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<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amlodipine 5 mg PO DAILY
2. Bisacodyl 10 mg PR HS:PRN constipation
3. Calcium Carbonate 1250 mg PO QHS
4. Docusate Sodium 100 mg PO TID
5. Doxazosin 1 mg PO HS
6. Furosemide 40 mg PO PRN Ankle edema
7. Isosorbide Mononitrate 60 mg PO DAILY
8. Lactulose 15 mL PO BID
9. Metoprolol Tartrate 12.5 mg PO BID
10. Nitroglycerin SL 0.3 mg SL PRN Angina
11. Senna 1 TAB PO DAILY:PRN constipation
12. Vitamin D 1000 UNIT PO DAILY
13. GlipiZIDE 2.5 mg PO DAILY
14. Calcitriol 0.25 mcg PO MOFR
15. Pravastatin 40 mg PO HS
16. Aspirin 81 mg PO DAILY
17. Pantoprazole 40 mg PO Q12H
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
NSTEMI
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. ___, thank you very much for giving us the
opportunity to take care of you.
You were admitted to our service for concerns of acute coronary
syndrome. Your clinical presentation of chest pain and markedly
elevation of serum biomarkers, despite an absence of ST segment
changes, suggest you experienced a non-ST elevation myocardial
infarction (NSTEMI). We were particularly concerned given your
history of coronary artery disease. You were put on a brief
course of heparin drip as a prophylaxis for further ischemic
events. However, due to your GIB risk, we stopped the heparin
drip and will no discharge you without any form of
anti-coagulating agents. You are, however, recommended to take a
full dose aspirin (325 mg) PO daily as a prophylaxis for future
ischemic events until your appointment with Dr. ___, who
at the time will decide whether to put you on anticoagulating
agents or not.
Medication changes:
START Aspirin 325mg to prevent future heart attacks
START Pantoprazole to prevent future GI bleeds</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Citalopram 15 mg PO DAILY
2. Docusate Sodium 100 mg PO BID
3. Pantoprazole 40 mg PO Q24H
4. Polyethylene Glycol 17 g PO DAILY:PRN constipation
5. Simethicone 40-80 mg PO QID:PRN gas
6. Acetaminophen 1000 mg PO Q8H
7. Lidocaine 5% Patch 1 PTCH TD QAM
8. OxycoDONE (Immediate Release) 2.5 mg PO Q4H:PRN pain
RX *oxycodone 5 mg Take ___ tablet by mouth every 4 hours Disp
#*16 Tablet Refills:*0
9. Ferrous Sulfate (Liquid) 300 mg PO DAILY
10. Furosemide 20 mg PO DAILY
11. Enoxaparin Sodium 30 mg SC DAILY
Start: Today - ___, First Dose: Next Routine Administration
Time
12. Outpatient Lab Work
___
Basic metabolic panel
13. Outpatient Lab Work
___
Basic metabolic panel
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
Primary Diagnosis:
- Left Hip Fracture
- Hypoxia secondary to Bilateral Pleural Effusions
Secondary Diagnosis:
- Dementia
- Depression
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. ___ and ___,
It was a pleasure taking care of you at the ___
___. You were admitted to the hospital
after a fall at home. You reported pain in your left hip and
initially had an x-ray that showed no fracture. You continued to
have pain and you had a CT scan of your hip that showed two
small fractures in your left hip. Orthopedic surgery was
consulted and recommended no operations. Your pain was better
controlled with pain medications. You should continue your
Lovenox for 4 weeks to prevent blood clots. Remember to call the
Orthopedic surgeons and see them in 2 weeks to look at the hip
again.
You were also found to have low oxygen levels. This was likely
related to fluid in your lung. You were given Lasix to help
remove the fluid and your oxygen levels improved.
All the best,
Your ___ Team</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. Ranitidine 150 mg PO DAILY
3. Rosuvastatin Calcium 10 mg PO DAILY
4. Tiotropium Bromide 1 CAP IH DAILY
5. Vitamin D ___ UNIT PO DAILY
6. Alavert (loratadine) 10 mg oral BID
7. ammonium lactate 12 % topical daily
8. Dexilant (dexlansoprazole) 60 mg oral daily
9. Lorazepam 1 mg PO Q6H:PRN anxiety
10. MetFORMIN (Glucophage) 500 mg PO BID
11. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation
inhalation BID
12. TraMADOL (Ultram) 50 mg PO Q4H:PRN pain
13. Zonalon (doxepin) 5 % TOPICAL DAILY itching
14. Senna 8.6 mg PO BID:PRN constipation
RX *sennosides [senna] 8.6 mg 1 tab by mouth twice a day Disp
#*60 Capsule Refills:*0
15. Docusate Sodium 100 mg PO BID:PRN constipation
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice
a day Disp #*60 Capsule Refills:*0
16. Metoclopramide 10 mg PO TID:PRN nausea
RX *metoclopramide HCl 10 mg 1 tablet(s) by mouth three times a
day Disp #*12 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSES:
Abdominal pain
Colon polyp
Liver granulomas
ASSOCIATED DIAGNOSES:
Diabetes mellitus
Fibromyalgia
Discharge Condition:
Mental Status: Oriented x 3
Level of Consciousness: Alert and attentive
Ambulatory Status: Ambulatory, independent
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you while you were at ___.
You were admitted because you had worsening of your abdominal
pain. We are not certain what caused this worsening pain, but
it improved with some pain medications and a medication to help
with nausea called Reglan/metoclopramide. We ran some studies
on your blood which were all normal, and importantly there was
no evidence of any injury to your liver. The CT scan that you
had in ___ also showed no evidence of any perforation (hole
in the bowel) which can sometimes occur with colonoscopy.
Your CT scan as well as an ultrasound of your liver showed some
abnormalities. Because you had no signs of liver injury on your
examination or on any of your laboratory tests, we think these
can be further investigated as an outpatient. These should be
followed with your primary care doctor.
We are unsure what caused your pain, but we think it could be
related to the polyp in your colon that your doctor had tried to
remove this week. Regardless of whether the polyp is causing
your pain, it should be removed in order to prevent colon
cancer. Because it cannot be removed by colonoscopy, this will
have to be done through an operation. You already have an
appointment to see the surgeons in ___, but we wanted to see
if they would recommend removing the polyp any sooner. We had
the surgery team come to evaluate you while you were in the
hospital. They did not think your pain was related to the polyp
and recommended outpatient followup with Dr. ___.
You can continue to take ibuprofen to help manage any abdominal
pain. You were given a prescription for reglan, which you can
take for nausea on an as-needed basis. We are giving you some
nausea medication and some laxatives.
Again, it was a pleasure taking care of you while you were here.
We wish you all the best.
Sincerely,
Your ___ medical 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 shortness of breath
You will take this medication ONLY when you are short of breath
RX *albuterol sulfate 90 mcg 2 puff IH every 4 hours Disp #*2
Inhaler Refills:*0
2. Nicotine Patch 14 mg TD DAILY
RX *nicotine 14 mg/24 hour 1 patch to arm Daily Disp #*28 Patch
Refills:*0
3. Tiotropium Bromide 1 CAP IH DAILY
You will take this medication ONCE per day, EVERYDAY.
RX *tiotropium bromide [Spiriva with HandiHaler] 18 mcg 1 cap IH
daily Disp #*30 Capsule Refills:*0
4. Levofloxacin 750 mg PO Q48H
RX *levofloxacin 750 mg 1 tablet(s) by mouth every other day
Disp #*2 Tablet Refills:*0
5. Thiamine 100 mg PO DAILY
RX *thiamine HCl 100 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
6. Multivitamins 1 TAB PO DAILY
RX *multivitamin [One Daily Multivitamin] 1 tablet(s) by mouth
daily Disp #*30 Tablet Refills:*0
7. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
8. FreeStyle Lancets (lancets) 28 gauge miscellaneous prn blood
glucose
RX *lancets [FreeStyle Lancets] 28 gauge use with glucometer
four times a day Disp #*1 Box Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
COPD exacerbation
Secondary:
weight loss
thrombocytopenia
anemia
essential tremor
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>Dear Mr. ___,
You were admitted to the hospital because you were having a COPD
exacerbation, which means that you had a flare of your lung
disease. We treated you with antibiotics, steroids and breathing
medications. You will continue to take these medications for the
next few days.
Please follow up with the PCP appointment we have set up for
you. It is very important that you see a doctor regularly for
your health.
Please stop smoking. Your lung disease will only worsen if you
continue to smoke. If you need assistance quitting, your primary
care doctor may be able to help you with certain medications.
Please do not drink alcohol, or at the least, limit your intake
to 1 small drink per day. If you continue to drink, you are
risking worsening of your health, including liver disease.
It was a pleasure taking care of you.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO DAILY:PRN pain
2. Aspirin 81 mg PO DAILY
3. Calcium Carbonate 750 mg PO TID:PRN heartburn
4. Creon 12 3 CAP PO TID W/MEALS
5. Docusate Sodium 100 mg PO DAILY
6. Fexofenadine 180 mg PO DAILY
7. Fluticasone Propionate NASAL 2 SPRY NU DAILY:PRN allergy
8. GlipiZIDE XL 2.5 mg PO DAILY
9. Meclizine 25 mg PO BID
10. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY with dinner
11. Miconazole Powder 2% 1 Appl TP TID
12. Multivitamins 1 TAB PO DAILY
13. Pantoprazole 40 mg PO Q12H
14. Ranitidine 150 mg PO HS
15. Rosuvastatin Calcium 5 mg PO DAILY
16. Cepastat (Phenol) Lozenge 1 LOZ PO PRN sore throat
RX *phenol [Cepastat] 14.5 mg 1 tablet as needed twice daily
Disp #*18 Lozenge Refills:*0
17. Ciprofloxacin HCl 500 mg PO Q12H UTI
RX *ciprofloxacin [Cipro] 500 mg 1 tablet(s) by mouth twice a
day Disp #*17 Tablet Refills:*0
18. alfuzosin 10 mg oral daily
19. solifenacin 5 mg oral daily
20. Senna 8.6 mg PO BID constipation
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS
Presumptive UTI
SECONDARY DIAGNOSIS
Pancreatic Ca
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 brought to the hospital because you had a low grade
fever after your chemotherapy session. While at the hospital, it
was found that you may have had a low grade urinary tract
infection. As a result, we started you an an antibiotic, and you
subsequently had no fevers. You will go home on an oral
antibiotic to treat your infection. We ask that you follow up
with your oncology appointments as below (first appointment ___
___ at 1 pm).
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. acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q6H (every
6 hours) as needed for pain or fever.
2. Celexa 10 mg Tablet Sig: One (1) Tablet PO once a day.
3. Vitamin D 50,000 unit Capsule Sig: One (1) Capsule PO once a
month.
4. iron 325 mg (65 mg iron) Tablet Sig: One (1) Tablet PO once a
day.
5. Prometrium 200 mg Capsule Sig: One (1) Capsule PO at bedtime
as needed for excessive menstruation.
Discharge Disposition:
Home
Discharge Diagnosis:
acute pancreatitis
pancreatic divisum
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were hospitalized for pancreatitis likely related to
pancreatic divisum. We recommend that you eat a bland, low fat,
diet until you have followed up with Gastroenterology. If you
have recurrent abdominal pain, fevers, or chills, please contact
your PCP.
No changes were made to your medications.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 10 mg PO DAILY
RX *amlodipine 10 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
2. Furosemide 80 mg PO DAILY Duration: 1 Dose
RX *furosemide 80 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
3. Influenza Vaccine Quadrivalent 0.5 mL IM NOW ___. Nephrocaps 1 CAP PO DAILY
RX *B complex with C 20-folic acid [Triphrocaps] 1 mg 1
capsule(s) by mouth once a day Disp #*30 Capsule Refills:*0
5. sevelamer CARBONATE 800 mg PO TID W/MEALS
RX *sevelamer carbonate 800 mg 1 tablet(s) by mouth TID with
meals Disp #*90 Tablet Refills:*0
6. Sodium Bicarbonate 650 mg PO TID
RX *sodium bicarbonate 650 mg 1 tablet(s) by mouth three times a
day Disp #*90 Tablet Refills:*0
7.Outpatient Lab Work
Chem 10 and CBC
N18.4
Please fax to ___ Dr. ___
___ Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Chronic kidney disease, stage IV-V
Hyperkalemia
Hyperphosphatemia
Secondary diagnosis:
Hypertension
___ edema
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a privilege caring for you at ___
___!
WHY WAS I IN THE HOSPITAL?
- You kidneys are not working well causing electrolyte
abnormalities which could cause serious effects to your health
WHAT HAPPENED TO ME IN THE HOSPITAL?
- You had labs and studies done to monitor electrolyte levels.
- You received medications to help the electrolytes
abnormalities.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
-Please continue to take all of your medications as prescribed
-It is extremely important you follow-up with your doctors as
listed below! You will die from your kidney disease if it is not
monitored!
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: [/INST] </s><s>Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
Monitor your blood glucose three times a day with meals, and at
bed time, use your insulin sliding scale as prescribed. If you
are urinating and drinking more than usual, this means you are
likely hyperglycemic. If you feel dizzy or lose consciousness,
please return to the emergency department by calling 911.
Drink sufficient water so you do not feel dehydrated.
Schedule a follow up appointment with your primary care provider
and endocrinologist immediately.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Cavilon Skin Cleanser (skin cleanser combination no11) 1
unit topical every 3 days
RX *skin cleanser combination no11 [Cavilon Skin Cleanser]
Please apply to denuded area surronding GJ tube Every 3 days
Disp #*1 Bottle Refills:*2
2. Foley Catheter Tray (catheterization tray) ___ Fr daily daily
Only use Foley BAG to hook up to G tube. Do not insert Foley
catheter for any reason.
RX *catheterization tray [___ Universal Foley Cath Tray] once
a day Disp #*1 Tray Refills:*30
3. Saline Wound Wash (sodium chloride) 0.9 % miscellaneous PRN
wound cleanse
RX *sodium chloride [Safe Wash] 0.9 % PRN Refills:*0
4. 24 Hour Allergy Relief (fluticasone propionate) 50
mcg/actuation nasal BID
5. amoxicillin 1500 mg oral PRN
6. Apixaban 5 mg PO BID
7. Bisacodyl 10 mg PR QHS:PRN Constipation - Second Line
8. Diastat AcuDial (diazePAM) ___ mg Other PRN seizure
9. Ferrous Sulfate 325 mg PO DAILY
10. GuaiFENesin ___ mL PO Q6H:PRN cough or congestion
11. Ibuprofen Suspension 200 mg PO Q6H:PRN Pain - Mild
12. LACOSamide (lacosamide) 10 mg/mL oral QAM
13. LACOSamide (lacosamide) 10 mg/mL oral QPM
14. LevETIRAcetam Oral Solution 1500 mg PO BID
15. Miconazole Powder 2% 1 Appl TP QID:PRN after incontinent
episode
16. Milk of Magnesia 30 mL PO DAILY:PRN Constipation - Third
Line
17. nystatin 100,000 unit/gram topical Q8H:PRN prn
18. Pantoprazole 40 mg PO Q24H
19. Silver Sulfadiazine 1% Cream 1 Appl TP BID
20.Wound Care
Please keep G tube to gravity. Please give all meds via J tube.
G/J tube site Wound Care
-Cavillon Advanced Skin Protectant (CASP) applied to denuded
___ skin every 3 days.
FOR NURSING :
-DO NOT apply any powders, creams, or ointments over ___
site or abdominal/pannus folds.
-OKAY to replace Lyofoam sponge if becomes saturated. Lyofoam
sponge separating external bumper from skin.
-NO TAPE over skin
-OKAY to fold small softsorb to separate abdominal skin folds if
increased moisture
21.Lyfoam
Please change Lyofoam when saturated as needed.
22.saline
23.softsorb
Discharge Disposition:
Home
Discharge Diagnosis:
Primary
---------------
Abdominal Wall Cellulitis
Cystitis
Secondary
---------------
Asthma
Pulmonary embolism
HTN
Epilepsy
Cerebral Palsy
GERD
Discharge Condition:
Activity Status: Bedbound.
Level of Consciousness: Alert and interactive.
Mental Status: Clear and coherent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a privilege taking care of you at ___
___.
WHY WAS I ADMITTED TO THE HOSPITAL?
===================================
- You were admitted to the hospital because your jejunostomy
tube (J-tube) was malpositioned. You also had an infection of
the wall of your stomach.
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
==========================================
- While you were in the hospital you were evaluated by the
interventional radiologist who replaced your jejunostomy tube
(J-tube). Your jejunostomy tube was still leaking so this was
replaced with a gastrojejunostomy tube (GJ tube) which improved
the amount of leaking surrounding the tube. We also started you
on antibiotics for your infection of the wall of your stomach.
Lastly, we also have the wound nurse evaluate your wound and
provide specific recommendations to help with healing.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
============================================
- Please continue to take all your medications and follow up
with your doctors at your ___ appointments.
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. brivaracetam 50 mg oral BID
RX *brivaracetam [Briviact] 50 mg 1 tablet(s) by mouth twice a
day Disp #*60 Tablet Refills:*0
2. brivaracetam 25 mg oral BID
RX *brivaracetam [Briviact] 25 mg 2 tablet(s) by mouth twice a
day Disp #*6 Tablet Refills:*0
3. felbamate 600 mg oral TID
4. Calcium Carbonate 500 mg PO QID:PRN indigestion
5. Hydroxychloroquine Sulfate 400 mg PO DAILY
6. Levothyroxine Sodium 175 mcg PO DAILY
7. LORazepam 1 mg PO Q4H:PRN as needed for seizure
8. Multivitamins 1 TAB PO DAILY
9. Pravastatin 20 mg PO QPM
10. Rufinamide 1200 mg PO BID
11. Vitamin D ___ UNIT PO DAILY
12.Outpatient Speech/Swallowing Therapy
Epilepsy and recurrent seizures G40
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Refractory epilepsy, focal epilepsy with simple partial, complex
partial, and secondarily generalized tonic-clonic seizures.
Seizure clusters.
Secondary diagnosis:
Lupus
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 increased seizure
frequency, in addition to difficulties with your gait. We
placed you on continuous brain wave (EEG) monitoring. While on
this monitoring, you had seizures. Because of this, we started
Brivatiracetam that significantly improved both the frequency
and duration of your seizures. We also completed an MRI of your
brain and did not see any concerning signs of inflammation in
the brain or signs of Lupus affecting the brain. We also placed
you on high density EEG to look for signs of seizure focus. We
continued your felbamate and rufinamide, in addition to the
Brivatirecetam. Moving forward, you will follow up with Dr.
___ in clinic.
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. Albuterol Inhaler 2 PUFF IH Q4-6H:PRN cough and/or wheezing
2. Fluoxetine 20 mg PO 3X/WEEK (___)
3. Fluoxetine 40 mg PO 4X/WEEK (___)
4. Apixaban 5 mg PO BID
5. GlipiZIDE 5 mg PO BID
6. Lisinopril 2.5 mg PO DAILY
7. Triamcinolone Acetonide 0.1% Ointment 1 Appl TP BID:PRN rash
8. Tizanidine ___ mg PO QHS:PRN pain
9. Insulin SC
Sliding Scale
Fingerstick QACHS
Insulin SC Sliding Scale using REG Insulin
10. Miconazole Powder 2% 1 Appl TP TID:PRN rash
11. Cephalexin 250 mg PO Q6H
12. Famotidine 20 mg PO BID
13. Metoprolol Tartrate 50 mg PO QPM
14. Metoprolol Tartrate 100 mg PO QAM
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Right MCA Ischemic Stroke
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were hospitalized due to sudden weakness in the left side of
your body 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 gave you something called tissue plasminogen activator, which
is a medicine that can break up the clot in your brain to make
the symptoms you experience from a stroke better.
Stroke can have many different causes, so we assessed you for
medical conditions that might raise your risk of having stroke.
Your biggest risk factor is your atrial fibrillation, which
causes your heart to beat irregularly and form clots within the
heart and then travel to your brain. In order to prevent future
strokes, we plan to modify those risk factors. Your risk factors
are:
Atrial fibrillation
Diabetes
High blood pressure
We are changing your medications as follows:
- You will continue taking apixaban 5 mg twice a day instead of
coumadin
- You are now taking Keflex for your UTI. The last day of
treatment should be ___.
Please take your other medications as prescribed.
Please also weigh yourself every morning, and call your primary
care doctor if your weight goes up more than 3 lbs.
Please follow-up 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
We wish you all the best!
Sincerely,
Your ___ Neurology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Enoxaparin Sodium 80 mg SC Q12H
Start: ___, First Dose: Next Routine Administration Time
RX *enoxaparin 80 mg/0.8 mL 80 mg SC every twelve (12) hours
Disp #*14 Syringe Refills:*1
2. Warfarin 5 mg PO DAILY16
RX *warfarin 2.5 mg 2 tablet(s) by mouth once a day Disp #*60
Tablet Refills:*0
3. Calcium Carbonate 500 mg PO QHS:PRN vitamin
4. Vitamin D ___ UNIT PO DAILY
5.Outpatient Lab Work
I___.220
___, INR
Results to:
Name: ___.
Phone: ___
Fax: ___
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
deep vein thrombosis
pulmonary embolism
renal vein thrombosis
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 stay at ___.
WHY WAS I HERE?
-You had a large blood clot
WHAT WAS DONE WHILE I WAS IN THE HOSPITAL?
-You were given blood thinners and seen by the kidney doctors
and ___
WHAT SHOULD I DO WHEN I GO HOME?
-You should see your PCP and get your INR checked
-You should see your hematologist.
-You should talk to your doctor about having a mammogram,
colonoscopy, and pap smear if needed.
Be well!
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. ATRIPLA *NF* (efavirenz-emtricitabin-tenofov) ___ mg
Oral daily
2. Citalopram 30 mg PO DAILY
3. Lorazepam 2 mg PO HS:PRN insomnia
4. Propranolol 40 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
Metabolic encephalopathy
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dr. ___,
___ was a pleasure taking care of you while you were in the
hospital. You came into the hospital after falling and acting a
bit confused at home. You had a head CT and chest x- ray which
did not show any evidence of an acute process that would explain
these symptoms. You were monitored over ___ hours and you
returned to your baseline mental status. Your platelets were low
and your liver function tests were high which is likely related
to your alcohol intake. We obtained an ultrasound of your liver
and gallbladder which was also unremarkable for acute pathology
at this time.
We spoke to you about your alcohol use and recommended
decreasing your regular alcohol intake. We think this may have
contributed to your falls and change in mental status.
