIPine until you see your primary care doctor
16. HELD- Furosemide 20 mg PO DAILY This medication was held.
Do not restart Furosemide until you see your primary care doctor
17. HELD- Lisinopril 40 mg PO DAILY This medication was held.
Do not restart Lisinopril until you see your primary care doctor
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS
==================
Oral pharyngeal and esophageal dysphasia
Acute kidney injury
hypotension
SECONDARY DIAGNOSIS
=====================
Urinary tract infection
Chronic regional pain syndrome
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>======================
DISCHARGE INSTRUCTIONS
======================
Dear Ms. ___,
It was a privilege caring for you at ___.
WHY WAS I IN THE HOSPITAL?
- You came to the hospital because you were found to have a low
blood pressure by your outpatient providers.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- Your blood pressure improved after providing you with fluid.
This was likely caused by your low food intake from not being
able to eat properly.
- We placed a tube to provide you extra nutrition with the hopes
we may be able to improve your ability to swallow. You were very
nausea and uncomfortable with the tube in your nose so you had a
tube in your belly placed.
- You received teaching on how to use the tube feeds.
- Please follow up with your primary care doctor, ___
___ neurologist, Dr. ___ to determine need for long term need
for supplemental feeding.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Make sure you continue to have bowel movements. Can take senna
or miralax if you do not have a bowel movement in 2 days.
- Continue to take all your medicines and keep your
appointments.
We wish you the best!
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Glargine 25 Units Bedtime
Regular 7 Units Lunch
Regular 7 Units Dinner
Regular 7 Units at 0000
Insulin SC Sliding Scale using REG Insulin
2. Aspirin 81 mg PO DAILY
3. Docusate Sodium 100 mg PO DAILY:PRN Constipation - First
Line
4. Dronabinol 10 mg PO TID
5. Escitalopram Oxalate 10 mg PO DAILY
6. Famotidine 20 mg PO Q12H
7. Ferrous Sulfate 325 mg PO DAILY
8. Furosemide 20 mg PO DAILY
9. Heparin 5000 UNIT SC BID
10. HYDROmorphone (Dilaudid) ___ mg PO Q6H:PRN Pain - Moderate
11. Levothyroxine Sodium 150 mcg PO DAILY
12. LORazepam 0.5 mg PO Q8H:PRN anxiety
13. melatonin 5 mg oral QHS
14. Mirtazapine 15 mg PO QHS
15. Moexipril 3.75 mg PO DAILY
16. Multivitamins 1 TAB PO DAILY
17. Ondansetron ODT 4 mg PO Q8H:PRN nausea
18. Senna 17.2 mg PO DAILY:PRN constipation
19. TraZODone 25 mg PO QHS:PRN insomnia
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Hyperglycemia
Recurrent necrotizing fasciitis
Sacral uclers
Gastroparesis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>You came in with high blood sugars as you felt your diabetes was
not well managed at the facility you were at. We increased your
long-acting insulin and your blood sugars improved.
We are sending you to a different facility for you to continue
getting rehab and the nursing care you need
It was a pleasure taking care of you at ___
___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet(s) by mouth daily Disp #*90 Tablet
Refills:*0
2. Atorvastatin 40 mg PO QPM
3. Losartan Potassium 100 mg PO DAILY
4. Omeprazole 40 mg PO DAILY
5. Tamsulosin 0.4 mg PO QHS
6. PNEUMOcoccal 23-valent polysaccharide vaccine 0.5 ml IM NOW
X1
Start: ___, First Dose: Next Routine Administration Time
7. Spironolactone 12.5 mg PO DAILY
RX *spironolactone 25 mg 0.5 (One half) tablet(s) by mouth daily
Disp #*90 Tablet Refills:*0
8. Isosorbide Mononitrate (Extended Release) 90 mg PO DAILY
RX *isosorbide mononitrate 30 mg 3 tablet(s) by mouth daily Disp
#*90 Tablet Refills:*0
9. HydrALAZINE 25 mg PO TID
RX *hydralazine 25 mg 1 tablet(s) by mouth three times a day
Disp #*90 Tablet Refills:*0
10. Carvedilol 3.125 mg PO BID
RX *carvedilol 3.125 mg 1 tablet(s) by mouth twice a day Disp
#*180 Tablet Refills:*0
11. Torsemide 40 mg PO DAILY
RX *torsemide 20 mg 2 tablet(s) by mouth daily Disp #*90 Tablet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY
======
Acute on Chronic Systolic CHF
Cardiogenic Shock
SECONDARY
========
___ on CKD
CAD s/p CABG
Renal Mass
GERD
BPH
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted after you were found to have worsening heart
failure. We were nervous that you might have been developing a
condition called "cardiogenic shock," where your body has
difficulty delivering enough oxygen to the organs in your body.
You were therefore briefly on a medication that helps strengthen
your heart's pumping abilities. We also started you on a lot of
the Lasix via a drip, and you had excellent urine output in
response, and your heart failure improved.
Please weigh yourself every morning, and call your PCP or
cardiologist if your weight goes up more than 3 lbs. Your dry
weight is 125.5kg.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
2. Amiodarone 400 mg PO BID
3. Docusate Sodium 100 mg PO BID
4. Metoprolol Tartrate 25 mg PO TID
Hold for HR<55 or SBP <90
5. Senna 8.6 mg PO BID:PRN constipation
6. Warfarin 5 mg PO DAILY16
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
1. bilateral pulmonary emboli
2. subarachnoid hemorrhage
3. left DVT
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to the Acute Care Trauma service on ___
after a fall. You were found to have a small subarachnoid
hemorrhage, bilateral pulmonary emobli and a left femoral leg
blood clot. You underwent IVC placement and were
anticoagulated. You were additionally found to be in atrial
fibrillation and you were treated with multiple agents- you will
be discharged home on metoprolol and amiodarone.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. mercaptopurine 50 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. Fish Oil 300-500 mg Capsule Sig: One (1) Capsule PO once a
day.
3. cyanocobalamin (vitamin B-12) 1,000 mcg/mL Solution Sig: One
(1) Injection once a month.
4. multivitamin,tx-minerals Tablet Sig: One (1) Tablet PO
DAILY (Daily).
5. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
6. fluticasone 50 mcg/actuation Spray, Suspension Sig: Two (2)
Spray Nasal DAILY (Daily).
7. enoxaparin 80 mg/0.8 mL Syringe Sig: One (1) syringe
Subcutaneous twice a day.
Disp:*28 syringe * Refills:*0*
8. metronidazole 500 mg Tablet Sig: One (1) Tablet PO every
eight (8) hours for 14 days: do not drink while taking this
medication.
Disp:*42 Tablet(s)* Refills:*0*
9. Cipro 500 mg Tablet Sig: One (1) Tablet PO twice a day for 14
days.
Disp:*28 Tablet(s)* Refills:*0*
10. oxycodone 5 mg Capsule Sig: One (1) Capsule PO every eight
(8) hours as needed for pain: do not drive while taking this
medication as it can make you tired .
Disp:*10 Capsule(s)* Refills:*0*
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis
Abscess
Crohns Disease
Microscopic hematuria
Secondary Diagnosis
Nephrolithiasis
Urethral strictures.
Rosacea.
Anxiety
depression
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
It was a pleasure participating in your care while you were
admitted to ___. As you know
you were admitted because you were having abdominal pain. You
had a MRI which showed a collection of pus called an abscess. A
drain was placed to remove the infected fluid. You were started
on antibiotics which you will need to continue for at least 14
more days. You will follow-up with Dr. ___ if you
need to continue antibiotics for a longer period of time
You were given a medication that reverses the effects of your
warfarin so that the drain could be placed. You were started on
lovenox in place of the warfarin. You will continue on this
medication in the place of the warfarin. You should discuss this
further with Dr. ___ at your next appointment.
You also had small amount of blood in your urine. You will need
to follow up with your PCP about this
___ made the following changes to your medications.
1. START ciprofloxacin 500 mg twice a day
2. START flagyl 500 mg every 8 hours
3. START lovenox 80 mg twice a day
4. STOP Warfarin
5. START oxycodone as needed for pain
You should continue to take all other medications as instructed.
Please call with any questions or concerns.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 500 mg PO Q6H:PRN Pain - Mild/Fever
2. Calcium Carbonate 500 mg PO QID:PRN heartburn
3. Colchicine 0.6 mg PO DAILY
4. Famotidine 20 mg PO BID:PRN heartburn
5. Furosemide 20 mg PO QPM
6. Furosemide 40 mg PO QAM
7. LORazepam 0.25 mg PO BID:PRN anxiety
8. Losartan Potassium 100 mg PO QHS
9. MethylPHENIDATE (Ritalin) 10 mg PO BID
10. Metoprolol Succinate XL 25 mg PO DAILY
11. Spironolactone 25 mg PO DAILY
12. HELD- Apixaban 5 mg PO BID This medication was held. Do not
restart Apixaban until the morning of ___
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
==================
post-polypectomy lower gastrointestinal bleed
SECONDARY DIAGNOSES:
====================
atrial fibrillation
hypertension
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure to care for you at the ___
___.
Why did you come to the hospital?
-You were having black sticky stools which was concerning for
bleeding from your intestines.
What did you receive in the hospital?
-You underwent a colonoscopy which showed that you had blood
clot over the site where they removed a polyp a few weeks ago
during a prior colonoscopy. This suggests that you had a recent
bleed from this area, though there were no signs of active
bleeding seen. You had clips placed over this area to prevent
any further bleeding. You were also seen to have an ulcer at
another site where you had a polyp remove which is a normal
process of healing after a polyp removal; this did not show any
signs of bleeding and a clip was placed at that site to prevent
any possible future bleeding.
-You were monitored for any more signs of bleeding afterwards
and we held your blood thinner Eliquis (apixaban) for 48 hours
to decrease your risk of rebleeding.
-Your blood counts were stable while you were here which was
reassuring that you had no more bleeding.
-You did not have any bowel movements while here to show that
there was no more bleeding but we were reassured by your blood
counts.
-We felt you were stable after 2 nights of monitoring and
discharged you home.
What should you do once you leave the hospital?
-Please resume your Eliquis on the morning of ___.
-Please make sure to get a CT scan of your lungs to work up the
lung nodule that we found.
-Please monitor your bowel movements at home. It may be normal
for you to have a small streaks of black in your first bowel
movement from blood that remained in your intestines after the
colonoscopy. If you continue to have large black sticky bowel
movements or large amounts of blood in your bowel movements -
please call your doctor. If you are having any lightheadedness,
dizziness, chest pain, trouble breathing or any other symptoms
that concern you please go to the nearest emergency room.
-Please follow up with your primary care office as scheduled
below
We wish you the best!
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H pain
RX *acetaminophen 325 mg ___ tablet(s) by mouth every six (6)
hours Disp #*60 Tablet Refills:*0
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*30 Capsule Refills:*0
3. Milk of Magnesia 30 mL PO Q6H:PRN constipation
4. OxycoDONE (Immediate Release) ___ mg PO Q3H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth every three (3) hours
Disp #*60 Tablet Refills:*0
5. Polyethylene Glycol 17 g PO DAILY
6. Senna 8.6 mg PO BID:PRN constipation
7. Enoxaparin Sodium 40 mg SC QHS
Start: Today - ___, First Dose: Next Routine Administration
Time
RX *enoxaparin 40 mg/0.4 mL 40 mg SC at bedtime Disp #*14
Syringe Refills:*1
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Anterior column acetabular fracture, right side
Right open olecranon fracture
Left subarachnoid hemorrhage
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>You were admitted to ___ after a bike accident. Your injuries
include a right olecranon fracture, a right acetabular fracture,
and a small bleed in your head. You were seen by Neurosurgery
who reviewed your imaging. Your repeat head cat scan did not
show any progression of the bleeding and your neuro exam has
been stable. You do not need to follow-up with Neurosurgery.
Orthopedics was consulted and you were taken to the operating
room for repair of the olecranon fracture.
INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week.
- Resume your regular activities as tolerated, but please follow
your weight bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
- Touch down weight bearing right lower extremity
- non-weight bearing right upper extremity
MEDICATIONS:
- Please take all medications as prescribed by your physicians
at discharge.
- Continue all home medications unless specifically instructed
to stop by your surgeon.
- Do not drink alcohol, drive a motor vehicle, or operate
machinery while taking narcotic pain relievers.
- Narcotic pain relievers can cause constipation, so you should
drink eight 8oz glasses of water daily and take a stool softener
(colace) to prevent this side effect.
ANTICOAGULATION:
- Please take as prescribed.
- You are being discharged home with Lovenox. You should give
yourself one injection per day until follow up with the
orthopedic surgery department outpatient.
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- No dressing is needed if wound continues to be non-draining.
- Splint can be worn for comfort as needed.
- Do NOT get splint wet
DANGER SIGNS:
Please call your PCP or surgeon's office and/or return to the
emergency department if you experience any of the following:
- Increasing pain that is not controlled with pain medications
- Increasing redness, swelling, drainage, or other concerning
changes in your incision
- Persistent or increasing numbness, tingling, or loss of
sensation
- Fever > 101.4
- Shaking chills
- Chest pain
- Shortness of breath
- Nausea or vomiting with an inability to keep food, liquid,
medications down
- Any other medical concerns</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. CeftriaXONE 2 gm IV Q 12H
please continue until ___ for a total of a 2 week course
___ - ___
RX *ceftriaxone 2 gram 2 grams IV every twelve (12) hours Disp
#*16 Bag Refills:*0
2. Losartan Potassium 50 mg PO DAILY
RX *losartan 50 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
3. Fluticasone-Salmeterol Diskus (100/50) 1 INH IH BID
4. Ascorbic Acid ___ mg PO BID
5. Albuterol Inhaler ___ PUFF IH Q6H:PRN sob
6. Artificial Tears Preserv. Free ___ DROP BOTH EYES HS:PRN dry
eyes
RX *dextran 70-hypromellose [Artificial Tears] ___ drops in
each eye at bedtime Disp #*1 Bottle Refills:*0
7. Calcium Carbonate 500 mg PO QID:PRN heart burn
RX *calcium carbonate 200 mg calcium (500 mg) 1 tablet(s) by
mouth four times a day Disp #*120 Tablet Refills:*0
8. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours
Disp #*40 Tablet Refills:*0
9. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush
10. Reclast *NF* (zoledronic acid-mannitol&water) 5 mg/100 mL
Injection q ___ year
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Strep Bovis pneumonia, meningitis and bacteremia
hyponatremia
hypocalcemia
thromobocytopenia
Sjogrens sydrome
hematuria
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>___ were admitted to ___ with fatigues, myalgias and cough and
were found to have pneumonia and likely meningitis with bacteria
in your blood. ___ improved with antibitoics. ___ were also
found to have a low platelet count, which improved with
steroids. ___ will be sent home with IV antibioitcs and will
need to complete a 2 week course of IV antibiotics. ___ should
follow closely with your outpatient team of doctors. ___ will
need an outpt colonoscopy.
.
___ underwent a transesophageal echocardiogram, which did not
show evidence of infection in your heart valves.
.
Medications changes-see next page. please take as prescribed /
listed.
.
Please f/u with your doctors as listed below.
.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO Q6H:PRN pain
2. Ciprofloxacin HCl 500 mg PO Q24H
RX *Cipro 500 mg 1 tablet(s) by mouth once a day Disp #*5 Tablet
Refills:*0
3. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *Flagyl 500 mg 1 tablet(s) by mouth three times a day Disp
#*15 Tablet Refills:*0
4. NIFEdipine *NF* 30 mg Oral daily
extended release
5. Pentoxifylline 400 mg PO DAILY
extended release
6. Valsartan 80 mg PO BID
7. Allopurinol ___ mg PO EVERY OTHER DAY
8. Atorvastatin 20 mg PO DAILY
9. Glargine 25 Units Bedtime
10. Warfarin 3 mg PO DAILY16
Discharge Disposition:
Home
Discharge Diagnosis:
cholangitis
choledocholithiasis
esrd
protein c deficincy
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please call Dr. ___ ___ if you have
any of the following: temperature of 101 or greater, chills,
nausea, vomiting, abdominal pain, jaundice or diarrhea.
-you need to take antibiotics for 5 days (ciprofloxacin and
flagyl)
-continue a low fat diet
-resume Coumadin
-resume your outpatient hemodialysis schedule</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild
RX *acetaminophen 500 mg 2 tablet(s) by mouth every eight (8)
hours Disp #*50 Tablet Refills:*0
2. Glargine 20 Units Breakfast
3. Allopurinol ___ mg PO DAILY
4. Amitriptyline 10 mg PO QHS
5. Aspirin 81 mg PO DAILY
6. Atorvastatin 40 mg PO QPM
7. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY
8. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES QHS
9. Levothyroxine Sodium 175 mcg PO DAILY
10. Lisinopril 10 mg PO DAILY
11. Metoprolol Succinate XL 100 mg PO DAILY
12. Nephrocaps 1 CAP PO DAILY
13. Omeprazole 20 mg PO DAILY
14. Vitamin D 4000 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY
Musculoskeletal chest pain
SECONDARY:
End Stage Renal Disease
Diabetes Mellitus
Hypothyroidism
Depression
Hypertension
Anemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you.
Why you were here?
-You were in the hospital because of chest pain. We ruled out
any dangerous conditions including heart attack, a clot in your
lung, and infection. We suspect your chest pain is related to
muscle strain
What did we do?
-We gave you Tylenol and your chest pain improved
-You got a lung scan, chest xray, ultrasound, and EKG which were
all normal
What you should do when you go home?
-Continue taking Tylenol to relieve your chest pain.
-Take your medications and follow up with your primary care
doctor
___ wish you the best,
Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear. Ms. ___,
It was a pleasure taking care of ___ during your stay at ___.
WHY WAS I HERE?
- ___ were having diarrhea and belly pain
WHAT WAS DONE WHILE I WAS IN THE HOSPITAL?
- ___ were given IV fluids
WHAT SHOULD I DO WHEN I GO HOME?
- ___ should drink plenty of fluids
- ___ can take the medication ondansetron if ___ feel nauseous.
- ___ should eat a bland (BRAT) diet for the next day or two
- ___ should go to see your PCP
- ___ should get your INR checked early next week and fax it
over to your doctor!
Be well!
-Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amlodipine 5 mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Ferrous Sulfate 325 mg PO DAILY
4. Finasteride 5 mg PO DAILY
5. Glargine 20 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
6. Lisinopril 10 mg PO DAILY
7. Omeprazole 20 mg PO DAILY
8. PrednisoLONE Acetate 1% Ophth. Susp. 1 DROP BOTH EYES TID
9. PredniSONE 10 mg PO DAILY
10. Rosuvastatin Calcium 10 mg PO DAILY
11. Tamsulosin 0.4 mg PO HS
12. Vancomycin 1500 mg IV Q 12H
RX *vancomycin 750 mg 1500 mg iv every twelve (12) hours Disp
#*126 Vial Refills:*0
13. Vitamin D 1000 UNIT PO DAILY
14. diclofenac sodium 0.1 % OPHTHALMIC TID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Fever
Secondary
Staph epidermis bacteremia
Diabetes Mellitus
Minimal change disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was ___ caring for you here at ___. You came in
because of fevers. We repeated tests to check for infection and
you did not have a new infection.
Your fevers are resolved and you are ready to go home.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcium Carbonate 1500 mg PO DAILY
2. CloNIDine 0.1 mg PO QHS
3. Docusate Sodium 100 mg PO BID
4. Multivitamins W/minerals 1 TAB PO DAILY
5. Ramelteon 8 mg PO QHS
6. ClonazePAM 0.125 mg PO QAM
7. DULoxetine 40 mg PO DAILY
8. Levothyroxine Sodium 125 mcg PO DAILY
9. Liothyronine Sodium 5 mcg PO DAILY
10. Sulfameth/Trimethoprim DS 1 TAB PO 3X/WEEK (___)
11. Vitamin D 800 UNIT PO DAILY
12. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
13. AzaTHIOprine 150 mg PO DAILY
14. LamoTRIgine 50 mg PO BID
15. Mirtazapine 45 mg PO QHS
16. Omeprazole 20 mg PO DAILY
17. Polyethylene Glycol 17 g PO DAILY
18. PredniSONE 30 mg PO DAILY
19. Pyridostigmine Bromide 60 mg PO Q8H
20. Senna 17.2 mg PO BID
21. Thiamine 100 mg PO DAILY
22. HELD- Acidophilus (Lactobacillus acidophilus) 1 cap oral BID
This medication was held. Do not restart Acidophilus until you
see your primary care provider
23. HELD- GuaiFENesin ER 600 mg PO Q12H This medication was
held. Do not restart GuaiFENesin ER until you see your primary
care provider
24. HELD- Juven (arginine-glutamine-calcium bmb) ___ gram
oral BID This medication was held. Do not restart Juven until
you see your primary care provider
___:
Extended Care
Facility:
___
Discharge Diagnosis:
PRIMARY
=======
Toxic metabolic encephalopathy
Delirium
SECONDARY
=========
Depression with suicidal ideations
Normal pressure hydrocephalus status-post VP shunt
Subdural hematoma
Hypothyroidism
Hypertension
Benign prostatic hypertrophy
Left clavicular fracture
Myasthenia ___
GERD
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
WHY YOU WERE ADMITTED
=======================
- You had altered mental status and were not behaving like
yourself
- You had a small brain bleed likely from falling
WHAT WE DID FOR YOU IN THE HOSPITAL
====================================
- We made sure you were not having an infection, which you did
not
- We checked all your electrolytes, vitamin levels, and thyroid
levels which were all normal
- We made sure your head bleed remained stable with CT scans
- We made sure your VP shunt for your normal pressure
hydrocephalus was working properly
- We changed your medications to make sure they were not
affecting your mental status
- You had an EEG study done that showed your mental status was
most likely affected by something temporary, most likely the
mediations you were taking
WHAT YOU SHOULD DO WHEN YOU LEAVE
=================================
- You should continue to take your medications as prescribed
- You should use a cane/walker to get around to make sure you do
not fall
It was a pleasure taking care of you!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. T.E.D. Anti-Embolism Stocking (comp
stocking,knee,regular,sml) 2 stockings miscellaneous DAILY
2. Acetaminophen 1000 mg PO TID
3. ALPRAZolam 0.5 mg PO QHS:PRN insomnia
4. B-12 DOTS (cyanocobalamin (vitamin B-12)) 1000 mcg oral
DAILY
5. Calcium Carbonate 600 mg PO BID
6. Clozapine 37.5 mg PO QHS
7. Docusate Sodium 100 mg PO DAILY
8. Escitalopram Oxalate 20 mg PO DAILY
9. Hydrochlorothiazide 25 mg PO DAILY
10. L-Methylfolate (levomefolate calcium) 15 mg oral DAILY
11. Latuda (lurasidone) 80 mg oral QHS
12. Lithium Carbonate CR (Eskalith) 450 mg PO QHS
Eskalith CR
13. Omeprazole 20 mg PO BID
14. Rivaroxaban 15 mg PO BID
15. Simvastatin 20 mg PO QPM
16. Vitamin D 800 UNIT PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
==================
Left lower extremity DVT
Secondary DIAGNOSES:
====================
Hypertension
GERD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you. You were admitted to the
___ because your left leg was
swollen, red, and painful despite recently being started on
treatment for a clot in that same leg.
What did we do for you while you were in the hospital?
- We were initially concerned for a complication of a leg clot
that causes interruption of the blood flow to the leg. We
initially started you on a blood thinner called heparin because
we were concerned the Xarelto was not working well for you. You
were evaluated by vascular surgery who did not think that this
complication was present and who recommended that we continue
your Xarelto and make sure that we keep the leg compressed and
elevated whenever possible.
What should you do after you leave the hospital?
You should continue to take your Xarelto twice daily with large
meals. You should try to elevate your legs as much as possible
and wear your compression stockings. This is the primary
treatment for your blood clot. You should follow-up with your
primary care physician and vascular surgery within ___ weeks of
discharge.
We recommend at least ___ year of Xarelto, perhaps even life long
therapy. This should be discussed with both your PCP and ___
___ Expert.
Wishing you a speedy recovery,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amitriptyline 100 mg PO HS
2. Aspirin 81 mg PO DAILY
3. Carbamazepine (Extended-Release) 200 mg PO BID
4. Glucagon 1 mg IM ONCE prn:hypoglycemia
5. Glargine 60 Units Bedtime
Humalog 10 Units Breakfast
Humalog 10 Units Lunch
Humalog 10 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
6. Metoclopramide 5 mg PO QIDACHS
7. Multivitamins 1 TAB PO DAILY
8. Omeprazole 40 mg PO BID
9. Pregabalin 150 mg PO QID
10. Ranitidine 150 mg PO DAILY
11. Sucralfate 1 gm PO TID
12. Lisinopril 5 mg PO DAILY
RX *lisinopril 5 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
13. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*30 Capsule Refills:*2
14. Senna 8.6 mg PO BID:PRN constipation
RX *sennosides [senna] 8.6 mg 1 capsule by mouth twice a day
Disp #*30 Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Hyperglycemia
Hyponatremia
Abdominal Pain
Secondary:
Diabetes mellitus
Hypertension
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to the hospital with nausea and vomiting. Your
blood sugars were high since you had not been able to take your
insulin. You were treated with intravenous fluids for
dehydration. Your blood sugars returned to normal levels once
your insulin was restarted. Please take your medications as
prescribed and make sure that you are having regular bowel
movements. Please follow up with the ___ doctors and your
primary care doctors in the next ___ weeks.
