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<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
2. Lactulose 30 mL PO TID
RX *lactulose 20 gram/30 mL 30 mL by mouth three times a day
Refills:*0
3. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
4. Nicotine Patch 14 mg TD DAILY
RX *nicotine 14 mg/24 hour apply to skin daily Disp #*30 Patch
Refills:*0
5. Nystatin Oral Suspension 5 mL PO QID
RX *nystatin 100,000 unit/mL 5 mL by mouth four times a day
Refills:*0
6. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain - Severe
RX *oxycodone 5 mg 1 tablet(s) by mouth every six (6) hours Disp
#*12 Tablet Refills:*0
7. Rifaximin 550 mg PO BID
RX *rifaximin [Xifaxan] 550 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
8. Thiamine 100 mg PO DAILY
RX *thiamine HCl (vitamin B1) 100 mg 1 tablet(s) by mouth daily
Disp #*30 Tablet Refills:*0
9. BuPROPion 150 mg PO TID
10. Fluticasone Propionate 110mcg 2 PUFF IH BID
11. Furosemide 40 mg PO DAILY
12. Omeprazole 20 mg PO DAILY
13. Salmeterol Xinafoate Diskus (50 mcg) 1 INH IH Q12H
14. Spironolactone 50 mg PO DAILY
15. HELD- Amphetamine-Dextroamphetamine 10 mg PO QAM This
medication was held. Do not restart
Amphetamine-Dextroamphetamine until seeing your PCP
___:
Home
Discharge Diagnosis:
Primary Diagnosis
Alcoholic hepatitis
Alcoholic cirrhosis
Alcohol intoxication
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 has been a pleasure taking care of you at ___.
Why was I here?
You were admitted to monitor you for withdrawal symptoms from
alcohol use.
What was done for me here?
You were monitored for alcohol withdrawal symptoms and treated
for any symptoms.
You were given pain medications for your alcoholic hepatitis.
What should I do when I go home?
- Please call the liver transplant social worker/coordinator to
get set up with alcohol abuse treatment.
- You also need to make an appointment with Dr. ___ in clinic.
Call the ___ at ___.
- Please continue to take all of your medications as prescribed
for your liver disease.
Sincerely,
Your ___ Liver Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Diltiazem Extended-Release 120 mg PO DAILY
RX *diltiazem HCl 120 mg 1 capsule(s) by mouth once a day Disp
#*30 Capsule Refills:*0
2. Apixaban 5 mg PO BID
3. Atorvastatin 80 mg PO QPM
4. Losartan Potassium 50 mg PO DAILY
5. Tamsulosin 0.4 mg PO DAILY
6. HELD- amLODIPine 5 mg PO DAILY This medication was held. Do
not restart amLODIPine until you see your primary care doctor
7. HELD- Finasteride 5 mg PO DAILY This medication was held. Do
not restart Finasteride until you see your primary care doctor
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGONSIS:
-Chest pain
SECONDARY DIAGNOSIS:
-HTN
-HLD
-Prostate cancer s/p XRT
-CVA
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 pleasure taking care of you at ___
___.
WHY WAS I ADMITTED TO THE HOSPITAL?
- You were admitted to the hospital because you had chest pain.
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
- You had blood tests drawn that did not show signs of decreased
perfusion to your heart.
- You had a thorough workup for fevers and confusion, and there
were no signs of any active infection.
WHAT SHOULD I DO WHEN I GO HOME?
- You should continue to take your medications as prescribed.
- If you are experiencing new or concerning chest pain that is
coming and going you should call the heartline at ___.
If you are experiencing persistent chest pain that is not
getting better with rest, you should call ___.
- You should also call the heartline if you develop swelling in
your legs, abdominal distention, or shortness of breath at
night.
- You should attend the appointments listed below.
We wish you the best!
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Morphine Sulfate (Concentrated Oral Solution) 20 mg/mL ___
mg PO Q1H:PRN Pain - Moderate
RX *morphine concentrate 100 mg/5 mL (20 mg/mL) ___ mg by mouth
q1h Refills:*0
2. Ondansetron 8 mg PO Q8H:PRN Nausea/Vomiting - First Line
Reason for PRN duplicate override: Alternating agents for
similar severity
RX *ondansetron 8 mg 1 tablet(s) by mouth every eight (8) hours
Disp #*42 Tablet Refills:*0
3. Polyethylene Glycol 17 g PO BID
RX *polyethylene glycol 3350 [Miralax] 17 gram 1 powder(s) by
mouth twice a day Disp #*56 Packet Refills:*0
4. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 1 tablet by mouth twice a day Disp
#*60 Tablet Refills:*0
5. Atorvastatin 80 mg PO QPM
6. Magnesium Oxide 400 mg PO DAILY
7. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
RX *oxycodone 10 mg 1 tablet(s) by mouth every four (4) hours
Disp #*42 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
Bilateral retinal detachment
Metastatic esophageal cancer
Bilateral DVTs
Secondary:
CAD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you at ___
___.
WHY WAS I IN THE HOSPITAL?
-You were transferred here for further evaluation and management
of your vision changes.
WHAT HAPPENED TO ME IN THE HOSPITAL?
-You were seen by an eye cancer specialist. Your vision changes
are likely due to metastatic disease (cancer spread).
-You were found to have new blood clots in your legs. Your
warfarin medication was held, but your INR level was too high
for us to safely start you on a blood thinning medication
(lovenox).
-Case management here worked to set you and your family up with
hospice services.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
-You need to recheck your INR level with an outpatient provider
in the next ___ days. They should start you on lovenox (blood
thinning medication) when your INR is under 2.
-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. Multivitamins 1 TAB PO DAILY
2. degludec 80 Units Bedtime
glulisine 7 Units Breakfast
glulisine 7 Units Lunch
glulisine 7 Units Dinner
3. BuPROPion XL (Once Daily) 300 mg PO DAILY
4. Furosemide 40 mg PO DAILY
5. Lactulose 30 mL PO TID
6. Lithium Carbonate 300 mg PO BID
7. lurasidone 120 mg oral DAILY
8. Nadolol 20 mg PO DAILY
9. Omeprazole 20 mg PO BID
10. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation
Q6H:PRN dyspnea
11. rifAXIMin 550 mg PO BID
12. Spironolactone 50 mg PO DAILY
13. Topiramate (Topamax) 15 mg PO DAILY
14. Vitamin D 400 UNIT PO DAILY
15. HELD- Rosuvastatin Calcium 20 mg PO QPM This medication was
held. Do not restart Rosuvastatin Calcium until your liver
function tests normalize
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
rhabdomyolysis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
___ was a privilege taking care of you at ___
___.
WHY WAS I ADMITTED TO THE HOSPITAL?
===================================
- You were feeling weak and fell
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
==========================================
- We gave you IV fluids
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 ___!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. HYDROmorphone (Dilaudid) 2 mg PO Q6H:PRN BREAKTHROUGH PAIN
do not drink alcohol or drive while taking this medication
RX *hydromorphone 2 mg 1 tablet(s) by mouth four times a day
Disp #*20 Tablet Refills:*0
2. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth once a day Disp #*14
Capsule Refills:*0
3. Polyethylene Glycol 17 g PO DAILY:PRN constipation
RX *polyethylene glycol 3350 [Miralax] 17 gram 1 powder(s) by
mouth once a day Disp #*30 Packet Refills:*0
4. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 1 tablet by mouth twice a day Disp
#*60 Tablet Refills:*0
5. Furosemide 40 mg PO DAILY
6. DULoxetine 90 mg PO DAILY
7. FoLIC Acid 1 mg PO DAILY
8. Lisinopril 10 mg PO DAILY
9. LORazepam 0.5 mg PO BID
10. Methadone 5 mg PO BID
11.Outpatient Lab Work
Please have your AST, ALT, T bili, Alkk phos, and INR checked in
1 week with PCP
___:
Home With Service
Facility:
___
Discharge Diagnosis:
Alcoholic hepatitis
Cirrhosis
Abdominal pain
Chronic pain
Hypertension
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 abdominal pain. After much testing it
was felt that your pain was related to liver inflammation from
alcohol. You were also diagnosed with cirrhosis of the liver.
It is very important that you stop any alcohol use. Please do
not take more than 2 grams of Tylenol per day.
Please follow up closely as scheduled with your PCP and the
___ Liver Team. Please obtain the EGD report from ___
___ before your Liver Appointment.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Apixaban 5 mg PO BID
RX *apixaban [Eliquis] 5 mg 1 tablet(s) by mouth twice a day
Disp #*120 Tablet Refills:*0
2. Calcium Carbonate 500 mg PO DAILY with breakfast
RX *calcium carbonate [Calcium 500] 500 mg calcium (1,250 mg) 1
tablet(s) by mouth Daily with breakfast Disp #*60 Tablet
Refills:*0
3. CefTRIAXone 2 gm IV Q 24H
4. Metoprolol Succinate XL 100 mg PO DAILY
RX *metoprolol succinate [Kapspargo Sprinkle] 100 mg 1
capsule(s) by mouth once a day Disp #*60 Capsule Refills:*0
5. PredniSONE 20 mg PO DAILY Duration: 7 Doses
This is dose # 5 of 8 tapered doses
RX *prednisone 20 mg 1 tablet(s) by mouth Once in the morning
Disp #*7 Tablet Refills:*0
6. PredniSONE 15 mg PO DAILY Duration: 7 Doses
Start: After 20 mg DAILY tapered dose
This is dose # 6 of 8 tapered doses
RX *prednisone 5 mg 3 tablet(s) by mouth once in the morning
Disp #*21 Tablet Refills:*0
7. PredniSONE 10 mg PO DAILY Duration: 7 Doses
Start: After 15 mg DAILY tapered dose
This is dose # 7 of 8 tapered doses
RX *prednisone 10 mg 1 tablet(s) by mouth Once in the morning
Disp #*7 Tablet Refills:*0
8. PredniSONE 5 mg PO DAILY Duration: 7 Doses
Start: After 10 mg DAILY tapered dose
This is dose # 8 of 8 tapered doses
RX *prednisone 5 mg 1 tablet(s) by mouth once in the morning
Disp #*7 Tablet Refills:*0
9. PredniSONE 60 mg PO DAILY Duration: 4 Doses
Start: ___, First Dose: First Routine
Administration Time
This is dose # 1 of 8 tapered doses
RX *prednisone [Deltasone] 20 mg 3 tablet(s) by mouth Once in
the morning Disp #*12 Tablet Refills:*0
10. PredniSONE 50 mg PO DAILY Duration: 7 Doses
Start: After 60 mg DAILY tapered dose
This is dose # 2 of 8 tapered doses
RX *prednisone 10 mg 5 tablet(s) by mouth daily in the morning
Disp #*35 Tablet Refills:*0
11. PredniSONE 40 mg PO DAILY Duration: 7 Doses
Start: After 50 mg DAILY tapered dose
This is dose # 3 of 8 tapered doses
RX *prednisone [Deltasone] 20 mg 2 tablet(s) by mouth once in
the morning Disp #*14 Tablet Refills:*0
12. PredniSONE 30 mg PO DAILY Duration: 7 Doses
Start: After 40 mg DAILY tapered dose
This is dose # 4 of 8 tapered doses
RX *prednisone 10 mg 3 tablet(s) by mouth Daily in the morning
Disp #*21 Tablet Refills:*0
13. Vitamin D 1000 UNIT PO DAILY
RX *ergocalciferol (vitamin D2) 2,000 unit 0.5 (One half)
tablet(s) by mouth Dailly Disp #*60 Tablet Refills:*0
14. esomeprazole magnesium 40 mg oral qPM
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSES:
=================
Ulcerative Colitis flare
Aortic valve vegetation concerning for infective endocarditis
SECONDARY DIAGNOSES:
====================
Atrial fibrillation (AF)
Urinary tract infection
Central serous chorioretinopathy
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you at ___
___.
WHY WERE YOU IN THE HOSPITAL?
- You came to the hospital with bloody diarrhea and fevers of 4
weeks.
WHAT HAPPENED WHEN YOU WERE IN THE HOSPITAL?
- You were started on IV steroids, called methylprednisolone.
- You were found to have a heart murmur, and a cardiac
ultrasound, called echocardiography, was done.
- A mass was found near one of your heart valves, called the
aortic valve, that was suspicious of an infection.
- Despite extensive work-up, we could not identify the cause of
this mass. No specific organism was found.
- You were started on IV antibiotics, vancomycin and
ceftriaxone. Vancomycin was discontinued, and you were continued
on ceftriaxone with a plan to continue on that for 6 weeks (end
date ___.
- Since your ulcerative colitis (UC) flare did not improve on 72
hour mark of starting steroids, you were considered at increased
risk of developing complications when off-steroids. After
extensive discussion with the medical team, infectious disease
team and gastroenterologists, a shared decision with you and
your wife was made to start infliximab. You received your first
dose on ___.
- You improved on infliximab and were ready to leave the
hospital.
WHAT SHOULD YOU DO AFTER YOU LEAVE THE HOSPITAL?
- Please continue to take all your medicines as prescribed
below.
- Please follow-up with your doctors as ___.
- Please arrange an appointment with your ophthalmologist to
check on your eyes given UC flare.
- Please continue prednisone taper as follows:
-- 60mg for a week - ___
-- 50mg for a week - ___
-- 40mg for a week - ___ - ___
-- 30mg for a week - ___
-- 20mg for a week - ___
-- 15mg for a week - ___
-- 10mg for a week - ___ - ___
-- 5mg for a week - ___ - ___
- Please call your doctor or visit the ___ if you experience
sudden onset of shortness of breath, fainting, body weakness,
labored speech, bloody diarrhea, abdominal pain, fevers, chills,
or other concerning symptoms.
We wish you speedy recovery!
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Crutches
Dx: ICD10 R60.0 Ankle swelling
Prognosis: Good
Length of need: 13 months
2. Amlodipine 10 mg PO DAILY
3. Bisacodyl 10 mg PR QHS:PRN constipation
4. Calcium Carbonate 1500 mg PO DAILY
5. Fenofibrate 54 mg PO DAILY
6. Losartan Potassium 50 mg PO DAILY
7. Omeprazole 20 mg PO DAILY
8. Polyethylene Glycol 17 g PO DAILY:PRN constipation
9. Pravastatin 20 mg PO QPM
10. sevelamer HYDROCHLORIDE 1600 mg Other TID W/MEALS
11. Tacrolimus 5 mg PO BID
12. Torsemide 20 mg PO DAILY
13. TraMADol 50-100 mg PO Q8H:PRN pain
14. Vitamin D ___ UNIT PO 1X/WEEK (WE) WED
15. Acetaminophen 650 mg PO Q8H
16. darbepoetin alfa in polysorbat 100 mcg/0.5 mL injection
QMONTH
17. Zolpidem Tartrate 5 mg PO QHS:PRN insomnia
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Monoarthritis/ bursitis
Secondary diagnoses:
CKD stage V on Peritoneal dialysis
s/p kidney transplant c/b Allograft failure
Type 2 Diabetes Mellitus
Hypertension
Anemia
Hyperlipidemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You came into the hospital for left ankle pain and swelling.
You had an x-ray of your ankle that did not show any fracture or
dislocation. The orthopedic surgeons removed some of the fluid
from your ankle while you were in the emergency room. The cells
that made up that fluid did not appear consistent with an
infection and you had no fever, but given that you take a
medication called tacrolimus, your immune system might not react
as strongly as usual. You therefore received antibiotics and
were admitted to the hospital.
Your ankle appeared less swollen and you reported less pain on
the day of discharge. The swelling ___ have been due to
inflammation of one of the tendons in your leg. Given that the
fluid from your ankle did not grow any bacteria, you were
discharged home.
You should rest, ice, and elevate your leg. You can take Tylenol
and the tramadol you have at home for pain control. DO NOT use
NSAIDs because of your kidney function. You worked with physical
therapy who recommended that you use crutches for the time
being.
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. Zonisamide 500 mg PO QHS
RX *zonisamide 100 mg 5 capsule(s) by mouth at bedtime Disp
#*150 Capsule Refills:*3
2. amLODIPine 5 mg PO DAILY
3. Atorvastatin 10 mg PO QPM
4. LACOSamide 200 mg PO BID
5. LevETIRAcetam 1000 mg PO BID
6. LORazepam 1 mg PO Q8H:PRN seizure activity
7. Triumeq (abacavir-dolutegravir-lamivud) 600-50-300 mg oral
DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Breakthrough seizure
HIV
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 were you admitted?
You were confused and your family was worried you were having a
seizure.
What happened while you were here?
You were given medications to stop your seizure. You were
monitored on EEG. Your medication, zonisamide, was increased.
You were continued on your other home anti seizure medications.
You had an MRI that showed stable changes in the location of the
previous left frontal biopsy and in some parts of the white
matter.
What should you do when you get home?
-Continue to take increased dose of zonisamide (500mg daily)
- Take all your other medications as prescribed
- Follow up with neurology
- Follow up with your PCP.
All the best,
Your Neurology Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. CeFAZolin 2 g IV POST HD (___)
2g on ___, 2g on ___, 3g on ___
2. Albuterol Inhaler 2 PUFF IH Q4H:PRN shortness of breath
3. Aspirin 81 mg PO DAILY
4. Atorvastatin 40 mg PO QPM
5. Famotidine 20 mg PO Q24H
6. Ferrous Sulfate 325 mg PO DAILY
7. HydrALAZINE 50 mg PO Q8H
8. Magnesium Oxide 400 mg PO DAILY
9. Metoprolol Succinate XL 100 mg PO DAILY
10. Senna 8.6 mg PO BID:PRN Constipation - First Line
11. Terazosin 5 mg PO QHS
12. Torsemide 150 mg PO 4X/WEEK (___)
13. Warfarin 2 mg PO DAILY16
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
#T8-T9 Osteomyelitis with phlegmon
#End stage renal disease on dialysis
#Atrial flutter
Secondary Diagnoses:
Chronic heart failure with reduced ejection fraction
Hypertension
Coronary Artery Disease
Hypertension
Non-occlusive Deep Vein Thrombosis
Hyperthyroidism
Myelodysplastic syndrome
Gout
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>======================
DISCHARGE INSTRUCTIONS
======================
Dear Mr. ___,
It was a privilege caring for you at ___.
WHY WAS I IN THE HOSPITAL?
-You came to the hospital for a bone infection in your mid-back.
WHAT HAPPENED TO ME IN THE HOSPITAL?
-We got an MRI of your back which confirmed a bone infection in
your spine.
-Our interventional radiologists obtained a biopsy of your bone
infection.
-We gave you IV medications for your bone infection.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Continue to take all your medicines and keep your
appointments.
- You should continue receiving IV antibiotics (called
vancomycin) at dialysis. We called your ___ facility at
___ and they said they will be giving you this antibiotic
there.
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. Sirolimus 1 mg PO DAILY
Daily dose to be administered at 6am
2. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
3. PredniSONE 5 mg PO DAILY
4. Nephrocaps 1 CAP PO DAILY
5. Lorazepam ___ mg PO HS:PRN insomnia
6. Atorvastatin 80 mg PO DAILY
7. Carvedilol 12.5 mg PO BID
8. Docusate Sodium 100 mg PO BID
9. HydrOXYzine 10 mg PO DAILY:PRN itching
10. Boost High Protein *NF* (food supplement, lactose-free) 1
can Oral daily
11. Calcium Citrate + D *NF* (calcium citrate-vitamin D3)
630-400 Oral BID
12. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO Q6H:PRN pain
13. Ferrous Sulfate 325 mg PO DAILY
RX *Iron (ferrous sulfate) 325 mg (65 mg iron) 1 tablet(s) by
mouth daily Disp #*30 Tablet Refills:*0
14. Outpatient Lab Work
Please draw INR on ___. Please fax results to the ___
___ anticoagulation clinic at
___
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
- Acute on chronic kidney impairment
Secondary
- Dehydration
- Supratherapeutic INR
- Atrial fibrilation
- Status post three renal transplants
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 because you had one week of
nausea, vomitting, and diarrhea and found to have worsening
renal function. We also noted that your INR was elevated, above
the proper range. We replenished your hydration with fluids. We
stopped medicines that can worsen your kidney function
(Lisinopril and Lasix) and we checked for causes of the diarrhea
and vomitting. While in the hospitals you started to eating
food, your nausea resolevd, and you no longer had diarrhea. Your
renal function improved, however, it needs to be monitored by
your kidney and primary care doctors. Your INR remains elevated
and needs to be closely monitored by the ___ clinic. You
should have a your ___ draw your INR tomorrow and have this sent
to the ___ clinic.
Weigh yourself every morning, call MD if weight goes up more
than 5 lbs.
Please take only the medications on the provided list. We made
the following changes to your medications.
- STOP Warfarin until further instruction by your
___ clinic
(You have an appointment with the ___ clinic on ___
___
- HOLD Lasix until ___, as long as you are no longer
vomitting or having diarrhea. Call your Kidney doctors ___
have any quetions.
- STOP Lisinopril until further instruction from your outpatient
Kidney and Primary care doctors
- START Iron Supplements
- Continue all other medications</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Docusate Sodium 100 mg PO BID
2. Lisinopril 2.5 mg PO DAILY
3. Metoprolol Succinate XL 25 mg PO DAILY
4. Torsemide 20 mg PO DAILY
5. Warfarin 2 mg PO DAILY16
6. Gabapentin 100 mg PO QHS
7. Lidocaine Jelly 2% 1 Appl TP ASDIR
8. Rosuvastatin Calcium 5 mg PO QPM
9. Senna 8.6 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary: acute on chronic systolic heart failure, community
acquired pneumonia, acute on chronic kidney disease
Secondary: coronary artery disease, atrial fibrillation
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
Thank you for allowing us to participate in your care at ___!
You were admitted to the hospital with shortness of breath. We
believe this was caused by increased fluid in your body due to
heart failure. We treated you with medicine to help remove this
fluid and your symptoms improved.
We believe you may also have had infection in your lungs. We
treated you with antibiotics.
After discharge, please weigh yourself every morning, call your
doctor if your weight goes up more than 3 lbs.
We wish you the best!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen ___ mg PO Q6H:PRN Pain
do not exceed 4grams daily
2. Alendronate Sodium 70 mg PO WEEKLY
3. Aspirin 81 mg PO DAILY
4. Bisacodyl 5 mg PO BID:PRN constipation
5. Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY
6. Hydrocortisone Cream 2.5% 1 Appl TP ___ DAYS/MONTH pruritis
7. Glargine 26 Units Bedtime
8. Metoprolol Tartrate 50 mg PO BID
9. Multivitamins W/minerals 1 TAB PO DAILY
10. Mycophenolate Mofetil 250 mg PO BID
11. Pravastatin 10 mg PO DAILY
12. PredniSONE 5 mg PO DAILY
13. Raltegravir 400 mg PO BID
14. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
15. Tacrolimus 3 mg PO Q12H
16. Vitamin D 50,000 UNIT PO WEEKLY
17. Calcium 600 + D(3) *NF* (calcium carbonate-vitamin D3) 600
mg(1,500mg) -400 unit Oral daily
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY
Right upper extremity swelling
Brachiocephalic stenosis
SECONDARY
ESRD s/p kidney transplant
HIV
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>It was a pleasure taking care of you at ___. You were admitted
for swelling of your right arm. Imaging studies did not show any
signs of clot and your fistula remains patent. You did not
appear to have any infection.
We think the swelling was caused by a narrowing in the blood
vessels of your right arm. You should contact AV Care at
___ on ___ morning to arrange for a procedure to
open up that narrow vessel. In the meantime, keep your arm
elevated above the level of your heart and squeeze a stress ball
to keep exercising the muscles of your right arm.
If you have any fevers, chills, worsening pain or coolness of
the arm, you should come back to the hospital.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Clindamycin 450 mg PO Q6H Duration: 6 Days
RX *clindamycin HCl 300 mg 1 capsule(s) by mouth four times a
day Disp #*24 Capsule Refills:*0
2. Clindamycin 150 mg PO Q6H
RX *clindamycin HCl 150 mg 1 capsule(s) by mouth four times a
day Disp #*24 Capsule Refills:*0
3. Acetaminophen 500 mg PO Q6H:PRN pain
4. Calcium Carbonate 1500 mg PO DAILY
5. FLUoxetine 50 mg PO DAILY
6. Levothyroxine Sodium 112 mcg PO 6X/WEEK (___)
7. Levothyroxine Sodium 224 mcg IV 1X/WEEK (___)
8. Lorazepam 0.5 mg PO BID:PRN anxiety/sleep
9. Prochlorperazine 10 mg PO Q6H:PRN nausea
10. Senna 8.6 mg PO BID:PRN constipation
11. ValACYclovir 500 mg PO Q24H
12. Vitamin D3 (cholecalciferol (vitamin D3)) ___ units oral
weekly
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Cellulitis
Secondary diagnosis:
Ovarian cancer
Depression
Hypothyroidism
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 cellulitis (skin
infection) on your right thigh. You were treated with IV
antibiotics and you got better. These antibiotics were
transitioned to oral antibiotics (clindamycin) and you will take
these until you run out. Please ___ with your primary care
physician and your oncologist below.