Dr. ___ you while you were in the hospital and would
like you to follow-up with him as an outpatient next week.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Doxycycline Hyclate 100 mg PO Q12H
RX *doxycycline hyclate 100 mg 1 capsule(s) by mouth twice a day
Disp #*10 Capsule Refills:*0
2. Fluticasone Propionate NASAL 1 SPRY NU BID
RX *fluticasone 50 mcg/actuation 1 spray twice a day Disp #*1
Bottle Refills:*0
3. Insulin Pump SC (Self Administering Medication)Insulin
Lispro (Humalog)
Basal rate minimum: 0.85 units/hr
Basal rate maximum: 1.8 units/hr
Bolus minimum: 1 units
Bolus maximum: 10 units
Target glucose: ___
Fingersticks: QAC and HS
RX *insulin lispro [Humalog] 100 unit/mL 0.85 u/hr sc continuous
Disp #*1 Vial Refills:*3
4. Vancomycin Oral Liquid ___ mg PO Q6H
RX *vancomycin 125 mg 1 capsule(s) by mouth every six (6) hours
Disp #*120 Capsule Refills:*0
5. Probiotic (S.boulardii) (Saccharomyces boulardii) 1 tab oral
DAILY
6. Allopurinol ___ mg PO DAILY
7. aMILoride 2.5 mg PO DAILY
8. Atorvastatin 10 mg PO QPM
9. AzaTHIOprine 25 mg PO DAILY
10. Calcitriol 0.5 mcg PO DAILY
11. ClonazePAM 1 mg PO DAILY
12. ClonazePAM 1.5 mg PO QHS
13. Co Q-10 (coenzyme Q10) 200 mg oral DAILY
14. Dextroamphetamine 20 mg po QAM
15. Furosemide 40 mg PO BID
16. Gabapentin 300 mg PO TID
17. LACOSamide 250 mg PO BID
18. LevETIRAcetam 1500 mg PO BID
19. Mirtazapine 45 mg PO QHS
20. Potassium Chloride 30 mEq PO BID
Hold for K >
21. PredniSONE 15 mg PO EVERY OTHER DAY
22. Propranolol 30 mg PO TID
23. Sirolimus 1 mg PO DAILY
24. Verapamil 40 mg PO Q8H
25. Vitamin D 4000 UNIT PO DAILY
26. Zolpidem Tartrate 10 mg PO QHS
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Colitis secondary to clostridium difficile infection
Secondary:
Acute kidney injury
ESRD
Hypertension
S/p heart transplant
S/p kidney transplant
Diabetes with insulin pump
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 ___ because you were having
fevers and diarrhea.
WHILE YOU WERE HERE:
- We found that you had C. diff. This is a bacteria which can
infect the colon and cause your symptoms.
- You were started on oral vancomycin to treat the C. diff.
- Your kidney function was worse because you were dehydrated. It
improved with IV fluids.
WHEN YOU GO HOME:
- Please continue your vancomycin until you follow up with your
ID doctor.
- Some of your medications were changed and are listed below.
- Your follow up appointments are listed below.
It was a pleasure taking care of you and we wish you good
health.
Sincerely,
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
Discharge Disposition:
Home
Discharge Diagnosis:
Grade 3 liver laceration
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 ___ after
a motor vehicle collision. On imaging, it shows that there was a
laceration in your liver, but not active bleeding. You are
recovering well and are now ready for discharge. Please follow
the instructions below to continue your recovery:
*AVOID contact sports and/or any activity that may cause injury
to your abdominal area for the next ___ weeks.
*If you suddenly become dizzy, lightheaded, feeling as if you
are going to pass out go to the nearest Emergency Room as this
could be a sign that you are having internal bleeding from your
liver or spleen injury.
*AVOID any blood thinners such as Motrin, Naprosyn, Indocin,
Aspirin, Coumadin or Plavix for at least ___ days unless
otherwise instructed by the MD/NP/PA.
Please seek emergent care if you develop fever, chills,
abdominal pain, nausea or vomiting, confusion, dizziness,
headache, shortness of breath, and chest pain. Please follow up
with your primary care physician.</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. Hydrochlorothiazide 25 mg PO DAILY
4. Lisinopril 40 mg PO DAILY
5. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours
Disp #*30 Tablet Refills:*0
6. Pantoprazole 40 mg PO Q24H
7. Ranitidine 300 mg PO DAILY
8. Docusate Sodium 100 mg PO BID
hold for diarrhea
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*30 Capsule Refills:*0
9. Senna 8.6 mg PO BID:PRN constipation
Discharge Disposition:
Home
Discharge Diagnosis:
Acute cholecystitis
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 with acute cholecystitis. You
were taken to the operating room and had your gallbladder
removed laparoscopically. You tolerated the procedure well and
are now being discharged home to continue your recovery with the
following instructions.
Please follow up in the Acute Care Surgery clinic at the
appointment listed below.
ACTIVITY:
o Do not drive until you have stopped taking pain medicine and
feel you could respond in an emergency.
o You may climb stairs.
o You may go outside, but avoid traveling long distances until
you see your surgeon at your next visit.
o Don't lift more than ___ lbs for 4 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.
o You may start some light exercise when you feel comfortable.
o 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.
HOW YOU MAY FEEL:
o You may feel weak or "washed out" for a couple of weeks. You
might want to nap often. Simple tasks may exhaust you.
o You may have a sore throat because of a tube that was in your
throat during surgery.
o You might have trouble concentrating or difficulty sleeping.
You might feel somewhat depressed.
o You could have a poor appetite for a while. Food may seem
unappealing.
o 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:
o Tomorrow you may shower and remove the gauzes over your
incisions. Under these dressing you have small plastic bandages
called steri-strips. 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).
o Your incisions may be slightly red around the stitches. This
is normal.
o You may gently wash away dried material around your incision.
o Avoid direct sun exposure to the incision area.
o Do not use any ointments on the incision unless you were told
otherwise.
o You may see a small amount of clear or light red fluid
staining your dressing or clothes. If the staining is severe,
please call your surgeon.
o You may shower. As noted above, ask your doctor when you may
resume tub baths or swimming.
YOUR BOWELS:
o Constipation is a common side effect of narcotic pain
medications. 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.
o If you go 48 hours without a bowel movement, or have pain
moving the bowels, call your surgeon.
PAIN MANAGEMENT:
o It is normal to feel some discomfort/pain following abdominal
surgery. This pain is often described as "soreness".
o Your pain should get better day by day. If you find the pain
is getting worse instead of better, please contact your surgeon.
o You will receive a prescription for pain medicine to take by
mouth. It is important to take this medicine as directed. o Do
not take it more frequently than prescribed. Do not take more
medicine at one time than prescribed.
o Your pain medicine will work better if you take it before your
pain gets too severe.
o 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.
o If you are experiencing no pain, it is okay to skip a dose of
pain medicine.
o 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 following, 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.
If you have any questions about what medicine to take or not to
take, please call your surgeon.</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 ___.
WHY WAS I IN THE HOSPITAL?
- You had chest pain.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- Your blood pressures were very high, so we gave you
medications through the IV to help lower them.
- You were in the cardiac intensive care unit (CCU) because of
the medications you required.
- We did an transthoracic echocardiogram (TTE) of your heart,
which showed that it is pumping normally.
- We did a transesophageal echocardiogram (TEE) to look at your
larger arteries and confirm there was no tear.
- We did a pharmacological perfusion study of your heart, which
showed no areas concerning for blockage.
- We took xrays of your hip, knee and ankle. The wet read showed
no fractures.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- 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. Bisacodyl 10 mg PO DAILY:PRN Constipation - Second Line
2. Multivitamins W/minerals 1 TAB PO DAILY
3. Pantoprazole 40 mg PO Q12H
4. Simethicone 40-80 mg PO QID:PRN epigastric pain
5. Vitamin D 400 UNIT PO DAILY
6. Warfarin 2.5 mg PO DAILY16
7. Rosuvastatin Calcium 20 mg PO QPM
8. Acetaminophen 650 mg PO TID
9. amLODIPine 10 mg PO DAILY
10. Aspirin 81 mg PO DAILY
11. Cepacol (Sore Throat Lozenge) 1 LOZ PO Q4H:PRN sore throat,
cough
12. Collagenase Ointment 1 Appl TP 3X/WEEK (___)
13. Cyanocobalamin 1000 mcg PO DAILY
14. Docusate Sodium 100 mg PO BID
15. GuaiFENesin ___ mL PO Q6H:PRN congestion, cough
16. Metoprolol Succinate XL 150 mg PO DAILY
17. Mirtazapine 15 mg PO QHS
18. Polyethylene Glycol 17 g PO DAILY
19. Senna 8.6 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Inflammatory disorder, NOS
Anemia
Leukocytosis
Thrombocytosis
New ___ with persistently elevated Cr
Dry gangrene of R toes
AVN of bilateral femoral heads
IgG MGUS,
HFrEF
Transvere colonic intussusception
Pelvic mass with nondiagnostic biopsy
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 an absolute pleasure caring for you at ___.
WHY WAS I IN THE HOSPITAL?
- You came to the hospital because you had shortness of breath
and severe right foot pain.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- You were found to have a very low red blood cell count and got
transfusions. We did a very extensive workup looking for a
source of bleeding, but we did not find one. This may mean that
it was a very tiny bleed or that it already stopped on its own.
You were very lethargic until we stopped the gabapentin, and
your mental status improved dramatically. You had a bone marrow
biopsy that was negative for cancer. We didn't figure out why
your body seems to have ongoing inflammation, but we recommend
you have a special scan called a "Tagged WBC study" as
outpatient. You should also discuss fat pad biopsy with your
outpatient team. Your hematologist will talk to you more about
this study.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Continue to take all your medicines and keep your
appointments. It's very important that you work hard in rehab!
We wish you the very best!
Sincerely,
Your ___ 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. Clobazam 20 mg PO QHS
3. FoLIC Acid 1 mg PO DAILY
4. Vitamin D 800 UNIT PO DAILY
5. Clobazam 10 mg PO QAM
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Non-electrographic seizures
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were evaluated at ___ for
your seizure event.
Please continue your medication regimen as listed below, and as
a part of having seizure activity, please follow these
recommendations:</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Allopurinol ___ mg PO EVERY OTHER DAY
2. Aspirin 81 mg PO DAILY
3. Multivitamins W/minerals 1 TAB PO DAILY
4. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin 500 mg 1 tablet(s) by mouth twice a day Disp
#*25 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Gram negative rod bacteremia
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 while you were here at
___. You were admitted to the hospital with a life threatening
infection of bacteria in your blood. The source may have been
from a urinary tract infection or where your gallbladder was
previously. You were very ill when you arrived and required
close monitoring in the intensive care unit before stabilizing
with antibiotics. You were originally treated with IV
antibiotics and now switched to pill antibiotics based on what
the bacteria is sensitive to.
If you develop any fevers, chills, lightheadedness you should
seek medical attention.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Lithium Carbonate 300 mg PO BID
RX *lithium carbonate 600 mg 1 capsule(s) by mouth at bedtime
Disp #*10 Tablet Refills:*0
2. Lorazepam 0.5 mg PO Q4H:PRN anxiety, insomnia
RX *lorazepam 0.5 mg 1 tablet by mouth q4H:prn Disp #*35 Tablet
Refills:*0
3. Acetaminophen ___ mg PO Q6H:PRN pain
RX *acetaminophen 500 mg ___ tablet(s) by mouth q6h:prn Disp
#*100 Tablet Refills:*0
4. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*100 Capsule Refills:*0
5. Haloperidol 10 mg PO TID
RX *haloperidol 10 mg 1 tablet(s) by mouth three times a day
Disp #*21 Tablet Refills:*0
6. Haloperidol 10 mg PO QID:PRN anxiety, insomnia, ruminations,
mania, mood lability
RX *haloperidol 10 mg 1 tablet(s) by mouth QID:PRN Disp #*28
Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
urinary retention
post partum mood disorder
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please follow Nursing instructions and follow up with your
psychiatry appointments, with urogynecology and with Dr. ___.
Please call the office with any questions</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Nimodipine 60 mg PO Q4H
please take ___ through ___
RX *nimodipine 30 mg 2 capsule(s) by mouth every four (4) hours
Disp #*60 Capsule Refills:*0
2. Acetaminophen-Caff-Butalbital ___ TAB PO Q6H:PRN headache
DO NOT EXCEED 4 grams tylenol in 24 hours
RX *butalbital-acetaminophen-caff 50 mg-325 mg-40 mg ___
tablet(s) by mouth every six (6) hours Disp #*65 Tablet
Refills:*0
3. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice
a day Disp #*60 Capsule Refills:*1
4. Ondansetron 4 mg PO Q8H:PRN nausea
RX *ondansetron 4 mg 1 tablet(s) by mouth q8 Disp #*15 Tablet
Refills:*0
5. Outpatient Physical Therapy
out patient physical therapy
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
SAH
Posterior communicating artery aneurysm
___ nerve palsy
Discharge Condition:
alert and oriented to person, place, time.
EOM intact.
pupils 4-3mm bilaterally.
no pronator
strength is full bilateral upper/ lower extremities
third nerve palsy- right ptosis
left ptosis
incision well healed
Followup Instructions:
___ [/INST] </s><s>You are being discharged under 24 hour supervision as discussed.
Your wife has agreed to provide this support and superision.
You will both be staying at your mothers home for additional
support after your discharge from the hospital as discussed.
YOU HAVE BEEN prescribed NIMODIPINE. YOU WILL TAKR this
medication for a TOTAL of 21 days begining from ___. The
last day that you will be taking this medication is ___
Call your neurosurgeons office and speak to the Nurse
Practitioner if you experience:
-Any neurological issues, such as change in vision, speech or
movement
-Swelling, drainage, or redness of your incision
-Any problems with medications, such as nausea vomiting or
lethargy
-Fever greater than 101.5 degrees Fahrenheit
-Headaches not relieved with prescribed medications
Activity:
-Start to resume all activities as you tolerate but start
slowly and increase at your own pace.
-Do not operate any motorized vehicle until discussed in your
follow up visit.
Incision Care:
-Keep your wound clean and dry.
-You may shampoo your hair as your sutures have been removed.
-When you are allowed to shampoo your hair, let the shampoo run
off the incision line. Gently pad the incision with a towel to
dry.
-Do not rub, scrub, scratch, or pick at any scabs on the
incision line.
Post-Operative Experiences: Physical
-Jaw pain on the same side as your surgery; this goes away
after about a month
-You may experience constipation. Constipation can be
prevented by:
oDrinking plenty of fluids
oIncreasing fiber in your diet by eating vegetables, prunes,
fiber rich breads and cereals, or fiber supplements
oExercising
oUsing over-the-counter bowel stimulants or laxatives as
needed, stopping usage if you experience loose bowel movements
or diarrhea
-Fatigue which will slowly resolve over time
-Numbness or tingling in the area of the incision; this can
take weeks or months to fully resolve
-Muffled hearing in the ear near the incision area
-Low back pain or shooting pain down the leg which can resolve
with increased activity
Post-Operative Experiences: Emotional
-You may experience depression. Symptoms of depression can
include
oFeeling down or sad
oIrritability, frustration, and confusion
oDistractibility
oLower Self-Esteem/Relationship Challenges
oInsomnia
oLoneliness
-If you experience these symptoms, you can contact your Primary
Care Provider who can make a referral to a Psychologist or
Psychiatrist
-You can also seek out a local Brain Aneurysm Support Group in
your area through the Brain Aneurysm Foundation
oMore information can be found at ___</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 caring for you at ___. You came to the
hospital because of a urinary tract infection and fast heart
rate. We discovered that you have an infected ulcer ___ the
bottom of your genital region. Your urine grew out a bacteria
called e. coli. We treated you with antibiotics. For your fast
heart rate, we treated you with heart medications called
metoprolol and you did well. You were seen by our urologist who
did not believe there was any surgery to be done at this time
for your wound. You need good, daily wound care by your nurses.
___ Instructions:
- Your nurses must inspect your genital region at least twice a
day and clean the area
- You need continued IV antibiotics. Please follow-up ___
infectious disease clinic to determine when this can be stopped
- You will go to nursing home with a new IV line so we can
safely give you the antibiotics. This will be removed once the
antibiotics are stopped.
- Take all medications as prescribed. Follow-up with all
appointments below.
It was our pleasure to care for you at ___. We wish you the
best.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Symbicort (budesonide-formoterol) 80-4.5 mcg/actuation
inhalation 2 puffs BID
2. Acetaminophen 650 mg PO Q4H:PRN pain
3. Docusate Sodium 100 mg PO BID:PRN constipation
4. Aspirin 325 mg PO DAILY
5. Omeprazole 20 mg PO DAILY
6. Simvastatin 5 mg PO QPM
7. Tiotropium Bromide 1 CAP IH DAILY
8. Vitamin D 1000 UNIT PO DAILY
9. Cyanocobalamin 1000 mcg PO DAILY
10. budesonide-formoterol 80-4.5 mcg/actuation INHALATION DAILY
11. TraMADOL (Ultram) ___ mg PO Q4H:PRN pain
RX *tramadol 50 mg ___ tablet(s) by mouth every six (6)
hours Disp #*30 Tablet Refills:*0
12. Senna 17.2 mg PO HS:PRN constipation
13. Lisinopril 10 mg PO DAILY
14. albuterol sulfate 90 mcg/actuation inhalation QID prn
wheezing
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Left pneumothorax
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 chest tube placement to
help reinflate your left lung. Your tube has now been removed
and the lung is reinflated. You are now ready for discharge.
* Your chest tube dressing may be removed in 48 hours. If it
starts to drain, cover it with a clean dry dressing and change
it as needed to keep site clean and dry.
* If you need pain medication once you are home you can use
Tylenol. Use a stool softener or gentle laxative to stay
regular.
* Continue to stay well hydrated and eat well.
* Shower daily. Wash incision with mild soap & water, rinse, pat
dry
* No tub bathing, swimming or hot tubs until incision healed
* No lotions or creams to incision site
* Walk ___ times a day and gradually increase your activity as
you can tolerate.
Call Dr. ___ ___ if you experience:
-Fevers > 101 or chills
-Increased shortness of breath, chest pain 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. Benztropine Mesylate 1 mg PO BID
2. Benztropine Mesylate 0.5 mg PO BID:PRN rigidity, restlessness
3. Gabapentin 100 mg PO TID
4. Levothyroxine Sodium 150 mcg PO DAILY
5. Nadolol 20 mg PO HS
6. RISperidone 2 mg PO HS
7. TraZODone 100 mg PO HS Insomnia
8. FoLIC Acid 1 mg IV Q24H
RX *folic acid 1 mg 1 tablet(s) by mouth Daily Disp #*30 Tablet
Refills:*0
9. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth Daily Disp #*30 Tablet
Refills:*0
10. Omeprazole 20 mg PO DAILY
11. Thiamine 100 mg PO DAILY
RX *thiamine HCl 100 mg 1 tablet(s) by mouth Daily Disp #*30
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY:
Hypomagnesemia
Hypokalemia
Dizziness
SECONDARY:
Alcoholic Liver Disease
Alcoholic Dependence/Abuse
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 take care of you at ___
___. You were admitted because you were having dizziness
and were found to have low blood magnesium and potassium. You
were given more magnesium and potassium and were given
additional nutritional supplements. Best of luck to you in your
future health.
Please do not drink alcohol. Take all medications as
prescribed, attend all doctor 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. BuPROPion 100 mg PO DAILY
2. Citalopram 10 mg PO DAILY
3. Donepezil 10 mg PO HS
4. Haloperidol 0.5 mg PO BID:PRN agitation
RX *haloperidol 0.5 mg 1 tablet(s) by mouth BID PRN Disp #*15
Tablet Refills:*0
5. Lisinopril 2.5 mg PO DAILY
RX *lisinopril 2.5 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
6. Memantine 5 mg PO DAILY
7. Aquaphor Ointment 1 Appl TP BID
RX *white petrolatum [Aquaphor with Natural Healing] 41 % Apply
to dry skin twice a day Refills:*0
8. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
9. Atorvastatin 80 mg PO DAILY
RX *atorvastatin 80 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
10. Hydrocortisone Oint 1% 1 Appl TP BID
RX *hydrocortisone [Cortizone-10] 1 % apply to rash twice a day
Disp #*28 Gram Gram Refills:*0
11. Sarna Lotion 1 Appl TP BID:PRN itching
RX *camphor-menthol [Anti-Itch (menthol/camphor)] 0.5 %-0.5 %
apply to itchy skin twice a day Refills:*0
12. cholestyramine-aspartame 4 gram oral BID
13. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY
Do Not Crush
14. Metoprolol Succinate XL 12.5 mg PO DAILY
RX *metoprolol succinate 25 mg 0.5 (One half) tablet(s) by mouth
daily Disp #*15 Tablet Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
-Biomarker negative unstable angina
-Coronary artery disease
-Hypertension
-Hypotension
-Contact Dermatitis
-Dementia
-Diabetes mellitus
Discharge Condition:
Mental Status: Confused - always.
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 came to the
hospital because of chest pressure and concerning findings on
your EKG. It appears you have coronary artery disease and have a
condition called unstable angina. We started you on medications
to control your cholesterol and blood pressure. Please continue
to take this medication daily.
We also noted that you have a rash on your abdomen, back, and
legs which is most likely a contact dermatitis. Please continue
the topical steroid for ___s the moisturizing
lotions to help treat this rash.
Please follow up closely with your primary care physician as
well as your outpatient cardiologist. If you should develop any
chest pain, palpitations, shortness of breath please call your
primary care physician or report to the Emergency Department.
Be well and take care.
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Levothyroxine Sodium 25 mcg PO QOD
2. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *metronidazole 500 mg 1 tablet(s) by mouth every 8 hours
(total of 3 per day) Disp #*18 Tablet Refills:*0
3. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin 500 mg 1 tablet(s) by mouth once in morning
and once at night Disp #*12 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Infectious Colitis
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 transferred from ___ to
___ for blood in your stools.
While you were here, you had a flexible sigmoidoscopy exam which
showed concern for infectious colitis. You were given one week
of antibiotics. If you experience diarrhea, please see your
primary care provider for ___ stool sample to be sent for
infections, including C Diff. Please have a screening
colonoscopy in ___ weeks.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Haloperidol 0.25 mg IV Q4H:PRN agitation
2. Sodium Chloride 0.9% Flush 3 mL IV Q8H and PRN, line flush
3. HYDROmorphone (Dilaudid) 0.125 mg IV Q3H:PRN pain
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Gastric outlet obstruction
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
You were admitted to the intensive care unit because of gastric
outlet obstruction. Our surgical team evaluated you and
determined that surgery was too high risk to pursue. Your family
decided to focus on your comfort and you were discharged to
___ House.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atovaquone Suspension 1500 mg PO DAILY
2. Mycophenolate Mofetil 500 mg PO TID
3. Fluoxetine 20 mg PO DAILY
4. Docusate Sodium 100 mg PO BID:PRN constipation
5. Vitamin D 50,000 UNIT PO 1X/WEEK (TH)
6. Lorazepam 1 mg PO BID:PRN anxiety
pls hold for rr<12, sedation
7. Multivitamins 1 TAB PO DAILY
8. Fludrocortisone Acetate 0.1 mg PO DAILY:PRN low BP
9. Midodrine ___ mg PO BID:PRN low BP
10. Tacrolimus 1.5 mg PO Q12H
RX *tacrolimus 0.5 mg 3 Capsule(s) by mouth twice a day Disp
#*42 Tablet Refills:*0
11. Ciprofloxacin HCl 500 mg PO Q12H Duration: 14 Days
RX *ciprofloxacin 500 mg 1 Tablet(s) by mouth twice a day Disp
#*28 Tablet Refills:*0
12. Nystatin Oral Suspension 5 mL PO QID
Retain in mouth as long as possible, use x48 hours after
symptoms resolve.