Take care,
___ medicine team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acyclovir 400 mg PO Q8H
RX *acyclovir 400 mg 1 tablet(s) by mouth every eight (8) hours
Disp #*90 Tablet Refills:*0
2. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
RX *sulfamethoxazole-trimethoprim 400 mg-80 mg 1 tablet(s) by
mouth daily Disp #*30 Tablet Refills:*0
3. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth daily Disp #*30
Capsule Refills:*0
4. PredniSONE 80 mg PO DAILY
RX *prednisone 20 mg 4 tablet(s) by mouth daily Disp #*32 Tablet
Refills:*0
5. Amlodipine 10 mg PO DAILY
6. FoLIC Acid 5 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS
=================
WARM AUTOIMMUNE HEMOLYTIC ANEMIA
CHRONIC LYMPHOCYTIC LEUKEMIA
DIARRHEA
SECONDARY DIAGNOSIS
===================
HYPERTENSION
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ after
experiencing diarrhea with resultant chest pain and shortness of
breath. You were found to have low red blood cell count, known
as anemia. This was likely due to destruction of your red blood
cells known as hemolysis. You were transfused red blood cells to
increase your blood counts. You also received steroids to help
stop the destruction of the red blood cells. You also received a
medication called rituximab to help control your low blood
cells. These helped stabilize your red blood cell counts. By the
time of discharge you did not require a transfusion in 6 days.
You were discharged on a medication called prednisone. Please
take 80 milligrams of prednisone DAILY. You were also started on
a medication called acyclovir and a medication called
trimethoprim-sulfamethoxazole to help prevent infections.
Your lisinopril and hydrochlorothiazide were STOPPED as your
blood pressure was well controlled on your other blood pressure
medications. Please discuss this medication change with your
oncologist.
We would like you to follow up in clinic on ___ at 2PM to get a blood check to see what your blood levels
are.
Also on imaging of your chest, two nodules were noted in your
lung. PLEASE FOLLOW-UP WITH A REPEAT CT SCAN OF YOUR CHEST IN 3
MONTHS.
If you have any worsening symptoms including shortness of
breath, chest pain, lightheadedness, nausea, vomiting, or
diarrhea please seek medical assistance at your nearest
Emergency Department.
It was a pleasure taking care of you during hospitalization! We
wish you all the best!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Azithromycin 500 mg PO Q24H
RX *azithromycin 500 mg 1 tablet(s) by mouth daily Disp #*1
Tablet Refills:*0
2. HYDROmorphone (Dilaudid) 2 mg PO Q6H:PRN Pain - Severe
Duration: 2 Days
RX *hydromorphone [Dilaudid] 2 mg 1 tablet(s) by mouth every 6
hours as needed for pain Disp #*8 Tablet Refills:*0
3. PredniSONE 50 mg PO DAILY Duration: 1 Day
RX *prednisone 50 mg 1 tablet(s) by mouth daily Disp #*1 Tablet
Refills:*0
4. Acamprosate 666 mg PO TID
5. Albuterol Inhaler 2 PUFF IH Q4H:PRN dyspnea
6. Erythromycin 0.5% Ophth Oint 0.5 in BOTH EYES QID
7. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
8. FoLIC Acid 1 mg PO DAILY
9. Furosemide 40 mg PO DAILY
10. melatonin 3 mg oral QHS
11. Methadone 80 mg PO DAILY
12. Montelukast 10 mg PO DAILY
13. Multivitamins 1 TAB PO DAILY
14. Pantoprazole 40 mg PO Q24H
15. Sertraline 100 mg PO DAILY
16. Spironolactone 50 mg PO DAILY
17. Thiamine 100 mg PO DAILY
18. Tiotropium Bromide 1 CAP IH DAILY
19. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Abdominal pain
Alcohol withdrawal
Asthma exacerbation
Opiate dependence
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You came in with abdominal pain. We think that this pain is
either from irritation of your stomach or a very mild
pancreatitis. We treated you with pain medications which you
did not think helped very much and bowel rest for a day. We
also did a CT scan of your abdomen which did not show anything
concerning.
We also treated you for alcohol withdrawal while you were here
and continued you on your methadone. We also treated you for an
asthma exacerbation and your breathing was much improved by the
time you left.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 325 mg PO DAILY
2. Atorvastatin 10 mg PO DAILY
3. Losartan Potassium 25 mg PO DAILY
4. Metoprolol Succinate XL 100 mg PO DAILY
5. Omeprazole 20 mg PO DAILY
6. Tiotropium Bromide 1 CAP IH DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
Throat pain
Hypoxia
SECONDARY DIAGNOSIS:
Hypertension
Hyperlipidemia
COPD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you at ___
___. As you recall, you were admitted for throat
pain. Imaging did not show progression of your previous known
dissection. Imaging of your neck did not show anything that may
cause throat pain.
Please see below for follow up appointments.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amlodipine 10 mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Calcium Carbonate 500 mg PO DAILY
4. Docusate Sodium 100 mg PO BID
5. Enalapril Maleate 20 mg PO BID
6. Hydroxychloroquine Sulfate 200 mg PO DAILY; One tablet daily
alternating with 2 tablets daily.
7. NPH 15 Units Breakfast; NPH 5 Units Dinner
8. LeVETiracetam 750 mg PO BID
9. Lidocaine 5% Patch 1 PTCH TD DAILY:PRN pain
10. PredniSONE 5 mg PO DAILY
11. Simvastatin 10 mg PO DAILY
12. Vitamin D 1000 UNIT PO DAILY
13. DimenhyDRINATE 50 mg PO Q8H:PRN nausea
14. Furosemide 20 mg PO 3X/WEEK (___)
15. Doxazosin 2 mg PO HS
RX *doxazosin [Cardura] 2 mg 1 tablet(s) by mouth at bedtime
Disp #*30 Tablet Refills:*0
16. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth daily Disp #*30
Capsule Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Ectopioc atrial bradycardia, due to
Beta blocker toxicity
Chest pain
Coronary artery disease
Hypertension
Shortness of breath
Acute on chronic left ventricular diastolic heart failure
Acute kidney injury
Gastroesophageal reflux disease
Tremor
Diabetes mellitus
Hypothyroidism
Systemic lupus erythematosis
Rheumatoid arthritis
Seizure disorder
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>You were admitted because of chest pain and a slow heart rate.
We made sure you did not have a heart attack. Your slow heart
rate was likely due to being started on Propranolol. We
observed you off the medication and your heart rate resolved.
We have listed "beta blockers" as an allergy. Please discuss
possible alternative treatments for your tremor with your
Primary care doctor.
We made the following changes to your home medication list:
-STOP Propranolol
-START Omeprazole</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 80 mg PO QPM
RX *atorvastatin 80 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*2
2. Warfarin 5 mg PO DAILY
RX *Coumadin 1 mg 5 tablet(s) by mouth once a day Disp #*150
Tablet Refills:*2
Discharge Disposition:
Home
Discharge Diagnosis:
Acute ischemic stroke
Vertebral artery dissection
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were hospitalized due to symptoms of dizziness and vomiting
resulting from an ACUTE ISCHEMIC STROKE, a condition where a
blood vessel providing oxygen and nutrients to the brain is
blocked by a clot. The brain is the part of your body that
controls and directs all the other parts of your body, so damage
to the brain from being deprived of its blood supply can result
in a variety of symptoms.
We are changing your medications as follows:
Start taking warfarin (blood thinner)
Start taking atorvastatin (for cholesterol)
Please take your other medications as prescribed.
Please follow up with Neurology and your primary care physician
as listed below.
If you experience any of the symptoms below, please seek
emergency medical attention by calling Emergency Medical
Services (dialing 911). In particular, since stroke can recur,
please pay attention to the sudden onset and persistence of
these symptoms:
- Sudden partial or complete loss of vision
- Sudden loss of the ability to speak words from your mouth
- Sudden loss of the ability to understand others speaking to
you
- Sudden weakness of one side of the body
- Sudden drooping of one side of the face
- Sudden loss of sensation of one side of the body
Sincerely,
Your ___ Neurology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H
2. Gabapentin 100 mg PO TID
RX *gabapentin 100 mg 1 capsule(s) by mouth three times a day
Disp #*30 Capsule Refills:*0
3. Omeprazole 20 mg PO DAILY
4. Ondansetron 4 mg PO Q8H:PRN nausea
5. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain -
Moderate
RX *oxycodone 5 mg 1 tablet(s) by mouth Q6H:PRN Disp #*20 Tablet
Refills:*0
6. Polyethylene Glycol 17 g PO DAILY
7. Senna 8.6 mg PO BID:PRN constipation
Discharge Disposition:
Home
Discharge Diagnosis:
Post-operative pain, status-post open cholecystectomy
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
You were recently admitted to ___
___ pain control and evaluation of your post-operative
open cholecyctectomy recovery. We have reviewed your imaging
with our surgeons and radiologists several times and believe the
fluid collection seen on your outside hospital CT scan is a
small fluid collection consistent with normal post-operative
changes. At this time, you are ready for discharge and can
continue to recover at home. Please follow the instructions
below:
Please call your doctor or nurse practitioner or return to the
Emergency Department for any of the following:
*You experience new chest pain, pressure, squeezing or
tightness.
*New or worsening cough, shortness of breath, or wheeze.
*If you are vomiting and cannot keep down fluids or your
medications.
*You are getting dehydrated due to continued vomiting, diarrhea,
or other reasons. Signs of dehydration include dry mouth, rapid
heartbeat, or feeling dizzy or faint when standing.
*You see blood or dark/black material when you vomit or have a
bowel movement.
*You experience burning when you urinate, have blood in your
urine, or experience a discharge.
*Your pain in not improving within ___ hours or is not gone
within 24 hours. Call or return immediately if your pain is
getting worse or changes location or moving to your chest or
back.
*You have shaking chills, or fever greater than 101.5 degrees
Fahrenheit or 38 degrees Celsius.
*Any change in your symptoms, or any new symptoms that concern
you.
Please resume all regular home medications, unless specifically
advised not to take a particular medication. Also, please take
any new medications as prescribed.
Please get plenty of rest, continue to ambulate several times
per day, and drink adequate amounts of fluids. Avoid lifting
weights greater than ___ lbs until you follow-up with your
surgeon.
Avoid driving or operating heavy machinery while taking pain
medications.
Incision Care:
*Please call your doctor or nurse practitioner if you have
increased pain, swelling, redness, or drainage from the incision
site.
*Avoid swimming and baths until your follow-up appointment.
*You may shower, and wash surgical incisions with a mild soap
and warm water. Gently pat the area dry.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler ___ PUFF IH Q4H:PRN cough, SOB
2. Amlodipine 10 mg PO DAILY
RX *amlodipine 10 mg 1 tablet(s) by mouth daily Disp #*90 Tablet
Refills:*0
3. Aspirin 81 mg PO DAILY
4. Atorvastatin 40 mg PO DAILY
5. Carvedilol 12.5 mg PO BID
6. Ferrous Sulfate 325 mg PO BID
7. HydrALAzine 50 mg PO BID
8. Glargine 25 Units Breakfast
Humalog 5 Units Breakfast
Humalog 5 Units Lunch
Humalog 5 Units Dinner
9. Isoniazid ___ mg PO 3X/WEEK (___)
10. Losartan Potassium 50 mg PO BID
RX *losartan 50 mg 1 tablet(s) by mouth twice a day Disp #*90
Tablet Refills:*0
11. Nephrocaps 1 CAP PO DAILY
12. Omeprazole 10 mg PO DAILY
13. Pyridoxine 50 mg PO DAILY
14. sevelamer CARBONATE 800 mg PO TID W/MEALS
15. Vitamin D ___ UNIT PO DAILY
16. Fluticasone Propionate 110mcg 2 PUFF IH BID
Please talk to your primary care doctor if this does not help
you
RX *fluticasone [Flovent HFA] 110 mcg/actuation 2 puff inhaled
twice a day Disp #*1 Inhaler Refills:*0
17. Loratadine 10 mg PO EVERY OTHER DAY
RX *loratadine 10 mg 1 tablet(s) by mouth 3 times per week Disp
#*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSES:
#Chronic cough
#Pulmonary edema
#End stage renal disease
#Hypertensive urgency
#Diabetes ___ type 2, poorly controlled
#Dyspepsia
#SECONDARY DIAGNOSES:
#Latent tuberculosis infection
#Anemia of chronic kidney disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr. ___, you were admitted from the ER for workup of your
chronic cough. On arrival you had fluid in your lungs called
edema. The fluid in your lungs may cause cough. It seems that
you usually have too much fluid in your body, which happens when
people require dialysis. Please try sticking to a low salt diet
(meaning no fast food, chips, crackers, ___ fries). Feeling
better in terms of cough after dialysis may mean that your cough
is partially caused by fluid in the lungs.
We did not think that you had a bacterial pneumonia requiring
antibiotics. The most common causes of cough that does not go
away after ___ weeks are not infection. They are usually things
like asthma, acid reflux, and allergic post-nasal drip. You were
already treated with a stomach acid blocker for reflux in the
past few weeks without much help. However, you have not had
significant treatment for asthma, so we added an inhaled steroid
called fluticasone that you should use daily to prevent any
asthma symptoms. If this does not work, you should talk to your
primary care doctor (___) about stopping it.
Additionally, abdominal fullness and poor appetite you
described may be due to diabetes. People with poorly controlled
diabetes can develop nerve problems like tingling or numbness in
the feet. Occasionally, the nerve problems may affect the
stomach and intestines. This can cause food not to move through
normally and can make you feel sick or full.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Discharge Instructions
Dr. ___ of DBS battery and debridement
Activity
You may gradually return to your normal activities, but we
recommend you take it easy for the next ___ hours.
Heavy lifting, running, climbing, or other strenuous exercise
should be avoided for ten (10) days.
You may take leisurely walks and slowly increase your activity
at your own pace. ___ try to do too much too soon.
Do not go swimming or submerge yourself in water for fourteen
(14) days after your procedure.
You may use a damp washcloth to remove any dried blood or
iodine from your skin but do not get your head wet in the shower
until your staples or sutures are removed.
The incision on your chest has absorbable sutures and skin
sealant. You may take a shower and get your chest wet after 5
days.
Medications
Take any new medications (i.e. pain medications) as directed.
If you were on a medication such as Coumadin (Warfarin), or
Plavix (Clopidogrel), or Aspirin, do not take this until cleared
by your Neurosurgeon.
Do not take any anti-inflammatory medicines such as Motrin,
Aspirin, Advil, or Ibuprofen etc. until follow up.
You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
What You ___ Experience:
Mild tenderness along the incisions.
Soreness in your arms from the intravenous lines.
Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
pain medications), try an over-the-counter stool softener.
Call Your Doctor at ___ for:
Severe pain, swelling, redness or drainage from the incision
site.
Fever greater than 101.5 degrees Fahrenheit
Severe Constipation
Blood in your stool or urine
Nausea and/or vomiting
Extreme sleepiness
Severe headaches not relieved by pain relievers
Seizures
Any new problems with your vision or ability to speak
Weakness or changes in sensation in your face, arms, or leg
Follow-up Instructions
You will need to follow-up with Dr. ___ in ___ days from
your surgery for a wound check and staple/suture removal. Please
call ___ to make this appointment.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild/Fever
2. Docusate Sodium 100 mg PO BID
3. Nitrofurantoin Monohyd (MacroBID) 100 mg PO ONCE prophylaxis
RX *nitrofurantoin monohyd/m-cryst 100 mg ONE capsule(s) by
mouth once Disp #*2 Capsule Refills:*0
4. Oxybutynin 5 mg PO TID:PRN bladder spasms
5. Senna 8.6 mg PO ONCE Duration: 1 Dose
6. Tamsulosin 0.4 mg PO QHS
Discharge Disposition:
Home
Discharge Diagnosis:
Bilateral ureterolithiasis.
acute kidney injury (creatinine up to 1.7)
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>-You can expect to see occasional blood in your urine and to
possibly experience some urgency and frequency over the next
month; this may be related to the passage of stone fragments or
the indwelling ureteral stent.
-The kidney stone may or may not have been removed AND/or there
may fragments/others still in the process of passing.
-You may experience some pain associated with spasm of your
ureter. This is normal from the stent irritation.
-Ureteral stents MUST be removed or exchanged and therefore it
is IMPERATIVE that you follow-up as directed.
-Do not lift anything heavier than a phone book (10 pounds)
-You may continue to periodically see small amounts of blood in
your urine--this is normal and will gradually improve
-Resume your pre-admission/home medications EXCEPT as noted. You
should ALWAYS call to inform, review and discuss any medication
changes and your post-operative course with your primary care
doctor.
-___ ingredient of Advil, Motrin, etc.) may be taken
even though you may also be taking Tylenol/Acetaminophen. You
may alternate these medications for pain control.
-Ibuprofen should always be taken with food. Please discontinue
taking and notify your doctor should you develop blood in your
stool (dark, tarry stools)
-You may be given prescriptions for a stool softener and/or a
gentle laxative. These are over-the-counter medications that
may be health care spending account reimbursable.
-Colace (docusate sodium) may have been prescribed to avoid
post-surgical constipation or constipation related to use of
narcotic pain medications. Discontinue if loose stool or
diarrhea develops. Colace is a stool-softener, NOT a laxative.
-Senokot (or any gentle laxative) may have been prescribed to
further minimize your risk of constipation.
-Do not eat constipating foods for ___ weeks, drink plenty of
fluids to keep hydrated
-No vigorous physical activity or sports for 4 weeks</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. haloperidol 5 mg Tablet Sig: One half Tablet PO twice a day.
Disp:*14 Tablet(s)* Refills:*0*
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
Psychosis, NOS
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Dr. ___,
___ were admitted for a change in your behavior following the
recent death of your grandmother and other stressors in your
life. ___ were also managed for an increase in your heart rate
following administration of medication. Your heart rate
normalized during the admission and was not affected by the
haldoperidol that ___ were started on during this admission.
___ were also seen by Psychiatry for evaluation of your
behaviour change who recommended that ___ start haloperidol
2.5mg twice daily.
Collectively, it was felt that ___ are safe to go home with your
mother and with close psychiatric follow-up which as been
arranged for ___ by Psychiatry. ___ have an appointment at
___ Partial ___ Program- ___.,
___ on ___ at 9am.
___.
Take all medications as instructed. Please note the following
medication changes:
1. *ADDED* haloperidol 2.5mg twice daily.
___ and your mother agree to return to the emergency deparment
or call ___ should your symptoms worsen again or should ___
experience any suicidal or homicidal ideation. Your mother is to
remain with ___ after discharge from ___
___ to monitor your symptoms and assist with getting
___ to your appointments.
In addition to your psychiatric follow-up, ___ will need to make
a follow-up with Neurology to follow-up MRI findings that the
Neurologists did not feel needed to be worked-up acutely during
your admission. Call the following number to schedule an
appointment for within 2 weeks of discharge date with the first
available appointment: ___.
___ also have a follow-up appointment with your primary care
physician on ___ at 9AM.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO Q6H:PRN Pain - Mild/Fever
2. Dexamethasone 1 mg PO AS DIRECTED Duration: 7 Days
4mg q6hr x 8 doses
3mg q6hr x 8 doses
2mg q6hr x 4 doses
2mg q8hr x 3 doses
1mg q8hr x 3 doses
RX *dexamethasone 1 mg as directed by mouth as directed Disp
#*73 Tablet Refills:*0
3. Famotidine 20 mg PO BID
RX *famotidine 20 mg 1 tablet(s) by mouth twice a day Disp #*20
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Brain stem cavernous malformation
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Discharge Instructions
Brain Hemorrhage without Surgery
Activity
We recommend that you avoid heavy lifting, running, climbing,
or other strenuous exercise until your follow-up appointment.
You make take leisurely walks and slowly increase your
activity at your own pace once you are symptom free at rest.
___ try to do too much all at once.
No driving while taking any narcotic or sedating medication.
If you experienced a seizure while admitted, you are NOT
allowed to drive by law.
No contact sports until cleared by your neurosurgeon. You
should avoid contact sports for 6 months.
Medications
Please do NOT take any blood thinning medication (Aspirin,
Ibuprofen, Plavix, Coumadin) until cleared by the neurosurgeon.
You have been prescribed a steroid (dexamethasone) taper.
Please take this medication as follows:
4mg every six (6) hours for two days (8 doses)
3mg every six (6) hours for two days (8 doses)
2mg every six (6) hours for one day (4 doses)
2mg every eight (8) hours for one day (3 doses)
1mg every eight (8) hours for one day (3 doses)
Then stop.
You may use Acetaminophen (Tylenol) for minor discomfort if you
are not otherwise restricted from taking this medication.
What You ___ Experience:
You may have difficulty paying attention, concentrating, and
remembering new information.
Emotional and/or behavioral difficulties are common.
Feeling more tired, restlessness, irritability, and mood
swings are also common.
Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
pain medications), try an over-the-counter stool softener.
Headaches:
Headache is one of the most common symptom after a brain
bleed.
Most headaches are not dangerous but you should call your
doctor if the headache gets worse, develop arm or leg weakness,
increased sleepiness, and/or have nausea or vomiting with a
headache.
Mild pain medications may be helpful with these headaches but
avoid taking pain medications on a daily basis unless prescribed
by your doctor.
There are other things that can be done to help with your
headaches: avoid caffeine, get enough sleep, daily exercise,
relaxation/ meditation, massage, acupuncture, heat or ice packs.
When to Call Your Doctor at ___ for:
Severe pain, swelling, redness or drainage from the incision
site.
Fever greater than 101.5 degrees Fahrenheit
Nausea and/or vomiting
Extreme sleepiness and not being able to stay awake
Severe headaches not relieved by pain relievers
Seizures
Any new problems with your vision or ability to speak
Weakness or changes in sensation in your face, arms, or leg
Call ___ and go to the nearest Emergency Room if you experience
any of the following:
Sudden numbness or weakness in the face, arm, or leg
Sudden confusion or trouble speaking or understanding
Sudden trouble walking, dizziness, or loss of balance or
coordination
Sudden severe headaches with no known reason</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen (Liquid) 1000 mg PO Q8H
RX *acetaminophen 500 mg/5 mL 10 cc by mouth every eight (8)
hours Disp ___ Milliliter Refills:*0
2. Bacitracin Ointment 1 Appl TP BID
RX *bacitracin zinc [Antibiotic (bacitracin zinc)] 500 unit/gram
apply to suture line under chin twice a day Disp #*1 Tube
Refills:*0
3. Bisacodyl 10 mg PO DAILY:PRN constipation
RX *bisacodyl [Dulcolax (bisacodyl)] 5 mg 1 tablet(s) by mouth
once a day Disp #*20 Tablet Refills:*0
4. Chlorhexidine Gluconate 0.12% Oral Rinse 15 mL ORAL BID
RX *chlorhexidine gluconate 0.12 % rinse and spit 15 cc twice a
day Disp #*420 Milliliter Refills:*0
5. Docusate Sodium (Liquid) 100 mg PO BID
RX *docusate sodium 50 mg/5 mL 10 cc by mouth twice a day Disp
___ Milliliter Refills:*1
6. OxycoDONE Liquid ___ mg PO Q3H:PRN Pain
RX *oxycodone 5 mg/5 mL ___ cc by mouth every 3 hours Disp
#*360 Milliliter Refills:*0
7. Sarna Lotion 1 Appl TP QID:PRN itching
8. Senna 8.6 mg PO BID:PRN constipation
9. Cephalexin 500 mg PO Q6H
RX *cephalexin 250 mg/5 mL 10 cc by mouth every six (6) hours
Disp #*240 Milliliter Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
S/p assault
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted to the hospital after you were assaulted in
the face. You were taken to the operating room where underwent
repair of your jaw. Your vital signs have been stable and you
are preparing for discharge with the following instructions:
Wound care: Do not disturb or probe the surgical area with any
objects. The sutures placed in your mouth are usually the type
that self dissolve. If you have any sutures on the skin of your
face or neck, your surgeon will remove them on the day of your
first follow up appointment. SMOKING is detrimental to healing
and will cause complications.
Bleeding: Intermittent bleeding or oozing overnight is normal.
Placing fresh gauze over the area and biting on the gauze for
___ minutes at a time may control the bleeding. If you had
nasal surgery, you may have occasional slow oozing from your
nostril for the first ___ days. Bleeding should never be severe.
If bleeding persists or is severe or uncontrollable, please call
our office immediately. If it is after normal business hours,
please come to the emergency room and request that the oral
surgery resident on call be paged.
___: Normal healing after oral surgery should be as follows:
the first ___ days after surgery, are generally the most
uncomfortable and there is usually significant swelling. After
the first week, you should be more comfortable. The remainder of
your postoperative course should be gradual, steady improvement.
If you do not see continued improvement, please call our office.