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. Acetaminophen 1000 mg PO Q8H
2. Aspirin 81 mg PO DAILY
3. Atorvastatin 80 mg PO DAILY
4. Clopidogrel 75 mg PO DAILY
5. FoLIC Acid 1 mg PO DAILY
6. Lorazepam 0.5 mg PO Q8H:PRN anxiety
7. Metoprolol Succinate XL 150 mg PO DAILY
8. Bisacodyl ___AILY:PRN constipation
9. Docusate Sodium 100 mg PO BID
10. Lidocaine 5% Patch 1 PTCH TD DAILY pain
11. MethylPHENIDATE (Ritalin) 5 mg PO BID
12. Metoclopramide 10 mg PO QIDACHS
13. Ondansetron 4 mg IV Q8H:PRN nausea
14. Senna 1 TAB PO BID
15. Sulfameth/Trimethoprim DS 1 TAB PO BID Duration: 7 Days
16. TraMADOL (Ultram) 25 mg PO Q6H:PRN Pain
17. Omeprazole 40 mg PO DAILY:PRN gerd
18. Prochlorperazine 10 mg PO Q6H:PRN nausea
19. Benzonatate 100 mg PO TID:PRN cough
20. ZOFRAN ODT *NF* (ondansetron) 8 mg Oral Q8H:PRN Nausea
21. Morphine Sulfate 1 mg IV Q6H:PRN severe pain refractory to
tramadol
Please minimize doses as patient will get delerious.
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary: s/p Fall, Lightheadedness, Nausea, Dehydration
Secondary: Lung Cancer
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Lethargic but arousable.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure to care for you during your hospitalization.
You were admitted to the hospital after having a fall and
hitting your head as well as for significant nausea and vomiting
recently. You underwent a thorough evaluation which revealed
only some bruising on the back of your head but without any
significant abnormalities in your brain. We also evaluated your
heart and determined you did not have a heart attck. Your heart
function has actually improved since your recent heart attack.
.
We found that you had a urinary tract infection, and started an
antibiotic called Bactrim that you should take for a total of 7
days and complete on ___. You were treated with medications to
help control your nausea, vomiting, and pain. We also gave you
IV fluids for rehydration. Your symptoms may be related to a
decreased food and fluid intake, and we started a
medication(methylphenidate/Ritalin) to help stimulate your
appetite and give you more energy.
Please review your medication list for the details of the
changes. We have also made followup appointments for you, as
below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO Q6H:PRN for fever or pain
2. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
3. Diazepam 2 mg PO Q8H:PRN muscle spasm
4. Docusate Sodium 100 mg PO BID
5. Heparin 5000 UNIT SC BID
6. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN pain
7. Polyethylene Glycol 17 g PO DAILY:PRN constipation
8. Senna 17.2 mg PO QHS
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Herniated Disc L4-5
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>Surgery
Your dressing may come off on the second day after surgery.
*** Your incision is closed with staples or sutures. You will
need suture/staple removal. Please keep your incision dry until
suture/staple removal.
*** Your incision is closed with dissolvable sutures
underneath the skin and steri strips. You do not need suture
removal. Do not remove your steri strips, let them fall off.
Please keep your incision dry for 72 hours after surgery.
Do not apply any lotions or creams to the site.
Please avoid swimming for two weeks after suture/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 take Ibuprofen/ Motrin for pain.
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. azithromycin 250 mg Tablet Sig: One (1) Tablet PO Q24H (every
24 hours) for 3 doses.
Disp:*3 Tablet(s)* Refills:*0*
2. Lasix 20 mg Tablet Sig: 0.5 Tablet PO once a day.
3. finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
4. levothyroxine 150 mcg Tablet Sig: One (1) Tablet PO once a
day.
5. ammonium lactate 12 % Lotion Sig: One (1) application Topical
once a day.
6. calcitonin (salmon) 200 unit/actuation Spray, Non-Aerosol
Sig: One (1) puff per single nares Nasal at bedtime: alternate
nostril daily.
7. citalopram 20 mg Tablet Sig: 0.25 (___) Tablet PO once a day.
8. cyanocobalamin (vitamin B-12) 1,000 mcg/mL Solution Sig: 1000
(1000) mcg Injection once a month.
9. diclofenac sodium 1 % Gel Sig: One (1) application Topical
twice a day as needed for pain: apply to R knee twice a day as
needed for pain DJD R knee .
10. nystatin 100,000 unit/g Cream Sig: One (1) application
Topical once a day.
11. omeprazole 40 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
12. sucralfate 1 gram Tablet Sig: One (1) Tablet PO twice a day:
for stomach.
13. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO every
eight (8) hours as needed for pain.
14. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
15. calcium carbonate 260 mg (650 mg) Tablet, Chewable Sig: 0.5
Tablet, Chewable PO twice a day.
16. cholecalciferol (vitamin D3) 1,000 unit Capsule Sig: One (1)
Capsule PO once a day.
17. polyethylene glycol 3350 17 gram Powder in Packet Sig: One
(1) Powder in Packet PO DAILY (Daily).
18. Metamucil Powder Sig: One (1) tsp PO once a day: take
by mouth with big glass of liquid.
19. senna 8.6 mg Tablet Sig: ___ Tablets PO once a day as needed
for constipation.
20. PreserVision 226-200-5 mg-unit-mg Capsule Sig: One (1)
Capsule PO once a day.
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
1. Community acquired pneumonia
SECONDARY DIAGNOSIS:
1. paroxysmal atrial fibrillation
2. Chronic systolic heart failure (EF 45%)
2. history of deep vein thrombosis
3. chronic kidney disease
4. atrophic gastritis
5. gastroesophageal reflux
6. ___ esophagus
7. osteoporosis
8. osteoarthritis
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 the hospital with pneumonia. We started you
on an oral antibiotic and you were doing well at the time of
discharge. You have an appt scheduled at your geriatrician's
office in a few days on ___ to make sure that you are
feeling better. You should have a repeat chest xray in ___ weeks
to make sure that the pneumonia is gone.
Because you were having some weakness, our physical therapists
saw you and recommended you go to rehab, however you chose to go
home instead. In that case, they recommended you have in-home
physical therapy and visiting nurse
The following changes were made to your medications:
1. Start azithromycin daily for the next 4 days.
Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
It was a pleasure taking care of you at ___!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: None
Discharge Disposition:
Home
Discharge Diagnosis:
Vestibulopathy
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 for symptoms of dysequilibrium. Because this
can be a sign of stroke, you were evaluated on the Stroke
Neurology service. Thankfully, an MRI of the brain did not show
any evidence of neurovascular disease. Your hemoglobin A1c,
which is a test for diabetes, was within normal limits. Your
cholesterol levels are pending. The most likely diagnosis is a
vestibulopathy, or dysfunction of a peripheral vestibular
system. The cause was not identified, but likely will improve
with time. Please make sure to continue hydration.
Please follow up with your primary care provider as scheduled
for resolution of symptoms and follow up of laboratory data.
It was a pleasure taking care of you.
-___ Neurology</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Cefpodoxime Proxetil 400 mg PO Q24H Duration: 5 Days
RX *cefpodoxime 200 mg daily Disp #*10 Tablet Refills:*0
2. HydrALAzine 25 mg PO Q6H
Hold for SBP<100
3. PredniSONE 10 mg PO DAILY
4. Glargine 20 Units Breakfast
Glargine 20 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
5. budesonide *NF* 180 mcg/actuation Inhalation BID cough
6. Furosemide 100 mg PO DAILY
Hold for SBP<100
7. Metolazone 2.5 mg PO DAILY
HOld for SBP<100
Please give 30 minutes prior to furosemide
8. Aspirin 81 mg PO DAILY
9. Pravastatin 80 mg PO DAILY
10. Citalopram 40 mg PO DAILY
11. Diltiazem Extended-Release 360 mg PO DAILY
12. Metoprolol Succinate XL 150 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: Hyperglycemia, hyperosmolar ketoacidosis, urinary tract
infection
Secondary: Diabetes mellitus type II, hypertension,
hyperlipidemia, sarcoidosis, stage IV chronic kidney disease.
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms ___,
It was our pleasure to care for you at ___. You were admitted
for elevated blood sugars in the setting of a urinary tract
infection. We treated you with antibiotics to treat your
infection and gave you insulin to help control your blood sugar.
Your blood sugars improved and we were able to switch you to
oral medications to treat the infection.
We made the following changes to your medications:
Please START cefpodoxime
Please CHANGE your insulin humalog sliding scale. See attached
sheet please
Please CONTINUE insulin glargine 20 units every morning and 20
units every evening</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 500 mg PO Q6H:PRN pain
2. Aquaphor Ointment 1 Appl TP TID
3. Benzonatate 200 mg PO Q4H:PRN cough
4. Citalopram 20 mg PO DAILY
5. Heparin 5000 UNIT SC TID
6. HydrOXYzine 25 mg PO Q6H:PRN itch
7. Glargine 10 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
8. Omeprazole 40 mg PO DAILY
9. Digoxin 0.125 mg PO EVERY OTHER DAY
10. Diltiazem Extended-Release 120 mg PO DAILY
11. Docusate Sodium 100 mg PO BID
12. Gabapentin 300 mg PO DAILY
13. Gabapentin 200 mg PO 3X/WEEK (___)
14. Ipratropium-Albuterol Inhalation Spray 1 INH IH Q6H:PRN SOB
15. Latanoprost 0.005% Ophth. Soln. 1 DROP RIGHT EYE HS
16. Mupirocin Cream 2% 1 Appl TP TID
17. Nephrocaps 1 CAP PO DAILY
18. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain
19. Ondansetron 4 mg PO BID:PRN nausea
20. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
21. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation q
___ hours
22. Sarna Lotion 1 Appl TP QID:PRN itch
23. Senna 8.6 mg PO HS:PRN constipation
24. sevelamer CARBONATE 2400 mg PO TID W/MEALS
25. TraZODone 50 mg PO HS:PRN insomnia
26. Dextrose 50% 12.5 gm IV PRN hypoglycemia protocol
27. Glucagon 1 mg IM Q15MIN:PRN hypoglycemia protocol
28. Glucose Gel 15 g PO PRN hypoglycemia protocol
29. Midodrine 5 mg PO 3X/WEEK (___)
30. Guaifenesin ___ mL PO Q4H:PRN cough
31. Lidocaine 5% Ointment 1 Appl TP QAM
32. Renal Caps (B complex & C ___ acid) 1 mg oral Daily
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS
-----------------
Hypotension
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ due to low blood pressure and chest
pain. We monitored you overnight, and you blood pressure went
back up to normal and your chest pain resolved. We are glad to
tell you that you did NOT have a heart attack.
Please follow up with your scheduled appointments as listed
below.
It was a pleasure taking care of you at ___. We wish you well.
Sincerely,
Your Team at ___
Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol 0.083% Neb Soln 1 NEB IH TID:PRN wheezing
2. Aspirin 81 mg PO DAILY
3. Fluticasone Propionate 110mcg 2 PUFF IH BID
4. Fluticasone Propionate NASAL 2 SPRY NU DAILY
5. Hydrochlorothiazide 12.5 mg PO DAILY
hold for sbp<100
6. Levothyroxine Sodium 275 mcg PO DAILY
7. Lisinopril 10 mg PO DAILY
8. Multivitamins 1 TAB PO DAILY
9. Verapamil SR 120 mg PO Q24H
hold for sbp<100, hr<55
10. Pantoprazole 40 mg PO BID
RX *pantoprazole 40 mg 1 tablet(s) by mouth twice a day Disp
#*30 Tablet Refills:*1
11. PredniSONE 40 mg PO DAILY Duration: 6 Days
40mg from ___ 20mg from ___ then discuss tapering
with your endocrinologist.
Tapered dose - DOWN
RX *prednisone 20 mg 1 tablet(s) by mouth once a day Disp #*5
Tablet Refills:*0
12. Albuterol Inhaler 2 PUFF IH Q4H:PRN wheeze
do not take more than 3 times in one day without calling your
doctor
RX *albuterol sulfate 90 mcg 2 puffs by mouth every four (4)
hours Disp #*1 Inhaler Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Anaphylaxis to intravenous iron
Iron deficiency anemia of undetermined etiology
Secondary diagnosis:
atypical chest pain, possibly secondary to esophageal spasm
CAD
hypertension
chronic stable asthma
GERD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
___ was a pleasure taking part in your care during your
hospitalization at ___. You were admitted for a severe
allergic reaction to IV iron supplementation. You were treated
with medications including steroids to control the reaction. On
admission you were noted to be anemic. You were transfused with
one unit of red blood cells and your anemia improved. You also
experienced chest pain while you were here, but an EKG and blood
tests did not show evidence of heart muscle damage.
It is important that you continue taking prednisone as follows:
- 40mg for one more day (on ___
- 20mg daily for three additional days (___)
Please discuss tapering down your prednisone dose with your
endocrinologist at the appointment listed below.
Please follow up with your PCP at the appointment listed below
to discuss the blood test result for celiac disease and to
discuss increasing your dose of pantoprazole long term for your
stomach discomfort.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H:PRN Pain - Mild/Fever
RX *acetaminophen 500 mg 2 tablet(s) by mouth every eight (8)
hours Disp #*90 Tablet Refills:*0
2. Cyanocobalamin 1000 mcg PO DAILY
RX *cyanocobalamin (vitamin B-12) 1,000 mcg 1 tablet(s) by mouth
once a day Disp #*30 Tablet Refills:*0
3. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
4. Polyethylene Glycol 17 g PO TID:PRN Constipation - First
Line
RX *polyethylene glycol 3350 [Miralax] 17 gram/dose 1 dose by
mouth every twelve (12) hours Refills:*0
5. Romiplostim 600 mcg SC ONCE ITP Duration: 1 Dose
to be administered on ___
RX *romiplostim [Nplate] 500 mcg 600 mcg once Disp #*2 Vial
Refills:*0
6. Romiplostim 730 mcg SC ONCE Duration: 1 Dose
To be administered once on ___
RX *romiplostim [Nplate] 500 mcg 750 mcg once Disp #*2 Vial
Refills:*0
7. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 1 tab by mouth 2 times per day
Disp #*60 Capsule Refills:*0
8. Sodium Chloride Nasal ___ SPRY NU QID:PRN dry nose
RX *sodium chloride [Ocean Nasal] 0.65 % 1 spray once a day Disp
#*1 Spray Refills:*0
9. Lisinopril 30 mg PO DAILY
RX *lisinopril 30 mg 1 tab by mouth once a day Disp #*30 Tablet
Refills:*0
10. Famotidine 20 mg PO DAILY
RX *famotidine 20 mg 1 tablet(s) by mouth every twelve (12)
hours Disp #*60 Tablet Refills:*0
11. OxyCODONE (Immediate Release) 10 mg PO Q6H:PRN Pain -
Moderate
RX *oxycodone 10 mg 1 tablet(s) by mouth every six (6) hours
Disp #*30 Tablet Refills:*0
12. OxyCODONE SR (OxyCONTIN) 20 mg PO Q8H
RX *oxycodone 20 mg 1 tablet(s) by mouth every eight (8) hours
Disp #*42 Tablet Refills:*0
13. HELD- NuvaRing (etonogestrel-ethinyl estradiol) 0.12-0.015
mg/24 hr vaginal DAILY:PRN This medication was held. Do not
restart NuvaRing until you see your oncologist
14.Outpatient Lab Work
CBC with differential drawn 2x/week (___), and
faxed to ___ (attn Dr. ___.
Discharge Disposition:
Home
Discharge Diagnosis:
MCTD
SLE
myositis
ITP
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
DISCHARGE EXAM:
GENERAL: Young AA woman sleeping in bed but easily arousable
EYES: Anicteric, pupils equally round; no conjunctival pallor.
small L-sided conjunctival hemorrhage still present
ENT: Ears and nose without visible erythema, masses, or trauma.
OP w/ crusted lesions; cheek mucosa on L side w/ ulcers that are
crusted, intermittently bleeding, painful.
CV: Heart RRR, no murmurs/rubs/gallops.
RESP: Lungs clear to auscultation with good air movement
bilaterally. Breathing is non-labored
GI: Abdomen soft, non-distended, non-tender to palpation. Bowel
sounds present.
GU: No suprapubic fullness or tenderness to palpation
EXT: WWP, 2+ distal pulses, no ___ edema; L thigh w/ small
ecchymosis on dorsal medial thigh, unchanged. No edema in L
thigh. No changes in sensation. Neg straight leg test. No pain
on
hip abduction/adduction.
SKIN: petechiae diffusely on the ___, also now on
breasts b/l. ecchymoses on arms b/l, small ecchymoses on legs
b/l. No large arm swelling.
PSYCH: fatigued, appropriate affect
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to the hospital because of bleeding, and you
were found to have undetectable platelets (<5). You were
evaluated by the hematology team, and you were diagnosed with
immune thrombocytopenic purpura (ITP). Per the rheumatology
team, it did not seem that this was due to your mixed connective
tissue disease as your bloodwork did not show active disease
(negative dsDNA, normal complement levels C3 96, C4 13). Rather,
this seems to be a separate autoimmune process. You declined the
first line treatment for ITP, which is steroids, despite
multiple conversations. You then had two days of IVIG (full dose
for ITP), which you did not respond to. You were started on
N-plate, and had 2 doses of this inhouse, without improvement so
far (though the N-plate can take longer to work). We had several
discussions about a possible splenectomy, which would be the
next line of treatment. We discussed the vaccines that would be
needed (pneumococcal, meningococcal and h. influenzae) prior to
a splenectomy, and we confirmed their safety in terms of your
autoimmune disease with your rheumatologist Dr. ___.
We also discussed the use of Lupron to help decrease your
vaginal bleeding- after discussion with the gynecologists,
hematology/oncologists, and your rheumatologist Dr. ___,
___ determined that it would be safe for you to get a Lupron
injection in the short term to help with vaginal bleeding. Note
that after 12 months of usage it can cause ___ weakness as it
mimics the symptoms of menopause.
We finally discussed the possibility of a tagged platelet indium
scan to assess the success rate for a splenectomy, but we are
unfortunately unable to perform this test here at ___.
Tests that were done in the workup of your ITP included:
CMV IgG positive, IgM negative--> infection in the past with
antibodies made
EBV IgG positive, IgM negative--> infection in the past with
antibodies made
dsDNA negative
folate >20
vitamin B12 269 (borderline low)
HIV negative
HCV negative
H. pylori in the stool negative
A ___ marrow biopsy was not performed because per the
hematology team there is no alternate differential diagnosis
that would lead to platelets that are this low; and additionally
it would be quite morbid in the setting of persistent platelets
<5.
Ultimately, given the fact that you were just being monitored
inhouse in between N-plate treatments, you decided to leave the
hospital against our professional medical recommendation given
that your platelets were still undetectable and you are at risk
of catastrophic spontaneous bleeding in your brain, abdomen,
lungs, legs that can cause death.
During the hospitalization, you also had a CT
chest/abdomen/pelvis done and a ___ scan for staging of your
breast cancer, and this did not show any metastatic disease.
You also had severe L leg pain and had a CT of your left leg,
and this did not show any bleeding or other abnormalities.
Please have your blood count (CBC) checked 2 times per week
___ and ___ and faxed to Dr. ___ at
___.
When you return to ___, please call the hematologist's office
at ___ as soon as you return to schedule a follow up
appointment with Dr. ___ any available physician. Please
ask to speak to ___ specifically as she will help
you to be seen expeditiously.
PLEASE watch for the following, and go to the ED for:
-vomiting any amount of blood
-coughing up blood clots or frank blood
-large black tarry stools or large volume bright red blood in
your stool
-large amount of vaginal bleeding
-any new large bruises on your legs or abdomen
-any new areas of swelling anywhere on your body
-lightheadedness or faster heart rate lasting >30 minutes
-any new numbness/tingling, weakness anywhere on your body
-any sudden changes in your vision
-any worsening of your normal headache, or a new sudden "worst
headache of your life"
-any sudden onset of dizziness and vertigo
-new worsening fatigue, or confusion
-or ANY other symptom that concerns you.
I cannot emphasize enough how important it be that you seek
medical care for any of the above.
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: [/INST] </s><s>======================
DISCHARGE INSTRUCTIONS
======================
Dear Mr. ___,
It was a privilege caring for you at ___.
WHY WAS I IN THE HOSPITAL?
- You came to the hospital after developing an infection of your
right foot
WHAT HAPPENED TO ME IN THE HOSPITAL?
- Your podiatrist did a procedure to drain the abscess
- You had a CT scan that showed a possible recurrence of
osteomyelitis
- You received antibiotics to treat your infection.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- You were discharged on an oral regimen of antibiotics that is
not the most ideal regimen for your infection. Ideally, you
would be treated with IV antibiotics however this could not be
arranged before you left.
- You will need to continue taking these antibiotics until you
see your infectious disease team. From there, they will decide
if oral antibiotics can be continued or if you need IV
antibiotics.
- If you develop worsening symptoms in your foot, please call
your infectious disease team at ___ or your PCP, as
your infection may not be responding to the oral antibiotics.
- We have also changed your NPH schedule and reduced your NPH
dose given swings in your blood sugars and episodes of low blood
sugars. Starting on ___, you should take NPH in the morning
(dosing listed below) rather than in the evening.
- 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. Amlodipine 5 mg PO DAILY
2. Docusate Sodium 100 mg PO BID
3. Gabapentin 1200 mg PO TID
4. Hydroxychloroquine Sulfate 400 mg PO DAILY
5. Methylprednisolone 20 mg PO DAILY
RX *methylprednisolone 4 mg 5 tablet(s) by mouth daily Disp
#*150 Tablet Refills:*0
6. Mycophenolate Mofetil 1500 mg PO BID
7. Pantoprazole 40 mg PO Q24H
8. Senna 1 TAB PO BID
9. Sertraline 150 mg PO DAILY
10. Vitamin D 400 UNIT PO BID
11. Nystatin Oral Suspension 10 mL PO QID
Continue using this medication for 11 more days (last dose on
___.
RX *nystatin 100,000 unit/mL 10 mL by mouth four times a day
Disp #*1 Bottle Refills:*0
12. Polyethylene Glycol 17 g PO DAILY:PRN constipation
Use this medication as needed for constipation. This medication
will cause a bowel movement.
RX *polyethylene glycol 3350 [Miralax] 17 gram/dose 17 GR by
mouth daily Disp #*1 Bottle Refills:*0
13. butalbital-acetaminop-caf-cod *NF* 50-325-40-30 mg Oral
TID:PRN HA
14. Cetirizine *NF* 10 mg Oral Daily
15. Clobetasol Propionate 0.05% Cream 1 Appl TP QID:PRN rash
16. Cyclobenzaprine 20 mg PO BID:PRN pain
17. Lisinopril 10 mg PO DAILY
18. mupirocin *NF* 2 % Topical BID
19. Triamcinolone Acetonide 0.1% Cream 1 Appl TP BID to arms
20. Westcort *NF* (hydrocorTISone Valerate) 0.2 % Topical BID:
PRN to scalp
21. Epinephrine 1:1000 0.3 mg IM ONCE MR1 Duration: 1 Doses
22. Morphine SR (MS ___ 30 mg PO Q12H
RX *morphine [MS ___ 30 mg 1 tablet extended release(s) by
mouth twice a day Disp #*60 Tablet Refills:*0
23. Morphine Sulfate ___ 7.5 mg PO Q4H:PRN pain
RX *morphine 15 mg 0.5 (One half) tablet(s) by mouth q4h-q6h PRN
Disp #*120 Tablet Refills:*0
24. Dapsone 100 mg PO DAILY
RX *dapsone 100 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
25. Vancomycin 1250 mg IV Q 12H
The last dose of this medication will be on ___
RX *vancomycin 1 gram 1.25 GR IV twice a day Disp #*12.5 Gram
Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnoses:
- Cellulitis
Secondary Diagnoses:
- None
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 our pleasure caring for you at ___. You were admitted
to the hospital on ___ for an ulcer on your R ankle that
was likely infected. You also had swelling in your R ankle and
R knee that may have been a manifestation of your Lupus. You
were treated with IV antibiotics (Vancomycin) and the ulcer on
your leg improved. We also increased your dose of steroids in
consultation with your rheumatologst, Dr. ___. You
should continue on this dose until you follow-up with Dr.