RX *nystatin 100,000 unit/mL 5 ml by mouth four times a day Disp
#*300 Milliliter Refills:*0
13. Caltrate 600 + D *NF* (calcium carbonate-vitamin D3) 600
mg(1,500mg) -400 unit Oral bid
14. Benefiber (guar gum) *NF* (guar gum) 0 tsp ORAL PRN
constipation
15. Milk of Magnesia 30 mL PO Q12H:PRN constipation
Discharge Disposition:
Home
Discharge Diagnosis:
Urinary tract infection
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Continue your home medications with the following changes:
1. Start taking ciprofloxacin for a total course of 14 days as
an outpatient.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
RX *acetaminophen 500 mg 2 tablet(s) by mouth three times a day
Disp #*60 Tablet Refills:*0
2. crutch miscellaneous prn ambulation
RX *crutch Disp #*1 Package Refills:*0
3. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 tablet(s) by mouth twice daily Disp
#*50 Tablet Refills:*0
4. Enoxaparin Sodium 40 mg SC QPM
RX *enoxaparin 40 mg/0.4 mL 40 mg SC dialy Disp #*14 Syringe
Refills:*0
5. OxyCODONE (Immediate Release) 2.5-5 mg PO Q4H:PRN Pain -
Severe
RX *oxycodone 5 mg 1 to 2 tablet(s) by mouth every four (4)
hours Disp #*32 Tablet Refills:*0
6. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 1 tab by mouth twice daily Disp
#*50 Tablet Refills:*0
7. Omeprazole 20 mg PO DAILY
Discharge Disposition:
Home with Service
Discharge Diagnosis:
Left distal tibia 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>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:
- weight bearing as tolerated to the left lower extremity in
air-cast boot
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:
- 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
THIS PATIENT IS EXPECTED TO REQUIRE <30 DAYS OF REHAB
Physical Therapy:
weight bearing as tolerated to the left lower extremity in
air-cast boot
Treatments Frequency:
Any staples or superficial sutures you have are to remain in
place for at least 2 weeks postoperatively. Incision may be
left open to air unless actively draining. If draining, you may
apply a gauze dressing secured with paper tape. You may shower
and allow water to run over the wound, but please refrain from
bathing for at least 4 weeks postoperatively.
Please remain in the splint until follow-up appointment. Please
keep your splint dry. If you have concerns regarding your
splint, please call the clinic at the number provided.
Call your surgeon's office with any questions.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Clonazepam 0.5 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Serotonin 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>Mr. ___,
You were admitted to the hospital for symptoms of difficulty
walking and tremors. These symptoms were found to be the result
of too many anti-depressant medications resulting in something
called "Serotonin Syndrome" caused by an excess of serotonin.
When mild, this causes elevated heart rate, muscle
jerking/tremor, overresponsive reflexes, and other symptoms.
Other symptoms can include confusion, hallucinations, sweating,
nausea, and diarrhea. Not all symptoms may always be present.
The improvement in your symptoms after stopping these
medications indicates this as the likely diagnosis. Treatment is
to stop all offending medications for a period of time before
restarting some slowly. We discussed this with your psychiatrist
who informed us you were not supposed to be taking the Doxepin
any longer. Your psychiatrist agrees with this plan, and would
like to see you very soon in their office.
- STOP Doxepin
- STOP Prozac
- STOP Wellbutrin
Follow-up with your psychiatrist from the rehabilitation
facility.
It was a pleasure taking care of you!
Thank you,
Your ___ Neurology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atenolol 50 mg PO DAILY
2. Calcium Carbonate 1000 mg PO DAILY
3. Fish Oil (Omega 3) 1000 mg PO DAILY
4. Losartan Potassium 100 mg PO DAILY
5. Multivitamins 1 TAB PO DAILY
6. Nortriptyline 10 mg PO HS
RX *nortriptyline 10 mg 1 by mouth at bedtime Disp #*30 Capsule
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Tension/cerevicogemic headaches
Subjective right hemibody altertation in skin sensations of
undetermined etiology
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Neuro exam: Non focal. Decreased sensation to pinprick and
temperature on the right hemibody.
Followup Instructions:
___ [/INST] </s><s>Dear Ms ___,
It was a pleasure taking care you. You were here because of
headaches and abnormal sensation on the right side of the body.
You have got CT scan and MRI of your head which did not show any
stroke. We do not think that your symptoms are related to a
stroke. For your headache, we have prescribed nortriptyline to
be taken everyday at bedtime. Please follow up with your PCP as
scheduled.
Medication changes:
- We ADDED NORTRIPTYLINE 10mg qhs to be taken every day at
bedtime to treat your headaches.
Please continue to take the rest of your home medications as
previously prescribed.
Please call your doctor or go to the emergency room if
experience any of the danger signs listed below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Lisinopril 10 mg PO DAILY
RX *lisinopril 10 mg 1 tablet(s) by mouth daily Disp #*14 Tablet
Refills:*0
2. Furosemide 80 mg PO DAILY
RX *furosemide 80 mg 1 tablet(s) by mouth daily Disp #*14 Tablet
Refills:*0
3. Fluconazole 400 mg PO Q24H
Take two tablets on first day, then one tablet daily thereafter.
RX *fluconazole 200 mg 2 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
4. Narcan (nalOXone) 4 mg/actuation nasal ONCE:PRN overdose
Discharge Disposition:
Home
Discharge Diagnosis:
MSSA endocarditis
Gram positive cocci bacteremia (unspeciated at time of
discharge)
Yeast fungemia (unspeciated at time of discharge)
Severe aortic regurgitation
Severe tricuspid regurgitation
Acute heart failure with preserved ejection function
Subluxed left clavicle
L4-L5 epidural abscess/discitis
Left lung infarct
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 ___
for chest pain and shortness of breath. This was after being off
of intravenous antibiotics for one week. We found that you had a
second leaky valve (your aortic valve). Our cardiac surgeons
evaluated you and planned to do surgery. This ___ would have been the completion of your six weeks of
intravenous antibiotics for your endocarditis.
Unfortunately, blood cultulres from ___ are now growing gram
positive cocci bacteria, as well as yeast. This is likely from
contamination of your PICC line. This is a very serious
condition, for which you need both antibiotics and anti-fungals.
Unfortunately, despite our strong recommendation to stay, you
decided to leave against our medical advice. We are giving you a
prescription for fluconazole, which is for the yeast. You should
take 800 mg today and 400 mg daily thereafter. Please note, this
is not the optimal treatment, as we do not yet know the species
of yeast. Moreover, you should be getting this medication
intravenously, as well as intravenous vancomycin (another
antibiotic).
Please go to another hospital as soon as possible and tell them
that you had budding yeast and gram positive cocci in clusters
growing in your blood cultures.
If you change your mind, we are happy to continue caring for you
here.
We wish you all the best,
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 - Mild/Fever
2. Furosemide 10 mg PO DAILY
Stop taking if your weight drops more than 5 pounds or if your
swelling improves.
RX *furosemide 20 mg 0.5 (One half) tablet(s) by mouth QD:PRN
Disp #*15 Tablet Refills:*0
3. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation
Q8H:PRN SOB
RX *albuterol sulfate [ProAir HFA] 90 mcg 1 Puff Q8H every eight
(8) hours Disp #*1 Inhaler Refills:*0
4. Verapamil SR 120 mg PO Q24H
RX *verapamil 120 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnosis:
- Stage IV Lung Adenocarcinoma (___)
Secondary Diagnoses:
- Pericardial Effusion with cardiac tamponade
- New Atrial Fibrillation (transient)
- Tachyarrythmia, atrial ectopy
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 ___
___.
WHY WAS I IN THE HOSPITAL?
==========================
- You presented to hospital with worsening shortness of breath
and leg swelling.
WHAT HAPPENED IN THE HOSPITAL?
==============================
-You were found to have fluid around your heart that caused you
to be critically ill. You had a procedure to remove this fluid
and were monitored in the ICU until you improved.
-An additional surgery, called a pericardial window, was
performed on ___ to prevent further fluid from building up
around your heart.
-You were diagnosed with a new irregular heart rhythm called
Atrial Fibrillation in the ICU. This was felt to be due to the
fluid around your heart and resolved. You did have a fast heart
rate on the medical floor, so you were seen by the
cardiologists, who recommended you take a medicine called to
help with your fast heart rate. On ___, we placed a ziopatch
(heart rhythm monitor) on your chest to monitor your heart rate
and rhythm. You were also started on a medication, called
verapamil, to slow down your heart beat.
-You were seen by the Hematology/Oncology Team and were
diagnosed with Stage IV Non-small cell lung cancer. You had an
MRI of your brain, a scan of your bones, and a CT scan of your
abdomen, which did not show spread of your cancer to those
areas.
- You were discharged when you were breathing comfortably, there
was no more fluid around your heart, and your heart rate was
controlled.
WHAT SHOULD I DO WHEN I GO HOME?
================================
- Take all of your medications as prescribed: verapamil for your
heart rate, furosemide for your feet swelling (stop taking if
you lose more than 5 pounds or your swelling goes away),
compression stockings for your feet swelling, albuterol inhaler
for difficulty breathing, and multivitamin
- Follow up with your doctors: your PCP ___, Oncology team ___ at 9am), Cardiology (they will
call you to schedule), and Infectious Diseases ___ to
discuss treatment of your latent TB).
- You had a Ziopatch placed on ___ - please wear this for two
weeks (or until it falls off) and mail it in the return box.
Then follow up with cardiology as scheduled. If you have any
questions about your Ziopatch, you can call their language line
and receive help in ___ - ___
- You should see the cardiologist in ___ weeks; if they don't
call you by ___, please call their office to schedule an
appointment at ___
It was a pleasure participating in your care.
If you have any urgent questions that are related to your
recovery from your hospitalization or are experiencing any
symptoms that are concerning to you and you think you ___ need
to return to the hospital, please call the ___ HeartLine at
___ to speak to a cardiologist or cardiac nurse
practitioner.
-Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
You came to the hospital with a toe infection, which was
amputated by our podiatric surgeons. You received very strong
antibiotics through the IV for this.
The surgeons were worried about how the site of the amputation
would heal, so our vascular surgeons evaluated your leg with an
angiogram and determined that a much larger amputation would be
the best way to prevent worsening of the infection. This was not
something that made sense for you based on your goals of care,
so you are going to be discharged back home and will remain on
antibiotics to help prevent a worsening infection.
After you leave the hospital, it will be very important to keep
a close eye on the toe with wound care, antibiotics, and daily
dressings for now. Instructions will be passed on to your home.
It was a pleasure caring for you and 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. Allopurinol ___ mg PO DAILY
2. Aspirin 325 mg PO DAILY
3. Chlorthalidone 25 mg PO DAILY
4. Atorvastatin 80 mg PO DAILY
RX *atorvastatin 80 mg 1 tablet(s) by mouth Daily Disp #*30
Tablet Refills:*0
5. Losartan Potassium 75 mg PO DAILY
RX *losartan 50 mg 1 and ___ tablet(s) by mouth once a day Disp
#*45 Tablet Refills:*0
6. Pantoprazole 40 mg PO Q24H
RX *pantoprazole 40 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
7. Multivitamins 1 TAB PO DAILY
8. Naproxen 250 mg PO DAILY:PRN pain
9. Nystatin Cream 1 Appl TP DAILY
10. Metoprolol Succinate XL 100 mg PO DAILY
RX *metoprolol succinate 100 mg 1 tablet(s) by mouth once a day
Disp #*30 Tablet Refills:*0
11. Clopidogrel 75 mg PO DAILY
RX *clopidogrel 75 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*11
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: ST Elevation Myocardial Infarction
Secondary: Hypertension, Hyperlipidemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr ___,
As you know, you were admitted to the ___
___ with left shoulder pain and a concerning stress
test. We performed an EKG which was concerning for an acute
blockage in the blood vessels of the heart. You were taken to
the cardiac catheterization lab where we noted a near complete
blockage of the Right Coronary Artery which was opened with a
Drug Eluting Stent. We also noted a 70% blockage of the Left
Anterior Descending artery however this lesion was no thought to
be the culprit lesion and no stent was placed.
You will need to take clopidogrel for one year, it is imperative
that you do not miss doses of this medication, it prevents the
stent from closing. You will also need to take Aspirin 325mg
daily for one month (until ___ then decrease to aspirin
81mg which you will need to take lifelong.
We have arranged for follow up with Dr. ___ Dr. ___.
We made some changes to your blood pressure medication and
recommend that you have your blood drawn in one week for
monitoring.</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. Dexamethasone 4 mg PO Q6H
RX *dexamethasone 4 mg 1 tablet(s) by mouth every six (6) hours
Disp #*60 Tablet Refills:*0
3. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*30 Capsule Refills:*0
4. LevETIRAcetam 500 mg PO BID
RX *levetiracetam 500 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*1
5. Senna 8.6 mg PO BID:PRN constipation
6. aMILoride 5 mg PO DAILY
7. amLODIPine 10 mg PO DAILY
8. Fluticasone Propionate NASAL 1 SPRY NU BID
9. Hydrochlorothiazide 12.5 mg PO DAILY
10. Klor-Con M20 (potassium chloride) 20 mEq oral DAILY
11. MetFORMIN XR (Glucophage XR) 500 mg PO QPM
12. MetFORMIN XR (Glucophage XR) 1000 mg PO DAILY
Do Not Crush
13. Metoprolol Tartrate 75 mg PO BID
14. Ranitidine 150 mg PO BID
15. Simvastatin 20 mg PO QHS
16.Rolling walker
Diagnosis: Left frontal lesion
Prognosis: Good
Length: 13 months
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Left frontal brain lesion
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 Tumor
Surgery
You underwent a biopsy. A sample of tissue from the
lesion in your brain was sent to pathology for testing.
Please keep your incision dry until your sutures/staples are
removed.
You may shower at this time but keep your incision dry.
It is best to keep your incision open to air but it is ok to
cover it when outside.
Call your surgeon if there are any signs of infection like
redness, fever, or drainage.
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 discharged on Keppra (Levetiracetam). This
medication helps to prevent seizures. Please continue this
medication as indicated on your discharge instruction. It is
important that you take this medication consistently and on
time.
You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
What You ___ Experience:
You may experience headaches and incisional pain.
You may also experience some post-operative swelling around
your face and eyes. This is normal after surgery and most
noticeable on the second and third day of surgery. You apply
ice or a cool or warm washcloth to your eyes to help with the
swelling. The swelling will be its worse in the morning after
laying flat from sleeping but decrease when up.
You may experience soreness with chewing. This is normal from
the surgery and will improve with time. Softer foods may be
easier during this time.
Feeling more tired or restlessness is 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.
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: none
Discharge Disposition:
Home
Discharge Diagnosis:
left sided weakness
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 after an outpatient neurologist evaluated you
and found left sided weakness and decrease in sensation on your
left side. These problems had been occurring for about a month
but appeared to be worsening. He sent you to the ED at ___ for
admission and urgent MRI to rule out serious conditions.
Unfortunately, there was a delay in getting the MRI as and you
were not about to get the scan till the evening of your second
day of admission. At that time, the team was informed that you
were in the middle of your finals and had not realized that you
would be admitted to the hospital for such an extended time. The
decision was made to discharge you per your request so you can
attend the last day of finals on ___. A letter will be
provided to you to excuse you from finals during your
hospitalization (___). A ride with your uncle has
been arranged to help facilitate this late discharge. Please
follow up with your outpatient neurologist, Dr ___
Office: ___ on ___ to get the results of
the MRI and to arrange the appropriate follow up. An appointment
was not scheduled as your discharge was after office hours.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. phenytoin sodium extended 100 mg Capsule Sig: Two (2) Capsule
PO BID (2 times a day).
2. zolpidem 5 mg Tablet Sig: ___ Tablets PO HS (at bedtime).
3. lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
4. hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO
DAILY (Daily).
5. simvastatin 10 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).
6. famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
7. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
8. oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for Headache.
9. dexamethasone 2 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6
hours).
Disp:*240 Tablet(s)* Refills:*0*
10. acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q4H (every 4
hours) as needed for pain or fever.
11. docusate sodium 100 mg Tablet Sig: One (1) Tablet PO twice a
day.
12. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1)
packet PO once a day.
13. senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day as
needed for constipation.
Discharge Disposition:
Home
Discharge Diagnosis:
headache
frontal sinus neoplasm
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Neuro: no deficits
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you during your stay. You were
admitted for headaches. We did a spinal tap to rule out
increased intracranial pressure and infection. It showed neither
of these. We also took pictures of your head to rule out sinus
thrombosis, which also came back ok. We increased your steroids
to dexamethasone 4mg by mouth every 6 hours. Please continue
taking this as well as your previous home medications.
Please attend your appointment tomorrow, as listed below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ferrous Sulfate 325 mg PO DAILY
2. FoLIC Acid 1 mg PO DAILY
3. Glargine 24 Units Bedtime
4. Lactulose 30 mL PO TID
5. Loratadine 10 mg PO DAILY
6. Multivitamins 1 TAB PO DAILY
7. Pantoprazole 40 mg PO Q24H
8. Thiamine 100 mg PO DAILY
9. Magnesium Oxide 400 mg PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Cirrhosis
Ascites
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 came to us with worsening stomach
distension. We removed fluid from you belly. You should stop
taking Lasix and Aldactone and come in for a paracentesis, or
fluid removal every week. We do not feel that it's safe for you
to take diuretics without close follow up as you may damage
your kidneys and develop complications. We cannot stress the
importance of not drinking alcohol at all. It is very dangerous
for your liver. You should also stop taking Nadolol as this is
causing worsening ascites or stomach fluid.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amlodipine 10 mg PO DAILY
hold for sbp<100 or hr<60
2. Docusate Sodium 100 mg PO DAILY
3. Lisinopril 40 mg PO DAILY
hold for sbp<100 or hr<60
4. Mirtazapine 37.5 mg PO HS
5. Multivitamins W/minerals 1 TAB PO DAILY
6. Senna 2 TAB PO BID
7. Acetaminophen 650 mg PO Q4H:PRN pain/fever
8. Bisacodyl ___AILY:PRN constipation
9. Fleet Enema ___AILY:PRN constipation
10. Milk of Magnesia 30 mL PO DAILY:PRN constipation
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Mechanical fall
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 brought to the hospital
after falling at your nursing home. In the emergency room, we
noted a heart murmur that we wanted to make sure was not the
cause of your fall. We performed several lab tests and they all
returned normal. We also got an ultrasound of your heart and it
was normal. We think your fall was most likely mechanical.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler ___ PUFF IH Q4-6H:PRN sob
2. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
3. Simethicone 166-332 mg PO QID
4. Miconazole Nitrate Vag Cream 2% 1 Appl VG BID:PRN rash/itch
5. mometasone *NF* 0.1 % Topical BID
6. nystatin *NF* 100,000 unit/g Topical BID prn rash
7. BuPROPion (Sustained Release) 150 mg PO QAM
8. Erythromycin 0.5% Ophth Oint 0.5 in BOTH EYES QID
9. Acetaminophen 325-650 mg PO Q6H:PRN pain/fever
10. Sodium Chloride 0.9% Flush 10 mL IV PRN line flush
11. ALPRAZolam 0.5-1 mg PO QHS:PRN anxiety
12. Sodium Chloride Nasal ___ SPRY NU DAILY:PRN congestion
13. Ditropan XL *NF* (oxybutynin chloride) 15 mg Oral daily
14. Piperacillin-Tazobactam 4.5 g IV Q8H
D1- ___. Last doses on ___.
15. Vancomycin 1500 mg IV Q 8H
D1- ___. Last doses on ___.
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary diagnosis: Bilateral pre-septal cellulitis
Secondary diagnosis: asthma, depression, anxiety
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
___ were admitted after a visit with the eye doctor given their
concern for an infection around your eye. A CT scan was
performed and demonstrated infection of the skin, but no signs
of infection behind the eye. ___ were started on IV antibiotics
based on the recommendations of the eye doctors and ___
disease doctors. ___ were monitored and your antibiotics were
changed a few times to give ___ the best medication combination.
___ started improving and ___ will complete a 10 day course of
antibiotics at a skilled nursing facility.
Please see the medication page for changes to your antibiotic
regimen.
Please see below for details about upcoming appointments.
It was a pleasure participating in your care, thank ___ for
choosing ___!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Timolol Maleate 0.5% 1 DROP BOTH EYES BID
2. Warfarin 7.5 mg PO DAILY16
3. Heparin IV per Weight-Based Dosing Guidelines
Continue existing infusion at 1050 units/hr
Start: Today - ___, First Dose: 0900
Target PTT: 60 - 100 seconds
4. Ondansetron 4 mg IV Q8H:PRN nausea, vomiting
5. Aspirin 81 mg PO DAILY
6. Omeprazole 40 mg PO BID
Give in 1 tablespoon apple sauce or other cold soft food.
7. Furosemide 20 mg PO DAILY
8. Lisinopril 10 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
UGIB, Esophagitis with Stricture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid ___
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure being part of your care at ___. You were
admitted to the hospital due to vomiting of blood. You were
treated with medications to decrease bleeding risk, and your
anticoagulant medications were initially held. You had some
further vomiting while in the hospital but no blood was visible
and your blood counts were stable. You were evaluated by the
gastroenterology team who performed an endoscopy, and found an
esophageal stricture as well as evidence of irritation of your
gastrointestinal tract. Your diet was modified and your
anticoagulant medications were resumed.
You should continue your medications and please keep your
appointments as below. Thank you for allowing us to be part of
your care.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcium Carbonate 500 mg PO QID:PRN GERD
2. Fluocinolone Acetonide 0.01% Solution 1 Appl TP BID
RX *fluocinolone 0.01 % massage into scalp after washing hair.
leave in twice daily as needed 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. Nicotine Patch 14 mg TD DAILY
RX *nicotine 14 mg/24 hour 1 daily Disp #*30 Patch 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
7. Calcipotriene 0.005% Cream 1 Appl TP BID
8. Clobetasol Propionate 0.05% Cream 1 Appl TP BID
9. Loratadine 10 mg PO DAILY
10. Omeprazole 20 mg PO DAILY
11. PARoxetine 20 mg PO DAILY
RX *paroxetine HCl 20 mg 1 tablet(s) by mouth daily Disp #*10
Tablet Refills:*0
12. HELD- Albuterol Sulfate (Extended Release) Dose is Unknown
PO Frequency is Unknown This medication was held. Do not
restart Albuterol Sulfate (Extended Release) until you meet with
your new primary care doctor
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Alcohol Withdrawal
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 ___.
WHY DID YOU COME TO THE HOSPITAL?