Physical activity: It is recommended that you not perform any
strenuous physical activity for a few weeks after surgery. Do
not lift any heavy loads and avoid physical sports unless you
obtain permission from your surgeon.
Swelling & Ice applications: Swelling is often associated with
surgery. Swelling can be minimized by using a cold pack, ice bag
or a bag of frozen peas wrapped in a towel, with firm
application to face and neck areas. This should be applied 20
minutes on and 20 minutes off during the first ___ days after
surgery. If you have been given medicine to control the
swelling, be sure to take it as directed.
Hot applications: Starting on the ___ or ___ day after surgery,
you may apply warm compresses to the skin over the areas of
swelling (hot water bottle wrapped in a towel, etc), for 20
minutes on and 20 min off to help soothe tender areas and help
to decrease swelling and stiffness. Please use caution when
applying ice or heat to your face as certain areas may feel numb
after surgery and extremes of temperature may cause serious
damage.
Tooth brushing: Begin your normal oral hygiene the day after
surgery. Soreness and swelling may nor permit vigorous brushing,
but please make every effort to clean your teeth with the bounds
of comfort. Any toothpaste is acceptable. Please remember that
your gums may be numb after surgery. To avoid injury to the gums
during brushing, use a child size toothbrush and brush in front
of a mirror staying only on teeth.
Mouth rinses: Keeping your mouth clean after surgery is
essential. Use 1 teaspoon of salt dissolved in an 8 ounce glass
of warm water and gently rinse with portions of the solution,
taking 5 min to use the entire glassful. Repeat as often as you
like, but you should do this at least 4 times each day. If your
surgeon has prescribed a specific rinse, use as directed.
Showering: You may shower ___ days after surgery, but please ask
your surgeon about this. If you have any incisions on the skin
of your face or body, you should cover them with a water
resistant dressing while showering. DO NOT SOAK SURGICAL SITES.
This will avoid getting the area excessively wet. As you may
physically feel weak after surgery, initially avoid extreme hot
or cold showers, as these may cause some patients to pass out.
Also it is a good idea to make sure someone is available to
assist you in case if you may need help.
If you develop the following, please return to the emergency
room:
*fever
*chills
*nausea/vomitting
*abdominal pain
*bleeding from mouth
*difficulty breathing</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
RX *aspirin [Adult Low Dose Aspirin] 81 mg 1 tablet,delayed
release (___) by mouth Daily Disp #*30 Tablet Refills:*2
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice
a day Disp #*60 Capsule Refills:*0
3. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN Pain Duration:
5 Days
RX *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours
Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Multiple stab wounds
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
You were admitted to the ___ Surgery service at ___ after
sustaining multiple stab wounds - to the right flank, anterior
neck and posterior neck. We obtained several imaging scans
including CT of your head and neck, as well as CT with contrast
to evaluate the vessels in your head and neck. This scan showed
a small dissection in your L internal carotid artery. You were
also seen by our colleagues in Vascular Surgery who advised a
carotid doppler imaging study to further evaluate the
dissection. This study was reassuring; however, you should
follow-up with Vascular Surgery in ONE (1) month for a repeat
study and clinic visit. Please keep in mind the following
instructions:
1) Activity: You may resume all previous activities. You should
limit your alcohol intake as this appears to be causing damage
to your liver, a condition called alcoholic cirrhosis, which is
irreversible and can lead to very serious medical problems
including esophageal varices, bleeding and infection.
2) Medications: you may continue all previous medications.
However, you should check with your doctor before starting any
new medications that may interfere with, or worsen your liver
function.
3) Pain: we are providing you with oxycodone, an opiate pain
medication. Please wait at least four hours between doses, and
do not drive while taking this medication. You should avoid
overusing Tylenol (>3 grams/day) since this can affect your
liver as well.
4) Food: You may resume your previous diet.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Multivitamins W/minerals 1 TAB PO DAILY
2. Polyethylene Glycol 17 g PO DAILY
3. Acetaminophen 650 mg PO Q4H:PRN Pain - Mild
4. Allopurinol ___ mg PO DAILY
5. Aqua Care (urea) 10 % topical TID:PRN
6. Bisacodyl ___ID:PRN Constipation - First Line
7. Calcium Carbonate 500 mg PO Q6H:PRN indigestion
8. Docusate Sodium 100 mg PO BID
9. Doxycycline Hyclate 100 mg PO Q12H
10. Ferrous Sulfate 325 mg PO BID
11. Fluticasone Propionate NASAL 1 SPRY NU DAILY
12. Labetalol 200 mg PO BID
13. Levothyroxine Sodium 25 mcg PO DAILY
14. Pravastatin 40 mg PO QPM
15. Rivaroxaban 15 mg PO DAILY
16. Senna 17.2 mg PO BID
17. Tamsulosin 0.4 mg PO QHS
18. urea 10 % topical TID:PRN
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Acute metabolic Encephalopathy
Constipation
Acute kidney injury secondary to Dehydration
Chronic Systolic CHF
Dementia
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You came to the hospital because you were more confused and
having trouble walking. You were also nauseated. You were found
to be constipated which was likely causing your confusion and
your nausea. You felt better after having a bowel movement.
You were also found to have impaired kidney function.
Dehydration likely caused your constipation and the problem with
your kidneys. Your kidneys got better with fluids.
You worked with ___ for your walking and they recommended that
you go to rehab to get stronger.
It was a pleasure participating in your care. We wish you all
the best in the future.
Sincerely,
Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin EC 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet,delayed release (___) by mouth
daily Disp #*30 Tablet Refills:*0
2. Atorvastatin 80 mg PO DAILY
RX *atorvastatin 80 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
3. Metoprolol Tartrate 25 mg PO TID
RX *metoprolol tartrate 25 mg 1 tablet(s) by mouth three times a
day Disp #*90 Tablet Refills:*0
4. Guaifenesin ___ mL PO Q6H:PRN cough
RX *guaifenesin [Adult Tussin Chest Congestion] 100 mg/5 mL
___ liquid(s) by mouth every six (6) hours Disp #*1 Bottle
Refills:*0
5. Furosemide 40 mg PO BID Duration: 7 Days
RX *furosemide 40 mg 1 tablet(s) by mouth twice a day Disp #*14
Tablet Refills:*0
6. Potassium Chloride 20 mEq PO Q12H Duration: 7 Days
RX *potassium chloride [Klor-Con] 20 mEq 1 packet by mouth twice
a day Disp #*14 Packet Refills:*0
7. TraMADOL (Ultram) 50 mg PO Q4H:PRN pain
RX *tramadol 50 mg 1 tablet(s) by mouth every four (4) hours
Disp #*60 Tablet Refills:*0
8. Ranitidine 150 mg PO BID
RX *ranitidine HCl 150 mg 1 capsule(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
- Myocardial infarction, coronary artery disease s/p coronary
artery bypass graft x 3
- Mitral valve regurgitation s/p Mitral valve replacement
- Acute systolic Congestive heart failure
Past medical history:
- Obesity
- Hypertension
- Peripheral arterial disease
- COPD
Discharge Condition:
Alert and oriented x3 nonfocal
Ambulating with steady gait
Incisional pain managed with oral analgesia
Incisions:
Sternal - eschar at inferior pole, no drainage or erythema
Leg - healing well, no erythema or drainage.
Edema: 1+
Followup Instructions:
___ [/INST] </s><s>1. Please shower daily including washing incisions gently with
mild soap, no baths or swimming, and look at your incisions
2). Please NO lotions, cream, powder, or ointments to incisions
3). Each morning you should weigh yourself and then in the
evening take your temperature, these should be written down on
the chart
4). No driving for approximately one month and while taking
narcotics, will be discussed at follow up appointment with
surgeon when you will be able to drive
5). No lifting more than 10 pounds for 10 weeks
Females: Please wear bra to reduce pulling on incision, avoid
rubbing on lower edge
**Please call cardiac surgery office with any questions or
concerns ___. Answering service will contact on call
person during off hours**</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q4H
2. Docusate Sodium 100 mg PO BID
3. OxycoDONE (Immediate Release) ___ mg PO Q3H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth every 4 hours Disp
#*61 Tablet Refills:*0
4. Aspirin 325 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Right ankle fracture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Activity:
-Continue to be non weight bearing on your right leg.
-Elevate right leg to reduce swelling and pain.
-Do not remove splint. Keep splint dry.
Other Instructions
- Resume your regular diet.
- Avoid nicotine products to optimize healing.
- Resume your home medications. Take all medications as
instructed.
- Continue taking the aspirin 325 every day to prevent blood
clots.
-You have also been given Additional Medications to control your
pain. Please allow 72 hours for refill of narcotic
prescriptions, so plan ahead. You can either have them mailed
to your home or pick them up at the clinic located on ___ 2.
We are not allowed to call in narcotic (oxycontin, oxycodone,
percocet) prescriptions to the pharmacy. In addition, we are
only allowed to write for pain medications for 90 days from the
date of surgery.
- Narcotic pain medication may cause drowsiness. Do not drink
alcohol while taking narcotic medications. Do not operate any
motor vehicle or machinery while taking narcotic pain
medications. Taking more than recommended may cause serious
breathing problems.
If you have questions, concerns or experience any of the below
danger signs then please call your doctor at ___ or go
to your local emergency room.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Doxycycline Hyclate 100 mg PO DAILY Duration: 7 Days
End date ___
RX *doxycycline hyclate 100 mg 1 tablet(s) by mouth Daily Disp
#*7 Tablet Refills:*0
2. Alendronate Sodium 70 mg PO QWED
3. Aspirin 81 mg PO DAILY
4. Furosemide 10 mg PO DAILY
5. Gabapentin 200 mg PO QHS
6. Glargine 24 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
7. Lactulose 30 mL PO TID
8. Lidocaine 5% Ointment 1 Appl TP QID:PRN pain
9. Multivitamins W/minerals 1 TAB PO DAILY
10. Nadolol 20 mg PO DAILY
11. Omeprazole 20 mg PO DAILY
12. Rifaximin 550 mg PO BID
13. Sertraline 50 mg PO DAILY
14. Spironolactone 25 mg PO DAILY
15. Vitamin D ___ UNIT PO DAILY
16. HELD- Atorvastatin 40 mg PO QPM This medication was held.
Do not restart Atorvastatin until you talk to your doctor and
your blood enzymes return to normal
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary diagnosis:
Rhabdomyolysis
Urinary tract infection
Toxic metabolic encephalopathy
Hepatic encephalopathy
Secondary
Chronic diastolic heart failure
Diabetes mellitus
Pyoderma gangrenosusm
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Miss ___,
You were admitted due to weakness and leg pains. From your
laboratory results, we concluded you had rhabdomyolysis. This
also led to a rise in liver enzymes which is usually expected.
You were given fluids to help this resolve. We are unclear what
led to this happening; we suspect sitting in one place for days
could have caused that or the use of atorvastatin. We reviewed
the rest of your medications to ensure you're not on any new
other medications which could have caused this.
We also treated you for a urinary tract infection which was
initially treated with ciprofloxacin but your cultures showed an
organism called Enterococcus which was resistant to it, so we
switched you to Doxycyline 100mg daily for a 7 day course, last
dose on ___.
Note that we STOPPED your atorvastatin. Please do not take it
until you see your doctor.
Please ensure close follow up with your doctors after ___.
It was a pleasure being part of your care.
Sincerely,
Your ___ Liver Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325 mg PO DAILY
2. Allopurinol ___ mg PO DAILY
3. Amlodipine 5 mg PO DAILY
4. Atorvastatin 40 mg PO QPM
5. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES QHS
6. Metoprolol Succinate XL 25 mg PO DAILY
7. Omeprazole 20 mg PO DAILY
8. Timolol Maleate 0.5% 1 DROP BOTH EYES QAM
9. Torsemide 10 mg PO DAILY
10. Vitamin D ___ UNIT PO DAILY
11. Sodium Bicarbonate 650 mg PO BID
RX *sodium bicarbonate 650 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
12. Epoetin ___ ___ units SC Q5 WEEKS
13. GlipiZIDE 10 mg PO BID
14. Potassium Chloride 20 mEq PO DAILY
15. Outpatient Lab Work
Please have electrolytes drawn ___ and have then sent to
PCP: Dr. ___: ___
Fax: ___ ICD10: CKD N18.5
16. Glargine 19 Units Bedtime
Insulin SC Sliding Scale using novolog Insulin
Discharge Disposition:
Home
Discharge Diagnosis:
Postmenopausal bleeding
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted for vaginal bleeding and weakness. You had an
ultrasound of the uterus which showed thickened endometrium
which is abnormal. You should contact gynecology clinic to
schedule a biopsy of the endometrium.
On admission you felt well and did not have further episodes of
heavy bleeding or clots, and your blood counts were stable.
You felt at you baseline but were found to have low magnesium
and low bicarbonate which were repleted. You should continue
the bicarbonate supplement at home and have your labs rechecked
on ___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Ms. ___,
It was a pleasure meeting and caring for you during your most
recent hospitalization at ___.
You were admitted with an episode of unresponsiveness witnessed
by your daughter. Once you were admitted, we found that you
have a slow heart rate which you told us has been known about
for a long time. We asked the cardiologists and the
neurologists to evaluate you. The cardiologists did not believe
that your slow heart rate was related to your symptoms.
Following an extensive evaluation, we felt that your symptoms
were probably the result of ongoing confusion known as delirium
(a common condition we see in elderly patient's) or possibly due
to a condition called ___ Body Dementia.
Please continue to follow-up with your outpatient doctors. We
wish you a speedy recovery.
All the best,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Sulfameth/Trimethoprim SS 1 TAB PO BID
last day antibiotic: ___. Glargine 10 Units Bedtime
Humalog 3 Units Breakfast
Humalog 3 Units Lunch
Humalog 3 Units Dinner
3. Senna 8.6 mg PO BID:PRN constipation
4. Acetaminophen 325 mg PO Q6H:PRN Pain - Mild
5. Amlodipine 10 mg PO DAILY
6. Aspirin 81 mg PO DAILY
7. Atorvastatin 10 mg PO QPM
8. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
9. Calcium Acetate 667 mg PO TID W/MEALS
10. Clobetasol Propionate 0.05% Ointment 1 Appl TP BID
11. Clonidine Patch 0.3 mg/24 hr 1 PTCH TD QFRI
12. CycloSPORINE (Neoral) MODIFIED 75 mg PO Q12H
13. Entecavir 0.5 mg PO 1X/WEEK (___)
14. FoLIC Acid 1 mg PO 3X/WEEK (___)
15. Isosorbide Dinitrate 40 mg PO TID
16. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES QHS
17. LevETIRAcetam 250 mg PO BID
18. Levothyroxine Sodium 100 mcg PO DAILY
19. Lidocaine 5% Patch 1 PTCH TD QAM
20. Metoprolol Tartrate 50 mg PO Q6H
21. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain
22. Pantoprazole 40 mg PO Q24H
23. Sertraline 25 mg PO DAILY
24. sevelamer CARBONATE 800 mg PO TID W/MEALS
please use powder formulation
25. Vitamin D 1200 UNIT PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary:
Toxic metabolic encephalopathy
Urinary tract infection
Secondary:
HBV cirrhosis s/p liver transplant ___
ESRD
Hypertension
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you during your hospitalization
at the ___. You were admitted
to ___ because you were more confused than usual. This is
likely because you had a urinary tract infection. We gave you
antibiotics to treat the infection and your mental status
improve back to your regular baseline. You also received
dialysis for your kidney disease while you were hospitalized.
We had a family meeting with your wife and your son, ___, to
discuss the next best step with you. The neurology (brain)
doctor, explained that your mental status may not get much
better than it is now.
We recommend that you follow up with a urologist (urinary tract
doctor) to evaluate the cause of your frequent urinary tract
infections. We also recommend that you talk to your primary care
doctor and liver doctor about whether or not you need a feeding
tube for nutrition.
If you have fevers, chills, worsening confusion, or any symptoms
that concern you, please seek medical attention.
We wish you the best of luck in your health.
Sincerely,
Your ___ care team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Hydrocortisone Cream 2.5% 1 Appl TP BID PRN pruritis
2. Polyethylene Glycol 17 g PO DAILY:PRN constipation
3. Ranitidine 150 mg PO BID
4. Vitamin D ___ UNIT PO DAILY
5. Azithromycin 250 mg PO Q24H
RX *azithromycin 250 mg 1 tablet(s) by mouth daily Disp #*3
Tablet Refills:*0
6. MedroxyPROGESTERone Acetate 10 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Increased oral secretions
Endobronchial plugging
Tachycardia
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted because you had more oral mucous than you
normally do and you were having difficulty with these
secretions. Your symptoms may have been due to difficulty
swallowing or a pneumonia. We will be sending you home with
antibiotics to treat a pneumonia. A scan of your chest revealed
that you do have mucous build-up in your lungs. We have arranged
for you to receive suctioning at home, which will help with
these symptoms. We performed some tests to determine if your
symptoms are due to the flu. This test has not yet returned. We
will discharge you home with a mask until the tests return.
Please wear the mask whenever you are in public until we call
you with the results.
We were also concerned about your fast heart rate. This may have
been, in part, the result of dehydration. However, even though
you received a lot of fluids, your heart rate was still quite
fast. Sometimes this is due to a clot on your lungs. We
performed a scan of your chest which did not reveal a clot, but
did reveal a build up of mucous in your lungs. The fast heart
rate may be your body's response to this mucous build up. We
will manage this with suctioning at home.
Please continue to take your antibiotics through ___.
Please follow up with the appointments listed below.
It was a pleasure to be a part of your care!
Happy birthday from your ___ treatment team.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
2. Bisacodyl 10 mg PO/PR DAILY:PRN Constipation
3. Docusate Sodium 100 mg PO BID
4. Enoxaparin Sodium 40 mg SC QPM
RX *enoxaparin 40 mg/0.4 mL 1 syringe subcutaneous Nightly Disp
#*30 Syringe Refills:*0
5. Nitrofurantoin Monohyd (MacroBID) 100 mg PO Q12H Duration: 5
Days
Take for 5 total days (last day ___
RX *nitrofurantoin monohyd/m-cryst 100 mg 1 capsule(s) by mouth
Every 12 hours Disp #*6 Capsule Refills:*0
6. OxyCODONE (Immediate Release) 2.5-5 mg PO Q4H:PRN Pain
RX *oxycodone 5 mg ___ tablet(s) by mouth Every 4 hours as
needed Disp #*15 Tablet Refills:*0
7. Senna 8.6 mg PO BID
8. Aspirin 81 mg PO DAILY
9. Atorvastatin 40 mg PO QPM
10. CARVedilol 6.25 mg PO BID
11. Clopidogrel 75 mg PO DAILY
12. Furosemide 20 mg PO DAILY
13. Losartan Potassium 25 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Left intertrochanteric femur fracture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Discharge Instructions:
INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week.
- Resume your regular activities as tolerated, but please follow
your weight bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
-Weightbearing as tolerated left lower extremity
MEDICATIONS:
1) Take Tylenol ___ every 6 hours around the clock. This is
an over the counter medication.
2) Add oxycodone as needed for increased pain. Aim to wean
off this medication in 1 week or sooner. This is an example on
how to wean down:
then 1 tablet every 4 hours as needed x 1 day,
then 1 tablet every 6 hours as needed x 1 day,
then 1 tablet every 8 hours as needed x 2 days,
then 1 tablet every 12 hours as needed x 1 day,
then 1 tablet every before bedtime as needed x 1 day.
Then continue with Tylenol for pain.
3) Do not stop the Tylenol until you are off of the narcotic
medication.
4) Per state regulations, we are limited in the amount of
narcotics we can prescribe. If you require more, you must
contact the office to set up an appointment because we cannot
refill this type of pain medication over the phone.
5) Narcotic pain relievers can cause constipation, so you
should drink eight 8oz glasses of water daily and continue
following the bowel regimen as stated on your medication
prescription list. These meds (senna, colace, miralax) are over
the counter and may be obtained at any pharmacy.
6) Do not drink alcohol, drive a motor vehicle, or operate
machinery while taking narcotic pain relievers.
7) Please take all medications as prescribed by your
physicians at discharge.
8) Continue all home medications unless specifically
instructed to stop by your surgeon.
ANTICOAGULATION:
- Please take Lovenox daily for 4 weeks
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- Incision may be left open to air unless actively draining. If
draining, you may apply a gauze dressing secured with paper
tape.
- Splint must be left on until follow up appointment unless
otherwise instructed.
- Do NOT get splint wet.
DANGER SIGNS:
Please call your PCP or surgeon's office and/or return to the
emergency department if you experience any of the following:
- Increasing pain that is not controlled with pain medications
- Increasing redness, swelling, drainage, or other concerning
changes in your incision
- Persistent or increasing numbness, tingling, or loss of
sensation
- Fever ___ 101.4
- Shaking chills
- Chest pain
- Shortness of breath
- Nausea or vomiting with an inability to keep food, liquid,
medications down
- Any other medical concerns
FOLLOW UP:
Please follow up with your Orthopaedic Surgeon, Dr. ___. You
will have follow up with ___, NP in the
Orthopaedic Trauma Clinic 14 days post-operation for evaluation.
Call ___ to schedule appointment upon discharge.
Please follow up with your primary care doctor regarding this
admission within ___ weeks and for any new medications/refills.
THIS PATIENT IS EXPECTED TO REQUIRE ___ DAYS OF REHAB
Physical Therapy:
Weightbearing as tolerated left lower extremity
No other activity or range of motion restrictions
Treatments Frequency:
Skin staples or sutures to be removed at 2-week follow-up</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: The Preadmission Medication list is accurate and complete.
1. amLODIPine 10 mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Brimonidine Tartrate 0.15% Ophth. 1 DROP LEFT EYE BID
4. Furosemide 20 mg PO DAILY
5. Carvedilol 6.25 mg PO BID
6. Januvia (SITagliptin) 100 mg oral DAILY
7. PreserVision AREDS 2 (vit C,E-Zn-coppr-lutein-zeaxan)
250-200-40-1 mg-unit-mg-mg oral DAILY
8. Losartan Potassium 50 mg PO DAILY
9. Apixaban 2.5mg PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
right MCA stroke
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were hospitalized due to symptoms of left facial droop and
slurred speech resulting from an ACUTE ISCHEMIC STROKE, a
condition where a blood vessel providing oxygen and nutrients to
the brain is blocked by a clot. The brain is the part of your
body that controls and directs all the other parts of your body,
so damage to the brain from being deprived of its blood supply
can result in a variety of symptoms.
Stroke can have many different causes, so we assessed you for
medical conditions that might raise your risk of having stroke.
In order to prevent future strokes, we plan to modify those risk
factors. Your risk factors are:
-Hypertension
-Hyperlipidemia
-Atrial fibrillation
-Congestive heart failure
-Type 2 Diabetes
We are changing your medications as follows:
-Apixaban 2.5mg twice daily
Please take your other medications as prescribed.
Please followup with Neurology and your primary care physician.
If you experience any of the symptoms below, please seek
emergency medical attention by calling Emergency Medical
Services (dialing 911). In particular, since stroke can recur,
please pay attention to the sudden onset and persistence of
these symptoms:
- Sudden partial or complete loss of vision
- Sudden loss of the ability to speak words from your mouth
- Sudden loss of the ability to understand others speaking to
you
- Sudden weakness of one side of the body
- Sudden drooping of one side of the face
- Sudden loss of sensation of one side of the body
Sincerely,
Your ___ Neurology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amiodarone 200 mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Lisinopril 20 mg PO DAILY
4. Fish Oil (Omega 3) 1000 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
TIA
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
___ was a pleasure to take care of you at ___
___. You were admitted on ___ with a transient episode of
right hand numbness that progressed to problems with your
speech. The whole event lasted approximately 1 hour. When you
arrived, a Code Stroke was called an you were taken urgently for
CT which showed ___ new stroke or problems with your blood
vessels to account for your symptoms. We also did an MRI which
showed ___ stroke or obvious vascular cause of your symptoms. We
checked additional laboratory tests to evaluate for increased
lipids or diabetes. You do not have diabetes, but you did have
elevated cholesterol. We would like to start you on: fish oil
and feel strongly that you should start Pradaxa, which you
refused at this time but stated you will discuss with your
primary care doctor. An ultrasound of your heart was also done
which showed normal function. At this time we think your
symptoms of a transient ischemic attack or TIA. This is a brief
stroke-like event that resolves and causes ___ permanent deficit.
You may be at increased risk for future TIAs or stroke and it
is important that you come back to the ED if you have new or
persistent symptoms. Please remain on the medications listed
below and follow up as we have scheduled. Thank you for allowing
us to participate in your care.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler 2 PUFF IH Q6H:PRN SOB
2. Polyethylene Glycol 17 g PO DAILY
Stop medication if you have loose stools.
RX *polyethylene glycol 3350 [Miralax] 17 gram/dose 1 packet(s)
by mouth Daily Disp #*30 Packet Refills:*11
3. Psyllium 1 PKT PO DAILY
Hold for loose stools.
RX *psyllium 1 packet(s) by mouth Daily Disp #*30 Packet
Refills:*11
4. Bisacodyl 10 mg PO/PR DAILY constipation Duration: 2 Weeks
RX *bisacodyl 5 mg ___ tablet(s) by mouth or rectum Daily Disp
#*60 Tablet Refills:*0
5. Lorazepam 0.5 mg PO BID: PRN anxiety
Do not take if sedated or driving.