___.
Given your multiple prior back surgeries and description of pain
radiating down your right leg, we are concerned that a large
proportion of your pain may be related to compression of one of
the nerves in your back (radiculopathy). For this we started
you on pain medications and you will need to follow-up with your
back surgeon.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Levofloxacin 750 mg PO DAILY Duration: 5 Days
RX *levofloxacin 750 mg 1 tablet(s) by mouth daily Disp #*5
Tablet Refills:*0
2. Morphine Sulfate (Oral Solution) 2 mg/mL 20 mg PO Q4H:PRN
Pain - Severe
Reason for PRN duplicate override: Alternating agents for
similar severity
RX *morphine 10 mg/5 mL 10 mL by mouth Q4hr PRN Disp #*1000
Milliliter Milliliter Refills:*0
3. Polyethylene Glycol 17 g PO DAILY:PRN Constipation - Second
Line
RX *polyethylene glycol 3350 17 gram/dose 1 powder(s) by mouth
Daily Refills:*0
4. Senna 8.6 mg PO BID:PRN Constipation - First Line
RX *sennosides 8.6 mg 1 tablet by mouth twice a day Disp #*60
Tablet Refills:*0
5. Sertraline 50 mg PO DAILY
RX *sertraline 50 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
6. Albuterol 0.083% Neb Soln 1 NEB IH Q6H
RX *albuterol sulfate 2.5 mg/3 mL (0.083 %) 1 neb IH Q6hr Disp
#*2 Vial Refills:*0
7. Morphine SR (MS ___ 15 mg PO NOON
RX *morphine 15 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
8. Sodium Chloride 3% Inhalation Soln 5 mL NEB TID
RX *sodium chloride 3 % 5 mL IH three times a day Disp #*2 Vial
Refills:*0
9. Acetaminophen 1000 mg PO Q8H
10. Acetylcysteine 20% ___ mL NEB Q6H
RX *acetylcysteine 200 mg/mL (20 %) Use ___ mL NEB Q6hr Disp #*2
Vial Refills:*0
11. budesonide 0.5 mg/2 mL inhalation Q6H:PRN
RX *budesonide 0.5 mg/2 mL 2 mL IH every six (6) hours Disp #*2
Ampule Refills:*0
12. Calcium Carbonate 1200 mg PO DAILY
RX *calcium carbonate 600 mg calcium (1,500 mg) 2 tablet(s) by
mouth Daily Disp #*60 Tablet Refills:*0
13. ClonazePAM 2 mg PO BID:PRN anxiety
RX *clonazepam 2 mg 1 tablet(s) by mouth twice a day Disp #*30
Tablet Refills:*0
14. Dornase Alfa 2.5 mg Intrapleural BID
RX *dornase alfa [Pulmozyme] 1 mg/mL 2.5 mL IH twice a day Disp
#*2 Vial Refills:*0
15. GuaiFENesin ER 1200 mg PO Q12H
RX *guaifenesin 1,200 mg 1 tablet(s) by mouth Q12hr Disp #*60
Tablet Refills:*0
16. GuaiFENesin ___ mL PO Q6H:PRN Cough
RX *guaifenesin 100 mg/5 mL ___ mL by mouth Q6hr Refills:*0
17. Hydrocortisone Na Succ. 20 mg IV QAM
RX *hydrocortisone sod succinate [A-Hydrocort] 100 mg 0.2 mg IM
QAM Disp #*3 Vial Refills:*0
18. Hydrocortisone Na Succ. 10 mg IV QPM
RX *hydrocortisone sod succinate [A-Hydrocort] 100 mg 0.1 mg IM
QPM Disp #*3 Vial Refills:*0
19. Ipratropium Bromide Neb 1 NEB IH Q6H
RX *ipratropium bromide 0.2 mg/mL (0.02 %) 1 NEB IH every six
(6) hours Disp #*2 Vial Refills:*0
20. Levalbuterol Neb 0.63 mg NEB Q6H dyspnea
RX *levalbuterol HCl 0.63 mg/3 mL 3 ml IH every six (6) hours
Disp #*2 Vial Refills:*0
21. Morphine SR (MS ___ 30 mg PO Q12H
RX *morphine 30 mg 1 tablet(s) by mouth 12hr Disp #*60 Tablet
Refills:*0
22. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
23. OLANZapine 2.5 mg PO QID:PRN nausea with dilaudid
RX *olanzapine 2.5 mg 1 tablet(s) by mouth four times a day Disp
#*36 Tablet Refills:*0
24. Omeprazole 40 mg PO BID
RX *omeprazole 40 mg 1 capsule(s) by mouth twice a day Disp #*60
Capsule Refills:*0
25. Pancrelipase 5000 2 CAP PO TID W/MEALS
26. Ranitidine 150 mg PO QHS
RX *ranitidine HCl 150 mg 1 tablet(s) by mouth at bedtime Disp
#*30 Tablet Refills:*0
27. Tobramycin Inhalation Soln 300 mg IH BID
RX *tobramycin in 0.225 % NaCl 300 mg/5 mL 300 mg IH twice a day
Disp #*2 Ampule Refills:*0
28. TraZODone 150 mg PO QHS
RX *trazodone 150 mg 1 tablet(s) by mouth at bedtime Disp #*30
Tablet Refills:*0
29. Vitamin D 5000 UNIT PO DAILY
RX *ergocalciferol (vitamin D2) [Ergocal] 2,500 unit 2
capsule(s) by mouth daily Disp #*60 Capsule Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY
========
Anxiety
Tracheobronchomalacia
Mechanical Fall
SECONDARY
==========
Pancreatic insufficiency
Asymptomatic Bacteruria
Severe adrenal insufficiency
Insomnia
Weight Gain
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 care for you at the ___
___.
Why did you come to the hospital?
- You came to the hospital due to concerns for Addisonian
Crisis, worsening respiratory status.
What did you receive in the hospital?
- While in the hospital we restarted you intricate regiment of
medications to ensure you were receiving the correct medications
at the correct time.
- We also had our palliative care doctors and ___
___ you and make recommendations for changing your pain
medications and helping with your anxiety.
- The interventional pulmonologists removed your stent on
___ due to concerns it was not functioning properly.
What should you do once you leave the hospital?
- Please continue to take all medications as instructed.
- You should follow up with your primary care provider at home
to help establish you with a local palliative care doctor and
therapist for further management of your pain and anxiety.
- You are being discharged with multiple opioid medications. We
would encourage you to only use them as instructed. Do no take
them with alcohol. Do not use more than the recommended amount
in a day.
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. Lidocaine 5% Patch 1 PTCH TD QAM
may use over the counter 4% if not covered by insurance.
RX *lidocaine 5 % apply to ribs 12 hours on 12 hours off once a
day Disp #*14 Patch Refills:*0
2. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain - Severe
take lowest effective dose.
RX *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours
Disp #*30 Tablet Refills:*0
3. Acetaminophen ___ mg PO Q6H:PRN Pain - Mild
4. Acyclovir 400 mg PO Q8H:PRN x5 days for cold sores
5. Cyanocobalamin 1000 mcg IM/SC MONTHLY
6. Diphenoxylate-Atropine 1 TAB PO Q6H
7. Dolutegravir 50 mg PO DAILY
8. dutasteride 0.5 mg oral DAILY
9. Emtricitabine-Tenofovir alafen (200mg-25mg) *DESCOVY* 1 TAB
PO DAILY
10. Escitalopram Oxalate 30 mg PO DAILY
11. Excedrin Migraine (aspirin-acetaminophen-caffeine)
250-250-65 mg oral BID:PRN migraine pain
12. Fludrocortisone Acetate 0.2 mg PO DAILY
13. FoLIC Acid 1 mg PO DAILY
14. LevETIRAcetam 1000 mg PO BID
15. Lidotrex (lidocaine-aloe ___ 2 %-1 % -1.2 %
topical low back as needed
16. LOPERamide 4 mg PO DAILY:PRN loose stool
17. LORazepam 0.5 mg PO BID:PRN anxiety
18. Metoprolol Succinate XL 50 mg PO DAILY
19. Midodrine 7.5 mg PO TID
20. Montelukast 10 mg PO DAILY
21. Multivitamins 1 TAB PO DAILY
22. Omeprazole 40 mg PO DAILY
23. Potassium Chloride 20 mEq PO DAILY
24. Prochlorperazine 10 mg PO Q8H:PRN Nausea/Vomiting - First
Line
25. Promethazine 25 mg PO Q6H:PRN nausea
26. Simvastatin 20 mg PO DAILY
27. Thiamine 100 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Left anterior ___ rib fractures
Acute on chronic T12 vertebral body compression fracture
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 Acute Care Surgery Service on ___
after a fall sustaining left sided rib fractures and a fracture
of the vertebral body in your mid-back. You were seen by the
spine doctors who recommend ___ management and no need
for brace. You were monitored, given pain medication, and
encouraged to take deep breaths. You worked with the physical
therapist who recommended discharge home with continued physical
therapy. You are now doing better, and ready to be discharged to
continue your recovery.
Please note the following discharge instructions:
* Your injury caused left sided rib fractures which can cause
severe pain and subsequently cause you to take shallow breaths
because of the pain.
* You should take your pain medication as directed to stay ahead
of the pain otherwise you won't be able to take deep breaths. If
the pain medication is too sedating take half the dose and
notify your physician.
* Pneumonia is a complication of rib fractures. In order to
decrease your risk you must use your incentive spirometer 4
times every hour while awake. This will help expand the small
airways in your lungs and assist in coughing up secretions that
pool in the lungs.
* You will be more comfortable if you use a cough pillow to hold
against your chest and guard your rib cage while coughing and
deep breathing.
* Symptomatic relief with ice packs or heating pads for short
periods may ease the pain.
* Narcotic pain medication can cause constipation therefore you
should take a stool softener twice daily and increase your fluid
and fiber intake if possible.
* Do NOT smoke
* If your doctor allows, non-steroidal ___ drugs
are very effective in controlling pain ( ie, Ibuprofen, Motrin,
Advil, Aleve, Naprosyn) but they have their own set of side
effects so make sure your doctor approves.
* Return to the Emergency Room right away for any acute
shortness of breath, increased pain or crackling sensation
around your ribs (crepitus).</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. Amlodipine 7.5 mg PO DAILY
3. Artificial Tears ___ DROP BOTH EYES BID
4. Aspirin 81 mg PO DAILY
5. Bisacodyl 10 mg PO HS:PRN constipation
6. Cyanocobalamin 100 mcg PO DAILY
7. Ferrous Sulfate 325 mg PO DAILY
8. Captopril 25 mg PO BID
9. FoLIC Acid 1 mg PO DAILY
10. Glucagon 1 mg IM PRN glc < = 40
11. Labetalol 350 mg PO BID
12. Lactulose 30 mL PO DAILY
13. Levothyroxine Sodium 125 mcg PO DAILY
14. Omeprazole 40 mg PO DAILY
15. sevelamer CARBONATE 800 mg PO TID W/MEALS
16. Simvastatin 20 mg PO DAILY
17. Epoetin Alfa 7000 UNIT IV QWEEK
18. GlipiZIDE 2.5 mg PO BID
19. Hydrocodone-Acetaminophen (5mg-500mg 1 TAB PO Q6H:PRN pain
20. Hydrocodone-Acetaminophen (5mg-500mg 1 TAB PO Q12H
21. Nitroglycerin Ointment 2% ___ in TP Q6H:PRN SBP > 180
22. Senna with Docusate Sodium *NF* (sennosides-docusate sodium)
8.6-50 mg Oral 2 tabs BID
23. CefTAZidime 1 g IV POST HD Duration: 8 Days
Two week course finished on ___
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary diagnosis:
Pseudomonas aeruginosa sepsis
Neck pain
Secondary diagnoses:
ESRD on dialysis
HTN
T2DM
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Lethargic but arousable.
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were seen in the hospital for a bacterial infection in your
blood, which may have been related to your cathether. Your
dialysis cathether was removed and a new line was replaced.
There was no evidence of vegetations on your heart valves and
you will only need antibitoics for a total of two weeks (last
day ___, they will give you antibiotics at dialysis.
You should have a repeat chest CT scan in approximately 4 weeks.
You will also have to wear a cervical collar until you are seen
in the ___ clinic in 2 weeks.
START taking ceftazidime 1 gm with HD for a total of two weeks,
last day of antibiotics ___.</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 ___ after
your motor vehicle accident with rib fractures. You are
recovering well and are now ready for discharge. Please follow
the instructions below to continue your recovery:
* DUE TO YOUR SEIZURE HISTORY YOU SHOULD NOT DRIVE OR OPERATE
HEAVY MACHINERY UNTIL YOU ARE ___ BY YOUR PRIMARY
NEUROLOGIST.
* Your injury caused rib fractures which can cause severe pain
and subsequently cause you to take shallow breaths because of
the pain.
* You should take your pain medication as directed to stay ahead
of the pain otherwise you won't be able to take deep breaths. If
the pain medication is too sedating take half the dose and
notify your physician.
* Pneumonia is a complication of rib fractures. In order to
decrease your risk you must use your incentive spirometer 4
times every hour while awake. This will help expand the small
airways in your lungs and assist in coughing up secretions that
pool in the lungs.
* You will be more comfortable if you use a cough pillow to hold
against your chest and guard your rib cage while coughing and
deep breathing.
* Symptomatic relief with ice packs or heating pads for short
periods may ease the pain.
* Narcotic pain medication can cause constipation therefore you
should take a stool softener twice daily and increase your fluid
and fiber intake if possible.
* Do NOT smoke
* If your doctor allows, non-steroidal ___ drugs
are very effective in controlling pain ( ie, Ibuprofen, Motrin,
Advil, Aleve, Naprosyn) but they have their own set of side
effects so make sure your doctor approves.
* Return to the Emergency Room right away for any acute
shortness of breath, increased pain or crackling sensation
around your ribs (crepitus).</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Carvedilol 50 mg PO BID
RX *carvedilol 25 mg 2 tablet(s) by mouth twice daily Disp #*120
Tablet Refills:*3
3. Fish Oil (Omega 3) 1000 mg PO DAILY
4. Fluticasone Propionate NASAL 1 SPRY NU BID
5. Glargine 50 Units Bedtime
6. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY
7. Mesalamine ___ mg PO BID
8. Pantoprazole 40 mg PO Q24H
9. Valsartan 320 mg PO DAILY
10. Warfarin 2.5 mg PO DAILY at 4 pm
11. Clopidogrel 75 mg PO DAILY
RX *clopidogrel 75 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*3
12. Albuterol Inhaler 2 PUFF IH Q6H:PRN wheezing
13. budesonide-formoterol 160-4.5 mcg/actuation inhalation BID
14. Chlorthalidone 25 mg PO DAILY
15. glimepiride 4 mg ORAL DAILY
16. MetFORMIN (Glucophage) 1000 mg PO BID
17. Nitroglycerin SL 0.3 mg SL PRN chest pain
18. Terconazole 0.4% Vag. Cream 1 Appl VG DAILY
19. Pravastatin 80 mg PO HS
RX *pravastatin 80 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*3
20. Loratadine 10 mg PO DAILY:PRN allergies
RX *loratadine 10 mg 1 tablet(s) by mouth daily as needed Disp
#*30 TabletRefills:*3
21. Outpatient Lab Work
Check INR ___. Fax results to Dr. ___: ___
Discharge Disposition:
Home With Service
Facility:
___
___ Diagnosis:
# Coronary artery disease
# Bradycardia
# Junctional rhythm
# Hypotension, attributed to hypovolemia
# Acute kidney injury, attributed to hypovolemia
# Hypertension, poorly controlled
# Diabetes mellitus type 2
# Lactic acidosis
# Asymptomatic bactiuria
# Nausea and vomiting
# Atrial fibrillation, paroxysmal, on long term anticoagulation
# Hyperlipidemia
# Gastroesophageal reflux disease
# Asthma
# Allergic rhinitis
# Crohn's Disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Ms. ___, you were admitted for slow heart rate and
low blood pressure prior in the setting of vomiting prior to
getting a cardiac catheterization. In the ER you had a slow
heart rate in a rhythm called a junctional rhythm, which is
slower than a normal heart rhythm. You initially given IV fluids
and antibiotics and sent to the ICU for blood pressure support,
however, by the time you arrived in the ICU your symptoms had
resolved. The likely cause of your slow heart rate and low blood
pressure is what is called a "vaso-vagal" reaction from
vomiting. There was no evidence that you had a heart attack. You
were observed in the hospital so that you could get your
scheduled cardiac catheterization. Your blood pressure was
treated with your home medications. You had the cardiac
catheterization procedure on ___ which showed 90% blockage of
the left anterior descending artery (LAD), which was opened with
a drug-eluting stent. You were discharged home with a medication
called clopidogrel to help keep the stent open, as well as with
higher doses of blood pressure and cholesterol medications.
Please go to your outpatient follow up appointments in the
future.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 40 mg PO QPM
2. Maalox/Diphenhydramine/Lidocaine ___ mL PO QID:PRN gi
discomfort
3. Spironolactone 12.5 mg PO DAILY
4. Torsemide 20 mg PO DAILY
5. Carvedilol 6.25 mg PO BID
6. Lisinopril 5 mg PO DAILY
7. QUEtiapine Fumarate 100 mg PO BID
8. Albuterol Inhaler 1 PUFF IH Q6H:PRN SOB
9. Aspirin 81 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
Acute on chronic systolic heart failure
Coronary artery disease
Psychosis
SECONDARY DIAGNOSIS:
Hypertension
GERD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr ___,
You were admitted to ___ because you were having trouble
breathing. You were found to have extra fluid due to your heart
failure.
We have changed your medications. Please pay close attention to
your medications and take them every day, otherwise there is a
high chance you will return to the hospital. You will also need
to see a cardiologist in clinic at follow up for further care of
your sick heart.
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. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
2. Thiamine 100 mg PO DAILY
RX *thiamine HCl (vitamin B1) 100 mg 1 tablet(s) by mouth daily
Disp #*30 Tablet Refills:*0
3. Apixaban 5 mg PO BID
4. Cyanocobalamin ___ mcg PO DAILY
5. Flecainide Acetate 100 mg PO Q12H
6. Metoprolol Succinate XL 25 mg PO DAILY
7. Multivitamins W/minerals 1 TAB PO DAILY
8. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
acute pancreatitis
hypothermia
diarrhea
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 during your stay at ___
___. You were admitted for a low
temperature. You were found to have mild pancreatitis, which is
inflammation of your pancreas and can cause abdominal pain,
nausea and vomiting. This was likely caused by your alcohol
consumption. We continue to recommend decreasing the amount you
drink with the goal of quitting if possible.
Please check your blood sugar levels twice a day. If it is < 70,
please take some juice to keep your sugar levels appropriate.
Bring your blood sugar recordings to your next visit with your
PCP.
Please follow-up with your providers as previously scheduled.
Take care,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. HYDROmorphone (Dilaudid) ___ mg PO Q4H:PRN pain
RX *hydromorphone 2 mg ___ tablet(s) by mouth every four (4)
hours Disp #*60 Tablet Refills:*0
2. Acetaminophen 325-650 mg PO Q6H:PRN pain
3. Citalopram 40 mg PO DAILY
4. Fentanyl Patch 37 mcg/h TD Q72H Pain
5. Gabapentin 600 mg PO TID
6. Omeprazole 40 mg PO DAILY
7. Sumatriptan Succinate 100 mg PO DAILY:PRN headache
8. tofacitinib 5 mg oral BID
9. Calcium 500 + D (calcium carbonate-vitamin D3) 500
mg(1,250mg) -200 unit oral daily
10. Mirena (levonorgestrel) 20 mcg/24 hour ___ years) injection
in place
Discharge Disposition:
Home
Discharge Diagnosis:
1. Paresthesias
2. Crohn's Disease
3. Anemia
4. Carpal Tunnel Syndrome
5. Superficial Vein Thrombosis
Discharge Condition:
Good
No altered mental status
Ambulating without assistance
Followup Instructions:
___ [/INST] </s><s>Dear ___,
It was a pleasure to take care of you during your
hospitalization at ___. You were admitted for numbness,
tingling, pain, and swelling in your hands. We have ruled out
any electrolyte or mineral deficiency as a cause of these
symptoms. In addition, we ruled out a deep venous thrombosis as
a cause of your hand swelling. We did x-rays of your hand and
wrist to rule out any arthritis causing your symptoms and the
films did not show any. Therefore, at this point we believe your
symptoms are most likely due to carpal tunnel syndrome. The
initial treatment for carpal tunnel syndrome is wrist splinting.
During your hospitalization, the orthopedic technician fitted
you for wrist splints. We would like you to please wear these at
night and as much during the day as possible. We also recommend
that you discuss this with your primary care physician to
determine whether nerve conduction studies would be beneficial.
For your right hand and arm swelling, please keep your arms
elevaed and use hot and cold packs. For pain, please continue
your home regimen for pain. We will give you enough pain
medication to last this week prior to seeing your primary care
physician ___. Finally, for your Crohn's disease we ask
that you please continue to take your home medication until your
next appointment with Dr. ___.</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. Cyanocobalamin 1000 mcg PO DAILY
4. Docusate Sodium 100 mg PO BID
5. Fluticasone Propionate NASAL 2 SPRY NU DAILY
6. Furosemide 20 mg PO DAILY
7. Glargine 14 Units Bedtime
8. Lisinopril 15 mg PO DAILY
9. Spironolactone 12.5 mg PO DAILY
10. Vitamin D 400 UNIT PO DAILY
11. Warfarin 2.5 mg PO QHS
12. Amlodipine 5 mg PO DAILY
RX *amlodipine 5 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
13. Linzess (linaclotide) 290 mcg oral DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis: ___, bradycardia
Secondary diagnosis: atrial fibrillation, hypertension, diabetes
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you during your
hospitalization. You were admitted because you felt as though
you were going to pass out. You were monitored in the hospital
and did not have any repeat episodes which was reassuring. Your
heart rate is low however. We stopped a number of your
medications because they can decrease your heart rate. It is
very important that you review your medication list because
there have been some changes. You will follow up with Dr. ___
in clinic. You will also follow up with cardiology and
neurology.
It is very important that you notify your doctors ___ return to
the emergency room if you think you are going to pass out, if
you have chest pain or palpitations. If your heart rate remains
low and if you are symptomatic, you may need a pacemaker.
You will need to get a heart monitor placed after you leave the
hospital. We scheduled you an appointment tomorrow to get this
placed. This is very similar to the heart monitor that you had
on while you were in the hospital. If you cannot make this
appointment, please call ___ to reschedule.
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. Amlodipine 5 mg PO HS
2. Omeprazole 20 mg PO DAILY
3. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ capsule(s) by mouth every 4 hours as
needed Disp #*30 Capsule Refills:*0
4. Senna 8.6 mg PO BID constipation
RX *sennosides [senna] 8.6 mg 1 tablet by mouth twice a day Disp
#*60 Capsule Refills:*0
5. Valsartan 80 mg PO QAM
6. Acetaminophen ___ mg PO Q6H:PRN pain
Discharge Disposition:
Home
Discharge Diagnosis:
___ vein thrombus
Pulmonary Embolism
Rectus Sheath Hematoma
Glioblastoma Multiforme
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 leg swelling found to be due to a leg
clot and you also had small clots in the lungs. You were started
on blood thinners but had a bleed in your belly so the blood
thinners were stopped and you recieved a filter in your leg to
prvent the clot from travelling and also got medication to that
area to dissolve the clot. You were discharged home in a stable
condition.</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
2. Allopurinol ___ mg PO DAILY
3. Bisacodyl ___AILY:PRN constipation
4. Docusate Sodium 100 mg PO BID Constipation
5. Ezetimibe 10 mg PO DAILY
6. Omeprazole 40 mg PO DAILY
7. Ondansetron 4 mg PO Q8H:PRN nausea
8. OxycoDONE (Immediate Release) 5 mg PO Q6H:PRN pain
9. Polyethylene Glycol 17 g PO BID:PRN constipation
10. Prochlorperazine 10 mg PO Q6H:PRN nausea and vomiting
11. Senna 8.6 mg PO BID constipation
12. Simvastatin 40 mg PO QPM
13. Tamsulosin 0.4 mg PO QHS
14. Tiotropium Bromide 1 CAP IH DAILY
15. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation
INHALATION DAILY
16. Meclizine 25 mg PO BID
RX *meclizine 25 mg 1 tablet(s) by mouth TID prn Disp #*30
Tablet Refills:*1
Discharge Disposition:
Home
Discharge Diagnosis:
Benign paroxysmal positional vertigo
Metastatic small cell lung carcinoma
Benign prostatic hypertrophy
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr ___ it was a pleasure caring for you during your stay
at ___. You were admitted with new dizziness. Head CT and
brain MRI was done and there are no tumors other than the one
that remains on your scalp. There was also no sign of stroke.