You were withdrawing from alcohol
Your left arm was weak
WHAT HAPPENED WHILE YOU WERE HERE?
You were monitored for dangerous signs of alcohol withdrawal
You had an MRI to see if there were any dangerous reasons your
left arm was weak
WHAT SHOULD YOU DO WHEN YOU LEAVE THE HOSPITAL?
Please continue to take all of your medications as directed, and
follow up with all of your doctors. As we discussed, you should
not drink alcohol.
Again, it was a pleasure taking care of you!
Sincerely,
Your ___ Team
==========================================
TO PREVENT AND TREAT ALCOHOL INTOXICATION:
* Avoid alcohol or limit your drinking.
* Avoid drinking on an empty stomach.
* Drink plenty of water or non-alcoholic drinks (1 per alcoholic
drink).
* Stay positive and be patient with yourself as you try to limit
and/or stop your drinking. Try to avoid stress or find
alternate ways of relieving your stress (rather than alcohol).
SEEK CARE IMMEDIATELY IF:
* You feel you need help to deal with your drinking.
* You have thoughts about hurting yourself or someone else.
* You have chest pain, trouble breathing, or heart
palpitations.
* You pass out or have a seizure.
* You have any other new or concerning symptoms.
The following is a list of drug and alcohol treatment centers
that may be able to provide assistance with addiction and
chronic substance abuse problems.
<B>Drug/Alcohol Treatment Centers</B>
___ SUBSTANCE ABUSE HELP LINE
1 ___
*This line is open 24 hours a day, 7 days a week and can assist
with referrals to treatment centers.
___
Accepts uninsured and Mass Health
___
___
Accepts uninsured and Mass Health
___
CAB ___ TREATMENT ___
Accepts uninsured and Mass Health
___
1 ___
___ DETOX
Accepts private insurance/ Medicare only
___
___ DETOX
Accepts private insurance/ Medicare only
___
___ DETOX
Accepts private insurance/ Medicare only
___
___ DETOX
Accepts private insurance/ Medicare only
___ to ___, ___
___
___ HEALTH ___ RECOVERY
Accepts uninsured and Mass Health
___
___ETOX ___
Accepts uninsured and Mass Health
___
1 ___ETOX ___
Accepts uninsured and Mass Health
___
___
Accepts private insurance/ Medicare only
___
___ DETOX
Accepts uninsured and Mass Health
___, ___
1 ___
___ DETOX
Accepts uninsured and Mass Health
___, ___ ___
___.
Accepts uninsured and Mass Health
___, ___
___
Accepts private insurance/ Medicare only
___, ___
<B>EMERGENCY SHELTERS & DROP-IN DAY CENTERS</B>
<B>Shelters</B>
___
*Men and Women
___
___
*Men and Women
___
___
___ FOUND ___
*Men and Women (check-in at 3:00 p.m.)
___
___
___
*Men and Women
___
___
___
*Men Only
___
___
___
*Men Only
___
___
*Women Only (After 7:00 p.m.)
___
___
TRAVELER'S AID SHELTER
*Families Only
___
If after 5:00 p.m. call the ___ help line at ___ and
Travelers Aid will be paged.
___ SHELTER
*Women Only
___
___
<B>Drop-In Day Centers</B>
___ HOUSE
*Men and Women Only. No children
___
___
Open ___ - ___ 7:00 a.m. to 3:00 p.m.
Breakfast Daily: 7:30 a.m. to 9:00 a.m.
Lunch Daily: 11:30 a.m. to 1:00 p.m.
Sandwiches are served 1:00 p.m. to 2:00 p.m.
*Daily access to mental health and career counselors, on-site
medical clinic, and showers.
___
*Men and Women over the age of ___. No children
___
___
Open ___ ___: 8:30 a.m. to 3:30 p.m.
Breakfast Daily: 9:00 a.m.
Lunch Daily: 12:00 p.m.
*Daily access to mental health/substance abuse counseling,
housing advocates and a nursing clinic.
___ PLACE
*Women and children only
___
Open ___ - ___: 7:30 a.m. to 7:00 p.m.
Lunch served daily at 7:30 a.m.
Dinner served daily at 4:30 p.m.
*Daily access to wellness and educational centers, mental health
and career counseling, housing advocates, laundry and showers.
WOMENS LUNCH PLACE
*Women and children only
___
___
___
Open ___ ___: 7:00 a.m. to 2:00 p.m.
Breakfast: 8:00 a.m. to 11:00 a.m.
Lunch: 12:00 p.m. to 2:00 p.m.
___ SENIOR SERVICES
*Older Adults, 60+ and older only
___
___ (Fields Corner)
___
Open ___ ___: 8:00 a.m. to 2:00 p.m.
Lunch served daily at 11:30 a.m.
$2.00 donation for lunch
$10/year required for membership
*Mental health and housing counselors.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen ___ mg PO Q8H:PRN pain
2. Docusate Sodium 100 mg PO DAILY:PRN constipation
3. Gabapentin 600 mg PO TID
4. Glargine 40 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
5. Lisinopril 40 mg PO DAILY
6. NIFEdipine CR 90 mg PO DAILY
7. Pantoprazole 40 mg PO Q12H
8. Senna 8.6 mg PO BID:PRN constipation
9. Sertraline 150 mg PO DAILY
10. TraMADOL (Ultram) 50 mg PO DAILY:PRN pain
11. Bethanechol 25 mg PO QID
RX *bethanechol chloride 25 mg 1 tablet(s) by mouth four times a
day Disp #*56 Tablet Refills:*0
12. HYDROmorphone (Dilaudid) 4 mg PO Q6H:PRN moderate pain
RX *hydromorphone 4 mg 1 tablet(s) by mouth every six (6) hours
Disp #*5 Tablet Refills:*0
13. Metoclopramide 10 mg PO QIDACHS
RX *metoclopramide HCl 10 mg 1 tablet by mouth four times a day
Disp #*56 Tablet Refills:*0
14. Prochlorperazine 25 mg PR Q12H:PRN nausea
Contact your doctor if you need multiple doses of this medicine
since it can interact with others.
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis:
- Severe gastroparesis
Secondary Diagnosis
- Hypertensive urgency
- Mild Acute kidney injury
- Leukocytosis, stress-induced
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 caring for you during your hospitalization.
You were admitted to ___ on ___ after having another severe
flare of abdominal pain, nausea, and vomiting. You underwent an
extensive work-up including physical exams, blood tests, and
imaging tests. Based on these results, we do feel that the most
likely cause of your symptoms continues to be severe
gastroparesis (slow-moving stomach and intestines) related to
diabetes.
We did perform several additional lab tests to ensure there are
no other causes - these results are pending and can be discussed
as an outpatient.
Since you require very frequent placement of large IV lines in
your neck and groin, you underwent a procedure to place a Port
which will give hospitals easier and quicker access to give you
IV fluids and medications if needed.
** You need to always carry your Portacath card on you so that
it can be safely accessed if needed **
** You need to have your Port flushed in the ___ clinic
every 4 weeks. We are notifying your PCP ___ to
help facilitate this **
You were started on 2 medications to help with your
gastroparesis. These are called metoclopramide (Reglan) and
bethanechol. Please be sure to take these as prescribed.
Lastly, it is really important to avoid common triggers of
gastroparesis - this includes any fatty foods, making sure your
sugars are in good control, and not using any drugs that could
slow the gut down (including marijuana). Please be sure to
follow-up at your scheduled appointments below.
We wish you the best of luck!
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 Q4H:PRN pain
2. Aluminum-Magnesium Hydrox.-Simethicone 30 mL PO QID:PRN
indigestion/heartburn
3. Amlodipine 10 mg PO DAILY
4. Atorvastatin 10 mg PO DAILY
5. Calcium Carbonate 500 mg PO BID
6. Dexamethasone 2 mg PO Q12H
7. Famotidine 20 mg PO Q24H
8. Hydrochlorothiazide 25 mg PO DAILY
9. Glargine 10 Units Bedtime
NPH 20 Units Breakfast
NPH 15 Units Dinner
10. LeVETiracetam Oral Solution 1500 mg PO BID
11. Metoprolol Tartrate 50 mg PO BID
12. Multivitamins 1 TAB PO DAILY
13. Phenytoin (Suspension) 100 mg PO Q8H
14. Senna 2 TAB PO DAILY:PRN constipation
15. Levofloxacin 750 mg PO Q48H
Continue taking until ___
16. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
continue till ___. Docusate Sodium 100 mg PO BID
18. Insulin SC
Sliding Scale
Insulin SC Sliding Scale using HUM Insulin
19. MetFORMIN (Glucophage) 1000 mg PO BID
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Pneumonia
Acute kidney injury
Diabetes mellitus type II
Hypertension
Urinary tract infection
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 Ms. ___,
It was a pleasure taking care of you at ___. You were
admitted because you had low oxygen levels in your blood while
you were at ___. This was most likely due to a pneumonia
that was seen on scans of your chest. You were given
antibiotics, and your blood oxygen levels improved while you
were in the hospital. A special scan of the blood flowing to
your lungs did not show any blood clots.
There was some concern that you might have difficulty swallowing
regular foods because of your recent neurosurgery. A swallowing
study was done that showed good swallowing function, so you were
allowed to eat normally, and the feeding tube was removed.
The following changes were made to your medications:
- You should STOP taking Bactrim
- You should CONTINUE taking Levofloxacin and Flagyl until
___
- You should CHANGE the dose of Dexamethasone from 2 grams every
6 hours to 2 grams every 12 hours
- You should STOP taking lisinopril
No other changes were made to your medications</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ because you had chest pain
and sore throat.
WHILE YOU WERE HERE:
- Your scan showed no clot in the lungs.
- Your ultrasound showed no clot in the legs.
- Your heart tests showed no heart attack.
WHEN YOU GO HOME:
- Weigh yourself every morning, call the doctor if weight goes
up more than 3 lbs.
- Continue to take your medications. Your follow up appointments
are below.
It was a pleasure taking care of you and we wish you good
health.
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
RX *acetaminophen 500 mg 2 tablet(s) by mouth every eight (8)
hours Disp #*60 Tablet Refills:*0
2. Amlodipine 5 mg PO DAILY
3. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*60 Capsule Refills:*0
4. Enoxaparin Sodium 40 mg SC Q24H Duration: 4 Weeks
Start: Today - ___, First Dose: Next Routine Administration
Time
RX *enoxaparin 40 mg/0.4 mL 40 mg SC once a day Disp #*30
Syringe Refills:*0
5. OxycoDONE (Immediate Release) ___ mg PO Q3H:PRN Pain
RX *oxycodone 5 mg ___ tablet(s) by mouth Q3H Disp #*60 Tablet
Refills:*0
6. Sertraline 25 mg PO DAILY
7. Spironolactone 25 mg PO DAILY
8. Crutches
Dx- Ankle fracture
Prognosis- Good
Lenghth - 13 months
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Left trimalleolar ankle fracture dislocation
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:
- ___ LLE
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 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.
- No dressing is needed if wound continues to be non-draining.
- 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 surgeon's team (Dr. ___, 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 and any new
medications/refills.
Physical Therapy:
___ LLE
Treatments Frequency:
Please keep in splint until follow up</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 80 mg PO QPM
3. Lisinopril 10 mg PO DAILY
4. Metoprolol Succinate XL 50 mg PO DAILY
5. Omeprazole 20 mg PO DAILY
6. Fish Oil (Omega 3) 1000 mg PO DAILY
7. Warfarin 2.5 mg PO DAILY16
8. Ipratropium-Albuterol Neb 1 NEB NEB Q4H
RX *ipratropium-albuterol 0.5 mg-3 mg (2.5 mg base)/3 mL 1 neb
inh Q4H:PRN Disp #*120 Ampule Refills:*1
9. nebulizers 1 nebulizer miscellaneous Q4H:PRN shortness of
breath/wheezing
RX *nebulizers 1 nebulizer treatment Q4H:PRN Disp #*1 Each
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Influenza
Bacterial pneumonia
Acute bronchitis
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 the
hospital with influenza, bacterial pneumonia, and bronchitis.
You were treated with antibiotics and breathing treatments and
your symptoms improved.
We have prescribed a nebulizer machine and medications which you
can use as needed for shortness of breath and wheezing.
Your INR was elevated during this admission. We have decreased
your dose of warfarin to 2.5mg daily. You will need to go to the
___ clinic on ___ to have your INR checked
and for further changes in your warfarin dose.
Your PCP is working on an appointment for you and will contact
you. If you don't hear from them later today or on ___,
please call their office. You should see your PCP or one of his
colleagues next week.
If you have worsening fevers or difficulty breathing, please
contact your doctor or return to the hospital for additional
care.
Sincerely,
Your ___ 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. Aspirin 81 mg PO DAILY
You should take 1 aspirin daily for 3 months
RX *aspirin 81 mg 1 tablet(s) by mouth once a day Disp #*90
Tablet Refills:*0
3. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain -
Moderate
RX *oxycodone 5 mg 1 tablet(s) by mouth every six (6) hours Disp
#*10 Tablet Refills:*0
4. Polyethylene Glycol 17 g PO DAILY
5. Senna 8.6 mg PO BID
6. Oxybutynin 10 mg PO DAILY
7. Tamsulosin 0.4 mg PO QHS
Discharge Disposition:
Home
Discharge Diagnosis:
large splenic subcapsular hematoma
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 ___ due to a subcapsular splenic hematoma
that required interventional radiology embolization. You
tolerated the procedure well and you are now ready to head home.
Please follow this instructions to continue your recovery.
*AVOID contact sports and/or any activity that may cause injury
to your abdominal area for the next ___ weeks.
*If you suddenly become dizzy, lightheaded, feeling as if you
are going to pass out go to the nearest Emergency Room as this
could be a sign that you are having internal bleeding from your
liver or spleen injury.
*AVOID any blood thinners such as Motrin, Naprosyn, Indocin,
Aspirin, Coumadin or Plavix for at least ___ days unless
otherwise instructed by the MD/NP/PA.
Please follow up with your PCP for your pending vaccinations.
You should receive an extra dose of meningococcal vaccine in 8
weeks, and you should also receive a dose of Pneumovax in 8
weeks to prevent infections due to your spleen embolization.
Your ACS team.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear ___,
It was a pleasure caring for you at ___.
WHY WAS I IN THE HOSPITAL?
- You were admitted for severe back pain
WHAT HAPPENED TO ME IN THE HOSPITAL?
- You had an MRI of your spine that continued to show L4-5 disc
extrusion, which is likely causing your pain
- You had a steroid injection into your back to help with your
pain
- You had an x-ray of your ankle which was normal
- Your pain medications were adjusted
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Continue to take all your medicines and keep your
appointments.
- It is very important that you take your bowel medications:
1. Senna - take twice a day. Can hold if loose stools
2. Polyethylene glycol (miralax) - take daily. Can hold if loose
stools
3 Bisacodyl 10 mg as needed
4. Lactulose 15 mL daily as needed. You can take this up to 3
times a day if worsening constipation.
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. Acetaminophen 500 mg PO Q12H:PRN Pain - Mild/Fever
2. Albuterol Inhaler 1 PUFF IH Q4H:PRN sob/wheeze
3. Aspirin 81 mg PO DAILY
4. azelastine 0.15 % (205.5 mcg) nasal BID
5. bimatoprost 0.01 % ophthalmic (eye) QHS
6. Carvedilol 12.5 mg PO BID
7. Citracal + D Maximum (calcium citrate-vitamin D3) 3 tablets
oral Q12H
8. Diltiazem Extended-Release 180 mg PO DAILY
9. Fosfomycin Tromethamine 3 g PO Q10DAYS
10. Gabapentin 300 mg PO TID
11. Levothyroxine Sodium 88 mcg PO DAILY
12. Lidocaine 5% Patch 2 PTCH TD QAM
13. Lisinopril 10 mg PO QHS
14. Montelukast 10 mg PO DAILY
15. Multivitamins W/minerals 1 TAB PO DAILY
16. Polyethylene Glycol 17 g PO DAILY
17. Rosuvastatin Calcium 20 mg PO QPM
18. TraMADol 50 mg PO Q12H:PRN Pain - Severe
19. vancomycin 125 mg oral BID
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSES:
-occipital neuralgia
-Viral upper respiratory illness
SECONDARY DIAGNOSES:
-mild intermittent exotropia
-Acute on 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>Dear Ms. ___,
It was a pleasure caring for you during your admission to ___.
Below you will find information regarding your stay.
WHY WAS I ADMITTED TO THE HOSPITAL?
- You were admitted because you were having severe headaches and
fevers.
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
- You had a lumbar puncture that showed no evidence of an
infection in your spine.
- You were seen by the neurology team who gave you an injection
in your scalp and neck to help treat your pain.
- You were seen by the ophthalmology team who recommended you
follow up in clinic to address your blurry vision.
- You had an MRI of your spine that showed no changes or issues
with the surgical rods in your neck.
WHAT SHOULD I DO WHEN I GO HOME?
- Take your medications as prescribed
- Keep your follow up appointments with your team of doctors
Thank ___ for letting us be a part of your care!
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Diazepam 5 mg PO BID:PRN pain
RX *diazepam 5 mg 1 tab by mouth twice a day as needed Disp #*30
Tablet Refills:*0
2. Docusate Sodium 100 mg PO BID
3. Gabapentin 100 mg PO Q8H
RX *gabapentin 100 mg 1 capsule(s) by mouth three times a day
Disp #*45 Capsule Refills:*0
4. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain -
Moderate
RX *oxycodone 5 mg 1 tablet(s) by mouth every 6 hours as needed
Disp #*50 Tablet Refills:*0
5. Senna 8.6 mg PO BID
6. amLODIPine 10 mg PO DAILY
7. Atorvastatin 20 mg PO QPM
8. 70/30 36 Units Breakfast
70/30 40 Units Dinner
9. Lisinopril 40 mg PO DAILY
10. MetFORMIN (Glucophage) 1000 mg PO BID
11.Rolling Walker
Diagnosis: T6/7 lesions/cord compression
Prognosis: Good
Longevity: 13 months
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
T6/7 lesions/cord compression
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Surgery
Your incision is closed with staples. You will need staple
removal. Please keep your incision dry until staple removal.
Do not apply any lotions or creams to the site.
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
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.
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.
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 325-650 mg PO Q6H:PRN pain
2. Albuterol Inhaler 2 PUFF IH Q6H:PRN wheeze or sob
3. Aspirin 81 mg PO DAILY
4. Omeprazole 20 mg PO DAILY
5. Fluticasone Propionate NASAL 2 SPRY NU DAILY
6. Simvastatin 80 mg PO DAILY
7. Prochlorperazine 10 mg PO Q6H:PRN nasea
8. Estrace (estradiol) 0.01 % (0.1 mg/gram) vaginal weekly
apply to urethral opening and area in dime size amount once
weekly
9. Ferrous GLUCONATE 324 mg PO DAILY
10. Lorazepam 0.5 mg PO Q6H:PRN nausea or insomnia
do not drink alcohol, drive, or operate heavy machinery with
this medication
11. Ondansetron 8 mg PO Q8H:PRN nausea
12. Ranitidine 300 mg PO HS
13. OxycoDONE (Immediate Release) 5 mg PO Q6H:PRN pain
do not drink alcohol, drive, or operate heavy machinery with
this medication
14. 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
15. Lisinopril 10 mg PO DAILY
RX *lisinopril 10 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
16. Nystatin Oral Suspension 5 mL PO QID oropharyngeal thrush
Duration: 14 Days
RX *nystatin 100,000 unit/mL 5 mL by mouth four times a day Disp
#*300 Milliliter Refills:*0
17. Polyethylene Glycol 17 g PO DAILY:PRN constipation
RX *polyethylene glycol 3350 [Miralax] 17 gram 1 packet by mouth
daily PRN Disp #*30 Unit Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Stage IIIA infiltrating carcinoma of right breast
Chemotherapy related nausea/vomiting
Constipation
Thrush
Hypertension
Secondary diagnoses:
Diabetes
Hyperlipidemia
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 with nausea and vomitting,
likely related to your chemotherapy. We gave you medications for
symptom control and you improved. You were able to tolerate full
meals at the time of your discharge.
Your white blood cell count had been elevated, but this was
likely due to the neulasta.
You are being given medications for your constipation.
You are also being given medications for your thrush infection.
Finally, you were started on a medication called lisinopril for
your high blood pressure.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcium Carbonate 500 mg PO BID
RX *calcium carbonate 500 mg calcium (1,250 mg) 1 tablet(s) by
mouth twice a day Disp #*60 Tablet Refills:*0
2. Enoxaparin Sodium 40 mg SC QPM Duration: 28 Days
RX *enoxaparin 40 mg/0.4 mL 40 mg once daily Disp #*22 Syringe
Refills:*0
3. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth daily Disp #*30
Capsule Refills:*0
4. OxyCODONE (Immediate Release) 5 mg PO Q8H:PRN Pain -
Moderate Duration: 1 Day
RX *oxycodone [Oxaydo] 5 mg 1 tablet(s) by mouth Q8H:PRN Pain
Disp #*3 Tablet Refills:*0
5. PredniSONE 30 mg PO DAILY Duration: 5 Doses
Start: Tomorrow - ___, First Dose: First Routine
Administration Time
Your rheumatologist will determine further taper dosing when you
see her on ___
This is dose # 1 of 2 tapered doses
RX *prednisone 10 mg 3 tablet(s) by mouth Q9AM Disp #*15 Tablet
Refills:*0
6. PredniSONE 20 mg PO DAILY Duration: 4 Doses
Start: After 30 mg DAILY tapered dose
Your rheumatologist will determine further taper dosing when you
see her on ___
This is dose # 2 of 2 tapered doses
RX *prednisone 10 mg 2 tablet(s) by mouth Q9AM Disp #*8 Tablet
Refills:*0
7. Vitamin D 1000 UNIT PO DAILY
RX *ergocalciferol (vitamin D2) 2,000 unit 0.5 (One half)
tablet(s) by mouth daily Disp #*15 Tablet Refills:*0
8. Acetaminophen w/Codeine 1 TAB PO Q4-6H Pain
9. Mycophenolate Mofetil 1000 mg PO BID
10. PrednisoLONE Acetate 1% Ophth. Susp. 1 DROP BOTH EYES DAILY
11. Sildenafil 50 mg PO DAILY:PRN Sexual intercourse
12. testosterone cypionate 200 mg/mL injection Q2Weeks
13. HELD- Tocilizumab ? mg IV EVERY 4 WEEKS (___) This
medication was held. Do not restart Tocilizumab until speaking
with Dr. ___ on ___
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
Ankylosing spondylitis
Reactive arthritis
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. ___,
You came in with joint pain and swelling. You were seen by the
rheumatologists who felt that the arthritis you were
experiencing was related to your ankylosing spondylitis. You had
several samples of fluid taken from around your knee to make
sure that your knee was not infected. After the cultures did not
show any signs of infection you were started on prednisone. You
are discharged on a prednisone taper until your next appointment
with rheumatology. It will be very important to follow up with
the PCP and rheumatologist as outlined below.