RX *lorazepam 0.5 mg 1 tablet by mouth Twice a day Disp #*10
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Constipation
Depressed mood
Secondary diagnosis:
Asthma
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure participating in your care at ___. You were
admitted to the hospital with abdominal pain due to severe
constipation. You had a CT scan of your abdomen that showed
significant stool, but no other concerning process. You were
treated with laxatives and your symptoms improved.
You should continue to take laxatives at home as needed and make
sure to drink plenty of fluid and include fiber in your diet to
prevent this constipation from happening again in the future.
You spoke with the nutrition team to help with your diet. Please
discuss setting up a nutrition follow up appointment with your
doctor.
You appear to have a lot of stress in your life which may be
contributing to your abdominal pain and constipation. You felt
much better after talking to a social worker, so we recommend
that you see a social worker or other therapist after returning
home. Please follow up as scheduled with your new primary care
provider and note the changes to your medications on the next
page.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>MEDICATIONS:
- Please take all medications as prescribed by your physicians
at discharge.
- Continue all home medications unless specifically instructed
to stop by your surgeon.
- Do not drink alcohol, drive a motor vehicle, or operate
machinery while taking narcotic pain relievers.
- Narcotic pain relievers can cause constipation, so you should
drink eight 8oz glasses of water daily and take a stool softener
(colace) to prevent this side effect.
ANTICOAGULATION:
- Please take lovenox 40mg daily for 2 weeks
WOUND CARE:
- No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment or by your rehab
facility.
- No dressing is needed if wound continues to be non-draining.
ACTIVITY AND WEIGHT BEARING:
- Out of bed w/ assist
- Right lower extremity: Full weight bearing
- Left lower extremity: Full weight bearing
- Encourage turning, deep breathing and coughing Qhour when
awake
Physical Therapy:
- Activity: Out of bed w/ assist
- Right lower extremity: Full weight bearing
- Left lower extremity: Full weight bearing
- No ROM restrictions
- Encourage turning, deep breathing and coughing Qhour when
awake.
Treatments Frequency:
Site: Incision
Type: Surgical
Dressing: Gauze - dry
- Change daily or as needed to keep dry; OK to leave open to air
once non-draining.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Senna 8.6 mg PO BID:PRN constipation
2. Acyclovir 400 mg PO Q8H
3. amLODIPine 5 mg PO DAILY
4. Docusate Sodium 200 mg PO BID
5. Entecavir 0.5 mg PO DAILY
6. LORazepam 0.5 mg PO Q6H:PRN Nausea, anxiety
7. Ondansetron 4 mg PO Q8H:PRN Nausea
8. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
9. Pantoprazole 40 mg PO Q24H
10. Polyethylene Glycol 17 g PO DAILY:PRN constipation
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
==================
#Febrile Neutropenia
#DLBCL
SECONDARY DIAGNOSIS:
=====================
#Chronic HBV infection
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
You were admitted due to fever when your blood counts were low.
You were placed on IV antibiotics for your fever spikes. No
source of infection was found. Your counts recovered and you are
feeling better and are ready to be discharged home today. You
will follow up in the clinic as stated below. It was a pleasure
taking care of you.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H
2. Amiodarone 400 mg PO BID Duration: 5 Days
then decrease to 400mg daily x 5 days, then decrease to 200mg
daily continuous
3. Atorvastatin 80 mg PO DAILY
4. Docusate Sodium 100 mg PO BID
5. GuaiFENesin ER 1200 mg PO Q12H Duration: 4 Days
6. HYDROmorphone (Dilaudid) ___ mg PO Q4H:PRN Pain - Moderate
RX *hydromorphone [Dilaudid] 2 mg ___ tablet(s) by mouth every
four (4) hours Disp #*10 Tablet Refills:*0
7. Metoprolol Tartrate 25 mg PO TID
hold if SBP<90 or HR<55
8. Polyethylene Glycol 17 g PO DAILY
9. Potassium Chloride 20 mEq PO DAILY Duration: 7 Days
10. Ramelteon 8 mg PO QHS:PRN sleep
Should be given 30 minutes before bedtime
11. Ranitidine 150 mg PO BID
12. Senna 17.2 mg PO DAILY
13. Warfarin 5 mg PO ONCE Duration: 1 Dose
please dose daily for INR 2.5-3.5 (Mechanical AVR &
MVR/afib/CVA)
14. ___ MD to order daily dose PO DAILY16
please dose daily for INR 2.5-3.5 (Mechanical AVR &
MVR/afib/CVA)
15. Aspirin EC 81 mg PO DAILY
16. Furosemide 20 mg PO DAILY Duration: 7 Days
17. HELD- Losartan Potassium 25 mg PO DAILY This medication was
held. Do not restart Losartan Potassium until SBP consistently
>140
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary:
Redosternotomy s/p Mechanical Mitral Valve Replacement
RV lead extractions with upgrade to a CRT-D device on ___
postop ischemic stroke with Left weakness
Secondary:
aortic stenosis s/p prior Mechanical Aortic Valve Replacement
and Mitral valve repair with 30mm ___ II ring and LV
epicardial lead placement ___
Complete Heart Block-s/p Permanent PaceMaker ___
hypertension
hyperlipidemia
BPH
Shingles
Valvular cardiomyopathy
mitral regurgitation
Atrial fibrillation
H. pylori gastritis post-quadruple therapy (___)
Discharge Condition:
Alert and oriented x3, non-focal
Ambulating, gait steady
Sternal pain managed with oral analgesics
Sternal Incision - healing well, no erythema or drainage
Edema-left ___ edema 1+
Followup Instructions:
___ [/INST] </s><s>Please shower daily -wash incisions gently with mild soap, no
baths or swimming, look at your incisions daily
Please - NO lotion, cream, powder or ointment to incisions
Each morning you should weigh yourself and then in the evening
take your temperature, these should be written down on the chart
No driving for approximately one month and while taking
narcotics
Clearance to drive will be discussed at follow up appointment
with surgeon
No lifting more than 10 pounds for 10 weeks
Encourage full shoulder range of motion, unless otherwise
specified
**Please call cardiac surgery office with any questions or
concerns ___. Answering service will contact on call
person during off hours**</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 325 mg PO DAILY
2. Atorvastatin 80 mg PO DAILY
3. Clopidogrel 75 mg PO DAILY
4. Docusate Sodium 100 mg PO BID
5. HYDROmorphone (Dilaudid) 2 mg PO Q4H:PRN neuropathy
6. Metolazone 2.5 mg PO DAILY
7. PredniSONE 3 mg PO DAILY
8. Ropinirole 1.5 mg PO QPM
9. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
10. Acetaminophen 650 mg PO Q6H:PRN pain
11. Nitroglycerin SL 0.4 mg SL PRN chest pain
12. Prochlorperazine 10 mg PO Q8H:PRN nausea
DO NOT TAKE IF NOT NEEDED.
13. Vitamin D 50,000 UNIT PO 1X/WEEK (MO)
14. Metoprolol Tartrate 25 mg PO BID
15. Mycophenolate Mofetil 500 mg PO BID
16. Epoetin Alfa ___ UNIT SC QMOWEFR
17. Citalopram 20 mg PO DAILY
18. Levofloxacin 750 mg PO Q48H Duration: 2 Days
RX *levofloxacin 750 mg one tablet(s) by mouth EVERY 2 DAYS Disp
#*2 Tablet Refills:*0
19. Glargine 7 Units Breakfast
Glargine 8 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
20. Outpatient Lab Work
icd-9 996.81: please draw AM tacrolimus level before 8 am an
send to Dr. ___ at ___.
21. Torsemide 100 mg PO BID
22. Tacrolimus 1 mg PO Q12H
23. Outpatient Lab Work
Please check hematocrit on ___ and send to Dr. ___
___ at ___. icd-9 996.81.
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: CHF exacerbation
Acute kidney injury
Chronic kidney dysfunction
Type 1 Diabetes
Anemia
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to ___
because of acute kidney dysfunction and anemia (low blood
count). You were transfused both at ___, and at
___. Your low blood count was thought to be due to your long
term kidney dysfunction. You were started on a new medication to
improve your blood counts. We also treated you with IV
medication in order to help you lose some of the excess water in
your body. You were also seen by a diabetes specialist to help
you regulate your blood sugar.
It is IMPERATIVE that you quit tobacco.
While you were here, some changes were made to your medications,
please see the sheet below.
Please follow up below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Metoprolol Tartrate 12.5 mg PO BID
hold if SBP < 90 or HR < 60
3. Cyanocobalamin 100 mcg PO DAILY
4. Simvastatin 20 mg PO DAILY
5. MetFORMIN (Glucophage) 500 mg PO BID
6. Tamsulosin 0.4 mg PO HS
holf for sbp < 100
7. FoLIC Acid 1 mg PO DAILY
8. Thiamine 100 mg PO DAILY
9. Senna 2 TAB PO BID:PRN constipation
10. Polyethylene Glycol 17 g PO DAILY:PRN constipation
11. Docusate Sodium 200 mg PO BID:PRN constipation
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
Right upper lobe lung mass
Non-ST elevation MI
Anemia of Chronic Disease
Hypotension secondary to dehydration and poor PO intake
Hypercalcemia
Hypoglycemia
Type-II Diabetes
Urinary Retention
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted because of low blood pressure secondary to
dehydration, low blood counts, low blood sugars, high calcium
levels in your blood, and damage to your heart from a mild heart
attack. During your admission, a large mass in the upper aspect
of your right lung was found. Initially, this mass thought to be
an infection and you were treated with antibiotics; however,
these antibiotics were discontinued after further studies
suggested it was not an infection. The mass was biopsied, and
the results of the biopsy are pending. To correct your low
blood counts, you received a blood transfusion. To correct your
low blood pressure, dehydration, and high calcium, you received
intravenous fluids. To evaluate your heart, you received a heart
ultrasound, which suggests that you may have mild heart failure
and that one of your heart valves is permitting backflow. To
correct your low blood sugar, you received sugar intravenously.
During your hospitalization, urinary retention and difficulty
urinating was noted. You received a catheter in your bladder to
facilitate urine excretion, and were discharged with this
catheter.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amlodipine 5 mg PO BID
2. Aspirin 81 mg PO DAILY
3. Gabapentin 200 mg PO QHS
4. Glargine 40 Units Bedtime
Insulin SC Sliding Scale using UNK Insulin
5. Levothyroxine Sodium 75 mcg PO DAILY
6. Mycophenolate Mofetil 500 mg PO TID
7. PredniSONE 5 mg PO DAILY
8. Tacrolimus 1 mg PO Q12H
9. Ciprofloxacin 400 mg IV Q12H
10. Ganciclovir 390 mg IV Q12H
11. MetRONIDAZOLE (FLagyl) 500 mg IV Q8H
12. Pantoprazole 40 mg IV Q12H
Discharge Disposition:
Extended Care
Discharge Diagnosis:
Abdominal pain and fever
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure participating in your care at ___
___.
You were admitted with abdominal pain and you had a fever. As
you know, given your status, we are concerned that you may have
a CMV infection. You received a dose of antiviral medication and
then were transferred to the ___ for continued care.
You received a study to determine if gastroparesis was
contributing to your abdominal pain, and the results are not
available. We will send you a letter with the results.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
2. Benzonatate 100 mg PO TID
3. Enoxaparin Sodium 70 mg SC Q12H
4. Magnesium Oxide 400 mg PO TID Duration: 3 Doses
5. Warfarin 5 mg PO DAILY16
6. HYDROmorphone (Dilaudid) ___ mg PO Q4H:PRN Pain - Moderate
RX *hydromorphone 2 mg ___ tablet(s) by mouth every four (4)
hours Disp #*30 Tablet Refills:*0
7. Glargine 20 Units Bedtime
Humalog 3 Units Breakfast
Humalog 3 Units Lunch
Humalog 3 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
8. LORazepam 0.5 mg PO Q8H:PRN Anxiety
RX *lorazepam 0.5 mg 1 TAB by mouth every eight (8) hours Disp
#*30 Tablet Refills:*0
9. Nortriptyline 75 mg PO QHS
RX *nortriptyline 75 mg 1 tab by mouth at bedtime Disp #*30
Capsule Refills:*0
10. Acetaminophen-Caff-Butalbital 1 TAB PO BID
RX *butalbital-acetaminophen-caff 50 mg-300 mg-40 mg 1 tab by
mouth twice a day Disp #*20 Capsule Refills:*0
11. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN Wheezing
12. Albuterol Inhaler ___ PUFF IH Q4H:PRN Wheezing
13. amLODIPine 10 mg PO DAILY
14. Aspirin 81 mg PO DAILY
15. Atorvastatin 80 mg PO QPM
16. Cyclobenzaprine 10 mg PO TID:PRN Muscle spasm
17. diclofenac sodium 1 % TOPICAL Q4H
18. Fenofibrate 145 mg PO DAILY
19. Fentanyl Patch 37 mcg/h TD Q72H
RX *fentanyl 37.5 mcg/hour 1 patch q72h Disp #*10 Patch
Refills:*0
20. Ferrous Sulfate 325 mg PO DAILY
21. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
22. Gabapentin 300 mg PO QHS
23. guaiFENesin 600 mg oral BID
24. Ipratropium-Albuterol Neb 1 NEB NEB Q6H:PRN shortness of
breath
25. melatonin 10 mg oral QHS:PRN Insomia
26. methylcellulose (laxative) 15 mL oral DAILY:PRN
Constipation
27. Metoclopramide 10 mg PO QIDACHS
28. Metoprolol Succinate XL 25 mg PO QHS
29. Miconazole 2% Cream 1 Appl TP BID
30. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN Chest pain
31. Omeprazole 40 mg PO BID
32. Ondansetron ODT 4 mg PO BID:PRN Nausea/Vomiting - First
Line
33. Pancrelipase 5000 1 CAP PO TID W/MEALS
34. Polyethylene Glycol 17 g PO DAILY:PRN constipation
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Pain after fall
Hyponatremia
Poorly controlled type 2 diabetes mellitus
Tracheobronchomalacia
Chronic pain
Anxiety
SIADH
Cavitary lesions ___ lung
LV aneurysm
LV thrombus
Discharge Condition:
Ambulating with walker
Followup Instructions:
___ [/INST] </s><s>Dear ___ was a pleasure caring for you.
You were hospitalized with leg pain after your fall. There is
thankfully no fracture and your pain is slowly improving.
___ addition, you were found to have low sodium due to a
condition called "SIADH" or syndrome of inappropriate
antidiuretic hormone. SIADH is likely caused by your pain and
maybe your lung issues. This improved with fluid restriction,
and we recommend you continue to limit yourself to 1.5L of free
water daily. This will hopefully be temporary, but your doctors
___ when you can stop restricting.
We also found that you had lesions ___ your lungs ("cavitary
lesions"), the cause of which is not completely clear but which
may be from infection of mycobacteria. Tests are pending and you
will follow up with the lung doctors here to decide what if any
management will be necessary.
We also found you had a clot ___ your heart with an aneurysm ___
the heart. For this we started you on a blood thinner. You are
currently taking 2 blood thinners (Lovenox injections and
warfarin) until the warfarin kicks ___, after which you will stop
taking the Lovenox and just take the warfarin. You will be on
the warfarin for at least 3 months and will have follow up with
your cardiologist to consider what if any further
diagnosis/management will be necessary.
We found that you had slight widening of some of the biliary
tubes around your liver. This is likely not a problem, but at
some point ___ the near future you will need to have a test
called an "MRCP". We have informed your doctors about this.
We have increased some of your pain and anxiety medications, but
as we discussed, these increase your risk of fall and other
adverse outcomes, so we recommend you work with your doctors to
reduce these sedating medications as soon as able.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Levothyroxine Sodium 50 mcg PO DAILY
2. Paroxetine 10 mg PO DAILY
3. Simvastatin 40 mg PO DAILY
4. Warfarin 1 mg PO DAILY16
RX *warfarin 1 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*2
5. Lisinopril 5 mg PO DAILY
RX *lisinopril 5 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*2
6. Amiodarone 100 mg PO DAILY
RX *amiodarone 100 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*2
Discharge Disposition:
Home With Service
Facility:
___
___:
PRIMARY DIAGNOSES:
Fall
Atrial Fibrillation s/p embolic stroke
SECONDARY DIAGNOSES:
Hypertension
Celiac disease
Dyslipidemia
Hypothyroidism
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
It was a pleasure taking care of you at the ___
___. You were transferred to our hospital
from ___ because you had a fall while on the blood
thinner coumadin. ___ did a CT scan of your head
and did not see any evidence of bleeding. They transferred you
to ___ for a second opinion and any further management
that you would require. You had a carotid ultrasound which
showed no significant disease. You were seen by the physical
therapists in the hospital who determined that you are safe for
discharge home with physical therapy.
Please take all your medications as prescribed. We changed or
stopped the following medications:
Metoprolol: Please stop the metorpolol.
Amiodarone: Please continue your amiodarone at 100 mg by mouth
daily.
Coumadin: Your coumadin was decreased to 1 mg by mouth daily.
Lisinopril: Please start 1 tablet by mouth daily for blood
pressure control.
You will need to make a follow up appointment with your primary
care physician ___ 7 days after discharge. You
have an appointment with your cardiologist as listed below. It
is important that you make/keep these appointments as they might
want to make medication changes.
You will need to have an INR and renal function checked on
___ and have the results sent to Dr. ___
___.
Thank you for allowing us to participate in your care.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Citalopram 10 mg PO DAILY
3. Simvastatin 20 mg PO QPM
4. Cyanocobalamin 50 mcg PO DAILY
5. Docusate Sodium 100 mg PO BID
6. FoLIC Acid 1 mg PO DAILY
OTC Medication - Ask your Pharmacist
7. Multivitamins 1 TAB PO DAILY
OTC Medication - Ask your Pharmacist
8. Senna 17.2 mg PO HS
OTC Medication - Ask your Pharmacist
9. Thiamine 100 mg PO DAILY
OTC Medication - Ask your Pharmacist
10. Sodium Chloride 0.9% Flush 3 mL IV Q8H and PRN, line flush
11. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth every six (6) hours Disp
#*20 Tablet Refills:*0
12. Acetaminophen 325-650 mg PO Q6H:PRN Pain/Fever
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Traumatic Subarachnoid Hemorrhage
Chronic Left Subdural Hematoma
Rib fractures
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You suffered a small brain bleed after a fall. This did not
require surgery, but you will need follow-up as an outpatient
with repeat imaging.
Activity
- We recommend that you avoid heavy lifting, running, climbing,
or other strenuous exercise until your follow-up appointment.
- You make take leisurely walks and slowly increase your
activity at your own pace once you are symptom free at rest.
___ try to do too much all at once.
- No driving while taking any narcotic or sedating medication.
- If you experienced a seizure while admitted, you are NOT
allowed to drive by law.
- No contact sports until cleared by your neurosurgeon. You
should avoid contact sports for 6 months.
- Continue to use your Incentive Spirometer 10x every hour to
encourage deep breathing.
Medications
- You may take your Aspirin 81mg as previously prescribed.
Please do NOT take any additional blood thinning medication
(Ibuprofen, Plavix, Coumadin) until cleared by your
Neurosurgeon.
- You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
- You may use Oxycodone for more severe pain as needed. This
medication may make you drowsy. Do not drive or drink alcohol
while taking this medication.
What You ___ Experience:
- You may have difficulty paying attention, concentrating, and
remembering new information.
- Emotional and/or behavioral difficulties are common.
- Feeling more tired, restlessness, irritability, and mood
swings are also common.
- Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
pain medications), try an over-the-counter stool softener.
Headaches:
- Headache is one of the most common symptom after a brain
bleed.
- Most headaches are not dangerous but you should call your
doctor if the headache gets worse, develop arm or leg weakness,
increased sleepiness, and/or have nausea or vomiting with a
headache.
- Mild pain medications may be helpful with these headaches but
avoid taking pain medications on a daily basis unless prescribed
by your doctor.
- There are other things that can be done to help with your
headaches: avoid caffeine, get enough sleep, daily exercise,
relaxation/ meditation, massage, acupuncture, heat or ice packs.
When to Call Your Doctor at ___ for:
- Fever greater than 101.5 degrees Fahrenheit
- Nausea and/or vomiting
- Extreme sleepiness and not being able to stay awake
- Severe headaches not relieved by pain relievers
- Seizures
- Any new problems with your vision or ability to speak
- Weakness or changes in sensation in your face, arms, or leg
Call ___ and go to the nearest Emergency Room if you experience
any of the following:
- Sudden numbness or weakness in the face, arm, or leg
- Sudden confusion or trouble speaking or understanding
- Sudden trouble walking, dizziness, or loss of balance or
coordination
- Sudden severe headaches with no known reason</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin EC 81 mg PO DAILY
2. Atorvastatin 20 mg PO QPM
3. Docusate Sodium (Liquid) 100 mg PO BID
4. Senna 8.6 mg PO BID:PRN constipation
5. Furosemide 80 mg PO DAILY
RX *furosemide 40 mg 2 tablet(s) by mouth daily Disp #*60 Tablet
Refills:*3
6. Warfarin 2.5 mg PO DAILY16
RX *warfarin [Coumadin] 1 mg 3 tablet(s) by mouth daily Disp
#*90 Tablet Refills:*3
7. Outpatient Lab Work
Please check INR ___ and call ___
___ at ___ with results.
8. Metoprolol Succinate XL 75 mg PO DAILY
RX *metoprolol succinate 25 mg 3 tablet(s) by mouth daily Disp
#*90 Tablet Refills:*3
9. Potassium Chloride 10 mEq PO DAILY Duration: 24 Hours
RX *potassium chloride 10 mEq 1 capsule(s) by mouth daily Disp
#*30 Capsule Refills:*3
10. Outpatient Lab Work
Please draw chem 10 on ___ and call PCP ___ at
___ with the results.
11. Diltiazem Extended-Release 240 mg PO DAILY
RX *diltiazem HCl 240 mg 1 capsule(s) by mouth daily Disp #*30
Capsule Refills:*3
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
Acute on chronic diastolic congestive heart failure exacerbation
Left lower lobe pleural effusion
Secondary:
Atrial fibrillation
Aortic stenosis s/p TAVR
Aortic regurgitation
Complete heart block s/p pacer
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to the hospital with difficulty breathing due
to fluid in your lungs and excess fluid in your legs. We gave
you medication to remove this extra fluid. Your breathing and
swelling improved as the fluid was removed and you were able to
walk comfortably and no longer needing oxygen.
Please remember to continue to limit salt and total fluid intake
and to measure your weight every day.
It was a pleasure taking care of you.
Sincerely,
Your ___ Cardiology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Simvastatin 20 mg PO QPM
3. Metoprolol Succinate XL 12.5 mg PO DAILY
4. Ropinirole 2 mg PO DAILY
5. Tamsulosin 0.4 mg PO QHS
6. Finasteride 5 mg PO DAILY
7. Citalopram 10 mg PO DAILY
8. Calcitriol 0.25 mcg PO DAILY
9. Levothyroxine Sodium 50 mcg PO EVERY OTHER DAY
10. Lisinopril 10 mg PO DAILY
11. Melatin (melatonin) 3 mg oral QPM
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Partial bowel obstruction vs gastroenteritis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
You were admitted to the hospital for a partial small bowel
obstruction vs gastroenteritis. You were given bowel rest and
intravenous fluids. Your symptoms have subsequently resolved
after conservative management. You have tolerated a regular
diet, are passing gas and your pain is controlled with pain
medications by mouth. Furthermore you have not had any diarrhea,
bloody bowel movements, and your hematocrit (blood count levels)
have been stable. You may return home to finish your recovery.
Please monitor your bowel function closely. If you notice that
you are passing bright red blood with bowel movements or having
loose stool without improvement please call the office or go to
the emergency room if the symptoms are severe. If you have any
of the following symptoms please call the office for advice or
go to the emergency room if severe: increasing abdominal
distension, increasing abdominal pain, nausea, vomiting,
inability to tolerate food or liquids, prolonged loose stool, or
extended constipation.
Thank you for allowing us to participate in your care! Our hope
is that you will have a quick return to your life and usual
activities. Good luck!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Ibuprofen 600 mg PO Q8H:PRN pain
Discharge Disposition:
Home
Discharge Diagnosis:
Chest pain with positive stress test
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
Taking care of you at ___ was our pleasure. You came in
because you were having chest pain and had findings on your
stress test suggesting that your heart was possibly not getting
enough blood flow. Because of your ongoing pain, which worsened
over the last two days, decision was made to admit you for a
cardiac catheterization. The procedure showed normal coronary
arteries and no evidence of blockages. Your chest pain is not
related to heart disease. Please follow up with your primary
care doctor and continue all medications as before.
We wish you all the ___.