The dizziness is due to a condition called benign paroxysmal
positional vertigo. And your eye movements when we did head
maneuvers confirm this is the cause. You have also experienced
this is in the past. You can continue to take meclizine to
diminish the symptoms. You can also come for therapy if you
choose, call ___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. fidaxomicin 200 mg Tablet Sig: One (1) Tablet PO twice a day
for 10 days.
Disp:*20 Tablet(s)* Refills:*0*
2. Keppra 750 mg Tablet Sig: One (1) Tablet PO twice a day.
Disp:*60 Tablet(s)* Refills:*2*
3. mirtazapine 15 mg Tablet Sig: One (1) Tablet PO at bedtime.
4. Combivent ___ mcg/Actuation Aerosol Sig: Two (2) puffs
Inhalation every six (6) hours as needed for shortness of breath
or wheezing.
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnosis: Alcohol Withdrawal Seizure and C. Diff
diarrheal infection
Secondary Diagnosis:
COPD
EtOH dependence and history of withdrawal seizures
C. diff colitis
CAD
Diverticulitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you at ___
___. You were transferred here after you had a
seizure. You seizure was likely caused because you were going
into alcohol withdrawal from not having had any recent alcohol.
While here, you were stable and able to breathe on your own,
however you were noted to have persistent diarrhea. It appears
that your recent diarrheal infection has not been fully treated.
Youshould be treated with an antibiotic called fidaxomycin and
it is extremely important that you take this medication twice
daily for 10 days. DO NOT miss any of these doses.
Please make the following changes to your medication regimen:
TAKE Fidaxomycin 200mg by mouth twice daily for 10 days.
STOP Vancomycin
CONTINUE Keppra 750mg (1 tablet) by mouth twice daily
Please continue home mirtazipine as prescribed.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Ms. ___,
You were admitted to the hospital for chest pressure. Your
cardiac tests were reassuring against new or worsening heart
disease - we checked serial EKGs, troponins (an enzyme released
when your heart muscle is damaged), and a stress test. Your
stress test showed no evidence of new disease, but shows a
persistent scarred area from your previous heart attack.
We have made two adjustments to your medications to better treat
your heart disease:
- Changed atenolol to metoprolol
- Started lisinopril
Given the reassuring cardiac tests, we think your chest
discomfort is from coughing and the flu. You should complete a
full course of Tamiflu (oseltamivir) to help fight the
infection.
You should also follow up with your PCP in the next ___ weeks.
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. Artificial Tears ___ DROP BOTH EYES PRN dry eyes
2. Aspirin 81 mg PO DAILY
3. Atorvastatin 40 mg PO QPM
4. Metoprolol Succinate XL 50 mg PO DAILY
5. Multivitamins W/minerals 1 TAB PO DAILY
6. Omeprazole 20 mg PO BID
7. Tiotropium Bromide 1 CAP IH DAILY
8. saccharomyces boulardii 500 mg oral BID
9. Sodium Chloride 3% Inhalation Soln 15 mL NEB DAILY:PRN SOB
10. Levofloxacin 750 mg q48h
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Sepsis
Pneumonia
Secondary diagnosis:
COPD
bronchiectasis
HTN
CAD
oropharyngeal dysphagia
recurrent pneumonia
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 ___ for treatment of your fever and
cough. You were given Levaquin, an antibiotic, and improved with
this medication. We monitored you to make sure that your
symptoms did not worsen. Please take the Levofloxacin on ___ and
___ to complete your course. Then, start the azithromycin--take
2 tablets on the day you start this, then 1 tablet thereafter.
We hope that you do well at home!
Best wishes,
Your ___ treatment team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Cefpodoxime Proxetil 100 mg PO Q12H
Take 100mg twice a day until ___
RX *cefpodoxime 100 mg 100mg tablet(s) by mouth twice a day Disp
#*20 Tablet Refills:*0
2. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild/Fever
3. Albuterol Inhaler 1 PUFF IH Q6H:PRN sob
4. Famotidine 20 mg PO DAILY
5. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
6. letermovir 480 mg oral DAILY
7. Magnesium Oxide 400 mg PO BID
8. NIFEdipine (Extended Release) 90 mg PO DAILY
9. Pravastatin 40 mg PO QPM
10. PredniSONE 5 mg PO DAILY
11. Sodium Polystyrene Sulfonate 15 gm PO DAILY:PRN as directed
by transplant team
12. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
13. Tacrolimus (Extended Release) 1.5 mg PO QAM
14. Torsemide 20 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
Urinary tract infection
Secondary diagnosis:
End-stage renal disease s/p renal transplant
History of CMV infection
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 privilege caring for you at ___.
WHY WAS I IN THE HOSPITAL?
- You were having fevers and urinary urgency. You were found to
have a urinary tract infection.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- You were treated with antibiotics for your infection. Your
symptoms improved and you were ready to leave the hospital.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- You should continue your antibiotics until you have finished
the prescription, even if you are feeling better.
- Please continue to take all of your medications and follow-up
with your appointments as listed below.
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. Omeprazole 20 mg PO DAILY
2. Ciprofloxacin HCl 500 mg PO Q12H
last dose ___
RX *ciprofloxacin HCl [Cipro] 500 mg 1 tablet(s) by mouth every
12 hours Disp #*14 Tablet Refills:*0
3. Polyethylene Glycol 17 g PO DAILY
4. Megestrol Acetate 400 mg PO DAILY
RX *megestrol 400 mg/10 mL (10 mL) 10 mL by mouth daily
Refills:*0
5. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
last dose ___
RX *metronidazole [Flagyl] 500 mg 1 tablet(s) by mouth every 8
hours Disp #*21 Tablet Refills:*0
6. Aspirin 81 mg PO DAILY
7. Calcium 600 with Vitamin D3 (calcium carbonate-vitamin D3)
600 mg(1,500mg) -200 unit oral DAILY
8. Potassium Chloride 20 mEq PO DAILY Duration: 7 Days
last dose ___
RX *potassium chloride 20 mEq 1 tablet(s) by mouth daily Disp
#*7 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSES:
CHOLANGIOCARCINOMA
BILIARY OBSTRUCTION
SECONDARY DIAGNOSES:
POOR APPETITE
PANCYTOPENIA
H/O HYPERTENSION AND HYPERLIPIDEMIA
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure participating in your care here at ___
___. You came to us with poor appetite and
faitgue. A CT scan of your abdomen showed that your biliary
stents were clogged. You underwent ERCP with removal of
infectious material from your stents and placement of a new
stent in the common bile duct. Unfortunately, your procedure was
complicated by a small perforation that caused air to leak into
your abdomen. You recovered without further complication and
your appetite has improved every day. Upon discharge you were
eating and drinking adequately and walking independently with
physical therapy.
Please take your medications as prescribed and attend your
follow up appointments as outlines below.
Thank you for choosing ___ for your healthcare needs.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Sucralfate 1 gm PO BID
RX *sucralfate 1 gram/10 mL 1 Suspension(s) by mouth twice a day
Disp #*14 Gram Refills:*0
2. CefePIME 2 g IV Q24H
RX *cefepime [Maxipime] 2 gram 2 grams IV Q24H Disp #*14 Unit
Refills:*0
3. Vancomycin Oral Liquid ___ mg PO Q8H
RX *vancomycin 125 mg 125 mg by mouth every eight (8) hours Disp
#*90 Unit Refills:*0
4. Acetaminophen 650 mg PO Q8H:PRN pain
5. Furosemide 20 mg PO DAILY
6. Levothyroxine Sodium 125 mcg PO DAILY
7. Prochlorperazine 2.5-5 mg PO Q6H:PRN nausea
8. Ursodiol 300 mg PO TID
9. Calcium Carbonate 1000 mg PO TID W/MEALS
Do not take within 2 hours of taking levothyroxine
RX *calcium carbonate 400 mg (1,000 mg) 2 tablet, chewable(s) by
mouth three times a day Disp #*180 Tablet Refills:*0
10. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *metronidazole 500 mg 1 tablet(s) by mouth every eight (8)
hours Disp #*42 Tablet Refills:*0
11. Omeprazole 40 mg PO BID
RX *omeprazole 40 mg 1 capsule,delayed ___ by
mouth twice a day Disp #*60 Capsule Refills:*0
12. Potassium Chloride 20 mEq PO DAILY
RX *potassium chloride 10 mEq 2 capsules by mouth daily Disp
#*60 Capsule Refills:*0
13. Vitamin D 800 UNIT PO DAILY
RX *ergocalciferol (vitamin D2) 400 unit 2 tablet(s) by mouth
daily Disp #*60 Capsule Refills:*0
14. TraMADOL (Ultram) 50 mg PO Q6H:PRN pain
Hold for sedation
RX *tramadol 50 mg 1 tablet(s) by mouth every six (6) hours Disp
#*20 Tablet Refills:*0
15. Outpatient Lab Work
Diagnosis: Skin/Soft tissue infection on cefepime
- weekly BMP,ALT,AST,CBC w/diff start ___ till cefepime
completion. Please fax to:
Dr. ___
and ___: Fax: ___
Discharge Disposition:
Home with Service
Facility:
___
Discharge Diagnosis:
Primary: Superinfected abdominal fluid collection, GI bleed,
Left upper extremity DVT (Axillary and subclavian)
Secondary: Cholangiocarcinoma
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you at ___. You were
admitted for abdominal pain. A fluid collection was found which
tracked to your skin. This grew out a bacteria called
Pseudomonas. You are being treated for this with IV and oral
antibiotics. The fluid collection has improved.
You had an episode of low blood pressure and GI bleeding which
led to a stay in the ICU for a few days. An endoscopy showed
some inflammation in your esophagus and stomach and a small tear
but no active bleeding.
A PICC was placed in your left arm for the antibiotics, but this
caused a clot. Thus, this PICC was removed, and one was placed
on the right side.
You should have labs on ___ and then weekly to
ensure stability of your hematocrit and your renal and liver
function.
Please see attached for an updated medication list.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild/Fever
Please do not exceed 3gm in a 24 hour period.
RX *acetaminophen 500 mg 2 tablet(s) by mouth every eight (8)
hours Disp #*60 Tablet Refills:*0
2. Bisacodyl 10 mg PO DAILY:PRN Constipation - First Line
RX *bisacodyl [Laxative (bisacodyl)] 5 mg 2 tablet(s) by mouth
once a day Disp #*6 Tablet Refills:*0
3. Ibuprofen 800 mg PO Q8H:PRN Pain - Mild
Please take with food. Alternate with PO acetaminophen.
RX *ibuprofen 800 mg 1 tablet by mouth every eight (8) hours
Disp #*30 Tablet Refills:*0
4. Lidocaine 5% Patch 1 PTCH TD QPM
Please apply to affected area.
RX *lidocaine [Lidocaine Pain Relief] 4 % Please apply to
affected area. once a day Disp #*10 Patch Refills:*0
5. OxyCODONE (Immediate Release) ___ mg PO Q6H:PRN Pain -
Moderate
Please take lowest effective dose and wean as tolerated.
RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours
Disp #*24 Tablet Refills:*0
6. Polyethylene Glycol 17 g PO DAILY
7. Senna 8.6 mg PO BID
8. Omeprazole 20 mg PO DAILY
9.Outpatient Physical Therapy
Diagnosis: Gait instability
Prognosis: Good
Length: 13 months
Discharge Disposition:
Home
Discharge Diagnosis:
Right scalp hematoma/laceration
Comminuted right clavicular fracture
Right pneumothorax
Fracture of right ___ and ___ ribs
Fracture of left ___ rib
Nondisplaced distal radius fracture
Right L1-L3 transverse process fractures
Right iliac wing fracture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ after you fell and evaluated by the
trauma service. You suffered multiple broken bones, including
your right clavicle, ribs, spine, right wrist, and right iliac
wing (pelvis). You also required a chest tube because you had a
pneumothorax (when air leaks into the space between your lung
and chest wall) and a abrasion to your scalp. Your injuries were
managed non-operatively. Your wrist fracture was reduced and
placed in a splint and your right arm was placed in a sling due
to your clavicle fracture. You have since been seen by physical
and occupational therapy, who recommend you go home with
outpatient ___ services. Your pain has been well-controlled on
oral pain medications. You are ready to go home to continue your
recovery. Please follow the instructions below:
Please call your doctor or nurse practitioner or return to the
Emergency Department for any of the following:
*You experience new chest pain, pressure, squeezing or
tightness.
*New or worsening cough, shortness of breath, or wheeze.
*If you are vomiting and cannot keep down fluids or your
medications.
*You are getting dehydrated due to continued vomiting, diarrhea,
or other reasons. Signs of dehydration include dry mouth, rapid
heartbeat, or feeling dizzy or faint when standing.
*You see blood or dark/black material when you vomit or have a
bowel movement.
*You experience burning when you urinate, have blood in your
urine, or experience a discharge.
*Your pain in not improving within ___ hours or is not gone
within 24 hours. Call or return immediately if your pain is
getting worse or changes location or moving to your chest or
back.
*You have shaking chills, or fever greater than 101.5 degrees
Fahrenheit or 38 degrees Celsius.
*Any change in your symptoms, or any new symptoms that concern
you.
Please resume all regular home medications, unless specifically
advised not to take a particular medication. Also, please take
any new medications as prescribed.
Please get plenty of rest, continue to ambulate several times
per day, and drink adequate amounts of fluids. Avoid 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.
* Your injury caused right and left-sided rib fractures which
can cause severe pain and subsequently cause you to take shallow
breaths because of the pain.
* You should take your pain medication as directed to stay ahead
of the pain otherwise you won't be able to take deep breaths. If
the pain medication is too sedating take half the dose and
notify your physician.
* Pneumonia is a complication of rib fractures. In order to
decrease your risk you must use your incentive spirometer 4
times every hour while awake. This will help expand the small
airways in your lungs and assist in coughing up secretions that
pool in the lungs.
* You will be more comfortable if you use a cough pillow to hold
against your chest and guard your rib cage while coughing and
deep breathing.
* Symptomatic relief with ice packs or heating pads for short
periods may ease the pain.
* Narcotic pain medication can cause constipation therefore you
should take a stool softener twice daily and increase your fluid
and fiber intake if possible.
* Do NOT smoke
* If your doctor allows, non-steroidal ___ drugs
are very effective in controlling pain ( ie, Ibuprofen, Motrin,
Advil, Aleve, Naprosyn) but they have their own set of side
effects so make sure your doctor approves.
* Return to the Emergency Room right away for any acute
shortness of breath, increased pain or crackling sensation
around your ribs (crepitus).
Activity as tolerated:
Restrictions: Right upper extremity non-weight bearing in
splint, OK for ROMAT at elbow and digits, OK for light ADLs with
digits.
OK to start gentle pendulums at the shoulder, no ROM
restrictions at the shoulder or elbow. Sling for comfort as
needed, patient should limit use of sling to avoid shoulder
stiffness.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Levofloxacin 750 mg PO Q24H
Last dose will be on ___
RX *levofloxacin 750 mg 1 tablet(s) by mouth daily Disp #*1
Tablet Refills:*0
2. Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Toxic ingestion
Polysubstance abuse
Aspiration pneumonia
Transaminitis (hepatocellular)
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You came to the hospital after you were found unresponsive. You
required intubation with a breathing tube and monitoring in the
ICU. This was a complication of ingesting GHB while at the
hotel. Please stop taking GHB and other street drugs to reduce
the risk of this happening in the future. We recommend you see
a primary care doctor in follow-up and establish care with a
psychiatrist.
You were also found to have an aspiration pneumonia while you
were here. Please take the antibiotic, levofloxacin, for 1 more
day (last dose will be on ___.
We wish you the best.
-- Your Medical Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acyclovir 400 mg PO Q8H
2. Docusate Sodium 100 mg PO BID
3. Lisinopril 10 mg PO DAILY
4. Metoprolol Succinate XL 50 mg PO DAILY
5. OxycoDONE (Immediate Release) 5 mg PO Q6H:PRN pain
6. Polyethylene Glycol 17 g PO DAILY:PRN constipation
7. Spironolactone 25 mg PO DAILY
8. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
9. OSELTAMivir 75 mg PO Q12H
RX *oseltamivir [Tamiflu] 75 mg 1 capsule(s) by mouth twice a
day Disp #*2 Capsule Refills:*0
10. Levofloxacin 750 mg PO DAILY
RX *levofloxacin [Levaquin] 750 mg 1 tablet(s) by mouth Daily
Disp #*4 Tablet Refills:*0
11. OSELTAMivir 75 mg PO Q24H Duration: 14 Days
Beginning ___, last dose ___
RX *oseltamivir [Tamiflu] 75 mg 1 capsule(s) by mouth once a day
Disp #*14 Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY
#Neutropenic Fever
#Influenza 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 caring for you during your recent admission to
___. You were admitted for
evaluation of 2 days of fever, runny nose and cough. You were
found to have the flu based on a rapid influenza A test. You
improved clinically with Tamiflu and it was determined you could
be discharged to home. Please complete your final day of twice
daily dosed Tamiflu ___, and beginning ___ please take Tamiflu
75mg once a day for two weeks, ending ___ (this course may be
prolonged by your primary oncologist). In addition, please
complete the final 4 days of your Levaquin at home. You should
follow up with your primary oncologist, Dr. ___, on ___
___ at 12:20PM.
Please hold you home Lisinopril tomorrow, ___, given your
slightly low blood pressure. Address restarting it with your
primary oncologist, Dr. ___, on ___ at your visit.
Should you develop fevers, worsening cough or shortness of
breath, please seek medical care at a clinic or at your nearest
emergency department.
New medications:
Tamiflu 75mg twice a day for ___nding ___
Tamiflu 75mg daily for 14 days beginning ___ and ending
___
Levaquin 750mg daily for ___nding ___
Medications changed:
Please hold your home Lisinopril tomorrow ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. methenamine hippurate 1 gram oral DAILY
2. MetFORMIN (Glucophage) 500 mg PO DAILY
3. Docusate Sodium 100 mg PO BID:PRN constipation
4. Tiotropium Bromide 1 CAP IH DAILY
5. Senna 8.6 mg PO BID:PRN Constipation
6. Vitamin D ___ UNIT PO DAILY
7. Amiodarone 100 mg PO DAILY
8. Aspirin 81 mg PO DAILY
9. Fluticasone Propionate NASAL 1 SPRY NU DAILY
10. ___ Diskus (250/50) 1 INH IH BID
11. Gabapentin 100 mg PO TID
12. Levothyroxine Sodium 100 mcg PO DAILY
13. Lidocaine 5% Patch 1 PTCH TD QAM
14. Metoprolol Succinate XL 25 mg PO DAILY
15. Mirtazapine 30 mg PO HS
16. Nicotine Patch 14 mg TD DAILY
17. PredniSONE 7.5 mg PO DAILY
18. Acetaminophen 325 mg PO TID:PRN pain
19. Humulin ___ 10 Units Breakfast
20. Lisinopril 40 mg PO DAILY
21. Pantoprazole 40 mg PO Q24H
22. Ascorbic Acid ___ mg PO BID
23. Calcium Carbonate 500 mg PO TID:PRN abdominal pain
24. ___ (cranberry extract) 500 mg oral BID
25. Estrogens Conjugated 0.625 mg VG 2X/WEEK (MO,TH)
26. Murine Ear Wax Removal System (carbamide peroxide) 6.5 %
otic QHS
27. Ranitidine 300 mg PO HS
28. Simvastatin 20 mg PO DAILY
29. Sucralfate 1 gm PO QID
30. ___ 1 TAB PO TID:PRN pain
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Abdominal pain and nausea/vomiting caused by enteritis
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 abdominal pain,
nausea/vomiting, and diarrhea. You had a CT scan which showed
some thickening in your intestines, which made us worried about
infection or poor blood supply. You were treated with IV
fluids, pain and nausea medicine, bowel rest, and antibiotics,
and you got significantly better. You were seen by the surgeons.
After all this, it seemed like the most likely diagnosis was an
infection of your intestines caused by a virus. We stopped your
antibiotics, and you continued to improve. You should ___
with your outpatient providers as noted 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, fever
2. Ampicillin-Sulbactam 3 g IV Q6H
3. Apixaban 10 mg PO BID Duration: 9 Doses
4. Apixaban 5 mg PO BID
This medication should be started on ___.
5. Cepastat (Phenol) Lozenge 2 LOZ PO Q4H:PRN cough
6. Sodium Chloride 0.9% Flush 20 mL IV X1 PRN For PICC
insertion
7. Sodium Chloride 0.9% Flush ___ mL IV DAILY and PRN, line
flush
8. Sodium Chloride Nasal ___ SPRY NU QID:PRN dry nose
Discharge Disposition:
Extended Care
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
Overdose
Suicide attempt
Respiratory Failure
Strep Anginosus bacteremia
Aspiration pneumonia
s/p PEA arrest
Pulmonary Embolism
Reactive thrombocytosis
Diarrhea
Depression
Pneumomediastinum
Right pleural effusion
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 ___ at ___.
___ came to the hospital after ___ overdosed on antipsychotic
medications and were found unresponsive. ___ had a very
complicated course that included intubation and a cardiac
arrest. ___ had CPR and your heart restarted. When ___
overdosed, ___ vomited and developed a lung infection that
required IV antibiotics. ___ were also found to have a pulmonary
embolism. ___ were treated with heparin, then lovanox, and
transitioned to apixaban. ___ had diarrhea that was C. Difficile
negative. ___ were extubated and transferred to the general
medicine floor.
___ improved dramatically throughout your course. Your diarrhea,
fevers, and cough resolved. ___ were followed closely by the
infectious disease specialists and decided on antibiotic course
for total of 4 weeks from ___. ___ were switched to an
oral medication, apixaban, to treat your pulmonary embolism. ___
will take this medication for 3 months.
___ were seen by psychiatry after your overdose and per their
recommendations, ___ were discharged to an inpatient psychiatric
facility to undergo treatment for your depression and
suicidality.
We wish ___ the best of health,
Your medical team at ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Artificial Tear Ointment 1 Appl BOTH EYES QHS
2. Artificial Tears ___ DROP BOTH EYES PRN DRY EYES
3. Cephalexin 250 mg PO Q8H
RX *cephalexin 250 mg 1 capsule(s) by mouth every 8 hours Disp
#*13 Capsule Refills:*0
4. Aspirin 81 mg PO DAILY
5. Cyanocobalamin 250 mcg PO DAILY
6. Ferrous Sulfate 325 mg PO 2X/WEEK (MO,FR)
7. Levothyroxine Sodium 88 mcg PO DAILY
8. Naproxen 250 mg PO Q12H:PRN Pain - Mild
9. Vitamin D ___ UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Urinary tract infection
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 seen in the hospital for weakness and found to have a
urinary tract infection.
We treated you with antibiotics and you improved. You were also
seen by the physical therapists, who recommend home ___.
As we discussed, please work on your diet by eating smaller,
more frequent meals. Continue the protein supplementation in
your oatmeal. Please try to add an Ensure or Boost type drink
once to twice per day.
Please follow up with your primary care doctor within 2 weeks of
discharge.
Continue taking the antibiotics until the bottle is empty.
It was a pleasure caring from you. We wish you the very best!
- Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 7.5 mg PO DAILY
2. Citalopram 20 mg PO DAILY
3. Docusate Sodium 100 mg PO BID
4. Gabapentin 300 mg PO DAILY
5. Lisinopril 5 mg PO DAILY
6. Senna 17.2 mg PO QHS contipation
7. Ondansetron 8 mg PO Q8H:PRN nausea
8. Prochlorperazine 10 mg PO Q6H:PRN nausea
9. Sodium Chloride Nasal ___ SPRY NU 5X/DAY
10. Omeprazole 20 mg PO DAILY
11. LORazepam 0.5 mg PO Q8H:PRN anxiety or insomnia
12. Lactulose 30 mL PO Q6H:PRN constipation
13. Hydrocortisone (Rectal) 2.5% Cream ___ID
14. Cyclobenzaprine 5 mg PO TID:PRN muscle pain or cramps
15. Cyanocobalamin 1000 mcg IM/SC EVERY 4 WEEKS (MO)
16. Simethicone 40-80 mg PO QID:PRN gas pain
RX *simethicone 125 mg 1 capsule by mouth twice a day Disp #*30
Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
stage IV gastric cancer
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 weakness and dark stools.
You were evaluated and found not to have obvious blood in your
stool or evidence of dropping blood levels. Your abdominal pain
did not get any worse throughout your admission. You are now
safe for discharge home with close follow up.
It was a pleasure caring for you - we wish you all the best!