You were also started on calcium, vitamin D, and omeprazole to
prevent complications from steroid treatment. Your
rheumatologist will advise you regarding possibly also starting
antibiotic prophylaxis if steroids are continued for over 3
weeks.
You will need to continue Injections of Enoxaparin 40mg daily
for 28 days for prevention of clots after your orthopedic
procedure.
You will also need to have your blood pressure and blood glucose
checked at your PCP's office while on high dose steroids.
You may not drive a car until cleared to do so by your PCP.
Please DO NOT take any non-steroidal anti-inflammatory
medications (NSAIDs such as Celebrex, ibuprofen, Advil, Aleve,
Motrin, naproxen etc) unless instructed to do so by your out
patient providers.
Please return to the emergency department or notify your
physician if you experience any of the danger signs listed
below.</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. Albuterol Inhaler ___ PUFF IH Q4H:PRN SOB/wheezing
3. Aspirin 81 mg PO DAILY
4. Diltiazem Extended-Release 120 mg PO DAILY
RX *diltiazem HCl 120 mg 1 capsule, extended release(s) by mouth
once a day Disp #*30 Capsule Refills:*0
5. Docusate Sodium 100 mg PO DAILY
6. Fosfomycin Tromethamine 3 g PO Q10DAYS
7. Ipratropium Bromide MDI 2 PUFF IH QID SOB/wheezing
8. Levothyroxine Sodium 88 mcg PO DAILY
9. Metoprolol Succinate XL 100 mg PO DAILY
RX *metoprolol succinate 100 mg 1 tablet extended release 24
hr(s) by mouth once a day Disp #*30 Tablet Refills:*0
10. Montelukast Sodium 10 mg PO DAILY
11. Omeprazole 40 mg PO DAILY
12. Rosuvastatin Calcium 20 mg PO DAILY
13. azelastine 137 mcg nasal BID allergies
14. Lisinopril 10 mg PO DAILY
15. Potassium Acetate 20 mEq PO QD
16. TraMADOL (Ultram) 50 mg PO Q6H:PRN Pain
17. Travatan Z (travoprost) 0.004 % ophthalmic QHS
18. Senna 1 TAB PO BID
19. Bisacodyl ___AILY:PRN constipation
RX *bisacodyl 10 mg 1 suppository(s) rectally once a day Disp
#*30 Suppository Refills:*0
20. DiCYCLOmine 20 mg PO QID
RX *dicyclomine 20 mg 1 tablet(s) by mouth four times a day Disp
#*120 Tablet Refills:*0
21. Polyethylene Glycol 17 g PO DAILY
RX *polyethylene glycol 3350 17 gram 17 G by mouth once a day
Disp #*30 Packet Refills:*0
22. Ferrous Sulfate 325 mg PO DAILY
23. Pantoprazole 40 mg PO Q24H
Discharge Disposition:
Home
Discharge Diagnosis:
Diagnosis:
Constipation
IBS
Secondary diagnoses:
Diverticulitis s/p recent hemocolectomy
HTN
CKD
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 stay at ___
___. You were admitted for nausea
and vomiting and abdominal pain. You underwent a CT of the
abdomen which showed no obstruction in your bowels and no other
structural cause for your symptoms. We treated you with
anti-nausea and pain medications, and your symptoms improved.
You were sent home in stable condition to follow up with your
PCP and GI.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear ___,
It was a pleasure taking part in your care here at ___!
Why was I admitted to the hospital?
- You were admitted for a ruptured cyst in your kidney and
kidney failure.
What was done for me while I was in the hospital?
- You were given medications to help with your pain.
- You underwent dialysis because your kidneys were not working.
- You had a permanent dialysis line placed.
What should I do when I leave the hospital?
- You should continue to take the medications that we prescribed
to you and follow up with your upcoming appointments with your
doctors.
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcium Carbonate 500 mg PO QID:PRN upset stomach
2. FoLIC Acid 1 mg PO DAILY
3. MetFORMIN (Glucophage) 500 mg PO DAILY
4. Multivitamins 1 TAB PO DAILY
5. Phosphorus 500 mg PO BID Duration: 2 Days
6. Propranolol 10 mg PO/NG TID
7. Ranitidine 75 mg PO DAILY Epigastric pain
8. Thiamine 100 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
=======================
PRIMARY DIAGNOSIS
=======================
Refeeding syndrome
Hyperthyroidism w/ Thyroid Nodules ( Dx to be confirmed)
Hypovolemia
Hypokalemia
Hypomagnesemia
Hypophosphatemia
Lactic acidosis
Sinus Tachycardia
Malnutrition
=======================
SECONDARY DIAGNOSIS
=======================
Type II Diabetes
GERD
Melena
Vaginal Bleeding
Undifferentiated psychosis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
========================================
WHY DID YOU COME TO THE HOSPITAL?
========================================
You were admitted to the hospital because you had not eaten for
many months, which caused you to become severely dehydrated, and
caused a low level of many substances necessary for your body to
function. You also had a high heart rate.
========================================
WHAT HAPPENED AT THE HOSPITAL?
========================================
Medical Issues
We gave you medication that brought those substances ( called
electrolytes) necessary for your body to function. You were
given fluids, as well, given you were very dehydrated. You were
also found to have hyperthyroidism, causing your thyroid hormone
to be high, and multiple nodules in your thyroid. This was the
most likely cause of your increased heart rate.
Mental Health Issues
You spoke with the ___ Psychiatric team almost on a daily
basis for support of your mental health.
====================================================
WHAT NEEDS TO HAPPEN AFTER YOU LEAVE THE HOSPITAL?
====================================================
You should
-continue to eat three meals a day that are nutritious
-take the remaining Phosphorus packets ( which are critical for
your body to have good energy).
-take the medications we have prescribed for you
-follow up with outpatient appointments by calling the numbers
below
It was a pleasure taking care of you during your stay!
-Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO TID
2. Ascorbic Acid ___ mg PO DAILY Duration: 14 Doses
3. Dexamethasone 4 mg PO Q12H
4. Diltiazem 60 mg PO Q6H
5. Docusate Sodium 100 mg PO BID
6. Heparin 5000 UNIT SC BID
7. Lidocaine 5% Patch 1 PTCH TD QAM left shoulder
8. Multivitamins W/minerals 1 TAB PO DAILY
9. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain -
Moderate
10. Polyethylene Glycol 17 g PO DAILY
11. Senna 8.6 mg PO BID
12. TraZODone 25 mg PO QHS
13. Vitamin A ___ UNIT PO DAILY Duration: 14 Doses
14. Zinc Sulfate 220 mg PO DAILY Duration: 14 Doses
15. OxyCODONE--Acetaminophen (5mg-325mg) ___ TAB PO Q6H:PRN
Pain - Moderate
16. Doxazosin 4 mg PO HS
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Hypercalcemia
Renal Cell carcinoma with bone mets
Concern for brain mets
Sacral decubitus ulceration
Afib with RVR
Hypotension
Hypoalbuminemia
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 caring for you.
You were admitted for confusion caused by high calcium
("hypercalcemia") from your cancer. You got better with
medicines and IV fluids to lower your calcium as well as a
medication that still may be working in your system
For your cancer, we haven't started treatment for it - but you
are free to start whenever you wish after this hospitalization.
Your confusion really didn't get better until after we started
dexamethasone (steroids) therapy. We are not ___ sure why this
worked, but we are happy you are more with it.
We wish you the best in your recovery.</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. Docusate Sodium 100 mg PO BID:PRN constipation
3. Senna 8.6 mg PO BID:PRN constipation
4. Fluticasone-Salmeterol Diskus (100/50) 1 INH ___ BID
5. MetFORMIN XR (Glucophage XR) 1000 mg PO DAILY
6. Metoprolol Tartrate 25 mg PO BID
7. Pantoprazole 40 mg PO Q24H
8. Sucralfate 1 gm PO QID
9. TraMADol 50 mg PO Q6H:PRN Pain - Moderate
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
T3 compression fx w/ 2mm retropulsion
Occipital condylar fx
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. ___,
You were admitted to ___ after
a fall. You were found to have a skull fracture near the back
of your head as well as a compression fracture of your thoracic
spine. The Spine surgery service evaluated you for these
injuries and no operation was warranted. Your injuries were
managed with a Cervical Thoracic Orthosis brace. You have
worked with Physical Therapy and are now ready to be discharged
home with home Physical Therapy to continue your recovery.
Please note the following discharge instructions:
Please keep the CTO brace in place at all times
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.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 10 mg PO DAILY
2. Calcium Carbonate 1500 mg PO BID
3. Dronabinol 10 mg PO BID:PRN nausea
4. Glargine 3 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
5. Nephrocaps 1 CAP PO DAILY
6. Lactulose 15 mL PO BID
7. OxycoDONE (Immediate Release) 15 mg PO Q3H:PRN pain
8. Outpatient Lab Work
CBC
Anemia: ___
Fax to Name: ___
Location: ___
___
Address: ___
Phone: ___
Fax: ___
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis:
Gastrointestinal bleeding: Unspecified location
Anemia
Hypotension
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 with a significant
GI bleed that required multiple blood transfusions as well a
stay in the Intensive Care Unit. You were recommended to stay
one more day, however you have a strong preference to leave at
this time. Your blood count is currently very low, and if you
started bleeding again, this could be very dangerous. You were
able to understand the risks and benefits of leaving early but
it is VERY IMPORTANT that you return for any signs that you are
bleeding again. These include: chest or abdominal pain,
shortness of breath, light headedness/dizziness, blood in your
stool, or black/tarry stools. You should see your PCP in the
next 2 days to have a blood check to see if you're still
bleeding. You also need a follow up colonoscopy and possibly a
capsule endoscopy to look for bleeding in other areas of your GI
tract.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 20 mg PO QPM
2. Nephrocaps 1 CAP PO DAILY
3. Pantoprazole 40 mg PO Q24H
4. sevelamer CARBONATE 2400 mg PO TID W/MEALS
5. Aspirin 81 mg PO DAILY
6. Docusate Sodium 100 mg PO BID:PRN constipation
7. hydrOXYzine HCl 10 mg oral TID:PRN itching
8. melatonin 5 mg oral PRN insomnia
9. Senna 8.6 mg PO BID:PRN constipation
10. Warfarin 4 mg PO 6X/WEEK (___)
11. Warfarin 6 mg PO 1X/WEEK (FR)
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: GI bleeding s/p EGD s/p cauterization, sinus brady
Secondary: ESRD on HD
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 ___ due to GI bleeding. You underwent an
endoscopy and had a bleeding ulcer cauterized to stop the
bleeding. The gastroenterology team saw you, and they
recommended that you see them again soon and that you have
another repeat endoscopy in ___ weeks, which they will schedule
for you. While you were here you also had multiple blood
transfusions but your blood counts were stable and you no longer
appeared to be bleeding by the time you left. You will also need
to go to dialysis as scheduled and will need to see your primary
care physician.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. allopurinol ___ mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
2. amlodipine 10 mg Tablet Sig: One (1) Tablet PO once a day.
3. clonidine 0.1 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
4. Procrit 20,000 unit/mL Solution Sig: One (1) Injection Every
other week: Your next dose will be on ___.
5. escitalopram 10 mg Tablet Sig: Three (3) Tablet PO DAILY
(Daily).
6. fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff
Inhalation DAILY (Daily).
7. lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO Q8H
(every 8 hours) as needed for constipation.
8. sumatriptan succinate 50 mg Tablet Sig: One (1) Tablet PO
once a day as needed for headache.
9. labetalol 200 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
Disp:*60 Tablet(s)* Refills:*0*
10. butalbital-acetaminophen-caff 50-325-40 mg Tablet Sig: One
(1) Tablet PO Q6H (every 6 hours) as needed for headache.
11. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day: Please
hold if nauseous or vomiting or not tolerating food.
12. B complex-vitamin C-folic acid 1 mg Capsule Sig: One (1) Cap
PO DAILY (Daily).
Disp:*30 Cap(s)* Refills:*0*
13. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO BID (2 times a day).
14. Xanax 0.25 mg Tablet Sig: Two (2) Tablet PO once a day as
needed for anxiety.
15. Renvela 800 mg Tablet Sig: ___ Tablets PO TID with meals.
Discharge Disposition:
Home
Discharge Diagnosis:
Hypertensive Urgency
Viral Gastroenteritis
End Stage Renal Disease
Discharge Condition:
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Mental Status: Confused - sometimes.
Followup Instructions:
___ [/INST] </s><s>You were admitted to the hospital because you were having nausea
and vomiting along with fevers. We think that the fevers were
from a viral gastroenteritis. You were also noted to have a very
high BUN level that caused you to be nauseous. Your high blood
pressure also likely caused you to be nauseous. You also
complained of a headache which was from your high blood
pressure.
While you were in the hospital, you were started on several
antibiotics, one of which caused you to have an severe allergic
reaction. While we do not know exactly which one caused it, we
think it was either Ampicillin or Ceftriaxone. We have arranged
for you to have allergy testing to further determine which agent
caused this reaction.
While in the hospital, the kidney doctors helped manage your
peritoneal dialysis. In consultation with Dr. ___ are
making adjustments your dialysis settings. You should be in
contact with your PD nurse to get the exact details.
With regards to your lasix, please continue to hold this
medication until you are tolerating meals and fluids completely.
The following changes were made to your medications:
- STARTED labetolol 200mg twice a day
No other changes were made to your medications, please be sure
to take them as directed.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
You were admitted for 1 week of progressive increased confusion,
visual hallucinations, and periods of memory loss. Ultimately,
on infectious work up, you were found to have a right middle
lobe pneumonia that may have been from aspiration. Blood
cultures showed a contaminant in one bottle (Coagulase negative
staphyloccocus), but were otherwise negative. Urine culture was
negative. Outside hospital head CT had no acute intracranial
process and you could not get an MRI because you have a
pacemaker. 48 hr EEG showed generalized slowing but no seizure
activity. We empirically treated your pneumonia with 7 days of
IV vancomycin and zosyn. Unfortunately, on your ___ day of
antibiotic treatment (___), you developed diarrhea and were
found to have C. difficile + toxin in your stool. You have now
started a 14 day cource of oral vancomycin to be completed on
___.
Your confusion initially improved with treatment of your
pneumonia, but you then developed sundowning delirium from lack
of sleep in the hospital. Once we moved you to a window-ed room
and decreased monitoring frequency overnight, your mental status
returned to baseline - fully oriented, alert, conversant.
Your Coumadin dose required changing due to elevated INR (blood
thinning levels). Ultimately, you were discharged on Warfarin
3.5 mg qDay. You will continue to require frequent INR checks
(at least once weekly) to ensure you remain in therapeutic range
for your INR (___).</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Gabapentin 600 mg PO TID
RX *gabapentin 600 mg One tablet(s) by mouth every 8 hours Disp
#*90 Capsule Refills:*0
2. Omeprazole 40 mg PO BID
RX *omeprazole 40 mg One capsule,delayed ___ by
mouth twice a day Disp #*60 Capsule Refills:*0
3. Lorazepam 0.5 mg PO Q4H:PRN anxiety, nausea
RX *lorazepam 0.5 mg One tablet by mouth daily Disp #*4 Tablet
Refills:*0
4. Promethazine 25 mg PO Q6H:PRN nausea
RX *promethazine 25 mg One tablet by mouth every six hours as
needed Disp #*30 Tablet Refills:*0
5. Glargine 16 Units Breakfast
Glargine 18 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
RX *blood sugar diagnostic ___ Active Test] three
times a day Disp #*100 Each Refills:*0
RX *insulin glargine [Lantus] 100 unit/mL 24 units 16 Units
before BKFT; 18 Units before BED; Disp #*1 Vial Refills:*1
RX *insulin lispro [Humalog] 100 unit/mL 16 units Up to 16 Units
QID per sliding scale Disp #*1 Vial Refills:*1
RX *insulin syringe-needle U-100 [Insulin Syringe] 30 gauge x
___ with every injection as instructed Disp #*130 Syringe
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSES:
1. DKA
2. gastroparesis
3. Type I Diabetes
4. Coffe-ground vomiting
5. Abdominal pain
SECONDARY DIAGNOSES:
1. Hepatitis C infection
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 here at the ___
___. You presented with nausea, vomiting,
and abdominal pain and were found to be in diabetic
ketoacidosis. You were further admitted to ICU for further
management of your diabetic ketoacidosis, which was treated with
IV hydration, insulin, and repletion of your electrolytes. After
your diabetic ketoacidosis was improved, you were further
admitted to the floor for ongoing management of your diabetes,
vomiting, and abdominal pain. You were placed on phenergan and
ativan for your nausea. You were given erythromycin, both oral
and IV, for vomiting and abdominal pain secondary to
gastroparesis. Your pain was controlled by Dilaudid IV 1 mg.
Please see a primary care physician on ___ regular basis for
better control of your diabetes and associated symptoms,
including abdominal pain, nausea, and vomiting.
Please take your medication as instructed and follow up with
your outpatient appointments.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atenolol 50 mg PO DAILY
2. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
3. Benzonatate 100 mg PO TID:PRN cough
RX *benzonatate 100 mg 1 capsule(s) by mouth three times a day
Disp #*90 Capsule Refills:*0
4. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
5. Guaifenesin ___ mL PO Q6H:PRN cough
RX *guaifenesin [Cough Control (guaifenesin)] 100 mg/5 mL ___
ml by mouth every 6 hours Disp #*300 Milliliter Refills:*0
6. Multivitamins 1 TAB PO DAILY
RX *multivitamin [Multiple Vitamins] 1 tablet(s) by mouth
daily Disp #*30 Capsule Refills:*0
7. Pantoprazole 40 mg PO Q24H
RX *pantoprazole 40 mg 1 tablet,delayed release (___) by
mouth daily Disp #*30 Tablet Refills:*0
8. Thiamine 100 mg PO DAILY
RX *thiamine HCl 100 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Alcoholic cirrhosis
Pneumomediastinum
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mrs. ___,
___ were admitted to ___ and were
found to have a pneumomediastinum (air in the mediastinum). This
is likely the result of a rupture of a medium sized airway in
your lung. ___ will need a bronchoscopy to assess further.
In addition, on your imagining scans and your lab tests your
have a new dx of cirrhosis related to your alcohol use. ___ must
stop drinking alcohol as this is life threatening. Please
continue to work with your primary care physician for further
___ regarding alcohol cessation counseling and local
support groups in your community. In addition, ___ will need
___ with hepatology.
Please discuss your ongoing diarrhea with your primary care
physician.
It was a pleasure taking care of ___ here at ___
___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Hydrochlorothiazide 12.5 mg PO DAILY
2. Levothyroxine Sodium 75 mcg PO DAILY
3. Lisinopril 20 mg PO DAILY
4. Omeprazole 20 mg PO DAILY
5. Sertraline 75 mg PO DAILY
6. TraMADOL (Ultram) 50 mg PO BID
7. Cal-Citrate *NF* (calcium citrate-vitamin D2) 250-100 mg-unit
Oral BID
8. Ezetimibe 10 mg PO DAILY
9. ProAir HFA *NF* (albuterol sulfate) 90 mcg/actuation
INHALATION EVERY 6 HOURS: PRN Dyspnea
10. Pulmicort Flexhaler *NF* (budesonide) 180 mcg/actuation
Inhalation BID
11. Vitamin D 800 UNIT PO DAILY
12. Lidocaine 5% Patch 1 PTCH TD DAILY
apply to back
RX *lidocaine 5 % (700 mg/patch) daily Disp #*14 Not Specified
Refills:*0
RX *lidocaine 5 % (700 mg/patch) 1 patch to affected area daily
Disp #*14 Not Specified Refills:*0
13. Ondansetron 4 mg PO Q8H:PRN nausea
RX *ondansetron 4 mg 1 tablet(s) by mouth four times a day Disp
#*28 Tablet Refills:*0
14. Fexofenadine 60 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Viral diarrhea
Infectious neutropenia
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 hospitalized for diarrhea and a low white blood cell
count. Your diarrhea was most likely due to a viral infection,
and has significantly improved since your admission. Similarly,
your low white blood cell count was likely a result of your
viral infection, and has begun to rise back to normal levels at
the time of your discharge. We expect both of these issues to
completely self-resolve without further intervention in the next
___ weeks. Additionally, while you were here your oxygen
saturation was mildly low, dropping to 90-93% while you were
walking. Though this is a safe level and you did not have any
symptoms, it is below the typical range of normal, and you
should follow up with your PCP regarding this finding.
With regards to your low white blood cell count, several tests
were undertaken while you were here. Your stool cultures did not
reveal any causative bacteria, ova, or parasites. Your hepatitis
B and C tests were negative. Your HIV test was negative. You
have several tests still pending at the time of discharge,
including SPEP, EBV, and CMV assays. These should be followed up
with at your PCP's office.
Please take note of the following:
1) With regards to your diarrhea, please continue to hydrate, as
it is important to maintain fluid intake if you continue to have
diarrhea. Please follow up with your PCP so that he may assess
for improvement.
2) With regards to your low white blood cell count, your white
blood cells are rising back to a normal level and you should not
be at a significantly increased risk for infection. If you begin
experiencing fevers, chills, sweats, or a fast heart rate please
return to the ED immediately, as this may signal a serious
infection. Please follow up with your PCP so that you may have
your white blood cell count re-checked to assess for
improvement. Please have your PCP follow up with your pending
studies.
3) With regards to your low oxygen saturation with walking,
please follow up with your PCP to determine whether or not
further workup will be required in the outpatient setting.
4) You have a follow up appointment on ___ at 3:45
___ with your PCP ___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. dapsone 25 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
2. darunavir 400 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
3. lamivudine 150 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. ritonavir 100 mg Capsule Sig: One (1) Capsule PO DAILY
(Daily).
5. rifaximin 550 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
6. sucralfate 1 gram Tablet Sig: One (1) Tablet PO QID (4 times
a day).
7. pravastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
8. losartan 50 mg Tablet Sig: One (1) Tablet PO once a day.
9. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours).
10. nadolol 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).
11. polyethylene glycol 3350 17 gram/dose Powder Sig: One (1)
packet PO DAILY (Daily).
12. lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime) as needed for insomnia.
13. oxycodone 5 mg Tablet Sig: ___ Tablets PO every ___ hours as
needed for pain.
Disp:*40 Tablet(s)* Refills:*0*
14. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H
(every 6 hours) as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*
Discharge Disposition:
Home
Discharge Diagnosis:
Colonic adenocarcinoma
Acute blood loss anemia
Aortic stenosis
HIV
Idiopathic 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. ___,
You were admitted to ___ because you were anemic. You had a
colonoscopy, which unfortunately showed a cancer in your colon.
You were evaluated by the colorectal surgery service, who
recommended surgical removal of the mass. You received 1 unit
of blood prior to surgery and your blood counts improved.