Sincerely,
The ___ medical team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 325 mg PO DAILY
2. Avodart (dutasteride) 0.5 mg oral daily
3. Docusate Sodium 100 mg PO BID
4. Levothyroxine Sodium 175 mcg PO DAILY
5. Metoprolol Succinate XL 12.5 mg PO DAILY
6. Omeprazole 20 mg PO DAILY
7. Senna 17.2 mg PO QHS
8. Tamsulosin 0.4 mg PO DAILY
9. ALPRAZolam 1 mg PO DAILY:PRN anxiety
10. Klor-Con (potassium chloride) ___ meq oral BID
11. Theophylline ER 300 mg PO DAILY
12. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO Q4H:PRN pain
13. Lisinopril 5 mg PO DAILY
14. Nafcillin 2 g IV Q4H
15. Warfarin 5 mg PO DAILY16
16. NPH 22 Units Breakfast
NPH 22 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
17. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
18. Simvastatin 10 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
MSSA Bacteremia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair, requires TLSO brace when out of bed
Followup Instructions:
___ [/INST] </s><s>Dear Mr ___,
Thank you for allowing us to participate in your care. You were
admitted on ___ with symptoms of low back pain and fevers.
Our tests showed bacteria in your blood and we started you on
intravenous antibiotics for it. We continued your home
medications, and gave you medications for your back pain as
well. You responded well to therapy, and we placed a tube in
your arm veins through which you will continue to receive
antibiotics for 9 more days for a total of 14 days since you
started the antibiotics. Our neurosurgery, and infectious
disease teams who also saw and evaluated you while you were
admitted recommend that you follow up with them after you're
discharged at the appointments scheduled below.
Discharge instructions
- Continue receiving antibiotics through your PICC line till
___ for a total 2 week course till you see the infectious
disease team as scheduled below
- Please continue your coumadin on discharge and follow up with
your regular ___ clinic
- Please care for your PICC line as instructed to minimize
infections
- Your rehab can help remove the staples in your back on ___,
___
- Please remember to wear the TLSO brace whenever you are out of
bed till you see the neurosurgery team as scheduled below
- You were started on a small dose of metoprolol and statin to
help protect your heart. Please follow up with PCP to further
discuss these medication changes
- Weigh yourself every morning, call MD if weight goes up more
than 3 lbs
- Please follow up with our infectious disease and neurosurgery
teams as scheduled below</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 10 mg PO DAILY
2. Eplerenone ___ mg PO DAILY
3. Escitalopram Oxalate 20 mg PO DAILY
4. HydrALAZINE 25 mg PO TID
5. LamoTRIgine 100 mg PO BID
6. Lisinopril 10 mg PO DAILY
RX *lisinopril 10 mg 1 tablet(s) by mouth Daily Disp #*30 Tablet
Refills:*0
7. Modafinil 200 mg PO BID
8. Vitamin D ___ UNIT PO DAILY
9. Atorvastatin 80 mg PO QPM
RX *atorvastatin 80 mg 1 tablet(s) by mouth QPM Disp #*30 Tablet
Refills:*0
10. Torsemide 20 mg PO DAILY
RX *torsemide 20 mg 1 tablet(s) by mouth Daily Disp #*30 Tablet
Refills:*0
11. ammonium lactate 12 % topical BID
12. Multivitamins 1 TAB PO DAILY
13. Pantoprazole 40 mg PO Q12H
RX *pantoprazole 40 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
14. Outpatient Lab Work
ICD 10 K74.60
___ Labs: Please obtain Chem 10, LFTS, ___, PTT, CBC and Fax
to: PCP ___ ___ (P ___ Liver
Center Dr. ___ ___ (P ___
15. Outpatient Lab Work
ICD 10 K74.60
___ Labs: Please obtain Chem 10, LFTS, ___, PTT, CBC and Fax
to: PCP ___ ___ (P ___ Liver
Center Dr. ___ ___ (P ___
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnoses
=====================
Anemia
Variceal Bleeding s/p TIPS
NSTEMI
Acute on chronic diastolic heart failure
HCV Cirrhosis
Acute kidney injury
Sinus bradycardia
Secondary Diagnoses
=====================
Hypertension
Hyperaldosteronism
History of CVA c/b seizures
Vitamin D deficiency
Prolonged QTc
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you during your stay at ___. You
were admitted to the hospital with low blood counts. You were
found to have evidence of bleeding from your GI tract which is
caused by your cirrhosis. You were treated with a procedure
called a TIPS which can help lower the pressure in your liver
to help prevent further bleeds. Dilated blood vessels in your GI
tracts were also fixed by the interventional radiologists. You
were restarted on diuretics (water pills) while you were here in
the hospital.
You should weigh yourself every morning and call your doctor if
your weight goes up by more than 3 lbs.
It is very important that you follow up with our primary care
doctor, the interventional radiologists, liver doctors and ___
___ after you leave the hospital.
You will need to have labs drawn on ___ and every ___
after.
Your updated medication list and appointments are listed below.
We wish you the best!
- Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Spironolactone 12.5 mg PO DAILY
RX *spironolactone 25 mg 0.5 (One half) tablet(s) by mouth daily
Disp #*30 Tablet Refills:*0
2. Furosemide 40 mg PO DAILY
RX *furosemide 40 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
3. Lisinopril 10 mg PO DAILY
RX *lisinopril 10 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
4. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN shortness of
breath
5. Aspirin 81 mg PO DAILY
6. Atorvastatin 80 mg PO QPM
7. Metoprolol Succinate XL 25 mg PO DAILY
8. Warfarin 7.5 mg PO 2X/WEEK (MO,FR)
9. Warfarin 5 mg PO 5X/WEEK (___)
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
==================
- Acute heart failure with reduced ejection fraction
- LV thrombus
- Cholelithiasis
SECONDARY DIAGNOSIS:
====================
- CAD
- Tobacco use
- COPD
- Microcytic anemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
WHY WERE YOU ADMITTED TO THE HOSPITAL?
- You were admitted to ___ because you were feeling fatigued
and short of breath when you laid flat on your back.
WHAT WAS DONE FOR YOU IN THE HOSPITAL?
- You were treated with a medicine called Lasix, which was given
to you through your vein to help remove the extra fluid in your
body that was making it hard for you to breath. You were then
switched to an oral version of Lasix that you should take every
day to prevent more fluid from building up.
- You were started on a new medicine called spironolactone that
will protect your heart. You will take a 12.5mg tablet of this
medicine once a day. Your home lisinopril 5mg daily was
increased to 10mg daily.
- You were having some abdominal pain, so you had an ultrasound
of your stomach that showed you had gallstones. There is nothing
to do for this right now.
WHAT SHOULD YOU DO WHEN YOU GO HOME?
- You should continue taking all your medicines, as prescribed.
As we discussed, you should consider taking your Lasix pill in
the morning so you won't have to get up several times in the
middle of the night to urinate.
- You should follow up with your primary care doctor and
cardiologist.
- You should weigh yourself every morning using the same scale
and call your cardiologist if your weight increases by more than
3 lbs. in one day or 5lbs. in two days. Your discharge weight
is: 199.96 lb.
- You should drink less than 2 liters of fluid per day and avoid
eating salty foods, such as deli meats and canned soups. You
should consume less than 2 grams of salt per day.
- You should stop smoking. This is one of the most important
things you can do to protect your heart from further damage.
It was a pleasure taking care of you, and we wish you all the
best!
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. MetFORMIN (Glucophage) 425 mg PO BID
3. Rivaroxaban 20 mg PO DAILY
4. Simvastatin 20 mg PO DAILY
5. Acetaminophen ___ mg PO Q8H:PRN pain
6. Amlodipine 10 mg PO DAILY
7. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
8. Calcium Carbonate 500 mg PO QID:PRN heart burn
9. Docusate Sodium 100 mg PO BID
10. Polyethylene Glycol 17 g PO DAILY:PRN constipation
11. Senna 1 TAB PO BID:PRN constipation
12. Valsartan 40 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis:
acalculus cholecystitis
Secondary diagnosis:
A-fib
Diabetes Mellitus 2
Coronary artery disease
Constipation
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at ___. You came in with
7 days of constipation, loss of appetite, generalized weakness,
cough, and sudden onset of chest pain. While ___ were here, we
ran some tests including EKG, Troponins, and chest X-ray in
order to investigate cardiac causes of your pain. These tests
were all negative. You were found to have some upper right
quadrant abdominal pain on exam and some of your liver enzymes
associated with gallbladder injury were elevated. We did several
studies to investigate this further including an ultrasound and
a HIDA scan. The ultrasound showed that the gallbladder was
distended, there were gallstones and some biliary sludge
present, as well as gallbladder wall thickening. The HIDA scan
showed normal empting of the gallbladder. We had the surgical
team examine you to determine if emergent surgery was necessary.
Because you continued to have an elevated white blood cell
count and pain, you were taken to the operating room where you
had your gallbladder removed. You are slowly recovering from
your surgery and you are preparing for discharge home with the
following instructions:
Do not drive until you have stopped taking pain medicine and
feel you could respond in an emergency.
You may climb stairs.
You may go outside, but avoid traveling long distances until you
see your surgeon at your next visit.
Don't lift more than ___ lbs for 6 weeks. (This is about the
weight of a briefcase or a bag of groceries.) This applies to
lifting children, but they may sit on your lap.)
You may start some light exercise when you feel comfortable.
You will need to stay out of bathtubs or swimming pools for a
time while your incision is healing. Ask your doctor when you
can resume tub baths or swimming.
Heavy exercise may be started after 6 weeks, but use common
sense and go slowly at first.
You may resume sexual activity unless your doctor has told you
otherwise.
HOW YOU MAY FEEL:
You may feel weak or "washed out" for 6 weeks. You might want to
nap often. Simple tasks may exhaust you.
You may have a sore throat because of a tube that was in your
throat during surgery.
You might have trouble concentrating or difficulty sleeping. You
might feel somewhat depressed.
You could have a poor appetite for a while. Food may seem
unappealing.
All of these feelings and reactions are normal and should go
away in a short time. If they do not, tell your surgeon.
YOUR INCISION:
Your incision may be slightly red aroudn the stitches or
staples. This is normal.
You may gently wash away dried material around your incision.
Do not remove steri-strips for 2 weeks. (These are the thin
paper strips that might be on your incision.) But if they fall
off before that that's okay).
It is normal to feel a firm ridge along the incision. This will
go away.
Avoid direct sun exposure to the incision area.
Do not use any ointments on the incision unless you were told
otherwise.
You may see a small amount of clear or light red fluid staining
your dressing r clothes. If the staining is severe, please call
your surgeon.
You may shower. As noted above, ask your doctor when you may
resume tub baths or swimming.
Ove the next ___ months, your incision will fade and become
less prominent.
YOUR BOWELS:
Constipation is a common side effect of medicine such as
Percocet or codeine. If needed, you may take a stool softener
(such as Colace, one capsule) or gentle laxative (such as milk
of magnesia, 1 tbs) twice a day. You can get both of these
medicines without a prescription.
If you go 48 hours without a bowel movement, or have pain moving
the bowels, call your surgeon.
After some operations, diarrhea can occur. If you get diarrhea,
don't take anti-diarrhea medicines. Drink plenty of fluitds and
see if it goes away. If it does not go away, or is severe and
you feel ill, please call your surgeon.
PAIN MANAGEMENT:
It is normal to feel some discomfort/pain following abdominal
surgery. This pain is often described as "soreness".
Your pain should get better day by day. If you find the pain is
getting worse instead of better, please contact your surgeon.
You will receive a prescription from your surgeon for pain
medicine to take by mouth. It is important to take this medicine
as directied. Do not take it more frequently than prescribed. Do
not take more medicine at one time than prescribed.
Your pain medicine will work better if you take it before your
pain gets too severe.
Talk with your surgeon about how long you will need to take
prescription pain medicine. Please don't take any other pain
medicine, including non-prescription pain medicine, unless your
surgeon has said its okay.
IF you are experiencing no pain, it is okay to skip a dose of
pain medicine.
Remember to use your "cough pillow" for splinting when you cough
or when you are doing your deep breathing exercises.
If you experience any of the folloiwng, please contact your
surgeon:
- sharp pain or any severe pain that lasts several hours
- pain that is getting worse over time
- pain accompanied by fever of more than 101
- a drastic change in nature or quality of your pain
MEDICATIONS:
Take all the medicines you were on before the operation just as
you did before, unless you have been told differently.
In some cases you will have a prescription for antibiotics or
other medication.
If you have any questions about what medicine to take or not to
take, please call your surgeon.
DANGER SIGNS:
Please call your surgeon if you develop:
- worsening abdominal pain
- sharp or severe pain that lasts several hours
- temperature of 101 degrees or higher
- severe diarrhea
- vomiting
- redness around the incision that is spreading
- increased swelling around the incision
- excessive bruising around the incision
- cloudy fluid coming from the wound
- bright red blood or foul smelling discharge coming from the
wound
- an increase in drainage from the wound</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Escitalopram Oxalate 20 mg PO DAILY
2. Fentanyl Patch 50 mcg/h TD Q48H Back pain
3. Lorazepam 0.5 mg PO QHS:PRN Insomnia
4. OxycoDONE (Immediate Release) 15 mg PO Q4H:PRN Pain
5. Venlafaxine XR 75 mg PO DAILY
6. Zolpidem Tartrate 5 mg PO QHS Insomnia
7. Vitamin D 1000 UNIT PO DAILY
RX *ergocalciferol (vitamin D2) 2,000 unit ___ tablet(s) by
mouth daily Disp #*30 Tablet Refills:*0
8. Celecoxib 100 mg ORAL DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
- Syncope
- Right inferior orbital fracture
- Hypophosphatemia
- Hypomagnesemia
- Hypovitaminosis D
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
___ was a pleasure taking care of you at ___
___. You were transferred from ___ due
to concern for a seizure. While there, bloodwork showed
extremely abnormal electrolytes. While at ___, your
electrolytes were normal. An MRI of your brain was normal. The
EEG of your brain appeared normal and is in final review at the
time of discharge. Nevertheless, please follow-up with your PCP
to have repeat bloodwork done to ensure your electrolytes remain
normal. Also, please make sure to follow-up with a neurologist
as outlined below.
Because of the concern for seizure, **you cannot drive for six
months.**
When yawning or opening your mouth wide, you should brace jaw
with hands to avoid another jaw dislocation. You should apply
an ice pack to your face as needed to decrease swelling.
Regards,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB
2. Aspirin 81 mg PO DAILY
3. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
4. FoLIC Acid 1 mg PO DAILY
5. Mirtazapine 7.5 mg PO HS
6. Ocutabs (vitamin A-vitamin C-vit E-min) 1 tab oral daily
7. Omeprazole 20 mg PO DAILY
8. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO Q6H:PRN pain
9. Prochlorperazine 10 mg PO Q6H:PRN nausea
10. Tiotropium Bromide 1 CAP IH DAILY
11. Atorvastatin 80 mg PO DAILY
RX *atorvastatin 80 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
12. Balanced Nutritional (food supplement, lactose-free) 0 can
ORAL TID
13. Cyanocobalamin 1000 mcg IM/SC EVERY 9 WEEKS
14. Furosemide 20 mg PO DAILY:PRN swelling
15. garlic 1,000 mg oral daily
16. Metoprolol Succinate XL 25 mg PO DAILY
17. Nitroglycerin SL 0.4 mg SL PRN chest pain
1 tablet under the tongue every five minutes, Maximum of 3
(three) tablets total, for chest pain
RX *nitroglycerin 0.4 mg 1 tablet(s) sublingually as needed for
chest pain Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY: non-ST-elevation myocardial infarction, Non-small cell
lung cancer
SECONDARY: Chronic systolic heart failure, hypertension
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you at ___
___. You were admitted for chest pain, and you
appeared to have had a small heart attack. An echocardiogram
revealed that the muscle function of your heart seems to be
stable to prior. We recommend medical management for your heart
disease, including a baby aspirin, controlling your blood
pressure, and other medication changes as noted below. Please be
sure to follow up with a cardiologist, as below. Your CT-scan
showed relatively stable tumor, and you should discuss the
imaging with your oncologists.
Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB
2. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
3. Montelukast Sodium 10 mg PO DAILY
4. Omeprazole 40 mg PO DAILY
5. Albuterol Inhaler ___ PUFF IH Q4H:PRN SOB
6. Tiotropium Bromide 1 CAP IH DAILY
7. Nystatin Oral Suspension 5 mL PO QID thrush
RX *nystatin 100,000 unit/mL 5 cc by mouth four times a day Disp
#*1 Bottle Refills:*0
8. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
RX *sulfamethoxazole-trimethoprim 400 mg-80 mg One tablet(s) by
mouth daily Disp #*30 Tablet Refills:*0
9. PredniSONE 60 mg PO DAILY
RX *prednisone 10 mg One tablet(s) by mouth daily Disp #*80
Tablet Refills:*0
10. Ipratropium Bromide Neb 1 NEB IH Q6H SOB
11. Azathioprine 50 mg PO DAILY
RX *azathioprine 50 mg One tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
12. Pulmicort Flexhaler (budesonide) 180 mcg/actuation
inhalation BID
Discharge Disposition:
Home
Discharge Diagnosis:
1. asthma exacerbation
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you at ___
___. You presented to us with shortness of breath
and worsening of your asthma. We placed you on antibiotics,
scheduled nebulizer treatments, and IV steroid. You are being
discharged on prednisone, a new medication called azathioprine
as recommended by your pulmonologist, and bactrim. We consulted
pulmonology who agreed with our plan and made recommendations.
Please follow up with your pulmonology, Dr. ___, as scheduled.
We also consulted rheumatology to assess for Churg ___ and
they believed that your current presentation is unlikely to be
due to this illness since you lack many symptoms suggestive of
this disease.
Please take your medications as instructed. Please attend all
your follow up appointments.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Docusate Sodium 100 mg PO BID
2. Enoxaparin Sodium 100 mg SC DAILY
Start: Tomorrow - ___, First Dose: First Routine
Administration Time
3. Lorazepam 0.5 mg PO BID:PRN nausea/anxiety
4. Multivitamins 1 TAB PO DAILY
5. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth every 4 hours as
needed Disp #*60 Tablet Refills:*0
6. Polyethylene Glycol 17 g PO DAILY
7. Senna 8.6 mg PO BID
8. Temazepam 15 mg PO QHS:PRN sleep
9. Triumeq (abacavir-dolutegravir-lamivud) 600-50-300 mg oral
DAILY
10. Acetaminophen 650 mg PO Q6H:PRN fever
11. Nystatin Oral Suspension 5 mL PO QID
Discharge Disposition:
Home
Discharge Diagnosis:
Pancreatic cancer
Fever
History of biliary obstruction s/p bile duct stenting and
percutaneous cholecystostomy tube now removed
History of multi-drug resistant pseudomonas
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr ___ it was a pleasure caring for you during your stay
at ___. You were admitted again with fever. Given your
history of multiple pseudomonas infections in the recent past
and recent removal of the gallbladder tube you were restarted on
IV antibioitcs. However you did not have any fevers here in the
hospital and there were no signs of infection on blood cultures,
liver ultrasound or liver MRI.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Cyanocobalamin 1000 mcg PO DAILY
RX *cyanocobalamin (vitamin B-12) 1,000 mcg 1 tablet(s) by mouth
daily Disp #*30 Tablet Refills:*0
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*60 Capsule Refills:*0
3. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
4. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
5. Ondansetron 8 mg PO Q8H:PRN nausea
RX *ondansetron HCl 8 mg 1 tablet(s) by mouth q8 hours Disp #*42
Tablet Refills:*0
6. OxyCODONE SR (OxyconTIN) 30 mg PO Q12H
RX *oxycodone 30 mg 1 tablet(s) by mouth q12 hours Disp #*60
Tablet Refills:*0
7. Polyethylene Glycol 17 g PO DAILY:PRN constipation
RX *polyethylene glycol 3350 [Miralax] 17 gram 1 powder(s) by
mouth daily Disp #*24 Packet Refills:*0
8. Senna 8.6 mg PO BID:PRN constipation
RX *sennosides [senna] 8.6 mg 1 tab by mouth twice a day Disp
#*60 Tablet Refills:*0
9. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
RX *oxycodone 10 mg 1 tablet(s) by mouth q4 hours Disp #*84
Tablet Refills:*0
10. Hydrochlorothiazide 25 mg PO DAILY
RX *hydrochlorothiazide 25 mg 1 tablet(s) by mouth daily Disp
#*30 Tablet Refills:*0
11. Lisinopril 20 mg PO BID
RX *lisinopril 20 mg 1 tablet(s) by mouth twice a day Disp #*60
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
# High grade sarcoma
# Anemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at ___
___. You were admitted with bleeding from your
sarcoma. The bleeding stopped and we started you on your
radiation treatment, which you tolerated well. We also started
you on new pain medications. You also had a port placed to
prepare you to start the chemotherapy, along with radiation, to
start next ___. Be sure to return to 11 Reismann to be
re-admitted early ___ morning before your radiation session.
Sincerely,
Your ___ Care team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Multivitamins 1 TAB PO DAILY
2. BuPROPion (Sustained Release) 300 mg PO QAM
3. Complera (emtricitab-rilpivirine-tenofov) 200-25-300 mg Oral
QD
4. Acetaminophen 650 mg PO Q6H:PRN pain
5. Famotidine 20 mg PO Q12H
RX *famotidine 20 mg 1 tablet(s) by mouth Twice a day Disp #*60
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: abdominal pain
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure to care for you here at ___.
As you know, you were hospitilized for severe abdominal pain. We
are unsure of the cause of your abdominal pain. Obstruction of
your gallbladder can sometimes cause the type of pain your were
having. However, all of your labs were normal and a HIDA scan,
which is an imaging test used to look to see if your gallbladder
is obstructed, showed no gallbladder obstruction. We also
performed an ultrasound of your gallbladder which was equivocal,
but HIDA scan is a much better test to look for obstruction of
your gallbladder.
It is possible that your abdominal pain is being caused by
gastritis (inflammation of the stomach) or peptic ulcer disease.
We ordered an H. pylori test, which is currently pending, so you
will need to contact the hospital in 48 hours for these results.
We started you on famotidine, which is a medication that will
block acid secretion in your stomach and may help with your
symptoms.
You are being discharged because you are clinically stable, but
you should follow up with your primary care doctor. You should
also follow up in the ___ clinic. The information
needed in order to make an appointment is included in this
document. Please return to the hospital if you are experiencing
any symptoms that are concerning, including worsening or
persistent abdominal pain, blood in stool or black stool,
fevers, chills, nausea/vomiting, or any other symptoms that
concern you.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 20 mg PO DAILY
2. Atenolol 25 mg PO DAILY
3. Diltiazem 120 mg PO DAILY
4. Multivitamins 1 TAB PO DAILY
5. Omeprazole 40 mg PO BID
RX *omeprazole 40 mg 1 capsule,delayed ___ by
mouth every 12 hours Disp #*60 Capsule Refills:*1
6. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet,delayed release (___) by mouth
Daily Disp #*30 Tablet Refills:*0
7. Acetaminophen 1000 mg PO Q8H:PRN pain
RX *acetaminophen 500 mg 2 tablet(s) by mouth every 8 hours as
needed for shoulder pain Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Upper gastrointestinal bleed
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>It was a pleasure to participate in your care at ___. You came
to the hospital for dark stools and dizziness. We found that
your blood counts were low. You were seen by the
Gastroenterology Team who elected to do a camera study called an
EGD (upper endoscopy). Your study showed old blood in your small
bowel but no active bleeding. A repeat EGD should similar
results. Your blood counts were monitored after the procedure
and remained stable.
You developed shoulder pain while in the hospital. We treated
your pain with tylenol. Please do NOT take medications like
ibuprofen, motrin, or naproxen for your pain, as these
medications (NSAIDs) can cause bleeding in your gastrointestinal
tract.
Please take all medications as prescribed. Please follow up with
your primary care physician for further care. You will need to
have your blood counts checked soon to make sure that there is
no further bleeding. If you get dizzy or lightheaded please call
your PCP or go the ED to have your labs rechecked.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg ONE capsule(s) by mouth
twice a day Disp #*60 Capsule Refills:*0
2. Senna 1 TAB PO BID constipation
3. OxycoDONE (Immediate Release) ___ mg PO Q6H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth Q6hrs Disp #*40 Tablet
Refills:*0
4. Cephalexin 500 mg PO Q6H Duration: 5 Days
RX *cephalexin [Keflex] 500 mg ONE capsule(s) by mouth four
times a day Disp #*20 Capsule Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
___: SEVERE RIGHT HYDRONEPHROSIS
PREOPERATIVE DIAGNOSIS: Right multiple ureteral stones and
right renal calculus, history possible urosepsis.
POSTOPERATIVE DIAGNOSIS: Right multiple ureteral stones and
right renal calculus, history possible urosepsis.
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent
Followup Instructions:
___ [/INST] </s><s>-You can expect to see occasional blood in your urine and to
possibly experience some urgency and frequency over the next
month; this may be related to the passage of stone fragments or
the indwelling ureteral stent (if there is one).
-The kidney stone may or may not have been removed AND/or there
may fragments/others still in the process of passing.
-You may experience some pain associated with spasm of your
ureter.; This is normal. Take the narcotic pain medication as
prescribed if additional pain relief is needed.
-Ureteral stents MUST be removed or exchanged and therefore it
is IMPERATIVE that you follow-up as directed.