Sincerely,
Your ___ Oncology 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 - Moderate
2. Amoxicillin-Clavulanic Acid ___ mg PO Q12H biliary abscess
RX *amoxicillin-pot clavulanate 875 mg-125 mg 1 875 by mouth Q12
Disp #*12 Tablet Refills:*0
3. Atenolol 50 mg PO DAILY
4. Hydrochlorothiazide 25 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
lymphadenopathy. biliary abscess
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please call your surgeon or return to the Emergency Department
if you develop a fever greater than ___ F, shaking chills, chest
pain, difficulty breathing, pain with breathing, cough, a rapid
heartbeat, dizziness, severe abdominal pain, pain unrelieved by
your pain medication, a change in the nature or severity of your
pain, severe nausea, vomiting, abdominal bloating, severe
diarrhea, inability to eat or drink, foul smelling or colorful
drainage from your incisions, redness, swelling from your
incisions, or any other symptoms which are concerning to you. To
avoid dehydration, remember to sip small amounts of fluid
frequently throughout the day to reach a goal of approximately
___ mL per day. Please note the following signs of dehydration:
dry mouth, rapid heartbeat, feeling dizzy or faint, dark colored
urine, infrequent urination.
Medication Instructions:
Please refer to the medication list provided with your discharge
paperwork for detailed instruction regarding your home and newly
prescribed medications. You can start all your home medication
after discharge.
your ___ Team
Thank you,</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
2. Atenolol 25 mg PO DAILY
3. Calcitriol 0.25 mcg PO BID
4. Calcium Carbonate 1000 mg PO QID
5. Docusate Sodium 100 mg PO BID constipation
6. Levothyroxine Sodium 125 mcg PO DAILY
7. Senna 8.6 mg PO BID:PRN constipation
Discharge Disposition:
Home
Discharge Diagnosis:
Post-thyroidectomy neck hematoma
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were re-admitted to the inpatient general surgery unit from
the ED after your total thyroidectomy for a neck washout. You
have adequate pain control and have tolerated a regular diet and
may return home to continue your recovery. Please continue your
previous instructions regarding thyroid hormone replacement and
calcium supplement, please take as prescribed. Monitor for signs
and symptoms of low Calcium such as numbness or tingling around
mouth/fingertips or muscle cramps in your legs. If you
experience any of these signs or symptoms please call Dr.
___ for advice or if you have severe symptoms go
to the emergency room.
Please resume all regular home medications, unless specifically
advised not to take a particular medication and take any new
medications as prescribed. You will be given a prescription for
narcotic pain medication, take as prescribed. It is recommended
that you take a stool softener such as Colace while taking oral
narcotic pain medication to prevent constipation. You may also
take acetaminophen (Tylenol) as directed, but do not exceed 4000
mg in one day. Please get plenty of rest, continue to walk
several times per day, and drink adequate amounts of fluids.
Please call your surgeon or go to the emergency department if
you have increased pain, swelling, redness, or drainage from the
incision site. You may shower and wash incisions with a mild
soap and warm water. Avoid swimming and baths until cleared by
your surgeon. Gently pat the area dry. You have a neck incision
with steri-strips in place, do not remove, they will fall off on
their own.
Thank you for allowing us to participate in your care.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H
2. Amitriptyline 75 mg PO HS
3. Aripiprazole 5 mg PO DAILY
4. Azathioprine 50 mg PO TID
5. Cyanocobalamin 1000 mcg PO DAILY
6. Docusate Sodium 100 mg PO BID
7. Ferrous Sulfate 325 mg PO DAILY
8. Gabapentin 400 mg PO DAILY
9. NPH 70 Units Breakfast
10. LeVETiracetam Oral Solution 1500 mg PO BID
11. Methadone 20 mg PO TID
RX *methadone 10 mg 2 tabs by mouth three times a day Disp #*42
Tablet Refills:*1
12. 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:*1
13. Pantoprazole 40 mg PO Q24H
14. PredniSONE 20 mg PO DAILY
15. QUEtiapine Fumarate 200 mg PO DAILY
16. Senna 8.6 mg PO BID:PRN constipation
17. Sertraline 200 mg PO DAILY
18. Vitamin D 1000 UNIT PO DAILY
19. Warfarin 1.5 mg PO DAILY16
20. Ciprofloxacin HCl 500 mg PO Q12H
Please continue to take this medication until you see Podiatric
Surgery ___ follow up.
21. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
Please continue to take this medication until you see Podiatric
Surgery ___ follow up.
22. Nafcillin 2 g IV Q4H
Please continue to take this medication until you see Podiatric
Surgery ___ follow up.
23. Outpatient Lab Work
Labs to be drawn once per week for six weeks after discharge:
CBC with differential, BUN, Cr, AST, ALT, TB, ALK PHOS, ESR,
CRP.
Labs to be drawn 7 days after discharge: AST, ALT, TB, ALK PHOS
ALL LAB RESULTS SHOULD BE SENT TO... ATTN: ___ CLINIC,
FAX: ___
24. Multivitamins 1 TAB PO DAILY
25. Lorazepam 0.5 mg PO Q6H:PRN anxiety
RX *lorazepam [Ativan] 0.5 mg 1 tab by mouth every six (6) hours
Disp #*30 Tablet Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary:
Osteomyelitis
Secondary:
Bacteremia
Autonomic dysfunction
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It has been a pleasure being a part of your care during your
admission to ___. You were
admitted for an infection of your foot ulcer. You were taken to
the operating room with the Podiatry team, and your ulcer was
debrided. You were also found to have an infection ___ your
bloodstream, which was likely from the bacteria ___ your foot
ulcer that got into your blood. You were treated with IV and PO
antibiotics, which will continue for a minimum of 6 weeks
(earliest end date: ___. You had a PICC line placed,
basically a more permanent IV, ___ order to receive these
antibiotics even when you leave the hospital.
Your right leg was still very swollen and red after you went to
the operating room, and you had an ultrasound which showed that
there were no pockets of fluid or infectious collections that we
were missing.
Also, because you had bacteria ___ your blood, we wanted to make
sure that no bacteria were sitting on your heart valves. You had
an echocardiogram, which showed no evidence of this condition.
___ terms of your falls, you previously had a negative workup for
cardiac or neurological causes of your falls. It is likely the
combinations of medications that you are on, as well as your
diabetic neuropathy that is causing you to be unsteady on your
feet. Your Gabapentin and Amitriptyline were subsequently both
decreased ___ dose. Your Lasix (Furosemide) was also discontinued
this admission ___ an attempt to reduce your lightheadedness.
Please weigh yourself everyday. ___ your MD if your weight goes
up more than 3 lbs.
It was a pleasure to take care of you during your hospital stay.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Basaglar KwikPen U-100 Insulin (insulin glargine) 100
unit/mL (3 mL) subcutaneous Other
RX *insulin glargine [Basaglar KwikPen U-100 Insulin] 100
unit/mL (3 mL) ___ units subcutaneously twice a day Disp #*5
Syringe Refills:*0
2. HumaLOG KwikPen Insulin (insulin lispro) 100 unit/mL
subcutaneous ASDIR
RX *insulin lispro [Humalog KwikPen Insulin] 100 unit/mL 6 units
subcutaneously three times a day Disp #*5 Syringe Refills:*0
3. Ibuprofen 400 mg PO Q6H:PRN Pain - Mild
Take with food
4. OneTouch Delica Lancets (lancets) 30 gauge miscellaneous
ASDIR
RX *lancets [OneTouch Delica Lancets] 30 gauge puncture pad of
finger four times a day Disp #*1 Package Refills:*0
5. OneTouch Ultra Blue Test Strip (blood sugar diagnostic)
miscellaneous ASDIR
Place one strip into glucose meter to check blood sugar levels
RX *blood sugar diagnostic [OneTouch Ultra Blue Test Strip] Use
one strip with each blood sugar check four times a day Disp
#*100 Strip Refills:*0
6. OneTouch Verio System (blood-glucose meter) miscellaneous
ASDIR
1 (one) one touch meter
RX *blood-glucose meter [OneTouch Verio System] Use meter as
directed four times a day Disp #*1 Each Refills:*0
7. Senna 8.6 mg PO BID:PRN Constipation - First Line
8. Tamsulosin 0.4 mg PO BID
RX *tamsulosin 0.4 mg 1 capsule(s) by mouth twice a day Disp
#*10 Capsule Refills:*0
9. Acetaminophen ___ mg PO Q8H
Wean as tolerated.
10. Creon 12 3 CAP PO TID W/MEALS
RX *lipase-protease-amylase [Creon] 12,000 unit-38,000
unit-60,000 unit 3 capsule(s) by mouth three times a day Disp
#*63 Capsule Refills:*1
11. Diphenoxylate-Atropine 1 TAB PO TID:PRN loose stools
RX *diphenoxylate-atropine 2.5 mg-0.025 mg 1 tablet(s) by mouth
every eight (8) hours Disp #*21 Tablet Refills:*1
12. LOPERamide 6 mg PO TID:PRN diarrhea
RX *loperamide 2 mg 6 mg(s) by mouth three times a day Disp #*63
Tablet Refills:*1
13. Pregabalin 300 mg PO BID
RX *pregabalin 300 mg 1 capsule(s) by mouth every twelve (12)
hours Disp #*28 Capsule Refills:*0
14. HELD- Cholestyramine 4 gm PO BID This medication was held.
Do not restart Cholestyramine until you follow up with your
primary care provider
15. HELD- DULoxetine ___ 60 mg PO DAILY This medication was
held. Do not restart DULoxetine ___ ___ follow-up at your
scheduled primary care appointment
16. HELD- FoLIC Acid 1 mg PO DAILY This medication was held. Do
not restart FoLIC Acid until you follow up with your primary
care provider
17. HELD- Multivitamins 1 TAB PO DAILY This medication was
held. Do not restart Multivitamins until you follow up with your
primary care provider
18. HELD- Thiamine 100 mg PO DAILY This medication was held. Do
not restart Thiamine until you follow up with your primary care
provider
19. HELD- Vitamin D 400 UNIT PO DAILY This medication was held.
Do not restart Vitamin D until you follow up with your primary
care provider
20. HELD- Vitamin E and C Beauty Lotion (vit C palm-vit E
ac-panthenol) 14,000-100 unit-mg topical Q12H This medication
was held. Do not restart Vitamin E and C Beauty Lotion until you
follow up with your primary care provider
21. HELD- Zinc Sulfate 220 mg PO DAILY This medication was
held. Do not restart Zinc Sulfate until you follow up with your
primary care provider
___:
Home
Discharge Diagnosis:
DMI
DKA
LLL Pneumonia
Small bowel necrosis and pneumatosis
Substance abuse
Chronic diarrhea
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. ___,
You were admitted to the hospital because you were having
abdominal pain and you also had diabetic ketoacidosis (DKA)
because of very high blood sugars. You were also found to have a
possible pneumonia and urinary tract infection.
While you were here you were initially admitted to the ICU to
receive insulin through a continuous IV infusion and for close
monitoring. You were eventually transitioned to insulin shots
once your blood sugars improved and you were moved to the
medicine floor for treatment of a pneumonia. During your stay,
your abdominal pain worsened and a CT showed injury to your
bowel and you had to go to the OR to undergo exploratory
laparotomy and had a portion of your intestine removed.
You have now had return of bowel function, are tolerating a
regular diet and are ready to be discharged home. Please follow
the discharge instructions below:
Please call your doctor or nurse practitioner or return to the
Emergency Department for any of the following:
*You experience new chest pain, pressure, squeezing or
tightness.
*New or worsening cough, shortness of breath, or wheeze.
*If you are vomiting and cannot keep down fluids or your
medications.
*You are getting dehydrated due to continued vomiting, diarrhea,
or other reasons. Signs of dehydration include dry mouth, rapid
heartbeat, or feeling dizzy or faint when standing.
*You see blood or dark/black material when you vomit or have a
bowel movement.
*You experience burning when you urinate, have blood in your
urine, or experience a discharge.
*Your pain in not improving within ___ hours or is not gone
within 24 hours. Call or return immediately if your pain is
getting worse or changes location or moving to your chest or
back.
*You have shaking chills, or fever greater than 101.5 degrees
Fahrenheit or 38 degrees Celsius.
*Any change in your symptoms, or any new symptoms that concern
you.
Please resume all regular home medications, unless specifically
advised not to take a particular medication. Also, please take
any new medications as prescribed.
Please get plenty of rest, continue to ambulate several times
per day, and drink adequate amounts of fluids. Avoid lifting
weights greater than ___ lbs until you follow-up with your
surgeon.
Avoid driving or operating heavy machinery while taking pain
medications.
Incision Care:
*Please call your doctor or nurse practitioner if you have
increased pain, swelling, redness, or drainage from the incision
site.
*Avoid swimming and baths until your follow-up appointment.
*You may shower, and wash surgical incisions with a mild soap
and warm water. Gently pat the area dry.
*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.
When you go home, please continue taking all your medications as
prescribed and follow up with your doctors as listed below.
We wish you the best!
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. diazepam 5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6
hours) as needed for spasm: do not drive, drink alcohol, or
operate machinery/appliances while taking this medication.
Disp:*40 Tablet(s)* Refills:*0*
2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
3. acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q4H (every 4
hours).
4. ibuprofen 400 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours) as needed for pain.
5. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for pain: do not drive, drink alcohol, or
operate machinery/appliances while taking this medication.
Disp:*60 Tablet(s)* Refills:*0*
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Right hip contusion
Discharge Condition:
stable
alert and oriented
ambulatory
Followup Instructions:
___ [/INST] </s><s>******SIGNS OF INFECTION**********
Please return to the emergency department or notify MD if you
should experience severe pain, increased swelling, decreased
sensation, difficulty with movement; fevers >101.5, chills,
chest pain, shortness of breath or any other concerns.
******WEIGHT-BEARING*******
weight bearing as tolerated
******MEDICATIONS***********
- Resume your pre-hospital medications.
- You have been given medication for your pain control. Please
do not operate heavy machinery or drink alcohol when taking this
medication. As your pain improves please decrease the amount of
pain medication. This medication can cause constipation, so you
should drink ___ glasses of water daily and take a stool
softener (colace) to prevent this side effect.
-Medication refills cannot be written after 12 noon on ___.
*****ANTICOAGULATION******
No chemical anticoagulation. Please ambulate.
******FOLLOW-UP**********
Please follow up with ___ in 14 days for
evaluation. Call ___ to schedule appointment upon
discharge.
Please follow up with your PCP regarding this admission and any
new medications/refills.
Physical Therapy:
WBAT
Treatments Frequency:
home safety evaluation</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler ___ PUFF IH Q4H:PRN SOB, wheezing
2. Atenolol 50 mg PO DAILY
3. Levothyroxine Sodium 75 mcg PO DAILY
4. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY
Do Not Crush
5. PrednisoLONE Acetate 1% Ophth. Susp. 1 DROP BOTH EYES QID
RX *prednisolone acetate [Pred Forte] 1 % 1 drop both eyes four
times a day Refills:*0
6. Ibuprofen 600 mg PO DAILY:PRN headache
Do not take more than twice per week
RX *ibuprofen 600 mg 1 tablet(s) by mouth Daily Disp #*12 Tablet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Migraine
Uveitis
Retinal Cysts
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
___ were admitted for management of eye inflammation, vision
changes and headache. Our evaluation showed that these two
complaints are likely unrelated.
A variety of tests were sent to try to determine the cause of
your eye inflammation. The results of these tests were negative
or still pending at the time of discharge. In the meantime,
please continue using the eye drops provided by your
Ophthalmologist. Your vision changes ___ be due to problems with
your retina. Your headache does not seem to have been due to
increased pressure inside your head, and rather seems to be a
migraine type headache.
Screening labs also showed that your Thyroid medication may need
to be adjusted. Please discuss this matter with your Primary
Care Provider.
Follow up with Neurology (Dr. ___ - ___ has been
scheduled. Follow up with Ophthalmology (Dr. ___ - ___ will be arranged. If ___ do not hear from Ophthalmology
within three business days, please call the clinic.
Please call ___ registration at ___ to update your
patient information.
It was a pleasure being part of your care team.
___ Neurology</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Hydrochlorothiazide 25 mg PO DAILY
2. Simvastatin 20 mg PO QPM
3. Lisinopril 20 mg PO DAILY
4. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl [Cipro] 500 mg 1 tablet(s) by mouth Twice
a day Disp #*4 Tablet Refills:*0
5. Docusate Sodium 100 mg PO BID
Take 1 twice a day with plenty of water.
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth Twice
a day Disp #*60 Capsule Refills:*0
6. Milk of Magnesia 30 mL PO Q6H
Take 1 packet daily. Stop if diarrhea develops.
RX *magnesium hydroxide [Milk of Magnesia] 400 mg/5 mL 5 mL by
mouth Daily Refills:*3
7. Lorazepam 0.5 mg PO Q4H:PRN anxiety
Discharge Disposition:
Home
Discharge Diagnosis:
Partial small bowel obstruction
Discharge Condition:
VS: Temp 98.5 HR 58 BP 100/52 RR 16 O2 98% RA
Gen: alert, oriented to self, place and time. Not in any
distress.
HEENT: moist mucous membranes, no cervical lymphadenopathy
Chest: no crackles, bilateral breath sounds present
Heart: normal rate and rhythm
Abdomen: soft, nondistended, nontender. +BS in all four
quadrants.
Extremities: without edema, palpable pedal pulses
Activity: ad lib, unassisted
Followup Instructions:
___ [/INST] </s><s>DISCHARGE INSTRUCTIONS:
You were admitted to the hospital with a diagnosis of small
bowel obstruction. Your management included conservative
measures such as bowel rest and intravenous fluids, and serial
abdominal exams. You did not require antibiotics. You did not
require surgery for this condition. You were able to tolerate
regular diet and fluids at the time of your discharge. Please
follow instructions outlined below to ensure good recovery.
ANTIBIOTICS:
Please complete the full course of antibiotics as instructed. DO
NOT stop taking antibiotics if your symptoms resolve before the
end of the prescribed course. Take antibiotics with food to
avoid nausea.
ACTIVITY:
You may resume regular activity. You may climb stairs. You may
start some light exercise when you feel comfortable. You may
resume sexual activity unless your doctor has told you
otherwise.
HOW YOU MAY FEEL:
You may feel weak or "washed out" for 6 weeks. You might want to
nap often. Simple tasks may exhaust you. You might have trouble
concentrating or difficulty sleeping. You might feel somewhat
depressed. You could have a poor appetite for a while. Food may
seem unappealing. All of these feelings and reactions are normal
and should go away in a short time.
YOUR BOWELS:
Constipation is a common side effect of medicine such as
oxycodone, Percocet or codeine. If needed, you may take a stool
softener (such as Colace, one capsule) or gentle laxative (such
as milk of magnesia, 1 tbs) twice a day. You can get both of
these medicines without a prescription. If you go 48 hours
without a bowel movement, or have pain moving the bowels, call
your primary care doctor and the surgery office to schedule an
appointment. Drink plenty of fluids. If you develop diarrhea,
stop taking laxatives. If it does not go away, or is severe and
you feel ill, please call your surgeon.
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: 1. Divalproex (DELayed Release) 750 mg PO BID
2. Fluoxetine 60 mg PO DAILY
3. LACOSamide 200 mg PO BID
4. LaMOTrigine 100 mg PO QAM **DOSE TO BE INCREASED BY
OUTPATIENT NEUROLOGIST
5. LaMOTrigine 125 mg PO QPM **DOSE TO BE INCREASED BY
OUTPATIENT NEUROLOGIST
Discharge Disposition:
Home
Discharge Diagnosis:
Epilepsy
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 because of difficulty walking
and concern for seizure activity. You EEG did not show seizure
activity and your walking was back to normal by the following
day. You are back to baseline so you are safe to go home.
Please take it easy this weekend, drink plenty of fluids and get
plenty of rest. You may return to your normal activities on
___. Please call Dr. ___ first thing ___
morning to touch base and see when he would like to follow up
with you next. Please return to the nearest emergency room for
any persistent worsening of your symptoms or new concerns for
seizure.
There was some confusion regarding the dose of your home
medications upon your admission to the hospital. We recommend
that you make an up to date list of your current home
medications, including doses and how many times a day you take
each medication, and keep a copy of this in your purse or wallet
to help prevent this confusion from happening in the future.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. ChlorproMAZINE 50 mg PO TID
3. Duloxetine 30 mg PO DAILY
4. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
5. Furosemide 80 mg PO DAILY
6. Lisinopril 5 mg PO DAILY
7. Lorazepam 1 mg PO BID
8. Multivitamins 1 TAB PO DAILY
9. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN wheezing ,sob
10. Atorvastatin 40 mg PO DAILY
11. Bisacodyl 10 mg PO/PR DAILY:PRN Constipation
12. Diltiazem 60 mg PO TID
13. Docusate Sodium (Liquid) 100 mg PO BID
14. Enoxaparin Sodium 80 mg SC Q12H
Start: Today - ___, First Dose: Next Routine Administration
Time
15. FoLIC Acid 1 mg PO DAILY
16. Insulin SC
Sliding Scale
Fingerstick QACHS
Insulin SC Sliding Scale using HUM Insulin
17. Senna 8.6 mg PO BID:PRN Constipation
18. Thiamine 100 mg PO DAILY
19. Warfarin 5 mg PO DAILY16
20. Albuterol Inhaler 1 PUFF IH Q4H:PRN sob
21. Ascorbic Acid ___ mg PO DAILY
22. Polyethylene Glycol 17 g PO DAILY:PRN constipation
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
- Hypercarbic, hypoxemic respiratory failure (multifactorial)
- Health care associated pneumonia
- Acute PE
- Systolic congestive heart failure exacerbation
- COPD exacerbation
- Diabetes
- 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 ___,
You were admitted for respiratory failure / shortness of breath.
This was caused by a combination of Pneumonia, COPD
exacerbation, Heart failure, likely from a past heart attack.
You were placed on a breathing machine until you were able to
breathe effectively on your own. You were given antibiotics for
pneumonia. You were given oral steroids for a COPD
exacerbation. You were given diuretic medications for heart
failure to help you clear excess fluid in the lungs.
You were also found to have a blood clot in your lungs. You were
started on blood thinners to treat the blood clot. You will need
to continue the blood thinner for at least 3 months.
It is important that you follow up with a cardiologist to
discuss your heart disease.</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 during your hospitalization at
the ___. You were admitted
after a fall at your nursing home. This might have been from
confusion, as some elderly people can get confused at night or
with certain medications. You had a CT scan of your head that
show no new bleeding or new strokes. You did not have any falls
while in the hospital.
You also had one blood test that showed concern for a blood
infection and you were given antibiotics. However, further
testing showed that this was probably a contaminant and not a
real infection, and antibiotics were stopped.
Your family was concerned about your rapid decline in your
cognitive thinking and functioning over the past few months.
Unfortunately, we were not able to find any further reasoning
for this, but we recommend you continue to work with your
outpatient doctors and consider seeing a neurologist again.
If you have fevers, worsening confusion, problems breathing, or
anything that concerns you or your family, please seek medical
attention.
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 325-650 mg PO Q6H:PRN Pain - Mild
do not exceed 4 grams/ 24 hours
2. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*18 Tablet Refills:*0
3. MetroNIDAZOLE 500 mg PO Q8H
RX *metronidazole 500 mg 1 tablet(s) by mouth every eight (8)
hours Disp #*27 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Acute Appendicitis
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 Acute Care Surgery Service on ___
with abdominal pain probably related to an infection in your
appendix based on your clinical exam as well as CT scan imaging.
Your pain decreased with antibiotics. The risks and benefits of
surgery were discussed and medical treatment with antibiotic
therapy was determined appropriate. You are now doing better,
tolerating a regular diet, and ready to be discharged to home 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.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Clopidogrel 75 mg PO DAILY
2. Aspirin 325 mg PO DAILY
3. Pantoprazole 40 mg PO Q24H
4. Multivitamins 1 TAB PO DAILY
5. Rosuvastatin Calcium 20 mg PO DAILY
6. Amlodipine 2.5 mg PO DAILY
RX *amlodipine 2.5 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
7. Metoprolol Succinate XL 50 mg PO DAILY
8. Nitroglycerin SL 0.3 mg SL PRN chest pain
9. Morphine Sulfate ___ 15 mg PO BID:PRN chest pain
RX *morphine 15 mg ___ tablet(s) by mouth BID:prn Disp #*30
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
-refractory restenosis of LAD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you during your stay at ___
___. You were admitted to the
hospital because of chest pain. You underwent a cardiac cath
that showed restenosis or recurrent blockage of one of your
coronary arteries. Since this is the fourth time this occurs
during the last year, you were referred to cardiac surgery for a
redo CABG.
Please make sure to take all your medications and keep up with
your appointments. Also, please make sure you call an ambulance
if you experience worsening pain.