You were admitted to the hospital after an open Sigmoid
Colectomy with Primary Anastamosis for surgical management of
the mass obstructing your colon which was revealed to be colonic
adenocarcinoma. You have recovered from this procedure well and
you are now ready to return home. Samples from your colon were
taken and this tissue was sent to the pathology department for
analysis. As mentioned during you visit the results were that it
was cancerous and you will need to continue to follow up with
the Oncologists at ___.
You have tolerated a regular diet, passing gas and your pain is
controlled with pain medications by mouth. You may return home
to finish your recovery.
We made no changes to your medications while you were in the
hospital but we did add medications for pain and a stool
softener. Please continue taking your medications as prescribed
by your outpatient providers.
Please monitor your bowel function closely. Some loose stool and
passing of small amounts of dark, old appearing blood are
explected however, if you notice that you are passing bright red
blood with bowel movments or having loose stool without
improvement please call the office or go to the emergency room
if the symptoms are severe. If you are taking narcotic pain
medications there is a risk that you will have some
constipation. Please take an over the counter stool softener
such as Colace, and if the symptoms does not improve call the
office. 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,
prolonges loose stool, or constipation.
You have a long vertical incision on your abdomen that was
closed with staples. These have been removed and covered with
Steri-strips which should remain in place for ___ days. This
incision can be left open to air or covered with a dry sterile
gauze dressing if the incision become irritated from clothing.
Please monitor the incision for signs and symptoms of infection
including: increasing redness at the incision, opening of the
incision, increased pain at the incision line, draining of
white/green/yellow/foul smelling drainage, or if you develop a
fever. Please call the office if you develop these symptoms or
go to the emergency room if the symptoms are severe. You may
shower, let the warm water run over the incision line and pat
the area dry with a towel, do not rub.
No heavy lifting for at least 6 weeks after surgery unless
instructed otherwise by Dr. ___ Dr. ___. You may
gradually increase your activity as tolerated.
You will be prescribed a small amount of the pain medication.
Please take this medication exactly as prescribed. You may take
Tylenol as recommended for pain. Please do not take more than
4000mg of Tylenol daily. Do not drink alcohol while taking
narcotic pain medication or Tylenol. Please do not drive a car
while taking narcotic pain medication.
It has been a pleasure taking care of you at ___ and we wish
you a speedy recovery.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amiloride 5 mg Tablet Sig: Two (2) Tablet PO BID (2 times a
day).
2. cabergoline 0.5 mg Tablet Sig: 0.5 Tablet PO every other week
on ___ @ HS ().
3. dicyclomine 10 mg Capsule Sig: Two (2) Capsule PO QID (4
times a day).
4. esomeprazole magnesium 40 mg Capsule, Delayed Release(E.C.)
Sig: One (1) Capsule, Delayed Release(E.C.) PO twice a day.
5. fluticasone-salmeterol 500-50 mcg/dose Disk with Device Sig:
One (1) Disk with Device Inhalation BID (2 times a day).
6. furosemide 80 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
7. hydroxyzine HCl 25 mg Tablet Sig: One (1) Tablet PO at
bedtime as needed for itching.
8. ipratropium-albuterol ___ mcg/Actuation Aerosol Sig: Two
(2) Puff Inhalation Q6H (every 6 hours) as needed for SOB.
9. lactulose 10 gram/15 mL Syrup Sig: Sixty (60) ML PO three
times a day as needed for constipation.
10. ranitidine HCl 150 mg Tablet Sig: Two (2) Tablet PO BID (2
times a day).
11. rifaximin 550 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
12. tadalafil 10 mg Tablet Sig: One (1) Tablet PO PRN.
13. tiotropium bromide 18 mcg Capsule, w/Inhalation Device Sig:
One (1) Cap Inhalation DAILY (Daily).
14. trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime) as needed for insomnia.
15. ursodiol 300 mg Capsule Sig: One (1) Capsule PO three times
a day.
16. calcium carbonate-vitamin D3 500 mg(1,250mg) -200 unit
Tablet Sig: One (1) Tablet PO twice a day.
17. multivitamin Tablet Sig: One (1) Tablet PO DAILY
(Daily).
Discharge Disposition:
Home
Discharge Diagnosis:
Cirrhosis
Ascites
Esophageal varices
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 in the hospital because you were having abdominal
distension from ascites. We performed a paracentesis to remove
the fluid and make sure there was no infection. We are glad that
there was no infection. You were also due for an EGD so this was
also performed. This showed your varices had improved but are
still there. We did not make any changes to your medications.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen ___ mg PO Q6H:PRN for mild to moderate
pain
2. Carvedilol 6.25 mg PO BID
RX *carvedilol 6.25 mg 1 tablet(s) by mouth twice a day Disp
#*30 Tablet Refills:*0
RX *carvedilol 6.25 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
3. HydrALAZINE 25 mg PO TID
RX *hydralazine 25 mg 1 tablet(s) by mouth three times a day
Disp #*90 Tablet Refills:*0
4. Isosorbide Dinitrate 10 mg PO TID
RX *isosorbide dinitrate 10 mg 1 tablet(s) by mouth three times
a day Disp #*90 Tablet Refills:*0
5. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain -
Moderate
RX *oxycodone [Oxaydo] 5 mg 1 tablet(s) by mouth q6h prn Disp
#*20 Tablet Refills:*0
6. Glargine 12 Units Breakfast
Humalog 4 Units Breakfast
Humalog 4 Units Dinner
7. Aspirin 81 mg PO DAILY
8. Atorvastatin 40 mg PO QPM
9. Docusate Sodium 100 mg PO BID:PRN constipation
10. Gabapentin 900 mg PO QHS
11. Nephrocaps 1 CAP PO DAILY
12. Omeprazole 20 mg PO DAILY
13. sevelamer CARBONATE 1600 mg PO TID W/MEALS
14. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
CAD
Tachy-brady s/p ICD placememt
Cardiomyopathy, mixed ischemic/chagas/etoh
Acute on chronic systolic CHF exacerbation
ESRD on HD, c/b persistent hyperkalemia
HTN
DM1
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 ___
___!
Why was I admitted to the hospital?
-You were admitted because you had shortness of breath. You were
found to have worsening of your heart failure (Your heart pump
was not working as it should) which made it hard for you to
breath
What happened while I was in the hospital?
- You had a tests to find out why your heart was not pumping as
well
- You had a stress test that showed it was not due to any new
decreased blood flow to your heart (this is called ischemia from
heart artery disease)
- You had a pacemaker placed to help keep your heart rhythm
regular
- You had dialysis to take off volume that was making it hard
for you to breath, and also to lower your potassium
- You were found to have a likely problem with your fistula. The
kidney doctor team wanted you to have a "fistulogram" to look at
this more closely
What should I do after leaving the hospital?
- Take all your medications as directed. See below for
medication changes.
- Go to dialysis as scheduled
- Follow up with your doctors as noted below. Please call
___ to make appointments. We will also help get you
those appointments.
- Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
- You have ___ placed in your fistula: nurses at ___
___ remove this at your ___ dialysis session
Thank you for allowing us to be involved in your care, we wish
you all the best!
Your ___ Healthcare Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amitriptyline 10 mg PO HS
2. Escitalopram Oxalate 10 mg PO EVERY OTHER DAY
3. Escitalopram Oxalate 20 mg PO EVERY OTHER DAY
4. Fluticasone Propionate NASAL 2 SPRY NU DAILY
5. Sucralfate 1 gm PO BID
6. Acetaminophen 325-650 mg PO Q6H:PRN pain
7. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
8. Calcium Carbonate 500 mg PO QID:PRN gerd/indigestion
9. LeVETiracetam 500 mg PO BID
RX *levetiracetam [Keppra] 500 mg 1 tablet(s) by mouth twice a
day Disp #*60 Tablet Refills:*0
10. Dexamethasone 2 mg PO Q12H ___: ___
RX *dexamethasone 2 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
11. 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
12. Senna 1 TAB PO BID:PRN constipation
13. Lorazepam 0.25 mg PO DAILY:PRN anxiety
14. ZyrTEC (cetirizine) 10 mg oral daily
15. Loratadine 10 mg PO DAILY
16. LOPERamide 2 mg PO BID:PRN diaherrea
RX *loperamide [Anti-Diarrheal (loperamide)] 2 mg 1 tablet by
mouth twice a day Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Right extra-axial lesion.
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Craniotomy for Tumor Excision
Have a friend/family member check your incision daily for
signs of infection.
Take your pain medicine as prescribed.
Exercise should be limited to walking; no lifting, straining,
or excessive bending.
Dressing was removed on Day 2 after surgery.
Your wound was closed with staples. You must wait until after
they are removed to wash your hair. You may shower before this
time using a shower cap to cover your head.
Increase your intake of fluids and fiber, as narcotic pain
medicine can cause constipation. We generally recommend taking
an over the counter stool softener, such as Docusate (Colace) &
Senna while taking narcotic pain medication.
Unless directed by your doctor, do not take any
anti-inflammatory medicines such as Motrin, Aspirin, Advil, and
Ibuprofen etc.
You have been discharged on Keppra (Levetiracetam), you will
not require blood work monitoring.
You are being sent home on steroid medication, please make
sure you are taking a medication to protect your stomach
(Prilosec, Protonix, or Pepcid), as these medications can cause
stomach irritation. Make sure to take your steroid medication
with meals, or a glass of milk.
Clearance to drive and return to work will be addressed at
your post-operative office visit.
Make sure to continue to use your incentive spirometer while
at home.
CALL YOUR SURGEON IMMEDIATELY IF YOU EXPERIENCE ANY OF THE
FOLLOWING:
New onset of tremors or seizures.
Any confusion or change in mental status.
Any numbness, tingling, weakness in your extremities.
Pain or headache that is continually increasing, or not
relieved by pain medication.
Any signs of infection at the wound site: increasing redness,
increased swelling, increased tenderness, or drainage.
Fever greater than or equal to 101.5° F.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. MedroxyPROGESTERone Acetate 150 mg IM NOW ___. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
3. Albuterol Inhaler 1 PUFF IH Q4H:PRN SOB
4. Artificial Tears ___ DROP BOTH EYES PRN PRN
5. Aspirin 81 mg PO DAILY
6. Bisacodyl 10 mg PO DAILY:PRN constipation
7. Calcium Carbonate 1500 mg PO BID
8. Ferrous Sulfate 325 mg PO BID
9. Fluticasone Propionate NASAL 1 SPRY NU BID
10. Lisinopril 10 mg PO DAILY
11. melatonin 10 mg oral QHS
12. MetFORMIN (Glucophage) 1000 mg PO BID
13. Mineral Oil 15 mL PO Q12H:PRN Constipation
14. Multivitamins 1 TAB PO DAILY
15. Mycophenolate Mofetil 1500 mg PO BID
16. Omeprazole 40 mg PO QHS
17. Ondansetron 4 mg PO Q8H:PRN Nausea
18. Polyethylene Glycol 34 g PO Q12HR:PRN Constipation
19. Pravastatin 20 mg PO QPM
20. Psyllium Powder 1 PKT PO BID:PRN Constipation
21. QUEtiapine extended-release 600 mg PO QHS
22. Senna 8.6 mg PO BID:PRN Constipation
23. Sertraline 100 mg PO DAILY
24. Tacrolimus 4 mg PO Q12H
25. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Foreign body ingestion
Borderline personality disorder
Schizophrenia
Bipolar disorder
Prior heart transplant for congenital cardiomyopathy
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Lethargic but arousable.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted for swallowing thumbtacks. You had one
removed, and the others are slowly passing through. X-rays on
___ showed that all of the tacks had passed through and you were
cleared to be discharged from the hospital</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Outpatient Lab Work
ICD-10: D50.0
___
Please draw complete blood count
Fax to ___ Attn: Dr. ___
2. 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
3. Omeprazole 40 mg PO DAILY
RX *omeprazole 40 mg 1 capsule(s) by mouth daily Disp #*30
Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY: Acute blood loss anemia, iron deficiency anemia,
Gastric tumor
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 ___. You presented
because of fatigue and were found to have very low blood counts
on your initial labs. We treated you with several blood
transfusions. You were found to have blood in your stool, so you
underwent an upper and lower endoscopy to locate the source of
the bleeding. Unfortunately, you were found to have a large
tumor in your stomach. The results of your biopsy are still
pending, so we do not know which kind of malignancy, or cancer,
that it most likely is.
You will follow-up with the oncologists to discuss your biopsy
results. We have started you on omeprazole for stomach upset, as
well as iron pills for your anemia, or low blood counts. This
iron can cause constipation. Please let your PCP/oncologist know
if you are constipated.
It is important to take your medications as prescribed and
follow up with your doctors as noted below.
We wish you all the best,
Your ___ 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. Carbamazepine Chewable Tabs 300 mg PO BID
3. Docusate Sodium 100 mg PO DAILY
4. Doxazosin 2 mg PO DAILY
5. Omeprazole 20 mg PO DAILY
6. Vitamin D ___ UNIT PO DAILY
7. Aspirin 81 mg PO DAILY
8. Alendronate Sodium 70 mg PO QSUN
9. Guaifenesin-Dextromethorphan 10 mL PO Q6H:PRN cough
10. Lisinopril 40 mg PO DAILY
11. Cefpodoxime Proxetil 200 mg PO Q12H
12. Outpatient Lab Work
Pulmonary embolism and infarction ICD-9 Code: 415.1
Please draw ___ as per ___ clinic
recommendations. Please call ___
Anti-Coagulation Clinic with results at ___ also may
fax to attn: ___ clinic ___
13. Metoprolol Tartrate 75 mg PO Q6H
14. LeVETiracetam 1500 mg PO Q12H
15. Enoxaparin Sodium 90 mg SC Q12H
Start: Today - ___, First Dose: Next Routine Administration
Time
16. Miconazole Powder 2% 1 Appl TP QID:PRN skin rash
17. Warfarin 4 mg PO DAILY16
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Urosepsis
Atrial fibrillation and atrial flutter with rapid ventricular
rate
Discharge Condition:
Mental Status: Patient with MR, non-verbal at baseline, moves
head to voice/tracks voice
Level of Consciousness: Alert and interactive (non-verbal at
baseline)
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
It was a pleasure caring for you during your recent
hospitalization at ___. You
were admitted due to an infection in your kidneys. This
infection was caused by stone in your ureter which cause an
obstruction. A nephrostomy tube was placed to help control the
source of the infection and allow drainage of fluid behind the
obstruction. You were started on antibiotics and will be
discharged with a prescription, you should take the antibiotics
as directed and touch base with your urologist regarding the
length of the course of antibiotics. In addition, you were
noted to have an arrhythmia of the heart. You were started on a
medication to control your heart rate. You were also noted to
have clots in your lungs, thus were started on warfarin to treat
and prevent future clots. Your coagulation levels should be
followed by your PCPs office at the ___ clinic
___ clinic phone # ___. You were also
noted to have findings on EEG concerning for seizure activity -
you were started on keppra in addition to carbamazepine. You
should continue taking these as an outpatient and have follow-up
with your outpatient neurologist. Regarding your nephrostomy
tube, you should keep it in place until you see your outpatient
urologist. You have follow-up scheduled with your urologist Dr.
___ on ___ at 4pm who will manage the nephrostomy tube and
antibiotics. At that time you may also have your suprapubic
catheter changed out. You should take your medications as
directed and keep your appointments as scheduled. Should you
develop fevers, or a rapid heart rate that is not well
controlled with your medications, or shortness of breath, you
should seek evaluation at a medical facility or your nearest
emergency department.</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 daily
Disp #*60 Tablet Refills:*0
2. Atorvastatin 40 mg PO QPM
RX *atorvastatin 40 mg 1 tablet(s) by mouth daily Disp #*60
Tablet Refills:*0
3. LevETIRAcetam 500 mg PO DAILY
RX *levetiracetam 500 mg 1 tablet(s) by mouth daily Disp #*21
Tablet Refills:*0
4. HydrALAZINE 25 mg PO Q6H
5. Metoprolol Succinate XL 200 mg PO BID
6. Multivitamins 1 TAB PO DAILY
7.Outpatient Occupational Therapy
Discharge Disposition:
Home
Discharge Diagnosis:
Acute ischemic stroke
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 right hand clumsiness
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:
Atrial fibrillation
High blood pressure
High cholesterol
We are changing your medications as follows:
Starting atorvastatin 40mg daily to treat your high cholesterol
Downtitrating your Keppra: take 500mg daily for 3 weeks, then
stop.
Starting Apixiban 5mg twice a day
Please take your other medications as prescribed.
Please follow-up 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. Atovaquone Suspension 1500 mg PO DAILY
2. CycloPHOSPHAMIDE 100 mg PO DAILY
3. Pantoprazole 40 mg PO Q24H
4. PredniSONE 60 mg PO DAILY
To be tapered down as per nephrology after 2 weeks at this dose
(___).
5. Ramelteon 8 mg PO QHS:PRN Insomnia
6. Cyanocobalamin 1000 mcg PO DAILY
7. Fish Oil (Omega 3) 1000 mg PO DAILY
8. Fluticasone Propionate NASAL 2 SPRY NU DAILY
9. Vitamin D 600 UNIT PO DAILY
10.Outpatient Lab Work
M31.0: Hypersensitivity angiitis ___ vasculitis)
Please obtain a CBC and ___ basement membrane
antibody level on ___. Please fax results to ___
___, MD (___) and ___, MD
(___).
11.Outpatient Lab Work
M31.0: Hypersensitivity angiitis ___ vasculitis)
Please obtain a CBC and ___ basement membrane
antibody level on ___. Please fax results to ___
___, MD (___) and ___, MD
(___).
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis:
Acute Kidney Injury
Hyponatremia
Fever
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 ___ of you at ___. Please see below
for information on your time in the hospital.
WHY WAS I IN THE HOSPITAL?
=======================
-You were in the hospital because your creatinine level ( a
marker of kidney function ) was high.
WHAT HAPPENED IN THE HOSPITAL?
============================
-A renal ultrasound of your kidneys were taken, which did not
show any evidence of obstruction
- Your kidney function continued to get worse, so you were
started on dialysis
- You continued having low grade fevers while you were in the
hospital. The infectious disease team was consulted, and
recommended a very extensive infectious workup. There was no
evidence of a bacterial or viral infection causing the fever.
- You had a kidney biopsy, which showed inflammation of the
blood vessels ("ANCA vasculitis" and ___ vasculitis").
You were started on steroids and an immunosuppressive medicine
for this.
WHAT SHOULD I DO WHEN I GO HOME?
==============================
- It is very important that you ___ with Dr. ___
___ at ___
- You should also go to dialysis on ___ at
11:00am
- Please follow up at your dialysis and plasmapheresis sessions
as scheduled below.
- Please obtain weekly lab checks, starting ___. The
results should be faxed to your kidney doctor and primary
doctor.
The address and phone number of the treatment facility is:
___ Dialysis ___
Phone: ___
Nephrologist: ___
___ was a pleasure taking ___ of you. We wish you the best!
-Your ___ Team at ___</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 taking care of you at ___. You were admitted
for treatment of pancreatitis. Your abdominal pain improved
with bowel rest and pain medications. We understand that you
sometimes cause yourself to vomit in order to relieve abdominal
pain; however, self-induced vomiting can cause damage to your
esophagus and teeth. We strongly encourage you to try avoid
causing yourself to vomit. You may find that heating pads,
bowel rest and/or walking around help with your abdominal pain.
You were also found to have high blood pressure, so we started
you on a medication called amlodipine. Please follow up with
your primary care doctor at the appointment listed below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
2. alfuzosin 10 mg oral DAILY
3. Cyanocobalamin 1000 mcg PO DAILY
4. Docusate Sodium 100 mg PO BID
5. Ferrous Sulfate 325 mg PO DAILY
6. glimepiride 1 mg oral DAILY
7. Levothyroxine Sodium 175 mcg PO 6X/WEEK (___)
8. Levothyroxine Sodium 350 mcg PO 1X/WEEK (SA)
9. Metoprolol Succinate XL 100 mg PO DAILY
10. Multivitamins 1 TAB PO DAILY
11. OxyCODONE (Immediate Release) 2.5-5 mg PO Q4H:PRN Pain -
Moderate
12. Pravastatin 40 mg PO QPM
13. Pregabalin 75-150 mg PO QHS
14. Rivaroxaban 20 mg PO DAILY
15. Senna 8.6 mg PO BID
16. Torsemide 20 mg PO DAILY
17. Valsartan 160 mg PO QHS
18. Vitamin D ___ UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
recurrent hip dislocation
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>Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
1. Please return to the emergency department or notify your
physician if you experience any of the following: severe pain
not relieved by medication, increased swelling, decreased
sensation, difficulty with movement, fevers greater than 101.5,
shaking chills, increasing redness or drainage from the incision
site, chest pain, shortness of breath or any other concerns.
2. Please follow up with your primary physician regarding this
admission and any new medications and refills.
3. Resume your home medications unless otherwise instructed.
4. You have been given medications for pain control. Please do
not drive, operate heavy machinery, or drink alcohol while
taking these medications. As your pain decreases, take fewer
tablets and increase the time between doses. This medication can
cause constipation, so you should drink plenty of water daily
and take a stool softener (such as Colace) as needed to prevent
this side effect. Call your surgeons office 3 days before you
are out of medication so that it can be refilled. These
medications cannot be called into your pharmacy and must be
picked up in the clinic or mailed to your house. Please allow
an extra 2 days if you would like your medication mailed to your
home.
5. You may not drive a car until cleared to do so by your
surgeon.
6. Please call your surgeon's office to schedule or confirm your
follow-up appointment.
7. SWELLING: Ice the operative joint 20 minutes at a time,
especially after activity or physical therapy. Do not place ice
directly on the skin. You may wrap the knee with an ace bandage
for added compression. Please DO NOT take any non-steroidal
anti-inflammatory medications (NSAIDs such as Celebrex,
ibuprofen, Advil, Aleve, Motrin, naproxen etc) until cleared by
your physician.
8. ANTICOAGULATION: Please continue your Xarelto daily to help
prevent deep vein thrombosis (blood clots).
9. WOUND CARE: Prevena dressing will to be removed at you
follow-up appointment in a week's time. Please call your
doctor's office if any alerts occur. Check dressing/incision
regularly for signs of infection such as redness or thick yellow
drainage. Staples will be removed at your follow-up appointment
in two weeks.
10. ___ (once at home): Home ___, dressing changes as
instructed, wound checks.
11. ACTIVITY: Weight bearing as tolerated on the operative
extremity. Mobilize. Anterior & posterior precautions. Knee
immobilizer while sleeping (does not need while ambulating). No
strenuous exercise or heavy lifting until follow up appointment.