-Do not lift anything heavier than a phone book (10 pounds)
-You may continue to periodically see small amounts of blood in
your urine--this is normal and will gradually improve
-Resume all of your pre-admission medications and review your
post-operative course with your PCP.
-As advised, review your post operative course and medications
with your pediatrician and your OB-GYN. Medications that you
have been given may be excreted in your breat milk and this can
effect your child.
-Colace has been prescribed to avoid post surgical constipation
and constipation related to narcotic pain medication.
Discontinue if loose stool or diarrhea develops. Colace is a
stool softener, NOT a laxative, and available over the counter.
The generic name is DOCUSATE SODIUM. It is recommended that you
use this medication.
-Do not eat constipating foods for ___ weeks, drink plenty of
fluids to keep hydrated
-No vigorous physical activity or sports for 4 weeks and while
nephrostomy is in place. No sports, water-immersion (pool/tub).
NEPHROSTOMY TUBE INSTRUCTIONS FOR CARE---FOR ___ & FAMILY:
Please leave RIGHT PCN tube capped. If there is increased RIGHT
FLANK/BACK pain, the PCN may be uncapped and put to to external
gravity drainage. Please monitor and record urine output from
the PCN tube.
Catheter flushing for troubleshooting only: If there are
excessive blood clots or debris or thick urine within the
connecting tubing, this can also be flushed as needed to clear
from the stopcock into the drainage bag.
Change dressing daily. Gently cleanse around the skin entry site
of the catheter with povidone iodine or dilute hydrogen
peroxide. Dry and apply sterile gauze dressing. Dressing should
be changed daily for the first three days and then Q3days and
prn saturation.
Catheter security: a) Every shift, check to be sure the
catheter, the connecting tubing and the drainage bag are
securely attached to the patient and are not kinked. b) If the
catheter appears to be pulling, please notify Interventional
Radiology. c) If the catheter pulls out, please notify
Interventional Radiology with in 8 hours. SAVE THE CATHETER for
us to inspect. Do not throw it away.
Call Angio for ANY catheter related questions or problems.
___ or Fellow/Resident (pager# ___
IF Catheter is attached to drainage bag for external drainage;
please measure and record the net output every shift (or more
often if the urine output is high).</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ciprofloxacin HCl 500 mg PO BID Duration: 7 Days
2. Ondansetron ODT 4 mg PO Q8H:PRN Nausea/Vomiting - First Line
3. glatiramer 20 mg/mL subcutaneous five days a week
4. Spironolactone 50 mg PO DAILY
5. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Colitis
Multiple sclerosis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you during your hospitalization
at ___!
Why did you come to the hospital?
- Because you were having bloody stools
What happened while you were in the hospital?
- You were diagnosed with colitis of the left side of your
colon. You were treated with antibiotics and improved.
- You were tested for common bacteria that cause bloody
diarrhea, but tests came back negative.
What should you do after you leave the hospital?
- Please complete a total of 7d of antibiotic therapy (last day
___
- Follow up with Dr. ___ Dr. ___ as scheduled
- Please stick to a bland diet until your diarrhea improves.
- If you notice any recurrent bleeding, worsening abdominal
pain, intolerance of oral intake, please come back to the ED
right away.
We wish you the best!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO Q6H:PRN Pain - Mild
2. Ciprofloxacin HCl 500 mg PO Q12H
Take through morning of ___
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth every 12 hours
Disp #*8 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Elevated liver enzymes
Abdominal pain
Dilated common bile duct
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___
___ were admitted for abdominal pain and elevated liver enzymes.
___ underwent ERCP with sphincterotomy. No stones were found but
sludge was removed. Your liver enzymes improved after the
procedure. Your abdominal pain improved and ___ tolerated food.
___ will need to follow up with your PCP next week to check labs
again.
Thank ___ for allowing us to participate in your care
Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Allopurinol ___ mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Doxazosin 4 mg PO DAILY
4. Metoprolol Succinate XL 50 mg PO DAILY
5. Simvastatin 20 mg PO DAILY
6. Warfarin 2.5 mg PO DAILY16
7. Ferrous Sulfate 325 mg PO DAILY
RX *ferrous sulfate 325 mg (65 mg iron) 1 tablet(s) by mouth
daily Disp #*30 Tablet Refills:*0
8. Desonide 0.05% Cream 1 Appl TP DAILY
9. Oxycodone-Acetaminophen (5mg-325mg) ___ TAB PO TID:PRN jaw
pain Duration: 7 Days
before meals as needed, no driving or operating heavy machinery
while taking med
RX *oxycodone-acetaminophen 5 mg-325 mg ___ tablet(s) by mouth
every eight (8) hours Disp #*21 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: chronic iron deficiency anemia, hematuria
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
It was a pleasure taking care of you at ___
___. You were admitted due to shortness of breath.
Lab test revealed that you have iron deficiency anemia. The most
common cause of which is blood loss. This is most likely due to
chronic urinary blood loss however gastrointestinal blood loss
is possible as well.
You were transfused red blood cells and your numbers were stable
after this. Your primary care doctor may want to do a
colonoscopy or a bladder test after discharge. You were also
evaluated by physical therapy who recommended rehab, which you
did not want to do. You will go home with physical therapy
instead.
You also had some R jaw pain with chewing, most likely from
irritation. There were no signs of infection. You were
discharged with some pain medications as needed. Please follow
up with your PCP and dentist if the pain persists.
Thank you,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
2. Lactulose 30 mL PO TID:PRN confusion
RX *lactulose 20 gram/30 mL 30 mL by mouth three times a day
Disp #*90 Package Refills:*0
3. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 capsule(s) by mouth daily Disp #*30 Capsule
Refills:*0
4. Pantoprazole 40 mg PO Q24H
RX *pantoprazole 40 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
5. Rifaximin 550 mg PO BID
RX *rifaximin [Xifaxan] 550 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
6. Thiamine 100 mg PO DAILY
RX *thiamine HCl (vitamin B1) 100 mg 1 tablet(s) by mouth daily
Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis:
Septic shock
Pneumonia
Secondary diagnoses:
Obstructive sleep apnea
Upper GI bleed
Macrocytic anemia
Alcoholic hepatitis
Alcohol use disorder
Coagulopathy
Cirrhosis
Thrombocytopenia
Anisocoria
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
Why was I admitted?
You were admitted because your blood pressure was low and you
were found to have an infection in your lung called pneumonia.
We were was also concerned that you had bleeding in your belly.
What was done while I was here?
You were treated with antibiotics for your pneumonia. We
watched your bleeding from your belly very closely and looked
down your throat with a camera. You have no active bleeding but
are prone to bleeding from your underlying liver disease. Your
liver disease is thought to be due to alcohol. You were
monitored closely for withdrawal from alcohol and given
medication to prevent this.
In addition, we discovered that Your oxygen becomes low at night
and you are diagnosed with sleep apnea. Therefore, we tried to
have you sleep with a CPAP machine. Your oxygen also becomes low
when you walk; this is probably due to your resolving pneumonia
and your liver disease.
What should I do now?
You should take your medications as instructed. It is very
important that you never drink alcohol again to avoid worsening
your liver disease. If you continue to drink alcohol, you will
be at very high risk of dying from liver disease or problems
caused by liver disease. Make sure you seek support in
maintaining sobriety through help from you social workers and
doctors. You can try a group like AA if you think it would help
you stop drinking.
You will be discharged with home oxygen. You can use this when
you are walking and your oxygen level becomes low. A nurse ___
come to your home and help to measure your oxygen levels to see
how much you need.
Because you have sleep apnea, you will need to wear oxygen at
night at 4L per minute. You will need to see the sleep medicine
doctors after leaving the hospital to get a formal sleep study
so that you can obtain a CPAP machine. Once you get a CPAP
machine, you must use it every night.
You should attend your doctor appointments as below.
We wish you the best!
-Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain -
Moderate
RX *oxycodone 5 mg 1 (One) capsule(s) by mouth every four (4)
hours Disp #*18 Capsule Refills:*0
2. Allopurinol ___ mg PO DAILY
3. Omeprazole 20 mg PO DAILY
4. PHENObarbital 64.8 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSES:
==================
-Septic Shock
-E. Coli Bacteremia
-Cholecystitis s/p percutaneous cholecystostomy s/p laparoscopic
cholecystectomy
SECONDARY DIAGNOSES:
====================
-Chronic Pneumobilia
-Herpes re-activation
-Gout
-GERD
-Seizure disorder
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure to care for you at the ___
___.
Why did you come to the hospital?
- You were brought in to the hospital due to concerns for an
abdominal infection.
What did you receive in the hospital?
- Because of how sick you were and your low blood pressure, we
had to admit you to the intensive care unit. There you were
found to have cholecystitis, or inflammation of your bladder. On
___, our interventional radiologist placed a tube to help
drain your gallbladder.
- You then had your gallbladder removed by our surgery team.
- In addition, we found an infection in your blood related to
your gallbladder, and treated it with antibiotics.
- After starting antibiotics, you developed a small herpes
outbreak around your lips. We treated this with a anti-viral
medication.
What should you do once you leave the hospital?
- Please continue to take your medications as prescribed.
- Please keep all your follow-up appointments
We wish you the best!
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Sulfameth/Trimethoprim Suspension 20 mL PO BID
RX *sulfamethoxazole-trimethoprim 200 mg-40 mg/5 mL 20 mls by
mouth twice a day Refills:*0
2. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
3. albuterol sulfate 90 mcg/actuation inhalation Q6H:PRN
wheezing
4. ALPRAZolam 0.5 mg PO Q6H:PRN anxiaty
5. Atorvastatin 20 mg PO QPM
6. Dexamethasone 8 mg PO DAILY
7. Docusate Sodium 100 mg PO BID
8. Guaifenesin-CODEINE Phosphate 5 mL PO Q6H:PRN cough
9. Mirtazapine 30 mg PO QHS
10. Morphine SR (MS ___ 15 mg PO Q12H
11. Ondansetron 4 mg PO Q8H:PRN nausea
12. OxycoDONE Liquid ___ mg PO Q4H:PRN Pain - Moderate
13. Pantoprazole 40 mg PO Q12H
14. Polyethylene Glycol 17 g PO DAILY:PRN constipation
15. Prochlorperazine 10 mg PO Q6H:PRN nausea
16. TraMADol 50 mg PO Q6H:PRN Pain - Moderate
Discharge Disposition:
Home
Discharge Diagnosis:
Wound cellulitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>* You were admitted to the hospital for replacement of your J
tube and also for a cellulitis around the tube. You were
placed on antibiotics which initially seem to be working. The j
tube is not sutured in place but it's taped down securely so
that the skin around the tube can heal and you can have it
resutured in a day or 2.
* You should resume your tube feedings but be very careful not
to dislodge the tube. No showers until the tube is sutured in
place. For now a sponge bath.
* Keep a dry gauze over the insertion site. Dr. ___ see
you in clinic tomorrow to look at the site and possibly suture.
* Continue the Bactrim for a 10 day course.
* If you have any fevers > 101, abd pain, chills or any other
symptoms that concern you call Dr. ___ at ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H:PRN Pain - Mild/Fever
2. amLODIPine 10 mg PO DAILY
RX *amlodipine 10 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
3. Artificial Tears Preserv. Free ___ DROP BOTH EYES Q4H:PRN
dry eyes
4. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
5. Bisacodyl 10 mg PR QHS:PRN Constipation - Second Line
6. Captopril 37.5 mg PO TID
RX *captopril 25 mg 1.5 tablet(s) by mouth three times a day
Disp #*135 Tablet Refills:*0
7. CARVedilol 12.5 mg PO BID
RX *carvedilol 12.5 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
8. Chlorthalidone 25 mg PO DAILY
RX *chlorthalidone 25 mg 1 tablet(s) by mouth once a day Disp
#*30 Tablet Refills:*0
9. Docusate Sodium (Liquid) 100 mg PO BID
10. Fondaparinux 7.5 mg SC DAILY
RX *fondaparinux 7.5 mg/0.6 mL 1 once a day Disp #*30 Syringe
Refills:*0
11. Ipratropium-Albuterol Neb 1 NEB NEB Q4H
12. Metoclopramide 10 mg PO Q6H
13. Polyethylene Glycol 17 g PO DAILY:PRN Constipation - Third
Line
14. QUEtiapine Fumarate 12.5 mg PO QHS agitation
15. Senna 8.6 mg PO BID
16. Divalproex (DELayed Release) 500 mg PO BID
17. Gabapentin 800 mg PO TID
18. Lovastatin 40 mg oral DAILY
19. Memantine 10 mg PO DAILY ___
20. Memantine 5 mg PO DAILY AM
21. Omeprazole 20 mg PO DAILY
22. Warfarin 2 mg PO 5X/WEEK (___)
23. Warfarin 4 mg PO 2X/WEEK (___)
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Abdominal Aortic Aneurysm Rupture
Peripheral Vascular Disease
Anemia secondary to rupture requiring transfusion
Oliguria
Pleural effusions with pulmonary edema requiring diuresis
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Lethargic but arousable.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Mr. ___-
It was a pleasure taking care of you at ___
___. You were admitted to the hospital after
transfer from an outside institution for ruptured abdominal
aortic aneurysm. You underwent emergent repair which required
placement of a graft in you aorta. You also required an
incision made into your abdomen to release the blood that
collected after the rupture.
Please follow the recommendations below to ensure a speedy and
uneventful recovery.
Division of Vascular and Endovascular Surgery
Endovascular Abdominal Aortic Aneurysm Repair Discharge
Instructions
PLEASE NOTE: After endovascular aortic repair (EVAR), it is very
important to have regular appointments (every ___ months) for
the rest of your life. These appointments will include a CT
(CAT) scan and/or ultrasound of your graft. If you miss an
appointment, please call to reschedule.
WHAT TO EXPECT:
Bruising, tenderness, and a sensation of fullness at the groin
puncture sites (or incisions) is normal and will go away in
one-two weeks
CARE OF THE GROIN PUNCTURE SITES:
It is normal to have mild swelling, a small bruise, or small
amounts of drainage at the groin puncture sites. In two weeks,
you may feel a small, painless, pea sized knot at the puncture
sites. This too is normal. Male patients may notice some
swelling in the scrotum. The swelling will get better over
one-two weeks.
Look at the area daily to see if there are any changes. Be
sure to report signs of infection. These include: increasing
redness; worsening pain; new or increasing drainage, or drainage
that is white, yellow, or green; or fever of 101.5 or more. (If
you have taken aspirin, Tylenol, or other fever reducing
medicine, wait at least ___ hours after taking it before you
check your temperature in order to get an accurate reading.)
FOR SUDDEN, SEVERE BLEEDING OR SWELLING (Groin puncture site or
incision)
If you have sudden, severe bleeding or swelling at either of
the groin puncture sites:
-Lie down, keep leg straight and apply (or have someone apply)
firm pressure to area for ___ minutes with a gauze pad or
clean cloth.
-Once bleeding has stopped, call your surgeon to report what
happened.
-If bleeding does not stop, call ___ for transfer to closest
Emergency Room.
You may shower 48 hours after surgery. Let the soapy water
run over the puncture sites, then rinse and pat dry. Do not rub
these sites and do not apply cream, lotion, ointment or powder.
Wear loose-fitting pants and clothing as this will be less
irritating to the groin puncture sites.
MEDICATIONS
Take aspirin daily. Aspirin helps prevent blood clots that
could form in your repaired artery.
It is very important that you never stop taking aspirin or
other blood thinning medicines-even for a short while- unless
the surgeon who repaired your aneurysm tells you it is okay to
stop. Do not stop taking them, even if another doctor or nurse
tells you to, without getting an okay from the surgeon who first
prescribed them.
You will be given prescriptions for any new medication started
during your hospital stay.
Before you go home, your nurse ___ give you information about
new medication and will review all the medications you should
take at home. Be sure to ask any questions you may have. If
something you normally take or may take is not on the list you
receive from the nurse, please ask if it is okay to take it.
PAIN MANAGEMENT
Most patients do not have much pain following placement of the
stent alone. You had an abdominal incision in addition to this,
so recovery may take longer. Your puncture sites may be a
little sore. This will improve daily. If it is getting worse,
please let us know.
You will be given instructions about taking pain medicine if
you need it.
ACTIVITY
You must limit activity to protect the puncture sites in your
groin. For ONE WEEK:
-Do not drive
-Do not swim, take a tub bath or go in a Jacuzzi or hot tub
-Do not lift, push, pull or carry anything heavier than five
pounds
-Do not do any exercise or activity that causes you to hold your
breath or bear down with your abdominal muscles.
-Do not resume sexual activity
Discuss with your surgeon when you may return to other regular
activities, including work. If needed, we will give you a
letter for your workplace.
It is normal to feel weak and tired. This can last six-eight
weeks, but should get better day by day. You may want to have
help around the house during this time.
___ push yourself too hard during your recovery. Rest when
you feel tired. Gradually return to normal activities over the
next month.
We encourage you to walk regularly. Walking, especially
outdoors in good weather is the best exercise for circulation.
Walk short distances at first, even in the house, then do a
little more each day.
It is okay to climb stairs. You may need to climb them slowly
and pause after every few steps.
BOWEL AND BLADDER FUNCTION
You should be able to pass urine without difficulty. Call you
doctor if you have any problems urinating, such as burning,
pain, bleeding, going too often, or having trouble urinating or
starting the flow of urine. Call if you have a decrease in the
amount of urine.
You may experience some constipation after surgery because of
pain medicine and changes in activity. Increasing fluids and
fiber in your diet and staying active can help. To relief
constipation, you may talk a mild laxative. Please take to
your pharmacist for advice about what to take.
SMOKING
If you smoke, it is very important that you STOP. Research
shows smoking makes vascular disease worse. This could increase
the chance of a blockage in your new graft. Talk to your
primary care physician about ways to quit smoking.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
It was a pleasure to take care of you at ___
___. You were admitted because you fainted and broke
several bones in your spine, which in turn hurt your spinal
cord. Orthopedics performed surgery to stop the bones blocking
your spinal cord, you were monitored for improvement, and you
were discharged to rehab. Best of luck to you in your future
health.
Please take all medications as prescribed, attend all physician
appointments as scheduled, and call a doctor if you have any
questions or concerns.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Daptomycin 300 mg IV Q24H urinary tract infection Duration:
7 Days
RX *daptomycin 350 mg 300 mg IV q24h Disp #*7 Vial Refills:*0
2. Heparin Flush (10 units/ml) 2 mL IV DAILY and PRN, line
flush
3. Piperacillin-Tazobactam 4.5 g IV Q12H
RX *piperacillin-tazobactam 4.5 gram 4.5 grams IV every 12 hours
Disp #*15 Vial Refills:*0
4. amLODIPine 10 mg PO DAILY
5. Warfarin 5 mg PO DAILY16
6. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
7. Allopurinol ___ mg PO DAILY
8. Cerovite Advanced Formula (multivitamin-iron-folic acid)
___ mg-mcg oral daily
9. Cranberry Concentrate (cranberry conc-ascorbic
acid;<br>cranberry extract) 500 mg oral daily
10. Cyanocobalamin 500 mcg PO DAILY
11. Epoetin ___ ___ u SC WEEKLY
12. Finasteride 5 mg PO DAILY
13. FoLIC Acid 1 mg PO DAILY
14. Hydrochlorothiazide 25 mg PO DAILY
15. Levothyroxine Sodium 50 mcg PO DAILY
16. LORazepam 0.5 mg PO Q6H:PRN anxiety
17. Oxybutynin 5 mg PO BID PRN bladder spasms
18. OxyCODONE (Immediate Release) 10 mg PO Q6H:PRN Pain -
Moderate
19. OxyCODONE SR (OxyconTIN) 10 mg PO Q12H
20. PredniSONE 2.5 mg PO DAILY
21. Sertraline 150 mg PO DAILY
22. Vitamin D 1000 UNIT PO DAILY
23. HELD- Atorvastatin 20 mg PO QPM This medication was held.
Do not restart Atorvastatin until you have completed daptomycin
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Pyelonephritis, Catheter associated UTI
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure to look after you. As you know, you were
admitted with flank pain and signs of kidney infection on a CT
scan. You were initially placed on intravenous antibiotics;
both catheters (foley and nephrostomy tube) were exchanged.
Urine cultures grew out a resistant pseudomonas, and for that
reason, infectious disease team was consulted and made
recommendations regarding changes in the antibiotic. You will
be on Daptomycin and Zosyn through ___. Please do not take your
atorvastatin until you complete the daptomycin to prevent a
possible reaction.
Given elevated blood pressures in the hospital, your amlodipine
dose was increased to 10mg daily.
Please take your medications as prescribed and follow up with
your outpatient doctors as below.
With best wishes,
___ Medicine</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q8H
2. Amlodipine 10 mg PO DAILY
3. Aspirin 325 mg PO DAILY
4. Carvedilol 12.5 mg PO BID
5. CloniDINE 0.1 mg PO TID
6. Docusate Sodium 100 mg PO BID
7. FoLIC Acid 1 mg PO DAILY
8. Gabapentin 100 mg PO TID
9. HydrALAzine 50 mg PO TID
10. LeVETiracetam Oral Solution 750 mg PO BID
11. Lisinopril 40 mg PO DAILY
12. Paroxetine 10 mg PO DAILY
13. Prazosin 1 mg PO BID
14. Ranitidine 150 mg PO BID
15. traZODONE 25 mg PO QAM
16. traZODONE 25 mg PO QPM
17. traZODONE 50 mg PO HS
18. Atorvastatin 80 mg PO DAILY
RX *atorvastatin 80 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
19. Clopidogrel 75 mg PO DAILY
RX *clopidogrel 75 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
20. Glargine 23 Units Bedtime
novolog 5 Units Breakfast
novolog 5 Units Lunch
Insulin SC Sliding Scale using Lispro Insulin
21. Potassium Chloride 10 mEq PO DAILY
22. Loperamide 4 mg PO QID:PRN diarrhea
23. Psyllium 1 PKT PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
Non-ST segment myocardial infarction
Secondary:
Coronary artery disease
Hypertension
Diabetes mellitus, type II, with neuropathy
Prior cerebrovascular accidents
Gastroesophageal reflux disorder
Anxiety
Depression
Seizure disorder
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to ___
treatment and work-up of your chest pain. While you were here
you were found to have elevated cardiac enzymes and changes in
your EKG which were concerning for a type of heart attack called
Non-ST segment myocardial infarction (NSTEMI). While you were
here you underwent a cardiac cath, which showed that you have a
blockage in one of your vessels in your heart. You had a stent
placed in this vessel to help open it up.
Also, while you were here you had an unwitnessed fall. You had a
head CT scan which did not show any acute damage to your head
from the fall.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 500 mg PO Q6H:PRN pain
RX *acetaminophen 500 mg 1 tablet(s) by mouth every six (6)
hours Disp #*60 Tablet Refills:*0
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*60 Capsule Refills:*0
3. Fentanyl Patch 75 mcg/h TD Q72H
RX *fentanyl 75 mcg/hour Apply every 72 hours Disp #*10 Patch
Refills:*0
4. HYDROmorphone (Dilaudid) ___ mg PO Q3H:PRN pain
RX *hydromorphone [Dilaudid] 2 mg ___ tablet(s) by mouth every
three (3) hours Disp #*90 Tablet Refills:*1
5. Ranitidine 75 mg PO DAILY
RX *ranitidine HCl 75 mg 1 tablet(s) by mouth daily Disp #*60
Tablet Refills:*0
6. Senna 8.6 mg PO QHS
7. Amoxicillin 1000 mg PO Q12H Duration: 14 Days
RX *amoxicillin 500 mg 2 tablet(s) by mouth every twelve (12)
hours Disp #*50 Tablet Refills:*0
8. Clarithromycin 500 mg PO Q12H Duration: 14 Days
RX *clarithromycin 500 mg 1 tablet(s) by mouth every twelve (12)
hours Disp #*24 Tablet Refills:*0
9. Gabapentin 300 mg PO TID
RX *gabapentin 300 mg 1 capsule(s) by mouth three times a day
Disp #*90 Capsule Refills:*0
10. Pantoprazole 40 mg PO Q12H
RX *pantoprazole 40 mg 1 tablet(s) by mouth every twelve (12)
hours Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Abdominal pain due to T9 Lesion
H.pylori/gastritis
Multiple myeloma
Hypertension
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you. You were admitted to ___
___ for evaluation and treatment of
abdominal pain. While you were here, we performed imaging of
your abdomen and spine. This showed a lesion in the T9 bone,
which is likely the cause of your pain. We treated you with pain
medicines that help neurologic pain and also medicines that
decrease inflammation in your stomach. You were treated with
antibiotics to treat an infection in your stomach. Please
continue these medications (Pantoprazole 40mg po 2/day,
Clarithromycin 500mg 2/day, Amoxicillin 1 g 2/day) until ___.
It is very important that you attend follow-up appointments and
that you take your medicines as prescribed.
We wish you the best in the future.