Please call the echo lab on ___ morning at ___ to
find out what time your echo is.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Creon 12 5 CAP PO TID W/MEALS
RX *lipase-protease-amylase [Creon] 12,000 unit-38,000
unit-60,000 unit 5 capsule(s) by mouth three times a day Disp
#*100 Capsule Refills:*3
3. Creon ___ CAP PO DAILY:PRN with snacks
RX *lipase-protease-amylase [Creon] 12,000 unit-38,000
unit-60,000 unit ___ capsule(s) by mouth with snacks Disp #*100
Capsule Refills:*1
4. Lisinopril 20 mg PO DAILY
5. Metoprolol Tartrate 12.5 mg PO BID
6. Pantoprazole 40 mg PO Q24H
RX *pantoprazole 40 mg 1 tablet(s) by mouth every day Disp #*30
Tablet Refills:*0
7. Simvastatin 40 mg PO DAILY
8. Glargine 18 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
RX *insulin glargine [Lantus Solostar] 100 unit/mL (3 mL) ___ Units before BED; Disp #*30 Syringe Refills:*3
RX *blood-glucose meter [Contour Next Meter] Disp #*1 Each
Refills:*0
RX *insulin lispro [Humalog KwikPen] 100 unit/mL sliding sclae
Up to 18 Units QID per sliding scale Disp #*100 Syringe
Refills:*3
9. Contour Next Strips (blood sugar diagnostic) test strips
QACHS
2 bottles of 50
RX *blood sugar diagnostic [Contour Next Strips] 2 bottles of
50 qachs Disp #*2 Bottle Refills:*2
10. lancets 31 gauge miscellaneous qachs
1 box of 50
RX *lancets [Ultra Thin Lancets] 33 gauge Disp #*1 Each
Refills:*3
11. Lantus Solostar (insulin glargine) 18 units subcutaneous at
night
12. HumaLOG KwikPen (insulin lispro) 100 unit/mL subcutaneous
every meal
13. Pen Needle (insulin needles (disposable)) 32 x ___
miscellaneous every meal
32guagex5/32(4mm Nano)
RX *insulin needles (disposable) ___ Tier Unifine Pentips] 32
gauge X ___ Disp #*1 Box Refills:*3
Discharge Disposition:
Home
Discharge Diagnosis:
Pancreatic body mass
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please call your doctor or nurse practitioner if you experience
the following:
*You experience shakiness, nervousness, sweating, irritability,
confusion, lightheadedness, dizziness, hunger and nausea,
sleepiness, weakness and fatigue, as these may be signs of
hypogycemia.
*You experience frequent urination, increased thirst, blurred
vision, fatigue, headache, confusion, coma, abdominal pain, as
these may be signs of hypergylyemia.
*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 is 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.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Cepacol Sore Throat ___ mg Lozenge Sig: One (1) lozenge
Mucous membrane every ___ hours as needed for sore throat.
2. Outpatient Lab Work
Check labs twice weekly for 2 week duration: AST, ALT, Alk phos,
total bili, ___, chem7 panel, calcium, magnesium, phos
ICD 9 code: ___.3 hepatitis
3. Outpatient Lab Work
Please check labs on once weekly basis until LFTs normalize
(discontinued by PCP): AST, ALT, Alk phos, total bili,
___, chem7 panel, calcium, magnesium, phosph
ICD 9 code: 573.3 hepatitis
4. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
5. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
6. potassium chloride 10 mEq Tablet Extended Release Sig: Four
(4) Tablet Extended Release PO DAILY (Daily) for 7 days.
Discharge Disposition:
Extended Care
Discharge Diagnosis:
PRIMARY:
Tylenol overdose with liver failure
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. ___,
It was a pleasure taking care of you at ___
___. You were admitted with liver failure after a
tylenol overdose. Your liver function improved and it is safe to
discharge you to continue treatment for your depression.
You will follow up with your primary care doctor regarding your
liver health after psychiatric treatment. You do not need to be
seen in the liver clinic.
Please make the following changes to your medications:
# STOP lamicatal, adderall and ativan. Your medications will be
adjusted by the psychiatrists.
# START daily potassium supplementation for one week until labs
normalize.
# START thiamine and folic acid supplementation
Please have labs checked by twice weekly to monitor electrolytes
and liver function for 2 WEEKS then transition to once weekly
lab checks until liver function tests completely normalize.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen ___ mg PO Q8H
Reason for PRN duplicate override: Alternating agents for
similar severity
2. Aspirin 81 mg PO DAILY
RX *aspirin [Enteric Coated Aspirin] 81 mg 1 (One) tablet(s) by
mouth once a day Disp #*30 Tablet Refills:*0
3. Clopidogrel 75 mg PO DAILY SMA stent
RX *clopidogrel 75 mg 1 (One) tablet(s) by mouth once a day Disp
#*30 Tablet Refills:*0
4. Multivitamins W/minerals 1 TAB PO DAILY
5. Mirtazapine 15 mg PO QHS
6. albuterol sulfate 90 mcg/actuation inhalation DAILY:PRN
7. amLODIPine 5 mg PO DAILY
8. Citalopram 10 mg PO DAILY
9. Cyanocobalamin 1000 mcg PO DAILY
10. Levothyroxine Sodium 75 mcg PO DAILY
11. rOPINIRole 0.5 mg PO QPM
12. Tiotropium Bromide 1 CAP IH DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
acute on chronic mesenteric ischemia
malnutrition
delirium
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive. Responds slowly.
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
You were admitted to the hospital because of blocakages limiting
circulation to your intestines. You underwent surgery to fix
these blockages. After this first surgery, you had to go back
to the OR several times because of complications you were
having. Your circulation improved. While you were
hospitalized, you received a blood transfusion. Your appetite
was poor and you were not able to take in enough calories on
your own, so you were seen frequently by a nutritionist and a
speech and swallow therapist. A tube was placed through your
nostrils into your stomach to give you calories in addition to
the small amount of food you ate. You became delirious as many
people do while in the hospital during an illness. You are
getting better and ready to be discharged to rehab.
Please follow the below instructions carefully and call us with
any questions. ___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Docusate Sodium 100 mg PO BID
2. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
3. Pantoprazole 40 mg PO Q24H
4. Polyethylene Glycol 17 g PO ___
5. Senna 8.6 mg PO BID Constipation - First Line
6. Apixaban 5 mg PO/NG BID
7. Aspirin 81 mg PO ___
8. Atorvastatin 80 mg PO QPM
9. DULoxetine 60 mg PO BID
10. Gabapentin 300 mg PO TID
11. Losartan Potassium 12.5 mg PO ___
12. Metoprolol Tartrate 25 mg PO BID
Discharge Disposition:
Home
Facility:
___
Discharge Diagnosis:
small bowel obstruction
Discharge Condition:
Mental Status: Clear and coherent.
Activity Status: Ambulatory - Independent.
Level of Consciousness: Alert and interactive.
Followup Instructions:
___ [/INST] </s><s>You were admitted to the hospital with abdominal pain and poor
tolerance to food. You were placed on bowel rest and given
intravenous fluids. The abdominal pain recurred when you resumed
food and you again were placed on bowel rest. Because of this,
you were taken to the operating room where you underwent an
exploratory laparotomy and lysis of adhesions. You have resumed
a diet without abdominal pain. A small area of your abdominal
wound is open and VAC dressing was placed to help facilitate
closure. Your vital signs have been stable and you are
preparing for discharge with the following instructions:
You were admitted to the hospital with abdominal pain and poor
tolerance to food. You were placed on bowel rest and given
intravenous fluids. The abdominal pain recurred when you resumed
food and you again were placed on bowel rest. Because of this,
you were taken to the operating room where you underwent an
exploratory laparotomy and lysis of adhesions. You have resumed
a diet without abdominal pain. A small area of your abdominal
wound is open and VAC dressing was placed to help facilitate
closure. Your vital signs have been stable and you are
preparing for discharge with the following instructions:
ACTIVITY:
Do not drive until you have stopped taking pain medicine and
feel you could respond in an emergency.
You may climb stairs.
You may go outside, but avoid traveling long distances until you
see your surgeon at your next visit.
Don't lift more than ___ lbs for 6 weeks. (This is about the
weight of a briefcase or a bag of groceries.) This applies to
lifting children, but they may sit on your lap.)
You may start some light exercise when you feel comfortable.
You will need to stay out of bathtubs or swimming pools for a
time while your incision is healing. Ask your doctor when you
can resume tub baths or swimming.
Heavy exercise may be started after 6 weeks, but use common
sense and go slowly at first.
You may resume sexual activity unless your doctor has told you
otherwise.
HOW YOU MAY FEEL:
You may feel weak or "washed out" for 6 weeks. You might want to
nap often. Simple tasks may exhaust you.
You may have a sore throat because of a tube that was in your
throat during surgery.
You might have trouble concentrating or difficulty sleeping. You
might feel somewhat depressed.
You could have a poor appetite for a while. Food may seem
unappealing.
All of these feelings and reactions are normal and should go
away in a short time. If they do not, tell your surgeon.
YOUR INCISION:
Your incision may be slightly red aroudn the stitches or
staples. This is normal.
You may gently wash away dried material around your incision.
Do not remove steri-strips for 2 weeks. (These are the thin
paper strips that might be on your incision.) But if they fall
off before that that's okay).
It is normal to feel a firm ridge along the incision. This will
go away.
Avoid direct sun exposure to the incision area.
Do not use any ointments on the incision unless you were told
otherwise.
You may see a small amount of clear or light red fluid staining
your dressing r clothes. If the staining is severe, please call
your surgeon.
You may shower. As noted above, ask your doctor when you may
resume tub baths or swimming.
Ove the next ___ months, your incision will fade and become
less prominent.
YOUR BOWELS:
Constipation is a common side effect of medicine such as
Percocet or codeine. If needed, you may take a stool softener
(such as Colace, one capsule) or gentle laxative (such as milk
of magnesia, 1 tbs) twice a day. You can get both of these
medicines without a prescription.
If you go 48 hours without a bowel movement, or have pain moving
the bowels, call your surgeon.
After some operations, diarrhea can occur. If you get diarrhea,
don't take anti-diarrhea medicines. Drink plenty of fluitds and
see if it goes away. If it does not go away, or is severe and
you feel ill, please call your surgeon.
PAIN MANAGEMENT:
It is normal to feel some discomfort/pain following abdominal
surgery. This pain is often described as "soreness".
Your pain should get better day by day. If you find the pain is
getting worse instead of better, please contact your surgeon.
You will receive a prescription from your surgeon for pain
medicine to take by mouth. It is important to take this medicine
as directied. Do not take it more frequently than prescribed. Do
not take more medicine at one time than prescribed.
Your pain medicine will work better if you take it before your
pain gets too severe.
Talk with your surgeon about how long you will need to take
prescription pain medicine. Please don't take any other pain
medicine, including non-prescription pain medicine, unless your
surgeon has said its okay.
IF you are experiencing no pain, it is okay to skip a dose of
pain medicine.
Remember to use your "cough pillow" for splinting when you cough
or when you are doing your deep breathing exercises.
If you experience any of the folloiwng, please contact your
surgeon:
- sharp pain or any severe pain that lasts several hours
- pain that is getting worse over time
- pain accompanied by fever of more than 101
- a drastic change in nature or quality of your pain
MEDICATIONS:
Take all the medicines you were on before the operation just as
you did before, unless you have been told differently.
In some cases you will have a prescription for antibiotics or
other medication.
If you have any questions about what medicine to take or not to
take, please call your surgeon.
DANGER SIGNS:
Please call your surgeon if you develop:
- worsening abdominal pain
- sharp or severe pain that lasts several hours
- temperature of 101 degrees or higher
- severe diarrhea
- vomiting
- redness around the incision that is spreading
- increased swelling around the incision
- excessive bruising around the incision
- cloudy fluid coming from the wound
- bright red blood or foul smelling discharge coming from the
wound
- an increase in drainage from the wound</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ciprofloxacin HCl 500 mg PO Q12H Duration: 4 Days
stop ___
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth twice a day
Disp #*8 Tablet Refills:*0
2. Acetaminophen 325-650 mg PO Q6H:PRN Pain - Mild/Fever
3. amLODIPine 10 mg PO DAILY
4. Apixaban 5 mg PO BID
5. Atorvastatin 40 mg PO QPM
6. Docusate Sodium 100 mg PO BID
7. Furosemide 20 mg PO DAILY
8. HumaLOG KwikPen Insulin (insulin lispro) 100 unit/mL
subcutaneous ___ units with breakfast and dinner
9. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY
10. LaMIVudine 100 mg PO DAILY
11. Levothyroxine Sodium 25 mcg PO DAILY
12. Mycophenolate Mofetil 500 mg PO BID
13. Omeprazole 40 mg PO BID
14. Tacrolimus 1 mg PO Q12H
15. Tresiba FlexTouch U-100 (insulin degludec) 9 U subcutaneous
DINNER
16. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: Hematemesis, abdominal pain, nausea, urinary retention,
type I diabetes, ESRD s/ DDRT ___
Secondary: Atrial fibrillation, cirrhosis, hepatitis B, EtOH
use, HFmrEF, hypercalcemia, hypertension, thrombocytopenia,
hypothyroidism, hyperlipidemia
Discharge Condition:
Mental status: Clear and coherent
Level of consciousness: Alert and interactive
Level of activity: Ambulating independently
Followup Instructions:
___ [/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 nausea and dark vomiting.
What was done for me while I was in the hospital?
- We gave you anti-nausea medication and checked your labs to
make sure you weren't bleeding.
- Your labs were stable, so you did not need to get endoscopy.
- We slowly advanced your diet back to regular.
What should I do when I leave the hospital?
- Go to your follow-up appointments.
- Take all your medications correctly.
- Do not drink alcohol.
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
2. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth Twice daily
Disp #*28 Tablet Refills:*0
3. Lidocaine 5% Patch 1 PTCH TD DAILY Rib pain
RX *lidocaine 5 % Daily Disp #*30 Patch Refills:*0
4. MetroNIDAZOLE 500 mg PO Q8H
RX *metronidazole 500 mg 1 tablet(s) by mouth Every 8 hours Disp
#*42 Tablet Refills:*0
5. Morphine Sulfate (Oral Solution) 2 mg/mL 5 mg PO Q6H:PRN
Pain - Severe
RX *morphine 10 mg/5 mL 2.5 mL by mouth Every six hours
Refills:*0
6. Citalopram 20 mg PO DAILY
7. Naproxen 500 mg PO Q12H
8. Ranitidine 150 mg PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: Metastatic pancreatic adenocarcinoma
Secondary: Cholangitis, intrahepatic biliary duct obstruction,
pulmonary embolism, deep vein thrombosis.
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Lethargic but arousable.
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
Why you were here?
You came in after a fall
What we did while you were here?
We found out that you had pancreatic cancer.
You have an infection in your liver that is related to your
pancreatic cancer. We cannot treat the infection.
We are now focusing in your comfort and will have you go home
with hospice.
What to do when you go home?
If any questions come up please contact the hospice help line.
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. acetaminophen 325 mg Tablet Sig: ___ Tablets PO Q6H (every 6
hours) as needed for pain.
2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
3. senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day.
4. cholecalciferol (vitamin D3) 1,000 unit Tablet Sig: One (1)
Tablet PO DAILY (Daily).
5. carvedilol 6.25 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day).
6. albuterol sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig:
Two (2) Puff Inhalation Q6H (every 6 hours) as needed for
wheezing.
7. furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
8. latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at
bedtime).
9. timolol maleate 0.5 % Drops Sig: One (1) Drop Ophthalmic BID
(2 times a day).
10. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO QOD ().
11. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
12. warfarin 2 mg Tablet Sig: Three (3) Tablet PO Once Daily at
4 ___.
13. cyanocobalamin (vitamin B-12) 100 mcg Tablet Sig: One (1)
Tablet PO DAILY (Daily).
14. isosorbide mononitrate 30 mg Tablet Extended Release 24 hr
Sig: One (1) Tablet Extended Release 24 hr PO once a day.
15. Systane 0.4-0.3 % Dropperette Sig: One (1) Ophthalmic once
a day: as prescribed.
16. Vision Formula ___ unit-unit-mg Tablet Sig: One (1)
Tablet PO once a day.
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis:
Atypical Chest and Abdominal Pain
Secondary Diagnosis:
CKD
CAD
___
PAD
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 at the ___
___. You were admitted for pain in your chest and
abdomen. We perfored blood tests and an EKG that showed there
are no new problems with your heart. We also preformed an
ultrasound of your abdomen that showed no problems with your
liver or pancreas. Given your pain has completely resolved, we
feel you are safe to return home. We will email your
Cardiologist, Dr ___, to let him know you were in the
hosptial. He may want to perform a stress test as an outpatiet.
We made no changes to your medications.
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. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth twice a day
Disp #*3 Tablet Refills:*0
2. Mycophenolate Sodium ___ 360 mg PO BID
RX *mycophenolate sodium [Myfortic] 360 mg 1 tablet(s) by mouth
twice a day Disp #*60 Tablet Refills:*0
3. Vancomycin Oral Liquid ___ mg PO Q6H
RX *vancomycin 125 mg 1 capsule(s) by mouth four times a day
Disp #*64 Capsule Refills:*0
4. Tacrolimus 1 mg PO Q12H
RX *tacrolimus 1 mg 1 capsule(s) by mouth twice a day Disp #*60
Capsule Refills:*0
5. Acetaminophen 1000 mg PO BID:PRN Pain - Mild
6. Albuterol Inhaler ___ PUFF IH Q6H:PRN allergy symptoms
7. Aspirin 81 mg PO DAILY
8. Atovaquone Suspension 1500 mg PO DAILY
9. Calcium Carbonate 500 mg PO DAILY
10. FoLIC Acid 5 mg PO DAILY
11. LevETIRAcetam 500 mg PO BID
12. Metoprolol Succinate XL 25 mg PO DAILY
13. Multivitamins 1 TAB PO DAILY
14. PredniSONE 5 mg PO DAILY
15. Rosuvastatin Calcium 10 mg PO QPM
16. Thiamine 100 mg PO DAILY
17. Vitamin D ___ UNIT PO DAILY
18. Zinc Sulfate 220 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY: UTI, C. difficile colitis, syncope
SECONDARY: diabetic nephropathy complicated by ESRD status post
renal transplant
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>HOSPITAL SUMMARY
You were admitted to the hospital after having watery diarrhea
and 3 episodes of passing out at home. We diagnosed you with a
urinary tract infection for which we are giving you
ciprofloxacin, an antibiotic. We also found that you had an
infection of your colon caused by the bacteria, Clostridium
difficile, for which we are giving you a different antibiotic,
vancomycin. We believe the reason for your passing out is due
to dehydration from your diarrhea.
WHAT TO DO AT HOME
1. You will need to take ciprofloxacin until ___ or when
you run out of your prescription.
2. You will need to take vancomycin while you are taking
ciprofloxacin and continue for 2 weeks after you finish
ciprofloxacin. Therefore you will take vancomycin every 6 hours
until ___.
3. Please weigh yourself every morning after you wake up and go
to the bathroom but before you get dressed. If your weight goes
up by more than 3 pounds in 1 day or 5 pounds in 2 days, please
call your doctor and let them know.
4. Please note that there was a change in your regular
medications. In particular the brand of your mycophenolate was
changed. We changed it from CellCept to Myfortic. We have sent
the new prescriptions to your pharmacy so that you will receive
the right medication.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Famotidine 20 mg PO DAILY
2. Gabapentin 300 mg PO HS
3. Methadone 20 mg PO DAILY
RX *methadone 10 mg 2 by mouth once a day Disp #*60 Tablet
Refills:*0
4. OLANZapine 5 mg PO DAILY
5. Paroxetine 30 mg PO DAILY
6. TraZODone 100 mg PO HS
7. Acetaminophen 1000 mg PO Q6H
8. Heparin 5000 UNIT SC TID
9. HYDROmorphone (Dilaudid) ___ mg PO Q3H:PRN pain
RX *hydromorphone 2 mg ___ tablet(s) by mouth every three hours
Disp #*60 Tablet Refills:*0
10. Lidocaine 5% Patch 1 PTCH TD DAILY
11. Nicotine Patch 7 mg TD DAILY
12. Lorazepam 1 mg PO Q6H:PRN anxiety
13. Methocarbamol 750 mg PO QID muscle cramps
RX *methocarbamol 750 mg 1 tablet(s) by mouth four times a day
Disp #*60 Tablet Refills:*0
14. Vancomycin 1250 mg IV Q 8H
15. Senna 8.6 mg PO BID
16. Sodium Chloride 0.9% Flush ___ mL IV DAILY and PRN, line
flush
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Right sternoclavicular osteomylitis
Opiate withdrawal
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 an infection in your
right sternoclavicular joint which required debridement and
subsequent dressing changes. You will eventually need the
Plastic surgeons to close the area but in the mean time you will
need IV antibiotics and VAC dressing changes.
* A PICC line was placed for antibiotics and the Infectious
Disease service will determine the course but it's likely ___
weeks. You will need to be hospitalized during that time.
* Continue to eat well and stay well hydrated to help with
healing.
* Get out of bed and walk frequently
* The narcotic medications can cause constipation so make sure
that you take a stool softener or laxative to stay regular.
* You will need to be followed closely by the Plastic Surgery
service and Dr. ___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler ___ PUFF IH Q4H:PRN sob
2. ALPRAZolam 0.25 mg PO QHS:PRN anxiety
3. azelastine 137 mcg nasal BID
4. Fluoxetine 20 mg PO QAM
5. Fluticasone Propionate 110mcg 2 PUFF IH BID
6. Fluticasone Propionate NASAL 2 SPRY NU DAILY
7. Hydrochlorothiazide 12.5 mg PO DAILY
8. Lidocaine 5% Patch 1 PTCH TD QAM
9. Memantine 10 mg PO BID
10. Multivitamins 1 TAB PO DAILY
11. Myrbetriq (mirabegron) 25 mg oral QAM
12. TraMADOL (Ultram) 25 mg PO QHS:PRN pain
13. Vitamin D 1000 UNIT PO DAILY
14. Acetaminophen 1000 mg PO Q8H
15. Aluminum-Magnesium Hydrox.-Simethicone ___ ml PO Q6H:PRN
Dyspepsia
16. Docusate Sodium 100 mg PO BID
17. Enoxaparin Sodium 40 mg SC QPM
Start: Today - ___, First Dose: Next Routine Administration
Time
18. Omeprazole 20 mg PO DAILY
19. Senna 8.6 mg PO BID
20. Estradiol 0.5 mg PO 3X/WEEK (___)
Discharge Disposition:
Extended Care
Facility:
___
for Rehabilitation and Sub-Acute Care)
Discharge Diagnosis:
Left femoral neck fracture
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>Instructions After Orthopedic 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.
Medicines
- Resume taking your home medications unless specifically
instructed to stop by your surgeon. Please talk to your primary
care doctor within the next ___ weeks regarding this
hospitalization and any changes to your home medications that
may be necessary.
- Do not drink alcohol, drive, or operate machinery while you
are taking narcotic pain relievers (oxycodone/dilaudid).
- As your pain lessens, decrease the amount of narcotic pain
relievers you are taking. Instead, take acetaminophen (also
called tylenol). Follow all instructions on the medication
bottle and never take more than 4,000mg of tylenol in a single
day.
- If you need medication refills, call your surgeon's office
3-to-4 days before you need the refill. Your prescriptions will
be mailed to your home.
- Please take lovenox for 2 weeks to help prevent the formation
of blood clots.
Constipation
- Both surgery and narcotic pain relievers can cause
constipation. Please follow the advice below to help prevent
constipation.
- Drink 8 glasses of water and/or other fluids like juice, tea,
and broth to stay well hydrated.
- Eat foods that are high in fiber like fruits and vegetables.
- Please take a stool softener like docusate (also called
colace) to help prevent constipation while you are taking
narcotic pain relievers.
- You may also take a laxative such as senna (also called
Senokot) to help promote regular bowel movements.
- You can buy senna or colace over the counter. Stop taking them
if your bowel movements become loose. If your bowel movements
continue to stay loose after stopping these medications, please
call your doctor.
Incision
- Please return to the emergency department or notify your
surgeon if you experience severe pain, increased swelling,
decreased sensation, difficulty with movement, redness or
drainage at the incision site.
- You can get the wound wet/take a shower starting 3 days after
surgery. Let water run over the incision and do not vigorously
scrub the surgical site. Pat the area dry after showering.
- No baths or swimming for at least 4 weeks after surgery.
- Your staples/sutures will be taken out at your 2-week follow
up appointment. No dressing is needed if your wound is
non-draining.
- You may put an ice pack on your surgical site, but do not put
the ice pack directly on your skin (place a towel between your
skin and the ice pack), and do not leave it in place for more
than 20 minutes at a time.
Activity
- Your weight-bearing restrictions are: weight bearing as
tolerated at all times in both legs
Physical Therapy:
WBAT in BLE. ROMAT. No hip precautions.