Physical Therapy:
WBAT RLE
ANTERIOR AND POSTERIOR hip precautions x 8 weeks from date of
surgery
No hip bridging
Knee immobilizer while sleeping (does not need for ambulation)
Mobilize frequently
Treatments Frequency:
Prevena vac to remain on until follow-up appointment
Notify the clinic for any alarms/urgents with vac
Wound/vac checks daily</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q4H:PRN Pain - Mild
RX *acetaminophen 325 mg 2 tablet(s) by mouth q6hr Disp #*80
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. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
RX *oxycodone 5 mg ___ tablet(s) by mouth q4hr Disp #*50 Tablet
Refills:*0
4. Senna 8.6 mg PO BID:PRN Constipation - First Line
RX *sennosides [senna] 8.6 mg 1 tablet by mouth twice a day Disp
#*60 Tablet Refills:*0
5. Aspirin 325 mg PO DAILY
RX *aspirin 325 mg 1 tablet(s) by mouth daily Disp #*28 Tablet
Refills:*0
6. Atorvastatin 20 mg PO QPM
7. Calcium Carbonate 500 mg PO QAM
8. Multivitamins 1 TAB PO DAILY
9. ValACYclovir 500 mg PO Q24H
Discharge Disposition:
Home
Discharge Diagnosis:
Left olecranon 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>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:
-Nonweightbearing to left upper extremity in splint
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 aspirin 325 mg 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
THIS PATIENT IS EXPECTED TO REQUIRE <30 DAYS OF REHAB
FOLLOW UP:
Please follow up with an orthopedic surgeon of your preference
within ___ days.
Please follow up with your primary care doctor regarding this
admission within ___ weeks and for and any new
medications/refills.
Physical Therapy:
Nonweightbearing to left upper extremity in a splint
Treatments Frequency:
Please keep splint in place. Staples should remain for at least
2 weeks postoperatively.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___, you were admitted for evaluation of your vision
changes. You were seen by the neurology and ophthalmology
services during this admission, and you had MRIs of your brain
and orbits. We diagnosed you with optic neuritis. We discussed
that since you are improving, we would not recommend IV steroid
therapy at this point. We discussed the risks of developing
recurrent optic neuritis, multiple sclerosis, and the chances of
having some permanent vision loss. Some lab resuls are still
pending at the time of discharge, and these will be followed up
by your outpatient providers.
Please follow up in ophthalmology and neurology clinics.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. QUEtiapine Fumarate 50 mg PO BID
2. Acetaminophen 650 mg PO Q6H:PRN pain
3. Aspirin 81 mg PO DAILY
4. Atorvastatin 40 mg PO QPM
5. Bisacodyl 10 mg PO DAILY:PRN constipation
6. Cyanocobalamin 250 mcg PO DAILY
7. Estradiol 1 mg PO DAILY
8. Lisinopril 5 mg PO DAILY
9. Metoprolol Tartrate 50 mg PO TID
10. Milk of Magnesia 30 mL PO Q6H:PRN constipation
11. Omeprazole 20 mg PO DAILY
12. Lorazepam 1 mg PO TID
RX *lorazepam 1 mg 1 tablet by mouth Three times a day Disp #*32
Tablet Refills:*0
13. Senna 17.2 mg PO QHS
14. TraZODone 25 mg PO QHS:PRN insomnia
15. Cefpodoxime Proxetil 100 mg PO Q12H Duration: 7 Days
RX *cefpodoxime 100 mg 1 tablet(s) by mouth Every 12 hours Disp
#*11 Tablet Refills:*0
16. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN wheeze, sob
17. Lorazepam 0.5 mg IM TID if patient refuses PO ativan and
does not have IV access
RX *lorazepam 2 mg/mL 0.5 (One half) mg IM Three times a day
Disp #*10 Syringe Refills:*0
18. Lorazepam 0.5 mg IV TID If patient refuses PO ativan
RX *lorazepam 2 mg/mL 0.5 (One half) mg IV Three times a day
Disp #*10 Syringe Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary: Catatonia, UTI
Secondary: SChizoaffective 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 Ms. ___,
You were admitted to the hospital because there was concern that
you had a change in mental status thought to be catatonia. We
also found that you had a UTI which was thought to be
contributing to your catatonia. You were treated with
antibiotics for the UTI and ativan for the catatonia. While you
were here you also had your port replaced.
You are now ready to be discharged. Please take your medication
as prescribed and follow up with your home providers.
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. Aspirin 81 mg PO DAILY
2. Atenolol 12.5 mg PO DAILY
3. 70/30 15 Units Breakfast
70/30 15 Units Lunch
70/30 15 Units Dinner
4. Allopurinol ___ mg PO DAILY
5. Atorvastatin 80 mg PO QPM
6. Clopidogrel 75 mg PO DAILY
7. Fish Oil (Omega 3) 1000 mg PO DAILY
8. Furosemide 20 mg PO DAILY
9. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY
10. Losartan Potassium 50 mg PO DAILY
11. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN CP
12. OxyCODONE (Immediate Release) 10 mg PO DAILY:PRN Pain -
Moderate
13. Pantoprazole 80 mg PO DAILY heart burn
14. Tamsulosin 0.4 mg PO QHS
Discharge Disposition:
Home
Discharge Diagnosis:
CAD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You had a heart catheterization to evaluate your chest
discomfort. You were found to have a restenosis of the SVG in
the RCA coronary artery. Laser and drug eluting balloon was
placed to open the blockage and improve blood flow to the heart.
Continue all your current medications with the following
changes:
-Continue Plavix 75mg daily indefinitely
-Start Aspirin 81 mg daily, lifelong
-Start atenolol 12.5mg daily
Aspirin and plavix are taken to reduce the risk for a blood clot
from forming in the stent. Do not stop Aspirin or plavix unless
directed by Dr. ___.
Stopping Aspirin or plavix may put you at risk for a
life-threatening heart attack.
Activity restrictions and care of the groin are included in your
discharge instructions.
Follow up with with the ___ here at ___ about your
low platelets per the Hematology team when they saw you.
You have been given an updated list of current medications.
It has been a pleasure to have participated in your care. If you
have any questions that are related to your recovery from your
procedure or are experiencing any symptoms that are concerning
to you, please call the ___ heartline at ___ to speak
to a cardiologist or cardiac nurse practitioner.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Humalog 3 Units Breakfast
Humalog 3 Units Lunch
Humalog 3 Units Dinner
Levemir 15 Units Breakfast
Levemir 12 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
RX *insulin lispro [Humalog KwikPen] 100 unit/mL AS DIR with
meals Disp #*1 Syringe Refills:*1
RX *insulin detemir [Levemir FlexTouch] 100 unit/mL (3 mL) AS
DIR 15 Units before BKFT; 12 Units before DINR; Disp #*1 Syringe
Refills:*1
2. LORazepam 0.5 mg PO Q6H:PRN anxiety, nausea
Do not mix with alcohol or other sedating meds
RX *lorazepam 0.5 mg 1 tablet by mouth TID PRN Disp #*10 Tablet
Refills:*0
3. Sodium Bicarbonate 650 mg PO TID
RX *sodium bicarbonate 650 mg one tablet(s) by mouth three times
a day Disp #*180 Tablet Refills:*0
4. amLODIPine 10 mg PO DAILY
5. Sertraline 125 mg PO DAILY
RX *sertraline 25 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
6. Atorvastatin 40 mg PO QPM
7. Calcitriol 0.25 mcg PO DAILY
8. Fluticasone Propionate NASAL 1 SPRY NU DAILY
9. Furosemide 20 mg PO DAILY
10. HydrALAZINE 25 mg PO BID
11. linaclotide 290 mcg oral QAM
12. Losartan Potassium 50 mg PO DAILY
13. Ondansetron ODT 8 mg PO Q8H:PRN nausea
14. Pantoprazole 40 mg PO Q24H
15. Polyethylene Glycol 17 g PO DAILY
16. sevelamer CARBONATE 800 mg PO TID W/MEALS
Discharge Disposition:
Home
Discharge Diagnosis:
DKA
Gastroparesis
Acute on chronic CKD
Viral Syndrom
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 with nausea, vomiting, acute on chronic kidney
injury and DKA. You have been treated supportively for possible
viral syndrome and have improved with better blood sugars,
improved oral intake and kidney function back to baseline. We
have started low dose sodium bicarbonate tabs to help with
chronic acidosis and you will need follow up labs on ___ to
see if this dose needs to be increased.
Please keep all your appointments as scheduled and see below for
adjustments to your insulin regimen.
Best wishes from your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
You were admitted to the Acute Care surgery service on ___
with left scrotal swelling and pain. You were taken to the
operating room with concern for a hernia but no hernia was
found. You underwent CT scan to further evaluate cause of your
scrotal swelling. The urology team evaluated the diagnostic
imaging studies that you had and determined that there is no
damage to the testicle and follow up can be as an outpatient.
They will be in contact to set that up for you.
You are now doing better. Please also follow up in the Acute
Care Surgery clinic at the appointment listed below. Please
follow the instructions below.
ACTIVITY:
o Do not drive until you have stopped taking pain medicine and
feel you could respond in an emergency.
o You may climb stairs.
o You may go outside, but avoid traveling long distances until
you see your surgeon at your next visit.
o Don't lift more than ___ lbs for 4 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.
o You may start some light exercise when you feel comfortable.
o 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.
HOW YOU MAY FEEL:
o You may feel weak or "washed out" for a couple of weeks. You
might want to nap often. Simple tasks may exhaust you.
o You may have a sore throat because of a tube that was in your
throat during surgery.
o You might have trouble concentrating or difficulty sleeping.
You might feel somewhat depressed.
o You could have a poor appetite for a while. Food may seem
unappealing.
o 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:
o Tomorrow you may shower and remove the gauzes over your
incisions. Under these dressing you have small plastic bandages
called steri-strips. 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).
o Your incisions may be slightly red around the stitches. This
is normal.
o You may gently wash away dried material around your incision.
o Avoid direct sun exposure to the incision area.
o Do not use any ointments on the incision unless you were told
otherwise.
o You may see a small amount of clear or light red fluid
staining your dressing or clothes. If the staining is severe,
please call your surgeon.
o You may shower. As noted above, ask your doctor when you may
resume tub baths or swimming.
YOUR BOWELS:
o Constipation is a common side effect of narcotic pain
medications. 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.
o If you go 48 hours without a bowel movement, or have pain
moving the bowels, call your surgeon.
PAIN MANAGEMENT:
o It is normal to feel some discomfort/pain following abdominal
surgery. This pain is often described as "soreness".
o Your pain should get better day by day. If you find the pain
is getting worse instead of better, please contact your surgeon.
o You will receive a prescription for pain medicine to take by
mouth. It is important to take this medicine as directed. o Do
not take it more frequently than prescribed. Do not take more
medicine at one time than prescribed.
o Your pain medicine will work better if you take it before your
pain gets too severe.
o 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.
o If you are experiencing no pain, it is okay to skip a dose of
pain medicine.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for constipation: hold if loose stools.
2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day) as needed for constipation: hold if loose stools.
3. acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q6H (every 6
hours) as needed for pain fever.
4. atenolol 25 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily).
5. bupropion HCl 150 mg Tablet Extended Release Sig: One (1)
Tablet Extended Release PO QAM (once a day (in the morning)).
6. enoxaparin 100 mg/mL Syringe Sig: One (1) 100mg Subcutaneous
Q12H (every 12 hours).
7. levothyroxine 75 mcg Tablet Sig: Three (3) Tablet PO DAILY
(Daily).
8. sertraline 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
9. triamterene-hydrochlorothiazid 37.5-25 mg Capsule Sig: One
(1) Cap PO DAILY (Daily).
10. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
11. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: One (1) Inhalation every four (4) hours.
12. ZOFRAN ODT 4 mg Tablet, Rapid Dissolve Sig: One (1) Tablet,
Rapid Dissolve PO every eight (8) hours as needed for nausea.
13. bisacodyl 5 mg Tablet Sig: ___ Tablets PO once a day as
needed for constipation.
14. guaifenesin 100 mg Tablet, Chewable Sig: One (1) Tablet,
Chewable PO every four (4) hours as needed for cough.
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Migraine Headaches
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
NEURO EXAM: ataxia in UE's and ___
Followup Instructions:
___ [/INST] </s><s>Dear ___,
You were hospitalized due to symptoms of headaches resulting
from migraines.
We did not make any changes to your current medications. Please
take your medications as prescribed.
Please followup with Neurology and your primary care physician
as listed below.
If you experience any of the symptoms below, please seek medical
attention.
It was a pleasure providing you with care during this
hospitalization.</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. Atorvastatin 20 mg PO QPM
4. Dabigatran Etexilate 150 mg PO BID
5. Finasteride 1 mg PO DAILY
6. Lisinopril 2.5 mg PO DAILY
7. Magnesium Oxide 400 mg PO BID
8. Metoprolol Succinate XL 25 mg PO DAILY
9. Multivitamins 1 TAB PO DAILY
10. Spironolactone 25 mg PO DAILY
11. Torsemide 80 mg PO DAILY
12. Clindamycin 300 mg PO Q6H septic bursitis
Please take probiotics while you are on this antibiotic.
RX *clindamycin HCl 300 mg 1 capsule(s) by mouth every six (6)
hours Disp #*40 Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Sepsis/hypotension
R olecranon bursitis
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>it was a pleasure looking after you, Mr. ___. As you
know, you were admitted initially to the intensive care unit for
low blood pressure in the setting of an infected right elbow
bursa. You were given small amounts of intravenous fluid and
treated with intravenous antibiotics with good effect. Your
blood pressure recovered readily and you were transferred to the
medical floor the following day.
The bursa was tapped (fluid removed) and sample fluid was
sent for analyses. There was significant amounts of white blood
cells from the sample - indicating infection. Gram stain was
negative - and the culture is presently pending. The results of
this culture will need to be followed by your primary care
doctor.
You were prescribed an oral antibiotic (clindamycin) to take
for the infected right elbow bursa. Please take this for 10
days. If you, please take probiotics (to be obtained from
___ stores) before and after the antibiotic course - to
minimize possible side effects from the antibiotics.
You may resume your home medications as previously
prescribed. There are no changes to your regimen.
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. Citalopram 40 mg PO DAILY
2. CloniDINE 0.1 mg PO BID
3. Gabapentin 300 mg PO TID
4. NuvaRing (etonogestrel-ethinyl estradiol) 0.12-0.015 mg/24 hr
vaginal ASDIR
5. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
6. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
7. Thiamine 100 mg PO DAILY
RX *thiamine HCl (vitamin B1) 100 mg 1 tablet(s) by mouth once a
day Disp #*30 Tablet Refills:*0
8. Nicotine Patch 21 mg TD DAILY
RX *nicotine 21 mg/24 hour Apply one patch to upper arm daily
Disp #*28 Patch Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY
======
Facial Laceration
Alcohol Withdrawal
Polysubstance Abuse
SECONDARY
========
Depression
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 ___ after you fell while
drinking. We were concerned that you may have injured your head
-- we needed to intubate you in the ER, as you were very
agitated on arrival to the hospital, in order to scan your head
and neck. Fortunately, we didn't find any evidence of trauma.
While in the hospital, you showed signs of alcohol withdrawal,
which we treated.
We advise you to stop drinking all alcohol and to follow up with
your doctors and at the walk in ___ in
___ (walk in appointments ___ 11AM) for
substance abuse intake and assessment.
It was a pleasure taking care of you.
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Topiramate (Topamax) 50 mg PO BID
2. HydrOXYzine 25 mg PO Q4H:PRN nausea
RX *hydroxyzine HCl 25 mg 1 tablet by mouth Q6H:PRN Disp #*30
Tablet Refills:*2
3. Famotidine 20 mg PO Q12H
RX *famotidine [Acid Controller] 20 mg 1 tablet(s) by mouth
every 12 hours Disp #*60 Tablet Refills:*3
4. Omeprazole 40 mg PO BID
RX *omeprazole 40 mg 1 capsule(s) by mouth every twelve (12)
hours Disp #*60 Capsule Refills:*3
5. Metoclopramide 10 mg PO Q6H:PRN nausea
RX *metoclopramide HCl 10 mg 1 tablet by mouth Q6H:PRN Disp #*60
Tablet Refills:*2
6. Citalopram 20 mg PO DAILY
RX *citalopram [Celexa] 20 mg 1 tablet(s) by mouth daily Disp
#*30 Tablet Refills:*1
7. ZOFRAN ODT *NF* (ondansetron) 4 mg Oral Q8H:PRN nausea
RX *ondansetron [ZOFRAN ODT] 4 mg 1 tablet(s) by mouth Q8H:PRN
Disp #*60 Tablet Refills:*2
8. Lorazepam 1 mg PO Q4H:PRN nausea
RX *lorazepam [Ativan] 1 mg 0.5 to 1 tablet(s) by mouth Q4H:PRN
Disp #*40 Tablet Refills:*2
Discharge Disposition:
Home
Discharge Diagnosis:
Cyclic Vomiting syndrome
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 ___ for
your cyclic vomiting syndrome. Fortunately, you only had a few
episodes of vomiting and came to the hospital early in the
course of this exacerbation. In the ED you were given reglan,
zofran, and lorazepam. However, you were still somewhat
nauseated and could not tolerate PO so you were admitted to the
medicine service. Overnight we hydrated you with intravenous
fluids and gave you standing zofran, reglan, and ativan if
needed. We continued to give you fluids through the next day
and advanced your diet as tolerated. Unfortunately, your
nausea/vomiting returned intermittently through the next few
days. We consulted GI and added on hydroxyzine, and famotidine
and sucralfate. Your symptoms were refractory to these
medications so the GI doctors ___ your upper gastrointestinal
tract. They found some irritation of the mucosa, but again,
nothing that would explain your vomiting. We also consulted the
neurologists who ordered a sleep deprived EEG the results of
which were pending at the time of discharge. Finally we did a
repeat MRI of your ___ which was also pending at the time of
discharge.
You can follow up on the results of your MRI and EEG at your
post-discharge appointment this coming week. You can also page
us to discuss the results on ___ as we discussed.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Ms. ___,
Thank you for choosing ___ as your site of care.
Why was I in the hospital?
-You were having trouble breathing at home.
What was done for me while I was in the hospital?
-Because you were having trouble breathing, you were in the ICU
initially.
-You received water pills through an IV to remove the extra
fluid on your lungs.
-You were also given antibiotics to treat an infection in your
lungs.
-Initially you required oxygen to help you breath, this was
stopped prior to your discharge.
What should I do when I leave the hospital?
-Please continue taking all of your medications as prescribed.
-Try to limit your sodium to less than 2 grams daily.
-Please weigh yourself daily, if weight goes up more than 3 lbs
please call your doctor.
-___ follow up with your providers as detailed below.
Thanks,
Your ___ treatment team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES QHS
2. Simvastatin 20 mg PO DAILY
3. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth every day Disp #*30
Tablet Refills:*0
4. Thiamine 100 mg PO DAILY
RX *thiamine HCl 100 mg 1 tablet(s) by mouth every day Disp #*30
Tablet Refills:*0
5. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSES
=================
#withdrawal seizure
#alcohol withdrawal
#alcohol abuse
#Transaminitis
#thrombocytopenia
#Anion-gap metabolic acidosis
#Refeeding syndrome
SECONDARY DIAGNOSES
===================
#hyperlipidemia
#glaucoma
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 seen at the ___ after
being found to be having a seizure in the setting of likely
alcohol withdrawal. We treated you with medication to help
prevent withdrawal, and gave you vitamins that you were low on.
It is very important that you refrain from alcohol and continue
participating in AA, as with the appropriate support long-term
sobriety is definitely possible. It is also important that you
continue taking your vitamins as prescribed, as chronic alcohol
use can result in low vitamin levels.
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. Aspirin 81 mg PO DAILY
2. Atorvastatin 40 mg PO QPM
3. Carvedilol 12.5 mg PO BID
4. ClonazePAM 1 mg PO BID
5. OxyCODONE (Immediate Release) 10 mg PO Q6H:PRN Pain -
Moderate
6. Repaglinide 0.5 mg PO TIDAC
7. Sertraline 50 mg PO DAILY
8. HELD- Apixaban 5 mg PO BID This medication was held. Do not
restart Apixaban until you see your doctor
9. HELD- Furosemide 40 mg PO DAILY This medication was held. Do
not restart Furosemide until you see your doctor this ___ to
recheck your kidney function
10. HELD- Lisinopril 5 mg PO DAILY This medication was held. Do
not restart Lisinopril until you see your doctor this ___ to
recheck your kidney function
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis:
#Acute on Chronic Kidney Injury
#Acute tubular necrosis
Secondary Diagnoses:
#Ischemic Cardiomyopathy
#Chronic Systolic Heart Failure
___ chronic pain
#Type II Diabetes Mellitus
#Advanced MSI Colonic Adenocarcinoma
#Hx LV thrombus
#Anxiety
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 ___
because you had abnormal labs. Your doctors were concerned about
your kidney function. While you were here, we found that your
kidneys were temporarily damaged. We think that this damage was
caused by some of your medications (when they were not packaged
like they usually are). We monitored your kidney function very
closely, and it improved while you were here.
It will be very important that you continue taking your
medications exactly as prescribed. It is also very important
that you weigh yourself everyday. Call your doctor if you weight
changes by more than a lb in a day or 3 lbs in a week. It is
also VERY important you stop your home furosemide and
Lisinopril.
It was a pleasure caring for you,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atenolol 75 mg PO QAM
2. Atenolol 50 mg PO QPM
3. Atorvastatin 80 mg PO QPM
4. Diltiazem Extended-Release 180 mg PO DAILY
5. Docusate Sodium 100 mg PO BID
6. Finasteride 5 mg PO DAILY
7. Ciprofloxacin HCl 500 mg PO Q12H Duration: 5 Days
While catheter in place.
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth twice a day
Disp #*10 Tablet Refills:*0
8. Bacitracin Ointment 1 Appl TP QID
Apply to penile meatus to prevent catheter irritation.
RX *bacitracin zinc 500 unit/gram Apply to penile meatus to
prevent catheter irrtation four times a day Disp #*5 Packet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Gross Hematuria with Clot Retention
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>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.
Unless otherwise advised please hold Aspirin and Warfarin until
follow; If the urine is still pink, hold the aspirin until it
has been clear/yellow for at least three days.
-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
- AVOID STRAINING for bowel movements as this may stir up
bleeding.
-Do not eat constipating foods for ___ weeks, drink plenty of
fluids to keep hydrated
-No vigorous physical activity or sports for 4 weeks or until
otherwise advised
-Do not lift anything heavier than a phone book (10 pounds) or
participate in high intensity physical activity for a minimum of
four weeks or until you are cleared by your Urologist in
follow-up
-Tylenol should be your first line pain medication, a narcotic
pain medication has been prescribed for breakthrough pain >4.
Replace Tylenol with narcotic pain medication.
-Max daily Tylenol (acetaminophen) dose is 4 grams from ALL
sources, note that narcotic pain medication also contains
Tylenol
-Do not drive or drink alcohol while taking narcotics and do not
operate dangerous machinery. Also, if the Foley catheter and Leg
Bag are in place--Do NOT drive (you may be a passenger).
WHEN YOU ARE DISCHARGED WITH A FOLEY CATHETER:
-Please also reference the nursing handout and instructions on
routine care and hygiene
-Your Foley should be secured to the catheter secure on your
thigh at ALL times until your follow up with the surgeon.
-DO NOT have anyone else other than your urologist or your
urologist's representative remove your Foley for any reason.