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ciprofloxacin HCl 500 mg PO Q12H Duration: 7 Days
RX *ciprofloxacin HCl 500 mg ONE tablet(s) by mouth twice a day
Disp #*14 Tablet Refills:*0
2. Tamsulosin 0.4 mg PO QHS
RX *tamsulosin [Flomax] 0.4 mg ONE capsule(s) by mouth Daily
Disp #*30 Capsule Refills:*1
3. OxycoDONE (Immediate Release) ___ mg PO Q6H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth Q6hrs Disp #*30 Tablet
Refills:*0
4. Zofran ODT (ondansetron) 4 mg oral Q8hrs prn nausea
RX *ondansetron [Zofran ODT] 4 mg ONE tablet(s) by mouth Q8hrs
Disp #*21 Tablet Refills:*0
5. Acetaminophen 325-650 mg PO Q6H:PRN Pain
6. Amitriptyline 25 mg PO HS
7. Aspirin 81 mg PO DAILY
8. Atorvastatin 40 mg PO HS
9. Ibuprofen 600 mg PO Q8H:PRN pain
RX *ibuprofen 600 mg ONE tablet(s) by mouth Q8hrs Disp #*30
Tablet Refills:*0
10. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg ONE capsule(s) by mouth
twice a day Disp #*60 Capsule Refills:*0
11. Lisinopril 5 mg PO DAILY
12. Lorazepam 1 mg PO QHS:PRN insomnia
13. pramipexole 0.25 mg oral QHS
14. Ranitidine 75 mg PO DAILY
15. Gabapentin 300 mg PO QHS
Discharge Disposition:
Home
Discharge Diagnosis:
ACUTE KIDNEY INJURY (creatinine to 1.7)
Right ureteral stone with obstruction and hydronephrosis.
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>-You can expect to see occasional blood in your urine and to
possibly experience some urgency and frequency over the next
month; this may be related to the passage of stone fragments or
the indwelling ureteral stent.
-The kidney stone may or may not have been removed AND/or there
may fragments/others still in the process of passing.
-You may experience some pain associated with spasm of your
ureter.; This is normal. Take the narcotic pain medication as
prescribed if additional pain relief is needed.
-Ureteral stents MUST be removed or exchanged and therefore it
is IMPERATIVE that you follow-up as directed.
-Do not lift anything heavier than a phone book (10 pounds)
-You may continue to periodically see small amounts of blood in
your urine--this is normal and will gradually improve
-Resume your pre-admission/home medications EXCEPT as noted. You
should ALWAYS call to inform, review and discuss any medication
changes and your post-operative course with your primary care
doctor. HOLD ASPIRIN and aspirin containing products for one
week unless otherwise advised.
-IBUPROFEN (the ingredient of Advil, Motrin, etc.) may be taken
even though you may also be taking Tylenol/Acetaminophen. You
may alternate these medications for pain control. For pain
control, try TYLENOL FIRST, then ibuprofen, and then take the
narcotic pain medication as prescribed if additional pain relief
is needed.
-Ibuprofen should always be taken with food. Please discontinue
taking and notify your doctor should you develop blood in your
stool (dark, tarry stools)
-You MAY be discharged home with a medication called PYRIDIUM
that will help with the "burning" pain you may experience when
voiding. This medication may turn your urine bright orange.
-Colace has been prescribed to avoid post surgical constipation
and constipation related to narcotic pain medication.
Discontinue if loose stool or diarrhea develops. Colace is a
stool softener, NOT a laxative, and available over the counter.
The generic name is DOCUSATE SODIUM. It is recommended that you
use this medication.
-Do not eat constipating foods for ___ weeks, drink plenty of
fluids to keep hydrated
-No vigorous physical activity or sports for 4 weeks and while
___ catheter is in place.
IF YOU ARE DISCHARGED HOME WITH A FOLEY CATHETER:
-Please refer to the provided nursing instructions and handout
on Foley catheter care, waste elimination and leg bag usage.
-Your Foley should be secured to the catheter secure on your
thigh at ALL times until your follow up with the surgeon.
-Follow up in 1 week for wound check and Foley removal. DO NOT
have anyone else other than your Surgeon remove your Foley for
any reason.
-Wear Large Foley bag for majority of time, leg bag is only for
short-term when leaving house.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Warfarin 5 mg PO DAILY16
RX *warfarin 5 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
2. amLODIPine 5 mg PO DAILY
3. Aspirin 81 mg PO DAILY
4. Atorvastatin 40 mg PO QPM
5. Finasteride 5 mg PO DAILY
6. Gabapentin 200 mg PO TID
7. GlipiZIDE XL 10 mg PO DAILY
8. Metoprolol Tartrate 25 mg PO BID
9. Mirtazapine 30 mg PO QHS
10. Nicotine Patch 14 mg TD DAILY
11. Venlafaxine XR 150 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Subacute infarcts due to LV thrombus
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to the hospital because there was concern
about possible bleeding in your brain from a recent stroke. You
had an MRI which showed multiple recent strokes in different
areas of the brain. There was some bleeding and tissue injury
due to the recent strokes.
You got an echocardiogram which showed you still have a very
large clot in the heart, which could break off and cause more
strokes. You were continued on aspirin but Plavix (clopidogrel)
was stopped.
You were started on Coumadin (or warfarin) as a blood thinner,
which requires regular blood tests to make sure the levels are
not too high or too low. You will follow up with your primary
doctor (___) to measure your INR levels and adjust your
Coumadin dose.
We discussed your condition with your neurologist (Dr. ___
and your primary doctor (___).
Follow up with your neurologist in the next ___ weeks. The
neurology clinic will call you to set up an appointment.
Follow up with your primary doctor (___) this ___
___.
Take your medications as prescribed.
Thank you for allowing us to participate in your care.
Sincerely,
Your ___ Neurology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN pain
2. Amoxicillin-Clavulanic Acid ___ mg PO Q12H
last dose ___
RX *amoxicillin-pot clavulanate 875 mg-125 mg 1 tablet(s) by
mouth every twelve (12) hours Disp #*14 Tablet Refills:*0
3. Docusate Sodium 100 mg PO BID
4. Omeprazole 20 mg PO DAILY
5. Senna 8.6 mg PO BID:PRN constipation
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
intra-abdominal fluid collection
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were readmitted to the hospital on ___ with nausea and
vomitting. You were also reported to have an elevated white
blood cell count. You underwent a cat scan of the abdomen and
you were found to have a fluid collection in the abdominal wall.
You were started on intravenous antibiotics. You had the fluid
collection drained and no bacteria was reported. Your white
blood cell count has normalized and you are preparing for
discharge home with the following instructions:
Please call your doctor or return to the emergency room if you
have any of the following:
* You experience new chest pain, pressure, squeezing or
tightness.
* New or worsening cough or wheezing.
* If you are vomiting and cannot keep in fluids or your
medications.
* You are getting dehydrated due to continued vomiting,
diarrhea or other reasons. Signs of dehydration include dry
mouth, rapid heartbeat or feeling dizzy or faint when standing.
* You see blood or dark/black material when you vomit or have a
bowel movement.
* You have shaking chills, or a fever greater than 101.5 (F)
degrees or 38(C) degrees.
* Any serious change in your symptoms, or any new symptoms that
concern you.
* Please resume all regular home medications and take any new
meds
as ordered.
Activity:
No heavy lifting of items ___ pounds for 6 weeks. You may
resume moderate
exercise at your discretion, no abdominal exercises.
Wound Care:
You may shower, no tub baths or swimming.
If there is clear drainage from your incisions, cover with
clean, dry gauze.
Your steri-strips will fall off on their own. Please remove any
remaining strips ___ days after surgery.
Please call the doctor if you have increased pain, swelling,
redness, or drainage from the incision site</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO twice a day.
2. nadolol 40 mg Tablet Sig: One (1) Tablet PO once a day.
3. sucralfate 1 gram Tablet Sig: One (1) Tablet PO QID (4 times
a day).
4. hydroxyzine HCl 25 mg Tablet Sig: Two (2) Tablet PO HS (at
bedtime).
5. zinc sulfate 220 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
6. furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
7. spironolactone 100 mg Tablet Sig: 1.5 Tablets PO DAILY
(Daily).
8. ondansetron HCl 4 mg Tablet Sig: One (1) Tablet PO Q8H (every
8 hours) as needed for nausea.
9. oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours) as needed for pain.
10. fluticasone 110 mcg/actuation Aerosol Sig: Two (2) Puff
Inhalation BID (2 times a day).
11. fluticasone 50 mcg/actuation Spray, Suspension Sig: One (1)
Spray Nasal DAILY (Daily).
12. B complex vitamins Capsule Sig: One (1) Cap PO DAILY
(Daily).
13. multivitamin Tablet Sig: One (1) Tablet PO DAILY
(Daily).
14. azithromycin 250 mg Tablet Sig: One (1) Tablet PO Q24H
(every 24 hours) for 2 days: Please complete 2 more doses, last
dose ___.
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY:
abdominal pain
SECONDARY:
hepatitis C
Cirrhosis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at ___
___. You were admitted with abdominal pain. You had a
CT scan done, which did not show any abnormalities. There was no
evidence of infection.
Please make the following changes to your medications:
# CONTINUE azithromycin 250 mg daily for 2 more days
Continue all other medications as prescribed.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>You were admitted with headache which was likely due to tapering
steroids too quickly after whole brain radiation. Your symptoms
improved with steroids.
You also experienced some nausea and abdominal fullness that was
in part due to steroids. You were started on some medications to
help with these symptoms.
This is the steroid taper recommended by radiation oncology:
Decadron 4mg bid until ___. Then, Decadron 4mg daily
for 3 days, then Decadron 2mg daily for 3 days, then Decadron
1mg daily for three days, then stop.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. insulin syringes (disposable) 1 miscellaneous DAILY
RX *insulin syringes (disposable) 1 mL Daily Disp #*1 Package
Refills:*0
2. Glargine 20 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
RX *insulin glargine [Lantus] 100 unit/mL 20 units Before bed
Disp #*1 Vial Refills:*0
3. Metoprolol Succinate XL 100 mg PO DAILY
RX *metoprolol succinate 100 mg 1 tablet(s) by mouth Daily Disp
#*30 Tablet Refills:*0
4. OneTouch SureSoft Lancing Dev (lancets) 1 miscellaneous
DAILY
RX *lancets [OneTouch Delica Lancets] 30 gauge Daily Disp #*1
Package Refills:*0
5. OneTouch Ultra Test (blood sugar diagnostic) 1
miscellaneous DAILY
RX *blood sugar diagnostic [OneTouch Ultra Test] Daily Disp
#*100 Strip Refills:*0
6. OneTouch Ultra2 ___ meter) 1 miscellaneous DAILY
RX ___ meter [OneTouch Ultra2] Daily Disp #*1 Kit
Refills:*0
7. Acetaminophen 500 mg PO Q6H:PRN Pain - Mild
8. Artificial Tears ___ DROP BOTH EYES PRN dry eyes
9. Bisacodyl 10 mg PO DAILY:PRN constipation
10. Enoxaparin Sodium 100 mg SC Q12H
Start: Today - ___, First Dose: Next Routine Administration
Time
RX *enoxaparin 100 mg/mL 100 mg twice a day Disp #*60 Syringe
Refills:*0
11. ___ Neb 1 NEB NEB Q6H:PRN Shortness of
breath
12. LOPERamide 2 mg PO TID:PRN Diarrhea
13. Ondansetron 4 mg PO Q8H:PRN nausea
14. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain -
Moderate
15. OxyCODONE SR (OxyconTIN) 20 mg PO Q12H
16. Pantoprazole 40 mg PO Q24H
17. Senna 8.6 mg PO BID:PRN constipation
18. Simvastatin 20 mg PO QPM
19. Tamsulosin 0.4 mg PO QHS
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Pancreatic ___ Tumor
___ infection
Diabetes mellitus
Pericardial effusion
Pleural effusion
Atrial fibrillation
Pulmonary embolism
Discharge Condition:
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Level of Consciousness: Alert and interactive.
Mental Status: Clear and coherent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
You were admitted to the hospital from rehab with confusion.
This confusion was due to high levels of carbon dioxide in your
blood. You were in the ICU and needed oxygen for a while, but
improved by the time you left the hospital.
The fluid around your pancreas became infected, and you were
treated with strong antibiotics for two weeks. You had an
additional drain placed, which helped drain the infected fluid.
The will keep these drains until you are seen by the surgeons,
flushing them with saline several times a day.
You developed fluid around your heart and left lung during this
admission. The fluid was drained from both places and did not
come back. We did not find that exact cause of this, but it may
have been related to the infection in your abdomen.
Your diabetes was managed with insulin in the hospital. You are
being discharged with diabetes supplies. Please inject 20 units
of Lantus every night. Check your blood sugar before you
eat/drink each morning and once after you eat/drink in ___.
Bring these numbers with you to your PCP and they ___ adjust
your insulin.
You were started on a different blood thinner, Lovenox, this
admission for you ___ and pulmonary embolism. You will inject
this medicine twice a day.
Surgery ___ with Dr. ___ able to be arranged in the
hospital. Please call ___ to set up an appointment time
in the next ___ weeks.
It was a privilege to care for you in the hospital, and we wish
you all the best.
Sincerely,
Your ___ Health Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Citalopram 40 mg PO DAILY
2. OxycoDONE (Immediate Release) 5 mg PO Q6H:PRN pain
3. PrimiDONE 50 mg PO BID
4. Senna 1 TAB PO BID:PRN constipation
5. Tiotropium Bromide 1 CAP IH DAILY
6. traZODONE 200 mg PO HS:PRN insomina
7. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
8. Symbicort *NF* (budesonide-formoterol) 160-4.5 mcg/actuation
INHALATION DAILY
9. Simvastatin 10 mg PO DAILY
10. Omeprazole 40 mg PO DAILY
11. Albuterol Inhaler 2 PUFF IH Q6H:PRN shortness of breath
12. Metoprolol Tartrate 25 mg PO BID
RX *metoprolol tartrate 25 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Aspiration PNA
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms ___,
It was a pleasure taking care of you during your hospitalization
at ___. You were admitted because of your shortness of breath
and recurrent pneumonia, which we treated with the same
antibiotics you had been getting at home. While you were here,
the bariatric surgery team was involved and removed fluid from
your lap band, which improved your symptoms and will help
decrease your risk of other pneumonias. You will remain on a
bariatric diet for 3 weeks, when you will follow up with the
bariatric team as below. While you were here, we were unable to
take you off oxygen without your oxygen levels decreasing.
Because of this, we did an ECHO (ultrasound) of your heart which
revealed high blood pressure in the arteries in your lungs
(pulmonary artery hypertension). You will need to follow up with
the lung doctors (___) as below. You then had a right
heart catheterization which showed that one of your valves is
leaky; you will need to follow up with the heart doctors
(___) as below.
In terms of your medications:
You should CONTINUE taking all your other medications as you had
been doing prior to being hospitalized. In terms of your home
oxygen, please use your pulse oximeter while you are at home. We
would like your pulse oxygen to remain above 92%. While you do
not feel short of breath when your oxygen saturation is low,
please continue taking your albuterol inhaler as needed and keep
your oxygen on.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler ___ PUFF IH Q4H:PRN sob or wheeze
2. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
3. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
4. Lactulose 30 mL PO DAILY
RX *lactulose 20 gram/30 mL 30 ml by mouth daily Disp #*1 Bottle
Refills:*0
5. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
6. Thiamine 100 mg PO DAILY
RX *thiamine HCl 100 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
7. Buprenorphine-Naloxone (8mg-2mg) 1 TAB SL BID
8. Cetirizine *NF* 10 mg Oral daily
9. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth daily Disp #*30
Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Alcohol withdrawal
Pancreatitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
It was a pleasure taking care of you at ___
___. You were admitted with alcohol intoxication and
pancreatitis. We gave you IV fluids, pain medicines, vitamins
and medicines to help you detox safely. We slowly advanced your
diet and you did well.
It is important that you refrain from drinking alcohol to
prevent this from happening again.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H
2. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
3. Docusate Sodium 100 mg PO BID
4. Enoxaparin Sodium 40 mg SC QPM
Start: Today - ___, First Dose: Next Routine Administration
Time
RX *enoxaparin 40 mg/0.4 mL 0.4 ml QPM Disp #*30 Syringe
Refills:*0
5. Omeprazole 40 mg PO DAILY
6. OxyCODONE (Immediate Release) 2.5 mg PO TID:PRN Pain -
Moderate
RX *oxycodone 5 mg 0.5 - 1 tablet(s) by mouth every four (4)
hours Disp #*45 Tablet Refills:*0
7. Polyethylene Glycol 17 g PO DAILY:PRN constipation
8. Senna 8.6 mg PO BID
9. Aspirin 81 mg PO DAILY
10. Atorvastatin 80 mg PO QPM
11. Fluticasone Propionate NASAL 1 SPRY NU DAILY
12. FoLIC Acid 1 mg PO DAILY
13. Furosemide 30 mg PO DAILY
14. Methotrexate 20 mg IM WEEKLY
15. Orencia (abatacept) 125 mg/mL subcutaneous Weekly
16. PredniSONE 5 mg PO DAILY
17. Ramelteon 8 mg PO DAILY:PRN agitation
18. Sertraline 25 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
periprosthetic fracture of L distal femur
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week.
- Resume your regular activities as tolerated, but please follow
your weight bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
- touch down weight Bearing in left lower extremity
MEDICATIONS:
- Please take all medications as prescribed by your physicians
at discharge.
- Continue all home medications unless specifically instructed
to stop by your surgeon.
- Do not drink alcohol, drive a motor vehicle, or operate
machinery while taking narcotic pain relievers.
- Narcotic pain relievers can cause constipation, so you should
drink eight 8oz glasses of water daily and take a stool softener
(colace) to prevent this side effect.
ANTICOAGULATION:
- Please take Lovenox daily for 4 weeks
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- Please remain in your dressing and do not change unless it is
visibly soaked or falling off.
- Splint must be left on until follow up appointment unless
otherwise instructed
- Do NOT get splint wet
DANGER SIGNS:
Please call your PCP or surgeon's office and/or return to the
emergency department if you experience any of the following:
- Increasing pain that is not controlled with pain medications
- Increasing redness, swelling, drainage, or other concerning
changes in your incision
- Persistent or increasing numbness, tingling, or loss of
sensation
- Fever > 101.4
- Shaking chills
- Chest pain
- Shortness of breath
- Nausea or vomiting with an inability to keep food, liquid,
medications down
- Any other medical concerns
Physical Therapy:
TDWB in LLE
ROMAT
Treatments Frequency:
___ & Rehab</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Clopidogrel 75 mg PO DAILY
3. Cyanocobalamin 500 mcg PO DAILY
4. Gemfibrozil 600 mg PO BID
5. Multivitamins 1 TAB PO DAILY
6. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain
7. Isosorbide Mononitrate (Extended Release) 30 mg PO BID
This dose has been decreased.
8. Pantoprazole 40 mg PO Q12H
RX *pantoprazole 40 mg 1 tablet,delayed release (___) by
mouth twice a day Disp #*60 Tablet Refills:*0
9. Sucralfate 1 gm PO BID
RX *sucralfate 1 gram/10 mL 10 mL by mouth twice a day Disp #*60
Unit Refills:*0
10. calcium carbonate-vitamin D3 *NF* 600 mg(1,500mg) -200 unit
Oral BID
11. Nadolol 10 mg PO DAILY
RX *nadolol 20 mg 0.5 (One half) tablet(s) by mouth once a day
Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis: Gastrointestinal bleeding
Secondary diagnoses: Cirrhosis, Esophageal Varices
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at the ___
___. You were admitted for your dark
stools, fatigue, and anemia due to bleeding in your
gastrointestinal tract. We followed your blood counts closely
and had the liver doctors ___.
As you know, you were at increased risk for bleeding because of
the aspirin and Plavix you are taking for your recent stent,
which you must continue for the time-being (discuss this with
your cardiologist).
While here, you had a esophagogastroduodenoscopy (EGD) and
colonoscopy to identify sources of bleeding, which did not show
any area concerning for acute bleeding though there were large
esophageal varices (which is a complication of liver disease).
In order to keep your blood counts up, we gave you 6 units of
blood. Your blood counts were stable the last 2 days of your
hospital stay with non-bloody stools, both of which are
reassuring that you are no longer bleeding.
Unfortunately you will stay at continued risk of bleeding
because of the medications you are taking for your stent, and
therefore you must remain cautious for any sources of bleeding.
With signs of bleeding or increasing weakness, you should seek
medical care.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Losartan Potassium 25 mg PO DAILY
RX *losartan 25 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
2. Metoprolol Succinate XL 100 mg PO DAILY
RX *metoprolol succinate 100 mg 1 tablet(s) by mouth daily Disp
#*30 Tablet Refills:*0
3. Albuterol Inhaler ___ PUFF IH Q4H:PRN Shortness of breath or
wheeze
4. Allopurinol ___ mg PO DAILY
5. Aspirin 81 mg PO DAILY
6. Atorvastatin 40 mg PO QPM
7. Finasteride 5 mg PO DAILY
8. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain
9. Tamsulosin 0.4 mg PO QHS
Discharge Disposition:
Home
Discharge Diagnosis:
Primary
---------
- Dyspnea of unknown etiology
- SVT with aberrancy
Secondary
----------
- Coronary artery disease s/p stent
- Recent pneumonia
- Hypertension
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure participating in your care here at ___
___. You were admitted for shortness of
breath
WHAT HAPPENED WHILE YOU WERE HERE:
- Your shortness of breath resolved without intervention. It did
not appear that you had residual pneumonia.
- You had a run of fast heartbeat on the heart monitor. We did
not see any signs of heart attack on your lab test or EKG.
- You had episodes of feeling sweaty, so we kept you an
additional night to watch you on the heart monitor.
- We increased the dose of your metoprolol, to keep the heart
rate down. We also decreased your dose of losartan so that your
blood pressure doesn't drop when on the higher dose of
metoprolol.
WHAT YOU SHOULD DO AFTER YOU LEAVE:
- Please follow up with your cardiologist, Dr. ___ the
next week.
- You will need a repeat ultrasound of your heart in about 2
weeks.
- You will receive ___ of hearts monitor in the mail to
monitor your heart rate. Please follow the instructions that
come with the monitor. If you have questions, call Dr. ___
___ they ___ be able to assist you with questions.
We wish you the best.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 5 mg PO DAILY
RX *amlodipine 5 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
2. Polyethylene Glycol 17 g PO DAILY
RX *polyethylene glycol 3350 17 gram/dose 1 g by mouth daily
Refills:*0
3. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild
4. Labetalol 100 mg PO BID
Hold dose if your systolic blood pressure is less than 120.
RX *labetalol 100 mg 1 tablet(s) by mouth twice a day Disp #*60
Tablet Refills:*0
5. Atorvastatin 40 mg PO QPM
6. Cyanocobalamin 1000 mcg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
==================
Subdural hematoma
Hypertension
Orthostatic Hypotension
SECONDARY DIAGNOSIS:
====================
Hyperlipidemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure to be part of your care.
You were admitted to the hospital because you were having
headaches, vomiting and erratic blood pressure at home.
We were concerned that your recent brain bleeding having
worsened. You received repeat head imaging which was evaluated
by neurosurgery and they determined that no intervention was
necessary.
Your blood pressure remained quite variable during this
admission. We adjusted your blood pressure medications to try to
maintain your systolic blood pressure between 110 and 160.
Please check your blood pressure at home and HOLD your labetalol
dose if your systolic blood pressure is <120.
If your blood pressure is dropping lower than systolic of 100 at
home or rising higher than systolic 160 at home then please call
your doctor. If you are falling down at home or your systolic
blood pressure is greater than 180 please return to the
hospital. Additionally, if your headaches worsen or you develop
new weakness or changes in sensation, please seek medical
attention immediately. Of note, your headaches or feeling of
head "pressure" will take over several weeks to resolve. Please
take Tylenol for your headache. Occasional doses of ibuprofen
(<400mg) are ok, but this should not be taken daily as it has
some risk of bleeding.
We wish you the best,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Atorvastatin 20 mg PO DAILY
3. Levothyroxine Sodium 100 mcg PO DAILY
4. Omeprazole 40 mg PO BID
5. ALPRAZolam 0.25 mg PO DAILY:PRN anxiety
RX *alprazolam 0.25 mg 1 tablet(s) by mouth Daily Disp #*30
Tablet Refills:*0
6. azelastine 137 mcg nasal BID
7. Calcium Carbonate 500 mg PO DAILY
Do not take with levothyroxine pill
8. Vitamin D 200 UNIT PO DAILY
9. Loratadine 10 mg PO DAILY:PRN as needed
10. Furosemide 20 mg PO DAILY
11. Outpatient Lab Work
Please draw chem7 panel.
Hyponatremia, 276.1
Dr. ___, Phone: ___
Fax: ___
12. Lisinopril 40 mg PO DAILY
13. Fluticasone Propionate NASAL 1 SPRY NU DAILY
RX *fluticasone 50 mcg 1 spray NU Daily Disp #*1 Bottle
Refills:*0
14. Outpatient Physical Therapy
Cervical ligament sprain, 847.0
Dr. ___, Phone: ___
Fax: ___
15. Walker
Please allow patient to obtain walker for aid with balance.
Cervical ligament sprain, 847.0
Dr. ___, Phone: ___
Fax: ___
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnoses:
Hyponatremia, SIADH
Subdural hematoma
Post-concussive symptoms
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was pleasure caring for you at ___. You were admitted with
low sodium in your blood, probably related to your head injury
and the hydrochlorothiazide you were taking. Your levels trended
back to normal with fluid restriction, salt tabs, lasix, and
stopping of the hydrochlorothiazide. Do not restart taking your
hydrocholorothiazide unless a physician tells you to.
Your subdural hematoma was found to be shrinking on CT of your
head. Your scalp stitches were removed.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
You came into the hospital because you were having fevers and
chills and feeling very tired. We started you on broad spectrum
antibiotics. You had multiple tests to look for infection
including chest xray, right foot xray, abdominal CT scan, blood
and sputum cultures which showed no evidence of infection. We
had the podiatry team come evaluate your right lower extremity
wound who felt it was not infected and recommended that you
follow-up with your podiatrist when you leave the hospital. Your
fever was most likely from a viral illness. You improved and
your antibiotics were stopped because we couldn't find any
source of infection, after which you continued to feel well. You
were evaluated by physical therapy who felt you need physical
therapy at home to help improve your transfers and safety at
home.
Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
It was a pleasure taking care of you!
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
2. Dexamethasone 3 mg PO EVERY 8 HOURS X 2 DOSES Duration: 2
Doses
Take at 6pm and 2am on ___, then discontinue
RX *dexamethasone 1 mg 3 tablet(s) by mouth Every 8 hours x 2
doses Disp #*6 Tablet Refills:*0
3. Docusate Sodium 100 mg PO BID
4. Ondansetron 4 mg PO Q8H:PRN nausea
RX *ondansetron 4 mg 1 tablet(s) by mouth Q8H PRN Disp #*30
Tablet Refills:*0
5. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
RX *oxycodone 5 mg 1 to 2 tablet(s) by mouth Every 4 hours PRN
Disp #*30 Tablet Refills:*0
6. Pantoprazole 40 mg PO Q24H
RX *pantoprazole 40 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
7. Aspirin 325 mg PO DAILY
8. TiCAGRELOR 90 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
Headache
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Activity
We recommend that you avoid heavy lifting, running, climbing,
or other strenuous exercise until your follow-up appointment.
You make take leisurely walks and slowly increase your
activity at your own pace once you are symptom free at rest.
___ try to do too much all at once.
No driving while taking any narcotic or sedating medication.
If you experienced a seizure while admitted, you are NOT
allowed to drive by law.
No contact sports until cleared by your neurosurgeon. You
should avoid contact sports for 6 months.
Medications
Please do NOT take any blood thinning medication (Aspirin,
Ibuprofen, Plavix, Coumadin) until cleared by the neurosurgeon.
You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
What You ___ Experience:
You may have difficulty paying attention, concentrating, and
remembering new information.
Emotional and/or behavioral difficulties are common.
Feeling more tired, restlessness, irritability, and mood
swings are also common.
Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
pain medications), try an over-the-counter stool softener.
Headaches:
Most headaches are not dangerous but you should call your
doctor if the headache gets worse, develop arm or leg weakness,
increased sleepiness, and/or have nausea or vomiting with a
headache.
Mild pain medications may be helpful with these headaches but
avoid taking pain medications on a daily basis unless prescribed
by your doctor.
There are other things that can be done to help with your
headaches: avoid caffeine, get enough sleep, daily exercise,
relaxation/ meditation, massage, acupuncture, heat or ice packs.
When to Call Your Doctor at ___ for:
Severe nausea and/or vomiting
Extreme sleepiness and not being able to stay awake
Severe headaches not relieved by pain relievers
Seizures
Any new problems with your vision or ability to speak
Weakness or changes in sensation in your face, arms, or leg
Call ___ and go to the nearest Emergency Room if you experience
any of the following:
Sudden numbness or weakness in the face, arm, or leg
Sudden confusion or trouble speaking or understanding
Sudden trouble walking, dizziness, or loss of balance or
coordination
Sudden severe headaches with no known reason</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
2. Multivitamins W/minerals 1 TAB PO DAILY
RX *multivitamin,tx-minerals [Vitamins and Minerals] 1
tablet(s) by mouth once a day Disp #*30 Tablet Refills:*0
3. Tamsulosin 0.4 mg PO DAILY
4. Allopurinol ___ mg PO BID
5. Citalopram 40 mg PO DAILY
6. Ensure (food supplemt, lactose-reduced) 5 bottle oral DAILY
7. Finasteride 5 mg PO DAILY
8. Fluvoxamine Maleate 100 mg PO QAM
9. Fluvoxamine Maleate 200 mg PO HS
10. Gabapentin 300 mg PO BID
11. Gabapentin 600 mg PO QAM
12. ibrutinib 280 mg oral DAILY
13. LOPERamide 1 mg PO BID:PRN loose stools
14. Pravastatin 20 mg PO QPM
15. Zolpidem Tartrate 10 mg PO QHS
16.Outpatient Physical Therapy
ICD: ___, I95.1, R26.2
Please provide ___ for gait stability, balance training and
humeral fracture
17.Outpatient Occupational Therapy
ICD: ___.201A, I95.1, R26.2
Please provide ___ for gait stability, balance training and
humeral fracture rehabilitation
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY
Fall
Orthostatic hypotension
L humerus fracture
Urinary retention
Hypertension
Elevated troponin
___
SECONDARY
Chronic lymphocytic leukemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you during your hospitalization
at ___.
You came to the hospital after you had fell and hit your arm.
We found that your broke your left shoulder. The orthopedic
doctors saw ___ and did not think you need surgery.
We found that you were dehydrated, and we gave you fluid to
replenish you. We did not give you your Flomax on the first day
and then restarted it at a once a day dosing to make sure we
prevent any further episodes of dizziness.
You were evaluated by physical therapy after your fall, and they
felt that over the course of your hospital stay you progressed
to where you could go home with physical and occupational
therapy services.
Please follow up with your primary care doctor who can help
___ on the above issues and continue to work on getting
stronger.
We wish you the best.
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325 mg PO Q6H:PRN TMJ pain
2. Benzonatate 100 mg PO TID:PRN cough
3. Guaifenesin-CODEINE Phosphate ___ mL PO Q6H:PRN cough
4. Multivitamins 1 TAB PO DAILY
5. Omeprazole 20 mg PO BID
6. Ondansetron 4 mg PO Q6H:PRN nausea
7. Phenytoin Sodium Extended 100 mg PO BID
8. QUEtiapine Fumarate 25 mg PO QHS
9. Simvastatin 40 mg PO DAILY
10. Venlafaxine XR 225 mg PO DAILY
11. Caltrate 600 + D (calcium carbonate-vitamin D3) 600
mg(1,500mg) -400 unit Oral daily
12. Meclizine 12.5 mg PO Q8H:PRN dizziness
13. Sodium Chloride Nasal ___ SPRY NU QID:PRN dry nose
14. Docusate Sodium 100 mg PO BID
15. Lorazepam 0.5 mg PO Q4H:PRN prior to CT
16. Aspirin 81 mg PO DAILY
17. Heparin IV Sliding Scale
No Initial Bolus
Initial Infusion Rate: 700 units/hr
Target PTT: 60 - 100 seconds
18. Ipratropium Bromide Neb 1 NEB IH Q6H
19. Metoprolol Succinate XL 50 mg PO DAILY
20. Warfarin 3 mg PO DAILY16
21. Acetaminophen 1000 mg PO Q8H:PRN Pain
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary: lung cancer
Secondary: paroxsysmal atrial fibrillation with rapid
ventricular rate, anxiety
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure caring for you at ___
___. You came to the hospital with shortness of
breath, fatigue, and dizziness. We were concerned for pneumonia
and treated you with IV antibiotics. A CT of your chest showed
no sign of pneumonia, so antibiotics were stopped. You had a
bronchoscopy to better understand what is causing your symptoms.
The results of these tests will be available by next week. This
is likely progression of your underlying lung cancer.
During your stay you had difficulty with anxiety. We recommend
that you use your medications to help control this problem,
which can make your breathing harder. Please discuss your
anxiety with your therapist.
While you were in the hospital, we noticed several short periods
of irregular heartbeat called atrial fibrillation. You were
previously on a medication called atenolol which we switched to
a similar medication metoprolol, which will better help to
control your heart rate. This irregular heartbeat can put you at
risk of forming blood clots, which increases your risk of
stroke. You had a blood clot in your heart in ___ for
which you were treated with Lovenox. To avoid forming similar
clots, you decided to start taking a blood thinning medication
called coumadin (warfarin). This medication requires regular
monitoring that can be done by the Rehab facility. Dr ___
___ help manage this medication after you leave the facility.
Thank you for allowing us to participate in your care.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Oxybutynin 5 mg PO TID
RX *oxybutynin chloride 5 mg 1 tablet(s) by mouth three times
daily Disp #*90 Tablet Refills:*0
2. OxyCODONE (Immediate Release) 5 mg PO Q8H:PRN Pain - Severe
RX *oxycodone 5 mg 1 tablet(s) by mouth every 8 hours Disp #*12
Tablet Refills:*0
3. Sulfameth/Trimethoprim DS 1 TAB PO BID Duration: 3 Days
RX *sulfamethoxazole-trimethoprim 800 mg-160 mg 1 tablet(s) by
mouth twice daily Disp #*8 Tablet Refills:*0
4. Albuterol Inhaler 2 PUFF IH Q6H:PRN shortness of breath
5. Budesonide 9 mg PO DAILY
6. butalbital-acetaminophen-caff 50-325-40 mg oral Q6H:PRN
headache
7. butalbital-acetaminophen-caff 50-300-40 mg oral Q6H:PRN
headache
8. Cholestyramine 4 gm PO DAILY
9. ClonazePAM 0.5 mg PO QHS:PRN anxiety
10. Diazepam 10 mg PO QHS anxiety / insomnia
11. Famotidine 20 mg PO BID
12. Fluticasone Propionate 110mcg 2 PUFF IH BID:PRN nose
13. Guaifenesin-Dextromethorphan 5 mL PO Q6H:PRN cough
14. Hydrocortisone Acetate 10% Foam 1 Appl PR QHS
15. HydrOXYzine 100 mg PO QHS
16. Hyoscyamine 0.125 mg PO TID:PRN spasma
17. LORazepam 0.5 mg PO Q6H:PRN nausea
RX *lorazepam 0.5 mg 1 tab by mouth every ___ hours Disp #*10
Tablet Refills:*0
18. Metadate CD (methylphenidate) 20 mg oral QAM
19. Methylphenidate SR 72 mg PO QAM
20. Metoclopramide 5 mg PO Q8H:PRN nausea
21. Multivitamins 1 TAB PO DAILY
22. olopatadine 0.1 % ophthalmic BID
23. Probiotic (B.breve-L.acid-L.rham-S.thermo;<br>L.
acidophilus-L. rhamnosus;<br>L.acidophilus-Bif.
animalis;<br>L.rhamn ___
acidophilus;<br>lactobacillus comb no.10;<br>lactobacillus
combination no.4;<br>lactobacillus combo no.11) 15 billion cell
oral DAILY
24. Ursodiol 600 mg PO BID
25. Vitamin D ___ UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
1. Peritoneal Inclusion Cyst s/p drainage.
2. Cystitis, complicated.
SECONDARY DIAGNOSIS:
1. Ulcerative Colitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you during your hospital stay
at ___. You were admitted to
the hospital for abdominal pain after a procedure by our
interventional radiologists. While here, you underwent drainage
of a peritoneal cyst with some fluid removal and started to have
relief of your pain. We continued to monitor you until you were
able to eat or drink, and your pain was controlled.
In addition, you had urinary retention. You were periodically
bladder scanned, and your bladder was drained with a straight
catheter. We wrote a prescription catheters for you to be able
to self-cath at home.
Please return to the hospital if you have worsening abdominal
pain, fevers, nausea, vomiting, diarrhea, pain with urination,
or blood in your urine.
Please continue to follow up with your primary care physician
and your your specialists upon discharge from the hospital.
Take Care,
Your ___ Team.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q8H:PRN pain or fever
2. Artificial Tear Ointment 1 Appl BOTH EYES PRN eye care
3. Docusate Sodium 100 mg PO BID
4. Senna 8.6 mg PO BID
5. amLODIPine 5 mg PO DAILY
6. Cyanocobalamin 1000 mcg PO DAILY
7. Famotidine 20 mg PO BID
8. Finasteride 5 mg PO DAILY
9. Pantoprazole 40 mg PO Q24H
10. QUEtiapine Fumarate 50 mg PO QHS
11. Tamsulosin 0.4 mg PO QHS
12. Vitamin B Complex 1 CAP PO DAILY
13. Warfarin 2.5 mg PO DAILY16 alternate with 5 mg QOD
14.rolling walker
Diagnosis: bladder perforation
Prognosis: good
___: 13 months
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
1) Bladder perforation
2) abdominal compartment syndrome
3) Cardiac Arrest: cardiovascular collapse with return of
circulation after CODE
4) Acute kidney injury on chronic kidney disease
5) generalized deconditioning
6) thrombosis, deep vein (pre-existing)
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>-Please also reference the instructions provided by nursing on
SUPRAPUBIC TUBE (SPT) catheter care, hygiene and waste
elimination.
-ALWAYS follow-up with your referring provider ___ your PCP
to discuss and review your post-operative course and
medications. Any NEW medications should also be reviewed with
your pharmacist.
-Resume your pre-admission medications except as noted on the
medication reconciliation
-You may take ibuprofen and the prescribed narcotic together for
pain control. FIRST, use Tylenol and Ibuprofen. Add the
prescribed narcotic (examples: Oxycodone, Dilaudid,
Hydromorphone) for break through pain that is >4 on the pain
scale.
-The maximum dose of Tylenol (ACETAMINOPHEN) is 3- 4 grams (from
ALL sources) PER DAY.
-Ibuprofen should always be taken with food. If you develop
stomach pain or note black stool, stop the Ibuprofen. Ibuprofen
works best when taken around the clock.
-For your safety and the safety of others; PLEASE DO NOT drive,
operate dangerous machinery, or consume alcohol while taking
narcotic pain medications.
-Do NOT drive while Foley catheter is in place.
-AVOID lifting/pushing/pulling items heavier than 10 pounds (or
3 kilos; about a gallon of milk) or participate in high
intensity physical activity (which includes intercourse) until
you are cleared by your Urologist in follow-up. Generally about
FOUR weeks. Light household chores are generally ok. Do not
vacuum.
-No DRIVING until you are cleared by your Urologist
-Do not drive or drink alcohol while taking narcotics and do not
operate dangerous machinery
-You may be given prescriptions for a stool softener ___ a
gentle laxative. These are over-the-counter medications that
may be health care spending account reimbursable.
-Colace (docusate sodium) may have been prescribed to avoid
post-surgical constipation or constipation related to use of
narcotic pain medications. Discontinue if loose stool or
diarrhea develops. Colace is a stool-softener, NOT a laxative.
-Senokot (or any gentle laxative) may have been prescribed to
further minimize your risk of constipation.
-You may shower as usual but do not immerse in bath/pool while
foley in place
-Your Foley should be secured to the catheter secure on your
thigh at ALL times until your follow up with the surgeon.
-DO NOT allow anyone that is outside of the urology team remove
your Foley for any reason.
-Wear Large Foley bag for majority of time; the leg bag is only
for short-term when leaving the house, etc.
-___ medical attention for fevers (temp>101.5), worsening pain,
drainage or excessive bleeding from incision, chest pain or
shortness of breath.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN pain
2. Albuterol Inhaler 2 PUFF IH Q6H:PRN SOB
3. Felodipine 5 mg PO DAILY
4. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
5. FoLIC Acid 1 mg PO DAILY
6. Ranitidine 300 mg PO QHS
7. Vitamin D 1000 UNIT PO DAILY
8. Ciprofloxacin HCl 500 mg PO Q12H Duration: 4 Days
RX *ciprofloxacin HCl 250 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*7 Tablet Refills:*0
9. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *metronidazole 500 mg 1 tablet(s) by mouth every eight (8)
hours Disp #*11 Tablet Refills:*0
10. Calcarb 600 With Vitamin D (calcium carbonate-vitamin D3)
600 mg(1,500mg) -200 unit oral BID
11. Infliximab 0 mg IV Q6WEEKS
12. Ondansetron 8 mg PO Q8H:PRN nausea
13. Prochlorperazine 10 mg PO Q8H:PRN nausea
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis: Abdominal pain/diarrhea
Secondary diagnosis: ___ disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you during your stay at ___.
You were admitted for abdominal pain and diarrhea. You were
found to have a fever and elevation in serum inflammatory
markers concerning for infection and/or ___ flare. You were
started on antibiotics and your symptoms improved. A colonoscopy
showed no sign of active ___. By discharge, you were
tolerating a regular diet with improved pain and decreased
inflammatory markers. You should continue the antibiotics as
prescribed and will be contacted by the ___ department for an
outpatient follow-up appointment.
Wishing you well,
Your ___ Medicine Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H
2. Amphetamine-Dextroamphetamine 15 mg PO TID
3. ClonazePAM 1 mg PO QID:PRN anxiety
4. OxycoDONE (Immediate Release) 20 mg PO Q4H:PRN pain
5. OxyCODONE SR (OxyconTIN) 40 mg PO Q12H
6. Senna 17.2 mg PO QHS
7. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
8. Diazepam 5 mg PO Q8H:PRN muscle spasm
9. Gabapentin 600 mg PO TID
10. Heparin 5000 UNIT SC TID
11. HydrALAzine 10 mg IV Q6H for SBP > 160
12. Omeprazole 40 mg PO BID
13. Simethicone 40-80 mg PO QID:PRN gas
14. Sodium Chloride 0.9% Flush 3 mL IV Q8H and PRN, line flush
15. Sodium Chloride 0.9% Flush ___ mL IV DAILY and PRN, line
flush
16. Vancomycin 1250 mg IV Q 12H
17. Tamsulosin 0.4 mg PO QHS
18. CloniDINE 0.2 mg PO QHS
19. Docusate Sodium 100 mg PO BID
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
T12 osteomyelitis
Anemia
Acute on chronic pain
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Discharge Instructions
Spinal Fusion
Surgery
Your dressing may come off on the second day after surgery.
Your incision is closed with staples or sutures. You will need
suture/staple removal.
Do not apply any lotions or creams to the site.
Please keep your incision dry until removal of your staples.
Please avoid swimming for two weeks after staple removal.
Call your surgeon if there are any signs of infection like
redness, fever, or drainage.
Activity
You must wear your brace at all times when out of bed. You may
apply your brace sitting at the edge of the bed. You do not need
to sleep with it on.
We recommend that you avoid heavy lifting, running, climbing,
or other strenuous exercise until your follow-up appointment.
You make take leisurely walks and slowly increase your
activity at your own pace. ___ try to do too much all at once.
No driving while taking any narcotic or sedating medication.
No contact sports until cleared by your neurosurgeon.
Do NOT smoke. Smoking can affect your healing and fusion.
Medications
Please do NOT take any blood thinning medication (Aspirin,
Ibuprofen, Plavix, Coumadin) until cleared by the neurosurgeon.
Do not take any anti-inflammatory medications such as Motrin,
Advil, Aspirin, and Ibuprofen etc
until cleared by your
neurosurgeon.
You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
It is important to increase fluid intake while taking pain
medications. We also recommend a stool softener like Colace.
Pain medications can cause constipation.
When to Call Your Doctor at ___ for:
Severe pain, swelling, redness or drainage from the incision
site.
Fever greater than 101.5 degrees Fahrenheit
New weakness or changes in sensation in your arms or legs.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN pain
2. Amiodarone 200 mg PO DAILY
3. Aspirin 81 mg PO DAILY
4. Metoprolol Tartrate 12.5 mg PO BID
5. Tamsulosin 0.4 mg PO HS
6. Rosuvastatin Calcium 10 mg PO DAILY
7. Vitamin D 1000 UNIT PO DAILY
8. HYDROmorphone (Dilaudid) 2 mg PO Q4H:PRN pain
9. Insulin SC
Sliding Scale
Fingerstick QACHS
Insulin SC Sliding Scale using REG Insulin
10. Furosemide 40 mg PO BID Duration: 7 Days
11. Potassium Chloride 20 mEq PO BID Duration: 7 Days
12. Omeprazole 20 mg PO QOD
13. Clopidogrel 75 mg PO DAILY
14. GlyBURIDE 2.5 mg PO BID
15. MetFORMIN (Glucophage) 500 mg PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
s/p Left thoracentesis ___
s/p Urgent coronary artery bypass graft x3: ___
Left internal mammary artery to left anterior descending
artery and saphenous vein graft to distal circumflex and
ramus arteries
Past Medical History:
MI ___, angioplasty 6 months later
DMII
dyslipidemia
Hypertension
BPH
Past Surgical History:
herniorrhaphy
Past Cardiac Procedures:
angioplasty ___
DES to Cx ___
Discharge Condition:
Alert and oriented x3 nonfocal
Ambulating with steady gait
Incisional pain managed with
Incisions:
Sternal - healing well, no erythema or drainage
Leg Right/Left - healing well, no erythema or drainage.
Edema
Followup Instructions:
___ [/INST] </s><s>Please shower daily including washing incisions gently with mild
soap, no baths or swimming until cleared by surgeon. Look at
your incisions daily for redness or drainage
Please NO lotions, cream, powder, or ointments to incisions
Each morning you should weigh yourself and then in the evening
take your temperature, these should be written down on the chart
No driving for one month or while taking narcotics. Driving will
be discussed at follow up appointment with surgeon.
No lifting more than 10 pounds for 10 weeks
**Please call cardiac surgery office with any questions or
concerns ___. Answering service will contact on call
person during off hours**</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Dapsone 100 mg PO DAILY
2. Aspart 12 Units Breakfast
Aspart 12 Units Lunch
Aspart 12 Units Dinner
Levemir 30 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
3. Gabapentin 400 mg PO TID
4. TraMADol 50 mg PO Q6H:PRN Pain - Moderate
5. Acetaminophen 500 mg PO Q6H:PRN Pain - Mild/Fever
Maximum 4 of the 500 mg tablets daily
6. Aspirin 81 mg PO DAILY
7. Benzonatate 100 mg PO BID:PRN cough
8. CefePIME 2 g IV Q12H
RX *cefepime 100 gram 2 g IV twice a day Disp #*60 Intravenous
Bag Refills:*1
9. Daptomycin 800 mg IV Q24H
RX *daptomycin 500 mg 800 mg IV once a day Disp #*30 Intravenous
Bag Refills:*1
10. Dronabinol 2.5 mg PO BID
11. Fluconazole 400 mg PO Q24H
12. Levothyroxine Sodium 25 mcg PO DAILY
13. Multivitamins W/minerals 1 TAB PO DAILY
14. Pantoprazole 40 mg PO Q12H
15. PredniSONE 5 mg PO DAILY
16. Psyllium Powder 1 PKT PO BID:PRN constipation
17. Tacrolimus 1 mg PO Q12H
18. Ursodiol 300 mg PO BID
19.Right ___ Brace S74.10XA supply one, wear when out of bed
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Hyperkalemia
History of liver transplant
DM
h/o right iliacus hematoma with right femoral nerve compression
Right leg numbness/pain/weakness
Neutropenia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (___
and ___ brace)
Followup Instructions:
___ [/INST] </s><s>Care Group ___ for IV Antibiotics
.
Please call the transplant clinic at ___ for fever of
101 or greater, chills, nausea, vomiting, diarrhea,
constipation, inability to tolerate food, fluids or medications,
yellowing of skin or eyes, increased abdominal pain, liver drain
and biliary drain sites have redness, drainage or bleeding,
dizziness or weakness, decreased urine output or dark, cloudy
urine, swelling of abdomen or ankles, weight gain of 3 pounds in
a day or any other concerning symptoms.
.
Bring list of current medications to every clinic visit.
.
You will need to have labwork drawn on ___ then twice
weekly as arranged by the transplant clinic. Usually ___ and
___
.
*** On the days you have your labs drawn, do not take your
Tacrolimus until your labs are drawn. Bring your Tacrolimus with
you so you may take your medication as soon as your labwork has
been drawn.
.
Follow your medication card, keep it updated with any dosage
changes, and always bring your card with you to any clinic or
hospital visits.
.
Patient may shower with assist. Do not allow drain bag to hang
freely.
Keep biliary drain (PTBD)open. Change gauze dressing daily and
as needed. Make sure to pin your drain to prevent accidently
pulling out
.
Flush the PTBD drain with 5cc STERILE saline-FORWARD flush ONLY
3 times a day. DO NOT ASPIRATE/PULL back.
.
Continue IV antibiotics via the PICC line as ordered. No end
date is established for the antibiotics.
PICC line care per protocol
.
No tub baths or swimming
.
Avoid direct sun exposure. Wear protective clothing and a hat,
and always wear sunscreen with SPF 30 or higher when you go
outdoors.
.
Report consistently elevated blood sugars or blood pressure
values above 160 or less than 110 systolic to the transplant
clinic
.
Do not increase, decrease, stop or start medications without
checking with the transplant coordinator at ___.</s> |