-Wear Large Foley bag for majority of time; the leg bag is only
for short-term periods for when leaving the house.
-Do NOT drive if you have a Foley in place (for your safety)</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acyclovir 400 mg PO Q8H
2. ALPRAZolam 0.5 mg PO TID:PRN anxiety
3. Dexamethasone 10 mg PO 1X/WEEK (___)
4. Fluticasone Propionate NASAL 1 SPRY NU DAILY
5. Guaifenesin-CODEINE Phosphate ___ mL PO HS:PRN cough
6. Levothyroxine Sodium 125 mcg PO DAILY
7. Pravastatin 40 mg PO HS
8. Rivaroxaban 20 mg PO DAILY
9. Albuterol Inhaler 2 PUFF IH Q6H:PRN wheeze
10. Lenalidomide 15 mg ORAL DAILY multiple myeloma
11. Ranitidine 150 mg PO DAILY
12. Symbicort (budesonide-formoterol) 80-4.5 mcg/actuation
inhalation BID
13. Furosemide 40 mg PO DAILY
14. Metoprolol Succinate XL 50 mg PO DAILY
RX *metoprolol succinate 50 mg 1 tablet(s) by mouth daily Disp
#*60 Tablet Refills:*0
15. Potassium Chloride 10 mEq PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS
------------------
Right atrial tachycardia (likely reentrant)
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 due to atrial fibrillation (Afib) with very
rapid heart rate. As you have been treated with many rate
controlling medications in the past but without control of your
heart rate, you underwent an ablative procedure to disrupt the
electric tract leading to the fast rate.
Please see the instructions below for a complete review of what
to expect after the procedure.
It was a pleasure taking care of you at ___.
Sincerely,
Your Team at ___
Atrial fibrillation ablation: pulmonary vein isolation
(PVI)Discharge instructions
If you have questions that are not answered by these
instructions,please ask your nurse or doctor. You had a
pulmonary vein isolation catheter ablation for thetreatment of
atrial fibrillation. During this procedure, areas in
thepulmonary veins are treated (ablated) so that they can no
longerconduct electrical signals and trigger atrial
fibrillation. The successof the procedure depends on many
factors and the success rateranges from approximately 70-80%.How
should I take care of my incisions?During the procedure,
catheters are placed into the blood vessels (veins) in both
groins. These catheters areremoved at the end of the procedure,
leaving two-four small incisions. These are small so they do not
___ You may remove the bandages over the
incision sites and shower the day after the procedure. Do not
take atub bath for one ___ You may leave the bandages
off beginning the day after the ___ Please use
only soap and water to clean the area around the incisions.
Avoid rubbing this area too brisklywhen showering as this may
disrupt the small scab that forms over the ___
Do not use powders or ointment in the area of the incisions for
one week after the ___ Do not swim in a pool,
lake, or ocean or use a Jacuzzi/ hot-tub for one week after the
___ I return to my usual activities?Here are some
guidelines about common activities. Please ask your doctor about
any other activities you are notsure ___ Do not
drive for 48 hours after the ___ For one week,
do not lift, push, pull, or carry anything heavier than 10
___ For one week, do not do any exercise or
activity that causes you to hold your breath or bear down with
yourabdominal muscles. Take care not to put strain on your
abdominal muscles when coughing, sneezing, ormoving your
bowels.One week after the procedure, you may go back to your
regular activities, including sexual ___ Ask your
doctor when you may go back to work. This will depend on the
type of work you ___ After one week, you may resume
your exercise program at half your usual routine for the first
few days,then gradually work back to your full routine.What
medications should I ___ Before you leave the
hospital, you will be given a list of all medicines you should
take once you are athome. Please be sure to ask any questions
you have about medications. If something you normally take isnot
on the list, please ask whether you should continue taking it.
This includes prescription medicines,nonprescription medicines,
vitamins, herbs, and ___ You will be given
specific instructions about taking a blood-thinning medicine
after the ablation. Bloodthinningmedicines are taken to decrease
the risk for stroke. The most common blood-thinning
medicinesprescribed are warfarin (Coumadin) and dabigatran
___ The doctor who performed the ablation will
tell you how long you will be on blood-thinning medicine andwhen
it may be ___ If you are taking warfarin
(Coumadin), you need to have a blood test checked once a week
for fourweeks after the ablation. The test is called an INR, and
it gives your doctor information about how ___ is
working. Sometimes, changes in dose are needed based on the INR.
The goal INR level is ___ In some cases, the doctor
recommends aspirin for one month after the ablation procedure to
help decreaseinflammation at the ablation sites. Your doctor
___ let you know if this applies to ___ You may take
acetaminophen (Tylenol) every six hours if you have discomfort
in the area where thecatheter was placed. If discomfort or pain
is not relieved with acetaminophen, contact your doctor. Note:
Itis not safe to take more than the recommended dose of
acetaminophen. Do not take more than what isrecommended on the
label. Also, a number of non-prescription products (such as some
cold medicines,other pain relievers) contain acetaminophen. Do
not take more than one product containing acetaminophen.What
testing will I have after the procedure?You will be given a
portable heart monitor to wear at home several times during the
first year after the ablation.This allows your doctor to monitor
and evaluate any abnormal heart rhythms. You may also have a
heart MRIor CT scan shortly after the procedure. This is to
evaluate the healing of the atrium and pulmonary veins.When will
I see the doctor again?Your doctor ___ let you know when you
should be seen again. Let your doctor know if you think you need
___ seen sooner than your next appointment. If you are not sure
when your next appointment is, please ask.What symptoms should I
expect?Recovery after pulmonary vein isolation is different for
everyone. The first six to eight weeks is called thehealing
phase. During this time, it is not uncommon for episodes of
atrial fibrillation to occur. This is becausethe ablation
procedure causes inflammation of the heart tissue around the
pulmonary veins, which may causeshort episodes of atrial
fibrillation. If this happens, you may experience symptoms
similar to those you hadbefore the procedure, but perhaps not as
severe. You should not be discouraged or assume that your
procedurewas unsuccessful. As the area around the pulmonary
veins heals, the episodes of atrial fibrillation related to
theprocedure should go away.For about one to three days
following the procedure, you may feel some chest tightness when
taking a very deepbreath. This symptom is related to
inflammation of heart tissue caused by the ablation procedure
and shouldgradually go away on its own.
Atrial fibrillation ablation: pulmonary vein isolation (PVI)
Discharge instructions
If you have questions that are not answered by these
instructions, please ask your nurse or doctor.
You had a pulmonary vein isolation catheter ablation for the
treatment of atrial fibrillation. During this procedure, areas
in the pulmonary veins are treated (ablated) so that they can
no longer conduct electrical signals and trigger atrial
fibrillation. The success of the procedure depends on many
factors and the success rate ranges from approximately 70-80%.
How should I take care of my incisions?
During the procedure, catheters are placed into the blood
vessels (veins) in both groins. These catheters are removed at
the end of the procedure, leaving two-four small incisions.
These are small so they do not require stiches.
___ You may remove the bandages over the incision sites
and shower the day after the procedure. Do not take a tub bath
for one week.
___ You may leave the bandages off beginning the day after
the procedure.
___ Please use only soap and water to clean the area
around the incisions. Avoid rubbing this area too briskly when
showering as this may disrupt the small scab that forms over the
incisions.
___ Do not use powders or ointment in the area of the
incisions for one week after the procedure.
___ Do not swim in a pool, lake, or ocean or use a
Jacuzzi/ hot-tub for one week after the procedure.
___ I return to my usual activities?
Here are some guidelines about common activities. Please ask
your doctor about any other activities you are not sure about.
___ Do not drive for 48 hours after the procedure.
___ For one week, do not lift, push, pull, or carry
anything heavier than 10 pounds.
___ For one week, do not do any exercise or activity that
causes you to hold your breath or bear down with your abdominal
muscles. Take care not to put strain on your abdominal muscles
when coughing, sneezing, or moving your bowels.
One week after the procedure, you may go back to your regular
activities, including sexual activity.
___ Ask your doctor when you may go back to work. This
will depend on the type of work you do.
___ After one week, you may resume your exercise program
at half your usual routine for the first few days, then
gradually work back to your full routine.
What medications should I take?
___ Before you leave the hospital, you will be given a
list of all medicines you should take once you are at home.
Please be sure to ask any questions you have about medications.
If something you normally take is not on the list, please ask
whether you should continue taking it. This includes
prescription medicines,
nonprescription medicines, vitamins, herbs, and supplements.
___ You will be given specific instructions about taking a
blood-thinning medicine after the ablation. Bloodthinning
medicines are taken to decrease the risk for stroke. The most
common blood-thinning medicines prescribed are warfarin
(Coumadin) and dabigatran (Pradaxa).
___ The doctor who performed the ablation will tell you
how long you will be on blood-thinning medicine and when it may
be stopped.
___ If you are taking warfarin (Coumadin), you need to
have a blood test checked once a week for four weeks after the
ablation. The test is called an INR, and it gives your doctor
information about how the warfarin is working. Sometimes,
changes in dose are needed based on the INR. The goal INR level
is ___.
___ In some cases, the doctor recommends aspirin for one
month after the ablation procedure to help decrease inflammation
at the ablation sites. Your doctor ___ let you know if this
applies to you.
___ You may take acetaminophen (Tylenol) every six hours
if you have discomfort in the area where the catheter was
placed. If discomfort or pain is not relieved with
acetaminophen, contact your doctor. Note: It is not safe to take
more than the recommended dose of acetaminophen. Do not take
more than what is recommended on the label. Also, a number of
non-prescription products (such as some cold medicines,
other pain relievers) contain acetaminophen. Do not take more
than one product containing acetaminophen.
What testing will I have after the procedure?
You will be given a portable heart monitor to wear at home
several times during the first year after the ablation.
This allows your doctor to monitor and evaluate any abnormal
heart rhythms. You may also have a heart MRI or CT scan shortly
after the procedure. This is to evaluate the healing of the
atrium and pulmonary veins.
What symptoms should I expect?
Recovery after pulmonary vein isolation is different for
everyone. The first six to eight weeks is called the healing
phase. During this time, it is not uncommon for episodes of
atrial fibrillation to occur. This is because the ablation
procedure causes inflammation of the heart tissue around the
pulmonary veins, which may cause
short episodes of atrial fibrillation. If this happens, you may
experience symptoms similar to those you had before the
procedure, but perhaps not as severe. You should not be
discouraged or assume that your procedure was unsuccessful. As
the area around the pulmonary veins heals, the episodes of
atrial fibrillation related to the procedure should go away.
For about one to three days following the procedure, you may
feel some chest tightness when taking a very deep breath. This
symptom is related to inflammation of heart tissue caused by the
ablation procedure and should gradually go away on its own.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Omeprazole 20 mg PO DAILY
2. Acetaminophen 1000 mg PO TID
3. TraMADOL (Ultram) 12.5 mg PO Q6H:PRN pain
4. Ciprofloxacin HCl 750 mg PO Q12H
Last dose ___
5. Amlodipine 10 mg PO DAILY
6. fenofibrate 134 mg oral Daily
7. Metoprolol Tartrate 25 mg PO BID
8. Rosuvastatin Calcium 20 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Cholangitis
Choledocholithiasis
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.
Followup Instructions:
___ [/INST] </s><s>You were admitted with a blood stream infection related to a
biliary blockage. You had an ERCP that showed a blocked duct,
and a stent was placed. The stent will need to be removed in
four weeks. You were started on antibiotics and will need to
continue these antibiotics for 2 weeks in total. The last day
___.
You also had complaints of foot pain, this may be due to
neuropathy. An xray was checked and did not show a fracture.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ibuprofen 600 mg PO Q8H:PRN Pain - Mild
2. Lidocaine 5% Patch 2 PTCH TD QAM
RX *lidocaine 5 % 2 patches every morning Disp #*10 Patch
Refills:*0
3. Polyethylene Glycol 17 g PO DAILY
RX *polyethylene glycol 3350 17 gram 1 packet by mouth once a
day Disp #*7 Packet Refills:*0
4. Methadone 20 mg PO DAILY
Consider prescribing naloxone at discharge
5. Acetaminophen 650 mg PO Q8H:PRN Pain - Mild/Fever
6. Amphetamine-Dextroamphetamine 30 mg PO BID
RX *dextroamphetamine-amphetamine 30 mg 1 tablet(s) by mouth
twice a day Disp #*6 Tablet Refills:*0
7. Entecavir 0.5 mg PO DAILY
8. FLUoxetine 40 mg PO DAILY
RX *fluoxetine 40 mg 1 capsule(s) by mouth once a day Disp #*7
Capsule Refills:*0
9. FoLIC Acid 1 mg PO DAILY
10. Gabapentin 800 mg PO TID
RX *gabapentin 800 mg 1 capsule(s) by mouth three times a day
Disp #*9 Tablet Refills:*0
11. HYDROmorphone (Dilaudid) ___ mg PO Q6H:PRN Pain - Moderate
12. Multivitamins W/minerals 1 TAB PO DAILY
13. Nicotine Patch 21 mg/day TD DAILY
14. Rivaroxaban 20 mg PO DAILY
RX *rivaroxaban [___] 20 mg 1 tablet(s) by mouth once a day
Disp #*7 Tablet Refills:*0
15. Thiamine 100 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS
===================
Fever, chills
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 part in your care here at ___!
Why was I admitted to the hospital?
- ___ were admitted for fevers and chills
What was done for me while I was in the hospital?
- ___ were treated with antibiotics to complete the course that
was stopped after ___ left the rehab
- ___ had imaging studies done which did not the prior abscess
- ___ had an echocardiogram of your heart, which showed the
function had improved since your last hospitalization, but it
was not yet within normal limits
- ___ were restarted on methadone with the help of the addiction
psych providers
- ___ had an ultrasound which showed a superficial clot in your
R arm
- ___ were treated with anticoagulation for your known clots
What should I do when I leave the hospital?
- Take all of your medications as prescribed
- Go to all of your scheduled doctor's appointments
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Artificial Tears ___ DROP BOTH EYES BID dry eyes
2. Gabapentin 100 mg NG TID
3. Glycopyrrolate 1 mg NG BID
4. Heparin 5000 UNIT SC TID
5. Lactulose 30 mL NG TID
6. Lansoprazole Oral Disintegrating Tab 30 mg G TUBE DAILY
7. LeVETiracetam 1500 mg PO BID
8. Nadolol 20 mg PO DAILY
9. Rifaximin 550 mg NG BID
10. Spironolactone 50 mg PO DAILY
11. LACOSamide 200 mg PO BID
12. Baclofen 10 mg NG QID
13. Furosemide 20 mg NG DAILY
14. Mirtazapine 15 mg NG QHS
15. Nystatin Oral Suspension 5 mL PO QID
16. OxycoDONE (Immediate Release) 5 mg NG Q6H:PRN pain
17. Potassium Chloride (Powder) 20 mEq PO DAILY
Hold for K > 4.0
18. TraZODone 50 mg NG QHS
19. Phenytoin Infatab 150 mg PO Q8H
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary Diagnosis:
Generalized Tonic Clonic Seizures
Status Epilepticus
Secondary Diagnosis:
Hemorrhagic Stroke
Ischemic Stroke
Dysphagia
Pneumonia
Cirrhosis
Discharge Condition:
Mental Status: Confused - sometimes. Oriented to self.
Level of Consciousness: Arousable.
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
It was a pleasure taking care of you at ___
___. You were admitted because of recurrent
seizures. It is thought that the seizures occured because of a
pneumonia which was treated while you were in the ___.
You were sedated and intubated to help ensure that you received
enough oxygen while you were seizing. You were given a
different regimen of anti-seizure medications while you were in
the hospital; the neurology service helped determine which
medications to give you to stop the seizures. You will need to
follow-up with neurology as scheduled.
You had a pneumonia that was treated with IV antibiotics that
were completed while you were here. You will need to follow-up
with your primary care doctor and recommend a repeat chest X-ray
within a month.
It is important that you take all of your medications as
prescribed, and that you attend all of your appointments as
scheduled. If you need to reschedule any appointments, please
attempt to schedule a follow-up appointment as close to your
originally scheduled appointment as possible.
We wish you the best of health,
Your Care Team at ___.</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
do NOT exceed 3gm in 24 hours
2. Acetaminophen-Caff-Butalbital ___ TAB PO Q6H:PRN headache
3. Biofreeze (menthol) (menthol) 4 % topical Q6H:PRN back pain
4. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
5. Docusate Sodium 100 mg PO BID
please hold for loose stool
6. Levothyroxine Sodium 88 mcg PO DAILY
7. Senna 8.6 mg PO BID:PRN constipation
8. TraZODone 25 mg PO QHS:PRN insomnia
9. Cyclobenzaprine 5 mg PO TID:PRN muscle spasm
10. Ibuprofen 600 mg PO Q8H:PRN Pain
please take with food
11. Lorazepam 0.5 mg PO Q4H:PRN anxity
12. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
do NOT drive or drink alcohol while taking this medication
RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours
Disp #*40 Tablet Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Self-stab wound to left chest
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 presented to the ___ on
___ with wounds to your chest. You were admitted to the
Trauma/Acute Care Surgery team and were taken to the Operating
Room for surgical intervention. You were then transferred to
the Intensive Care Unit for further monitoring.
You were transferred to the step-down surgical floor and are
recovering well. Your pain is controlled on oral medication,
you have ambulated and you are tolerating a regular diet. You
are now medically cleared to be discharged to ___ to
continue your recovery.
Please note the following discharge instructions:
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.
*If you have staples, they will be removed at your follow-up
appointment.
*If you have steri-strips, they will fall off on their own.
Please remove any remaining strips ___ days after surgery.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth daily Disp #*30
Capsule Refills:*0
2. Levothyroxine Sodium 75 mcg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Acute pancreatitis
Hypoxia
Secondary:
Pancreas divisum
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 abdominal pain and found
to have pancreatitis. The cause of your pancreatitis is not
clear but may relate to eating fatty foods. We recommend you see
a pancreas specialist as an outpatient. We treated you with
fluids, bowel rest and pain medications and you improved.
Please follow up with your primary care doctor and ___ pancreatic
specialist after discharge.
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. Glargine 20 Units Breakfast
RX *insulin glargine [Lantus Solostar U-100 Insulin] 100 unit/mL
(3 mL) AS DIR 20 Units before BKFT; Disp #*2 Syringe Refills:*0
RX *insulin syringe-needle U-100 [BD Insulin Syringe Ultra-Fine]
31 gauge x ___ for use with lantus solostar AS DIR Disp #*100
Packet Refills:*0
2. Penicillin G Potassium 3 Million Units IV Q4H Duration: 8
Days
last day = ___
RX *penicillin G pot in dextrose 3 million unit/50 mL 3 million
units IV every four (4) hours Disp #*48 Intravenous Bag
Refills:*0
3. Atorvastatin 40 mg PO QPM
4. canagliflozin 300 mg oral DAILY
5. Chlorthalidone 25 mg PO DAILY
6. GlipiZIDE 5 mg PO DAILY
7. Valsartan 160 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
# Group A Strep Sepsis secondary to acute blood stream infection
# R leg cellulitis
# Superficial thrombophlebitis of R leg
# Type 2 diabetes complicated by hyperglycemia
# Hypertension
# Hyperlipidemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Ms. ___:
It was a pleasure caring for you at ___. You were admitted
with a severe infection of your leg and blood stream. You were
seen by infection doctors and treated with antibiotics. You
improved.
During your hospital stay you were seen by diabetes specialists
from the ___ Diabetes. Per your discussion with
them you were started on lantus insulin.
You are now ready for discharge home with IV antibiotics.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Dexamethasone 4 mg PO Q12H
RX *dexamethasone 4 mg 1 tablet(s) by mouth every twelve (12)
hours Disp #*20 Tablet Refills:*0
2. Lidocaine-Prilocaine 1 Appl TP PRN prior to injections
RX *lidocaine-prilocaine 2.5 %-2.5 % apply to skin where
injecting needle as needed Refills:*0
3. Pantoprazole 40 mg PO Q24H
RX *pantoprazole 40 mg 1 tablet(s) by mouth q24h Disp #*30
Tablet Refills:*0
4. Ferrous Sulfate 325 mg PO DAILY
5. Lorazepam 0.5-1 mg PO Q4H:PRN anxiety, insomnia
RX *lorazepam 0.5 mg ___ tablet by mouth q4h: prn Disp #*30
Tablet Refills:*0
6. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth Q4H: prn Disp #*30
Tablet Refills:*0
7. HumaLOG KwikPen (insulin lispro) 100 unit/mL subcutaneous PRN
high blood sugar
according to scale provided or as instructed by ___
RX *insulin lispro [Humalog KwikPen] 100 unit/mL as directed as
directed Disp #*5 Syringe Refills:*0
8. Lantus Solostar (insulin glargine) 100 unit/mL (3 mL)
subcutaneous BID
43 units with breakfast, 16 units at bedtime.
RX *insulin glargine [Lantus Solostar] 100 unit/mL (3 mL) as
directed SC as directed Disp #*1 Box Refills:*0
9. BD Insulin Pen Needle UF Mini (insulin needles (disposable))
31 x ___ miscellaneous PRN for insulin
RX *insulin needles (disposable) [BD Insulin Pen Needle UF Mini]
31 gauge X ___ as directed as directed Disp #*2 Package
Refills:*0
10. One Touch Ultra Test (blood sugar diagnostic)
miscellaneous 5x daily
RX *blood sugar diagnostic [One Touch Ultra Test] use with
lancet and glucometer to test blood sugar up to 5x daily Disp
#*200 Strip Refills:*0
11. One Touch Delica Lancets (lancets) 33 gauge miscellaneous
prn
RX *lancets [One Touch Delica Lancets] 33 gauge use to check
blood sugar up to 5x daily Disp #*2 Package Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Non-small cell lung cancer
Spinal cord involvement
Ascites
Hyperglycemia
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 stay at ___.
You were admitted for fast heart rate and difficulty breathing.
You were found to have fluid in belly believed to be caused by
lung cancer. This was removed and you felt better, so you were
transferred to the medicine floor. There, a scan of your back
showed your cancer had spread to your spine and you were treated
with radiation to shrink it and protect your spinal cord. Once
this radiation course is finished, you will be started on a
chemotherapy pill to shrink your tumor.
During your stay you also had difficult to control blood sugars
thought to be caused by taking steroids in addition to your
diabetes. You will be discharged with insulin and have an
appointment scheduled with the ___ clinic as an
outpatient.
Check your blood sugar with every meal and at bedtime and
administer insulin as instructed. Be sure to eat when you take
your insulin.
*** If your blood sugar is higher than 300, administer insulin
per your scale and then call ___ at ___ to speak to
the doctor on call.
*** If your blood sugar is less than 80, DO NOT give yourself
more insulin. Call ___ at ___ to speak to the doctor
on call.
*** Be sure to call ___ at ___ to
schedule delivery of erlotinib to your home. Do not take this
medication until instructed by your oncologist.
Wishing you well,
Your ___ Oncology Team</s> |