Treatments Frequency:
Daily dry sterile dressing to left hip wound site</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 5 mg PO DAILY
This was sent to ___ and you can
pick it up here
2. Cefpodoxime Proxetil 400 mg PO Q12H Duration: 14 Days
3. Posaconazole Delayed Release Tablet 300 mg PO DAILY
4. Acyclovir 400 mg PO Q8H
5. Docusate Sodium 100 mg PO BID constipation
6. MetFORMIN (Glucophage) 1000 mg PO BID
7. Omeprazole 40 mg PO DAILY
8. Ranitidine 300 mg PO BID
9. Senna 8.6 mg PO BID:PRN constipation
10. HELD- Enoxaparin Sodium 70 mg SC Q12H This medication was
held. Do not restart Enoxaparin Sodium until Dr. ___ you
to restart
Discharge Disposition:
Home
Discharge Diagnosis:
AML
FN
plt transfusion reaction
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 due to fever after receiving a platelet
transfusion. You had persistent fevers therefore and was found
to have a pneumonia (lung infection) and a stomach infection.
You were placed on IV antibiotics and when your counts improved
your symptoms improved as well.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Guaifenesin-Dextromethorphan ___ mL PO Q6H:PRN cough
RX *dextromethorphan-guaifenesin 100 mg-10 mg/5 mL ___ mL by
mouth four times a day Refills:*0
2. amLODIPine 2.5 mg PO DAILY
3. Calcium 500 + D (calcium carbonate-vitamin D3) 500
mg(1,250mg) -200 unit oral DAILY
4. Fluticasone Propionate NASAL 2 SPRY NU BID
5. Gabapentin 200 mg PO TID
6. Magnesium Oxide 250 mg PO DAILY
7. Metoprolol Succinate XL 50 mg PO DAILY
8. Vitamin D 1000 UNIT PO DAILY
9. HELD- Furosemide 10 mg PO EVERY OTHER DAY This medication
was held. Do not restart Furosemide until you speak to your
primary care doctor
10. HELD- Potassium Chloride 60 mEq PO DAILY This medication
was held. Do not restart Potassium Chloride until you speak to
your primary care doctor
11.Outpatient Lab Work
Please check chem 7 panel (Na, K, Cl, HCO3, BUN, Cr, glucose)
Results should be faxed to attn: Dr. ___ ___
ICD ___.1
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Hyponatremia
Cough
Viral bronchitis
Hypertensive urgency
Secondary:
Chronic pain
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 came in with low sodium levels. We think this was due to
drinking too much water at home. When you go home you should
make sure not to drink more than 1.5L of fluid a day. You should
also make sure to eat enough salt. Ensure supplements can also
help increase sodium levels.
You also had a cough, which is most likely due to bronchitis.
You can continue taking cough medication as needed.
It will be very important to have your sodium levels checked on
___. We are sending you a prescription that you can
take to the lab.
It was a pleasure taking care of you, and we are happy that
you're feeling better!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amlodipine 5 mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Multivitamins 1 TAB PO DAILY
4. Oxybutynin 5 mg PO DAILY
5. Simvastatin 10 mg PO DAILY
6. Spironolactone 50 mg PO DAILY
7. Levofloxacin 750 mg PO DAILY Duration: 2 Days
RX *levofloxacin 750 mg 1 Tablet(s) by mouth once a day Disp #*2
Tablet Refills:*0
8. PredniSONE 40 mg PO DAILY Duration: 2 Days
RX *prednisone 20 mg 2 Tablet(s) by mouth once a day Disp #*4
Tablet Refills:*0
9. Albuterol Inhaler 2 PUFF IH Q4-6H PRN sob, wheezing
10. Magnesium Oxide 280 mg PO DAILY
11. Tiotropium Bromide 1 CAP IH DAILY
12. Vitamin D 0 UNIT PO DAILY
13. Pyridoxine 1 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: COPD exacerbation
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 hospitalized because of your shortness of breath and
were found to have a flair of your COPD, perhaps set off by a
beginning pneumonia. You received antibiotics, breathing
treatment, oral steroids. Your breathing improved. You were
weaned off of the supplementary oxygen and your oxygenation when
walking improved.
New Medications:
Please take levoquin 750mg Daily for 2 more days
Please take prednisone 40mg Daily for 2 more days
Please take all of your prescribed medications as they are
prescribed to you (i.e spiriva every day not just when you have
trouble breathing) to help prevent further COPD flairs.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atazanavir 400 mg PO HS
2. Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY
3. Omeprazole 20 mg PO DAILY
4. Ondansetron 8 mg PO Q8H:PRN nausea
5. Raltegravir 400 mg PO BID
6. Sulfameth/Trimethoprim DS 1 TAB PO DAILY
7. Temazepam 15 mg PO HS:PRN insomnia
8. Warfarin 2.5 mg PO 4X/WEEK (___)
9. Acyclovir 800 mg PO Q12H
10. Warfarin 5 mg PO 3X/WEEK (___)
11. HumaLOG *NF* (insulin lispro) 100 unit/mL Subcutaneous QACHS
12. insulin glargine *NF* 100 unit/mL Subcutaneous qHS
13. Nadolol 40 mg PO DAILY
14. OxycoDONE (Immediate Release) 5 mg PO Q8H:PRN pain
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: Abdominal Pain, Hyperkalemia, Acute Kidney Injury
Secondary: Hepatitis C, HIV, Cirrhosis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you at ___
___. You were admitted due to abdominal pain and very
high potassium. Your pain is most likely due to stretching of
your belly from the fluid you had accumulated. Your potassium
was high, probably due to an interaction between potassium
supplements and a high potassium diet with spironolactone. It is
very important you do not take potassium supplements, and to
avoid foods that are high in potassium (or at least use caution)
while you are on this medication.
Please STOP your furosemide and spironolactone until you see Dr.
___ on ___, and please have your labs checked then.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. butalbital-acetaminophen-caff 50-300-40 mg oral DAILY:PRN
headache
2. Cyanocobalamin 1000 mcg PO DAILY
3. Escitalopram Oxalate 20 mg PO DAILY
4. Famotidine 20 mg PO BID
5. LamoTRIgine 25 mg PO BID
6. Simvastatin 40 mg PO QPM
7. HELD- ClonazePAM 1 mg PO BID This medication was held. Do
not restart ClonazePAM until your doctor checks your blood
pressure and determines it is safe
8. HELD- Prazosin 4 mg PO QHS This medication was held. Do not
restart Prazosin until your doctor checks your blood pressure
and determines it is safe
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis
====================
Orthostatic hypotension
Syncope
Secondary diagnoses
=======================
Neurofibromatosis type 1
Anxiety
Psychogenic nonepileptiform seizures
GERD
HLD
HTN
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You came to ___ because your blood pressure was very low and
you were feeling lightheaded. Please see more details listed
below about what happened while you were in the hospital and
your instructions for what to do after leaving the hospital.
It was a pleasure participating in your care. We wish you the
best!
Sincerely,
Your ___ Care Team
===================================
WHAT HAPPENED AT THE HOSPITAL?
===================================
-We STOPPED your blood pressure medication called lisinopril.
-We monitored your blood pressure and it was normal.
-You had blood work done which was all normal.
-You had some tests done, including blood work and an
electrocardiogram, that showed that you did not have a heart
attack.
==================================================
WHAT NEEDS TO HAPPEN WHEN YOU LEAVE THE HOSPITAL?
==================================================
-Do not restart your lisinopril until your primary care doctor
says you should restart it.
-Do not drive or take a bath when you are home alone because of
your pseudoseizures
-Follow up with your PCP within ONE WEEK to check on your blood
pressure</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcitriol 0.25 mcg PO DAILY
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. Febuxostat 40 mg PO DAILY
4. Levothyroxine Sodium 75 mcg PO DAILY
5. Nadolol 20 mg PO DAILY
6. Omeprazole 40 mg PO DAILY
7. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 Tablet(s) by mouth q 4 hours Disp #*30
Tablet Refills:*0
8. Vitamin D 400 UNIT PO DAILY
9. Epoetin Alfa 8000 UNIT SC QMOWEFR
20,000 units weekly
10. Gabapentin 300 mg PO HS
11. Ferrous Sulfate 325 mg PO TID
Take apart from thyroid medication
12. Magnesium Oxide 400 mg PO ONCE Duration: 1 Doses
13. Klor-Con M20 *NF* (potassium chloride) 20 mEq Oral daily
Discharge Disposition:
Home
Discharge Diagnosis:
Incarcerated umbilical hernia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Please call the Dr. ___ office at ___ for fever,
chills, nausea, vomiting, diarrhea, constipation, increased
abdominal pain, incisional redness, drainage or bleeding,
inability to tolerate food, fluids or medications, yellowing of
skin or eyes, inanbility to pas gas or other concerning
symptoms.
No lifting greater than 10 pounds
No driving if taking narcotic pain medication
Continue all home medications as ordered.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. mycophenolate mofetil 500 mg Tablet Sig: Two (2) Tablet PO
BID (2 times a day).
2. nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO QID
(4 times a day).
3. zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime).
4. baclofen 10 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day)
as needed for spasticity.
5. pramipexole 0.25 mg Tablet Sig: One (1) Tablet PO QHS (once a
day (at bedtime)).
6. sulfamethoxazole-trimethoprim 400-80 mg Tablet Sig: One (1)
Tablet PO DAILY (Daily).
7. valganciclovir 450 mg Tablet Sig: Two (2) Tablet PO DAILY
(Daily).
8. allopurinol ___ mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
9. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
10. atenolol 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
11. metoclopramide 10 mg Tablet Sig: One (1) Tablet PO BID (2
times a day) as needed for nausea.
12. Vitamin D3 1,000 unit Capsule Sig: One (1) Capsule PO DAILY
(Daily).
13. Centrum Silver Tablet Sig: One (1) Tablet PO once a day.
14. cefpodoxime 200 mg Tablet Sig: One (1) Tablet PO twice a day
for 1 weeks: uti.
Disp:*14 Tablet(s)* Refills:*0*
15. tacrolimus 1 mg Capsule Sig: Three (3) Capsule PO Q12H
(every 12 hours).
16. miconazole nitrate 2 % Cream Sig: One (1) Appl Vaginal HS
(at bedtime) for 6 days.
Disp:*1 tube* Refills:*0*
17. Medication changes
Amlodipine decreased to 5mg daily.
Nephro cap changed to Centrum Silver multivitamin.
Cefpodoxime started for 1 week course for UTI
18. Nexium 40 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO once a day.
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
UTI
h/o kidney transplant ___
chest pain likely from gerd
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please call the Transplant Office ___ if you have any
of the following: temperature of 101 or greater, shaking chills,
nausea, vomiting, inability to eat/drink or take any of your
medications, chest pain, urinary frequency, urine cloudy/bloody
or foul smelling, or pain with urination, decreased urine
output, weight gain of 3 pounds in a day</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild/Fever
2. Ciprofloxacin 0.3% Ophth Soln 3 DROP LEFT EAR TID
RX *ciprofloxacin HCl 0.3 % 3 Drops In Left Ear three times a
day Refills:*0
3. Nexplanon (etonogestrel) 68 mg Other Other Birth Control
Discharge Disposition:
Home
Discharge Diagnosis:
Left temporal and frontal subarachnoid hemorrhage
Non-displaced fracture of mastoid
Mild Traumatic brain injury
Decreased Hearing Left Side
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to the Acute Care Surgery service on ___
after a fall sustaining a left temporal bone fracture and a
small head bleed. You were seen by the Ear, Nose, and Throat
specialists who evaluated the decreased hearing in your left
ear. You ear exam showed blood and air bubbles behind the ear
drum. Your hearing should gradually improve as this injury
continues to heal. Please continue to put ear drop in as
prescribed to prevent infection. Please call and schedule a
follow up appointment to have your ear and your hearing
re-tested in 3 weeks. You were seen by the neurosurgery service
for the head bleed and you should continue to follow the
"traumatic brain injury" instructions. Please call and schedule
an appointment in the concussion clinic in 4 weeks if you
continue to have post-concussive symptoms.
You are now ready to be discharged to home with the following
discharge instructions.
**IF YOU DEVELOP FACIAL NERVE WEAKNESS YOU NEED TO RETURN TO THE
EMERGENCY DEPARTMENT IMMEDIATELY FOR EVALUATION.**
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.
Sincerely,
Your ___ 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
RX *atovaquone 750 mg/5 mL 10 mL by mouth daily Refills:*0
2. PredniSONE 130 mg PO DAILY Duration: 3 Doses
Start: Tomorrow - ___, First Dose: First Routine
Administration Time
This is dose # 1 of 7 tapered doses
3. PredniSONE 110 mg PO DAILY Duration: 3 Doses
Start: After 130 mg DAILY tapered dose
This is dose # 2 of 7 tapered doses
4. PredniSONE 90 mg PO DAILY Duration: 3 Doses
Start: After 110 mg DAILY tapered dose
This is dose # 3 of 7 tapered doses
5. PredniSONE 70 mg PO DAILY Duration: 3 Doses
Start: After 90 mg DAILY tapered dose
This is dose # 4 of 7 tapered doses
6. PredniSONE 50 mg PO DAILY Duration: 3 Doses
Start: After 70 mg DAILY tapered dose
This is dose # 5 of 7 tapered doses
7. PredniSONE 30 mg PO DAILY Duration: 3 Doses
Start: After 50 mg DAILY tapered dose
This is dose # 6 of 7 tapered doses
8. PredniSONE 10 mg PO DAILY Duration: 3 Doses
Start: After 30 mg DAILY tapered dose
This is dose # 7 of 7 tapered doses
9. Ramelteon 8 mg PO QHS insomnia
Should be given 30 minutes before bedtime
RX *ramelteon [Rozerem] 8 mg 1 tablet(s) by mouth at bedtime
Disp #*30 Tablet Refills:*0
10. TraZODone 150 mg PO QHS
11. Acetylcysteine 20% ___ mL NEB BID:PRN congestion
12. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN shortness of
breath
13. Cetirizine 10 mg PO QID
14. ClonazePAM 0.5 mg PO BID:PRN anxiety
15. Clotrimazole Cream 1 Appl TP BID groin and abdomen skin
fold
16. DiphenhydrAMINE 50 mg IV Q6H:PRN allergic reaction
17. EPINEPHrine (EpiPEN) 0.3 mg IM ONCE MR1 allergic reaction
18. Famotidine 20 mg PO BID
19. GuaiFENesin ER 1200 mg PO Q12H
20. Levothyroxine Sodium 100 mcg PO DAILY
21. Omeprazole 40 mg PO BID
22. Otezla Starter (apremilast) 10 mg (4)-20 mg (4)-30 mg (47)
oral BID
23. OxyCODONE (Immediate Release) 10 mg PO Q4H:PRN Pain -
Moderate
24. Ranitidine 150 mg PO BID
25. Sodium Chloride 3% Inhalation Soln 15 mL NEB BID tracheal
stenosis
26. Triamcinolone Acetonide 0.1% Ointment 1 Appl TP BID
27. Vitamin D ___ UNIT PO 2X/WEEK (MO,FR)
28. HELD- Enoxaparin Sodium 150 mg SC Q12H This medication was
held. Do not restart Enoxaparin Sodium until ___ AM per
Interventional Pulmonology
29. HELD- varenicline 1 mg oral DAILY This medication was held.
Do not restart varenicline until discussing with PCP
___:
Home with Service
Discharge Diagnosis:
Primary:
Psoriasis flare
Secondary:
Community associated pneumonia
Tracheobronchomalacia
Recurrent idiopathic angioedema
___ Syndrome
Mast Cell Activation Syndrome
Insomnia
Adrenal insufficiency
Anxiety
Borderline PD
Chronic Pain
History of Pulmonary Embolism
GERD
Hypothyroidism
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 for a rash and facial
swelling. Your rash ultimately was felt to be most likely due to
partially treated psoriasis (however could not rule out drug
reaction) - the pathology did not show evidence of
life-threatening rashes such as SJS or DRESS. You also had a lot
of facial swelling during your hospitalization, which Allergy
saw you for and recommended continued doses of IV Benadryl and
the rest of your Mast Cell Activation Syndrome medications.
Finally, you developed neck pain and a bit of discharge from
your T-tube, which IP did a bronchoscopy for on ___.
Ultimately, you were stable for discharge.
What to do at home:
-Take all of your medications as prescribed below
-Go to all of your appointments as scheduled below
We wish you the best,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Metoprolol Succinate XL 12.5 mg PO BID
RX *metoprolol succinate 25 mg 0.5 (One half) tablet(s) by mouth
twice a day Disp #*30 Tablet Refills:*2
2. Spironolactone 25 mg PO DAILY
RX *spironolactone 25 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*2
3. Atorvastatin 80 mg PO QPM
RX *atorvastatin 80 mg 1 tablet(s) by mouth qPM Disp #*30 Tablet
Refills:*2
4. Aspirin 81 mg PO DAILY
5. bicalutamide 50 mg oral DAILY
6. Digoxin 0.25 mg PO DAILY
7. GlipiZIDE XL 5 mg PO DAILY
8. Haloperidol 2 mg PO QHS
9. Lisinopril 10 mg PO DAILY
10. MetFORMIN (Glucophage) 1000 mg PO BID
11. Rivaroxaban 20 mg PO DAILY
12. Torsemide 20 mg PO DAILY
13.Outpatient Lab Work
ICD10: I50
Heart failure
Please obtain Chem10 by ___
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS
Atrial fibrillation
Heart failure with reduced ejection fraction
SECONDARY DIAGNOSIS
Coronary artery disease
Venous stasis dermatitis
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 be part of your care at ___.
You were admitted to the hospital because you were concerned
that your left leg appeared more swollen than usual.
You received imaging of your lungs which showed that you might
have accumulated some fluid in your lungs. The fluid in your
legs and lungs is likely accumulating because of your heart
failure, which could have been worsened by the fact that your
heart doesn't beat regularly (you have an arrhythmia called
atrial fibrillation).
You received medication to help you remove that extra fluid by
urinating. You also were changed to a new medication to help
treat your heart arrhythmia. Your home statin medication was
increased.
If you experience any increased leg swelling, difficulty
breathing or chest pain please contact your doctor. Please weigh
yourself everyday, and if your weight increases by 3lb in one
day, please call your primary care physician.
MEDICATIONS TO TAKE:
Aspirin 81mg daily
Atorvastatin 80 mg daily (increased from 40mg daily)
Digoxin 0.25mg daily
Glipizide 5 mg daily
Haloperidol 2 mg every night
Metformin 1000 twice daily
Rivaroxaban 20mg daily
Torsemide 20 mg daily
Bicalutamide 50 mg oral DAILY
NEW MEDICATIONS TO TAKE:
Spironolactone 25mg daily
Metoprolol Succinate 12.5 twice a day
Lisinopril 10 mg daily
It was a pleasure to be part of your care,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Rosuvastatin Calcium 40 mg PO DAILY
2. Nephrocaps 1 CAP PO DAILY
3. sevelamer CARBONATE 2400 mg PO TID W/MEALS
4. Ezetimibe 10 mg PO DAILY
5. Aspirin 325 mg PO DAILY
6. Ferrous GLUCONATE 324 mg PO DAILY
7. Gabapentin 100 mg PO BID
8. Lorazepam 1 mg PO DAILY:PRN anxiety
9. Nystatin Cream 1 Appl TP BID
10. Omeprazole 40 mg PO DAILY
11. Metoclopramide 5 mg PO QIDACHS
12. Midodrine 10 mg PO BID
13. Sertraline 100 mg PO DAILY
14. HYDROmorphone (Dilaudid) ___ mg PO Q4H:PRN pain
RX *hydromorphone [Dilaudid] 2 mg ___ tablet(s) by mouth Q4HRS
Disp #*80 Tablet Refills:*0
15. Warfarin 2 mg PO DAILY16
Please start this dose on ___. Follow INR closely while on
coumadin and adjust dose as needed
RX *warfarin [Coumadin] 2 mg 1 tablet(s) by mouth Daily Disp
#*20 Tablet Refills:*0
16. Senna 1 TAB PO BID:PRN constipation
17. Docusate Sodium 100 mg PO BID
18. Glargine 12 Units Breakfast
Glargine 36 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
19. Glucose Gel 15 g PO PRN hypoglycemia protocol
20. Glucagon 1 mg IM Q15MIN:PRN hypoglycemia protocol
Discharge Disposition:
Home
Discharge Diagnosis:
Right hand ischemia
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 to the vascular surgery service with right
hand pain and color changes in your fingers concerning for
ischemia. A CT angiogram showed extensive atherosclerotic
calcifications in your hand distal to the wrist. You were
anticoagulated with a heparin drip, and transitioned to oral
coumadin (warfarin) to take as an outpatient. Your INR
(coumadin level) is now therapeutic, between 2.0-3.0 and you are
ready to return home. You will be on coumadin for the next
three months to treat a likely arterial embolic event. You
should follow your INR very closely with your primary doctor,
and adjust the coumadin dose as needed. Coumadin puts you at an
increased risk of bleeding, so please be vigilant in monitoring
these INR leves as well as any signs/symptoms of bleeding.
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. Adderall (dextroamphetamine-amphetamine) 20 mg oral qAM
2. Adderall (dextroamphetamine-amphetamine) 10 mg ORAL DAILY
3. Aspirin 325 mg PO DAILY
4. ClonazePAM 1 mg PO QID
5. fenofibrate 200 mg oral qd
6. Glargine 50 Units Breakfast
Glargine 50 Units Bedtime
Humalog 5 Units Breakfast
Humalog 5 Units Lunch
Humalog 5 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
7. Metoprolol Succinate XL 100 mg PO DAILY
8. Midodrine 5 mg PO QAM
9. Oxycodone-Acetaminophen (5mg-325mg) 2 TAB PO BID pain
10. Bisacodyl ___AILY:PRN constipation
RX *bisacodyl 10 mg 1 suppository(s) rectally daily Disp #*30
Suppository Refills:*0
11. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice daily
Disp #*60 Capsule Refills:*0
12. Polyethylene Glycol 17 g PO DAILY
RX *polyethylene glycol 3350 17 gram 1 powder(s) by mouth daily
Disp #*30 Packet Refills:*0
13. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 1 tablet by mouth twice daily Disp
#*60 Capsule Refills:*0
14. Gabapentin 600 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
Ileus
Pancreatic pseudocyst
Bacteremia, likely contaminant
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You presented with abdominal pain, nausea, and vomiting. There
was no evidence of pancreatitis on your lab work. Your symptoms
improved with a bowel regimen and subsequent passage of stool.
.
Of note, one of you blood cultures grew out a bacteria; however,
this was felt to be unlikely to represent a true infection.
Additional blood cultures are still pending. If you note any
fevers or chills, you should return to ___ ER or seek
immediate medical attention, as this may represent true
bacterial infection in the bloodstream.
.
On the day of discharge, we recommended that you continue to
stay in the hospital to optimize your pain control and bowel
regimen based on your subjective complaints. However, you
refused to stay and wanted to leave against medical advice, and
you acknowledge and accepted the risks of such a discharge.
.
Please see your physicians as listed below.
.
Please take your medications as listed.
.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcium Carbonate 500 mg PO TID
2. Docusate Sodium 100 mg PO BID
3. Heparin 5000 UNIT SC TID Duration: 2 Weeks
4. Multivitamins 1 TAB PO DAILY
5. Nicotine Patch 14 mg TD DAILY
6. Ondansetron 4 mg PO Q8H:PRN nausea
7. Senna 8.6 mg PO BID
8. Vitamin D 400 UNIT PO DAILY
9. ALPRAZolam 0.5 mg PO QID
10. DULoxetine 20 mg PO DAILY
11. Metoprolol Succinate XL 50 mg PO BID
12. OxyCODONE (Immediate Release) 5 mg PO 3 OR 4 TIMES A DAY
RX *oxycodone 5 mg 1 capsule(s) by mouth ___ capsule q 4 hour
Disp #*80 Capsule Refills:*0
***DO NOT TAKE OXYCODONE PRESCRIBED IN ADDITION TO YOUR HOME
DOSE (take no more than ___ mg or ___ capsules every 4
hours)***
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
Right hip fracture, now status post surgical fixation (TFN)
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
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 heparin 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
Physical Therapy:
WBAT RLE
Treatment Frequency:
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 change dressing on ___
Can replace with DSG (preferably waterproof - gauze and
tegederm) and may change daily. If no drainage after post-op
day 7, may leave open to air</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H
2. Ibuprofen 400 mg PO Q8H:PRN Pain - Mild
Reason for PRN duplicate override: Alternating agents for
similar severity
3. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN Pain -
Moderate
RX *oxycodone 5 mg 1 tablet(s) by mouth PRN Disp #*15 Tablet
Refills:*0
Discharge Disposition:
Home with Service
Discharge Diagnosis:
Restrained passenger in ___
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>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. lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6
hours) as needed for anxiety/sleep.
2. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
3. diazepam 5 mg Tablet Sig: 0.5 Tablet PO QHS (once a day (at
bedtime)).
4. atenolol 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
5. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2)
Capsule, Delayed Release(E.C.) PO BID (2 times a day).
6. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
7. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
Discharge Disposition:
Home
Discharge Diagnosis:
Coronary Artery Disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Ms. ___, you were admitted to our service because you had
worsening chest pains and shortness of breath. We received a
report that stated that your stress test results were
concerning. While with us, we performed a cardiac
catheterization that showed some occlusions in your vessels, but
none that warranted intervention. We decided that medical
management would be most appropriate for your care. We are
sending you home in stable condition.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcium Carbonate 500 mg PO DAILY
2. Cholestyramine 4 gm PO BID
3. Duloxetine 60 mg PO DAILY
4. Fluticasone Propionate NASAL 2 SPRY NU DAILY
5. FoLIC Acid 1 mg PO DAILY
6. Lisinopril 5 mg PO DAILY
7. Nicotine Patch 14 mg TD DAILY
8. Pantoprazole 40 mg PO Q24H
9. PredniSONE 20 mg PO DAILY
___: 20mg daily
___ 15mg daily
___ 10mg daily
___ 5mg daily
10. RISperidone 2 mg PO HS insomnia
11. Sulfameth/Trimethoprim DS 1 TAB PO 3X/WEEK (___)
12. Tiotropium Bromide 1 CAP IH DAILY
13. Torsemide 80 mg PO BID
14. Vitamin D 1000 UNIT PO DAILY
15. Enoxaparin Sodium 150 mg SC Q12H
Start: Today - ___, First Dose: Next Routine Administration
Time
To use as bridge with coumadin until INR ___ for 24 hours.
16. Warfarin 5 mg PO DAILY16
please use lovenox as bridge until INR ___ for 24 hours
17. Albuterol 0.083% Neb Soln 1 NEB IH Q2H:PRN wheezin,
shortness of breath
18. Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB, wheeze
19. budesonide-formoterol 160-4.5 mcg/actuation INHALATION BID
20. Cyanocobalamin 1000 mcg IM/SC EVERY 3 MONTHS
21. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO Q4H:PRN pain
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Final diagnosis: Chrons flare
Secondary Diagnosis:
COPD
Chrons disease
heart failure, chronic
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 the hospital after you were having
increased diarrhea and abdominal pain at home. We were
concerned about a Chrons flare and treated you with steroids.
Your pain and frequency of bowel movements seemed to improve.
The sigmoidoscopy did not reveal evidence of inflammation. Your
steroid regimen was adjusted. You should continue taking the
steroids after discharge and taper by 5mg every 10 days as
directed.
Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
It was a pleasure taking care of you and getting to know you
while you were in the hospital. Wishing you a complete
recovery!
-Your ___ care team-</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Metoprolol Tartrate 12.5 mg PO DAILY
RX *metoprolol tartrate 25 mg 0.5 (One half) tablet(s) by mouth
once daily Disp #*30 Tablet Refills:*0
2. albuterol sulfate 90 mcg/actuation inhalation Q6H:PRN
3. Aspirin 81 mg PO DAILY
4. Atorvastatin 40 mg PO QPM
5. Benzonatate 100 mg PO TID:PRN cough
6. FoLIC Acid 1 mg PO DAILY
7. Hydroxychloroquine Sulfate 400 mg PO BID
8. Levothyroxine Sodium 50 mcg PO DAILY
9. LORazepam 0.5 mg PO Q4H:PRN nausea
10. Morphine SR (MS ___ 15 mg PO Q8H
11. OxyCODONE (Immediate Release) 5 mg PO Q4H:PRN BREAKTHROUGH
PAIN
12. Rivaroxaban 20 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Acute on Chronic HFpEF exacerbation
Loculated Pleural Effusion
AS s/p TAVR, Mitral Stenosis
R-sided ER/PR+ Breast Cancer
VTE
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 this hospital due to concerns for acute on
chronic heart failure exacerbation based on presentation with
complaints of dyspnea and findings on examination consistent
with that of pulmonary edema.
You will be discharged home with a new medication with
metoprolol 12.5 mg once daily.
Please keep all scheduled follow-up appointments as described
below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 500 mg PO Q6H:PRN Pain - Mild
2. Multivitamins 1 TAB PO DAILY
3. Metoprolol Succinate XL 37.5 mg PO DAILY
RX *metoprolol succinate 25 mg 1.5 tablet(s) by mouth Daily Disp
#*45 Tablet Refills:*0
4. Baclofen 5 mg PO QID:PRN hiccups
5. DICYCLOMine 10 mg PO QID:PRN for abdominal pain
6. edoxaban 30 mg oral DAILY
7. Mirtazapine 15 mg PO QHS
8. Polyethylene Glycol 17 g PO DAILY:PRN Constipation - First
Line
9. Senna 8.6 mg PO EVERY OTHER DAY
10. Sulfameth/Trimethoprim DS 1 TAB PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
#Post-renal obstructive uropathy
#Acute kidney injury
#Hydronephrosis s/p bilateral PCN
#Metabolic acidosis
#Atrial fibrillation with rapid ventricular response
#Hypotension
#History of right apical clot
#Anemia
#Rectal cancer
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>You were admitted to the hospital due to obstruction of your
urinary tract, which was causing kidney failure. You had
nephrostomy tubes placed to drain the urine, which helped to
improve your kidney function. You also developed atrial
fibrillation with fast heart rates and low blood pressures,
which improved with changes to your medications, IV fluids, and
improved oral intake.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN pain
2. Aspirin 81 mg PO DAILY
3. ClonazePAM 0.5 mg PO BID
4. Clopidogrel 75 mg PO DAILY
5. Cyclobenzaprine 10 mg PO HS:PRN pain
6. Docusate Sodium 100 mg PO BID
7. Fluticasone Propionate NASAL 2 SPRY NU DAILY
8. Gabapentin 600 mg PO BID
9. Lidocaine 5% Patch 1 PTCH TD QAM
10. Lisinopril 20 mg PO DAILY
11. Loratadine 10 mg PO DAILY
12. Nicotine Polacrilex 2 mg PO Q1H:PRN nicotine cravings
13. Pantoprazole 40 mg PO Q24H
14. Sertraline 100 mg PO DAILY
15. Rosuvastatin Calcium 5 mg PO QPM
16. Ascorbic Acid ___ mg PO BID
17. Ferrous Sulfate 325 mg PO DAILY
18. MetFORMIN XR (Glucophage XR) 750 mg PO DAILY
RX *metformin 750 mg 1 tablet(s) by mouth daily Disp #*14 Tablet
Refills:*0
19. Metoprolol Succinate XL 100 mg PO DAILY
20. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: Heachache
Secondary: Hypertension
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ for a
severe headache. We were concerned for a possible bleed or
infection in your brain, given the severity of your pain. We
performed imaging of your brain and looked at the fluid in your
spinal cord (lumbar puncture). We did not see any evidence for
an infection or bleed in your brain. Please follow up with your
primary care doctor if you experience any more headaches.
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. Acetaminophen 325-650 mg PO Q6H:PRN Pain - Mild
RX *acetaminophen 500 mg 2 tablet(s) by mouth every 8 hours as
needed Disp #*100 Tablet Refills:*1
2. Enoxaparin Sodium 40 mg SC DAILY VTE prophylaxis Duration:
26 Days
Start: Today - ___, First Dose: Next Routine Administration
Time
RX *enoxaparin 40 mg/0.4 mL 1 syringe subc daily Disp #*26
Syringe Refills:*0
3. OxyCODONE (Immediate Release) ___ mg PO Q3H:PRN Pain -
Moderate
Reason for PRN duplicate override: Alternating agents for
similar severity
wean this medication as tolerated
RX *oxycodone 5 mg ___ tablet(s) by mouth every 4 hours as
needed for pain Disp #*80 Tablet Refills:*0
4. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 2 tablets by mouth at bedtime Disp
#*40 Tablet Refills:*0
5. TraZODone 50 mg PO QHS:PRN insomnia
RX *trazodone 50 mg 1 tablet(s) by mouth as needed for insomnia
Disp #*20 Tablet Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
acetablular fracture
Discharge Condition:
Discharge Condiiton:
AVSS
NAD, A&Ox3
Followup Instructions:
___ [/INST] </s><s>INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week.
- Resume your regular activities as tolerated, but please follow
your weight bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
- Touch down weight bearing
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 lovonox 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.
Physical Therapy:
weight bearing as tolerated
Treatments Frequency:
dressing changes PRN</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Escitalopram Oxalate 10 mg PO DAILY
2. Amoxicillin-Clavulanate Susp. 500 mg PO Q8H
RX *amoxicillin-pot clavulanate 250 mg-62.5 mg/5 mL 10 mL by
mouth every 8 hours Refills:*0
3. Ibuprofen 400 mg PO Q8H
4. Maalox/Diphenhydramine/Lidocaine 15 mL PO TID
RX *alum-mag hydroxide-simeth [Maalox Maximum Strength] 400
mg-400 mg-40 mg/5 mL 15 mL by mouth three ___ daily Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Acute pharyngitis with mucositis
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 with severe throat pain and mouth ulcers. Your
antibiotics were changed and you began to improve. Please
complete your antibiotic course and make sure to follow up with
your primary care doctor within one week to ensure you continue
to improve.
You can continue to take ibuprofen (Motrin/Advil) with food and
cough drops to help soothe your throat. Please avoid sharp foods
until your mouth feels better.</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. Alendronate Sodium 35 mg PO QSUN
3. Aspirin 81 mg PO DAILY
4. Clobetasol Propionate 0.05% Cream 1 Appl TP BID
apply to affected area. do not apply to face
5. Desonide 0.05% Cream 1 Appl TP BID
apply to skin folds and groin
6. Felodipine 10 mg PO DAILY
7. Fluocinonide 0.05% Ointment 1 Appl TP BID
apply to rash EXCEPT skin folds and groin
8. Hydrocortisone Cream 2.5% 1 Appl TP BID
apply to affected area folds
9. Losartan Potassium 75 mg PO DAILY
RX *losartan 50 mg 1.5 tablet(s) by mouth daily Disp #*45 Tablet
Refills:*0
10. Lovastatin 20 mg ORAL QHS
11. Ranitidine 150 mg PO BID
12. Vitamin D ___ UNIT PO DAILY
13. PredniSONE 10 mg PO ONCE Duration: 1 Dose
take last dose tomorrow ___
Tapered dose - DOWN
14. Carvedilol 12.5 mg PO BID
RX *carvedilol 12.5 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
15. Docusate Sodium 100 mg PO BID:PRN constipation
RX *docusate sodium 100 mg 1 capsule(s) by mouth BID:PRN Disp
#*60 Capsule Refills:*0
16. Furosemide 10 mg PO DAILY
RX *furosemide 20 mg 0.5 (One half) tablet(s) by mouth daily
Disp #*15 Tablet Refills:*0
17. Amiodarone 200 mg PO DAILY
18. Calcium 600 + D(3) (calcium carbonate-vitamin D3) 600 mg
calcium- 200 unit oral daily
19. camphor-menthol 0.5-0.5 % topical TID:PRN itch
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
primary diagnosis: acute on chronic diastolic congestive heart
failure exacerbation, tricuspid regurgitaton, hypertension
secondary diagnosis: atrial fibrillation
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
It was a pleasure caring for you while you were admitted to the
hospital. You were admitted with shortness of breath and a
congestive heart failure exacerbation. You were treated with
diuretic medications to remove fluids from your body. You
breathing improved. We started you on a new medication called
lasix.
Please take your medications as prescribed and follow up with
your doctors as ___.
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. Acyclovir 400 mg PO Q8H
2. Albuterol Inhaler ___ PUFF IH Q6H:PRN wheezing
3. Caphosol 30 mL ORAL QID
4. FoLIC Acid 1 mg PO DAILY
5. Gabapentin 300 mg PO Q12
6. Ketoconazole Shampoo 1 Appl TP ASDIR
7. Lorazepam 0.5 mg PO Q4H:PRN anxiety
8. Meclizine 12.5 mg PO TID
9. Montelukast Sodium 10 mg PO DAILY
10. Ondansetron 8 mg PO Q6-8HRS PRN nausea
11. Polyethylene Glycol 17 g PO DAILY:PRN constipation
12. Posaconazole Suspension 200 mg PO Q8H
13. PredniSONE 9 mg PO DAILY
9 mg daily until ___ then decrease by 1 mg every ___ until
you reach 5 mg.
14. Senna 2 TAB PO BID:PRN constipation
15. Sodium Fluoride 1.1% (Dental Gel) 1 Appl TP HS
16. Tiotropium Bromide 1 CAP IH DAILY
17. TraZODone ___ mg PO HS:PRN insomnia
18. Triamcinolone Acetonide 0.1% Ointment 1 Appl TP TID:PRN
rash, itching
19. Atovaquone Suspension 1500 mg PO DAILY
20. Ethanol 70% Catheter DWELL (Tunneled Access Line) 2 mL DWELL
DAILY
21. Pantoprazole 40 mg PO Q24H
22. Sodium Chloride 0.9% Flush 10 mL IV DAILY
23. Heparin Flush (10 units/ml) 2 mL IV DAILY and PRN, line
flush
24. Ethanol Lock
25. Curoscaps
26. Ciprofloxacin HCl 500 mg PO Q12H
27. OxycoDONE (Immediate Release) ___ mg PO Q6H:PRN pain
28. Glargine 10 Units Breakfast
NPH 10 Units Breakfast
Insulin SC Sliding Scale using HUM Insulin
29. Amoxicillin ___ mg PO ONCE before dental procedures
Duration: 1 Dose
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
1. AML with preceding polycythemia ___ and secondary
myelofibrosis
2. VRE Bacteremia
3. VRE Aortic Valve Endocarditis
4. Moderate to Severe Aortic Regurgitation
5. Anemia secondary to GI Bleeding
6. Adrenal Insufficiency
7. UTI
SECONDARY DIAGNOSIS:
1. Chronic GVHD with Cutaneous Manifestation
2. Diabetes Mellitus Type 2
3. Pulmonary MALT Lymphoma
4. Vertigo
5. Retinopathy ___ GVHD/AML
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. You came to ___ for
fevers and were found to have a very resistant strain of
bacteria both in the blood and in the urine. We placed you on
antibiotics and treated both infections. We also found that your
infection had involved the aortic valve (one of the heart
valves). As a result, you now have a condition called aortic
regurgitation. You will be followed by cardiology for this. You
received your ___ cycle of decitabine on this admission. This
was complicated by a GI bleed which we treated supportively with
medications and blood products. We attempted to do a bone marrow
biopsy on the day prior to your discharge, but we were
unsuccessful at obtaining an adequate sample. Dr. ___
decide if she would like to try again as an outpatient. At time
of discharge, your counts were low, but stable.
Please do not drive or drink alcohol while taking oxycodone.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Levofloxacin 750 mg PO DAILY Duration: 2 Days
RX *levofloxacin [Levaquin] 750 mg 1 tablet(s) by mouth once a
day Disp #*2 Tablet Refills:*0
2. Glargine 30 Units Bedtime
Humalog 12 Units Breakfast
Humalog 16 Units Lunch
Humalog 18 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
3. Tacrolimus 0.5 mg PO Q12H
RX *tacrolimus [Prograf] 0.5 mg 1 capsule(s) by mouth twice a
day Disp #*28 Capsule Refills:*0
4. Albuterol Inhaler 2 PUFF IH Q4H:PRN wheezing, shortness of
breath
5. amLODIPine 10 mg PO DAILY
6. Bevespi Aerosphere (glycopyrrolate-formoterol) ___ mcg
inhalation BID
7. budesonide-formoterol 80-4.5 mcg/actuation inhalation BID
8. Carvedilol 25 mg PO BID
9. Doxazosin 4 mg PO HS
10. Febuxostat 40 mg PO DAILY
11. Fenofibrate 54 mg PO DAILY
12. Fludrocortisone Acetate 0.1 mg PO DAILY
13. GuaiFENesin ER 600 mg PO Q12H
14. Mycophenolate Mofetil 500 mg PO BID
15. Nasonex (mometasone) 50 mcg/actuation nasal BID
16. Sodium Bicarbonate 1300 mg PO TID
17. Vitamin D ___ UNIT PO DAILY
18. ___- Ferrous Sulfate 325 mg PO DAILY This medication was
___ not restart Ferrous Sulfate until you finish your
antibiotics
19.Outpatient Lab Work
Tacrolimus level
Chem 7
Please fax to ___ ATTN: Dr. ___
___ Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
Acute Kidney Injury in Setting of Chronic Kidney Injury
Community Acquired Pneumonia
SECONDARY DIAGNOSES:
Chronic Cough
COPD
S/p renal and liver transplant on immunosuppression
Diabetes Mellitus Type 2
Hyperkalemia
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 for:
- chronic cough despite multiple rounds of antibiotics
- a rise in your creatinine indicating damage to you kidney,
this was likely caused by your Lasix and medications you took
for gout
While you were in the hospital:
- you were evaluated by the Infectious Disease and Pulmonology
Teams
- the Renal Transplant Team helped monitor your
immunosuppressive medications, your Pograf dose was changed to
0.5mg every twelve hours
- you received IV antibiotics for a lung infection
- you started using acapella flutter valve to help your lung
function
- we gave you IV fluids which helped your kidney function
improve
Now that you are going home:
- Please arrange Pulmonary follow-up (___) with repeat
chest CT in ___ wks (___), if opacities remain would
recommend bronchoscopy
- Your primary care doctor ___ arrange a video speech
and swallow study to ensure you are not swallowing into your
lungs
- Take levofloxacin for two more days
- ___ not take NSAIDS, ibuprofen at any time
- Please ensure tacrolimus level and creatinine checked on
___ at ___, Please fax to ___
ATTN: Dr. ___
- ___ not take Lasix until told to by a doctor
It was a pleasure taking care of you!
Your ___ Inpatient Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amoxicillin 1000 mg PO Q12H Duration: 14 Days
RX *amoxicillin 500 mg 2 (two) tablet(s) by mouth twice a day
Disp #*54 Tablet Refills:*0
2. Clarithromycin 500 mg PO Q12H Duration: 14 Days
RX *clarithromycin 500 mg 1 (one) tablet(s) by mouth twice a day
Disp #*27 Tablet Refills:*0
3. Pantoprazole 40 mg PO Q12H
RX *pantoprazole 40 mg 1 (one) tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
4. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 (one) tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
5. Atorvastatin 20 mg PO QPM
RX *atorvastatin 20 mg 1 (one) tablet(s) by mouth every night
Disp #*30 Tablet Refills:*0
6. amLODIPine 10 mg PO DAILY
7. Carvedilol 6.25 mg PO BID
8. HELD- Chlorthalidone 25 mg PO DAILY This medication was
held. Do not restart Chlorthalidone until ___ unless your blood
pressure is high at home.
9. HELD- Lisinopril 40 mg PO DAILY This medication was held. Do
not restart Lisinopril until ___ unless your blood pressure is
high at home.
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
- Duodenal/peptic ulcer disease
- Type II NSTEMI
- Melena
- Anemia secondary to bleeding
- H. pylori infection
SECONDARY DIAGNOSIS:
-HTN
-HLD
-Carotid Artery Stenosis
-Prostatic Adenocarcinoma s/p brachytherapy
-alcohol use disorder
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 medical intensive care unit at ___
___ for shortness of breath and
chest pain caused by low red blood cell count secondary to
bleeding from a duodenal (intestinal) ulcer.
For your low red blood cell count, you were treated with red
blood cell transfusions. For your ulcer, the gastroenterologist
performed an esophagogastroduodenscopy (EGD) and cauterized and
injected medicine to help constrict the vessel to help prevent
future bleeding. We monitored your hemoglobin levels and they
were stable.
To minimize your risk of developing more ulcers, it is important
for you to stop taking NSAIDs such as ibuprofen and aleve and to
also refrain from alcohol use. These two things can exacerbate
ulcers. Also, you were positive for H. pylori antibody which
indicates an infection of H. pylori in your intestines which
will also be contributing to ulcer formation. For this, you will
be treated with two antibiotics as well as your acid suppressing
medication. One of these medications (clarithromycin) has the
potential to interact with your statin. If you experience any
muscle pains, stop taking your statin and call your PCP right
away.
We are discharging you home. Please follow up with your PCP ___.
___ on ___. At that appointment, she will
work with you to coordinate follow-up imaging for your
pneumonia. In terms of your aortic stenosis, the ___ team
will be coordinating your appointments.
It was a pleasure taking care of you,
Your ___ Healthcare Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Vancomycin Oral Liquid ___ mg PO QID
Please take through ___. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild/Fever
3. Acyclovir 400 mg PO DAILY
4. Aspirin EC 81 mg PO DAILY
5. BusPIRone 5 mg PO BID
6. Finasteride 5 mg PO DAILY
7. Lisinopril 20 mg PO DAILY
8. Venlafaxine XR 150 mg PO DAILY
9. HELD- eluxadoline 100 mg oral BID This medication was held.
Do not restart eluxadoline until you finish antibiotics for your
c difficile infection
10. HELD- LOPERamide 2 mg PO DAILY:PRN diarrhea This medication
was held. Do not restart LOPERamide until you finish antibiotics
for your c difficile infection
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
C difficile colitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to the hospital with confusion and diarrhea
and were found to have an infection in your colon called C
difficile. You were treated with antibiotics and are improving.
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. Amlodipine 5 mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. FoLIC Acid 1 mg PO DAILY
4. Mycophenolate Mofetil 500 mg PO BID
5. Ranitidine 300 mg PO HS
6. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
7. Levemir Flexpen (insulin detemir) 12 units subcutaneous in
the morning, 36 units in the evening
8. NovoLOG FLEXPEN (insulin aspart) ___ SUBCUTANEOUS AS
DIRECTED
9. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chestpain
10. Tacrolimus 3 mg PO Q12H
You will be called at home if there are any further changes to
this medication
11. Furosemide 40 mg PO DAILY
12. Losartan Potassium 25 mg PO DAILY
13. Pravastatin 40 mg PO DAILY
14. Metoprolol Succinate XL 200 mg PO DAILY
15. Warfarin 5 mg PO ONCE Duration: 1 Dose
Dose may change depending on INR results
16. Ketoconazole 2% 1 Appl TP BID:PRN rash
Discharge Disposition:
Home
Discharge Diagnosis:
Primary
1. Acute Disatolic HF in setting of med non-compliance and
dietary indescretion
2. CKD stage ___ s/p renal transplant
3. new onset pAF : started coumadin
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 an exacerbation of your
heart failure because your Lasix was not taken as prescribed and
your diet contained a lot of salt while on vacation. Initially,
you were diuresed with IV Lasix and required supplemental
oxygen. Over 24 hrs, your symptoms improved and you were weaned
from the oxygen. You also had a fever, which resolved after
several hrs. No source of infection was found.
Please weigh yourself everyday at the same time and using the
same scale. Report a weight gain of ___ lbs over several days to
your cardiologist. Follow a low salt diet. ___ services were
suggested to help you monitor your weight, diet and medications,
but you declined these services at this time.
You also developed an abnormal heart rhythm called atrial
fibrillation. This rhythm can increase your risk of a stroke.
Because of this, you were started on a blood thinner called
warfarin. You will need frequent blood checks to make sure that
you are on the correct dose of warfarin. Your dose may change
depending on the results of this blood test (called an INR).
Please obtain blood work on ___ to check
your INR level and Tacrolimus level, and kidney function.
Continue to take your home medications.Your Aspirin was
decreased to 81 mg a day. Your Tacrolimus dose was changed to 3
mg twice a day for now. You had a Tacrolimus level pending at
the time of discharge. You will be called at home with that
result.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Apixaban 10 mg PO BID Duration: 6 Days
Transition to 5 mg PO BID on ___
RX *apixaban [Eliquis] 5 mg 2 tablet(s) by mouth twice a day
Disp #*24 Tablet Refills:*0
2. Apixaban 5 mg PO BID
Starting ___
RX *apixaban [Eliquis] 5 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*6
3. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
4. Albuterol Inhaler 2 PUFF IH Q6H:PRN shortness of
breath/wheezing
5. Anastrozole 1 mg PO DAILY
6. LORazepam 0.5-1 mg PO BID:PRN anxiety/insomnia
7. Mirtazapine 7.5 mg PO QHS
8. Omeprazole 20 mg PO DAILY
9. Ondansetron 4 mg PO Q8H:PRN nausea/vomiting
10. Polyethylene Glycol 17 g PO DAILY
11. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
# LLL Subsegmental Pulmonary Embolus
# Chronic abdominal pain
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms ___,
You were admitted to the hospital with chest tightness and
shortness of breath with exertion that we believe was likely due
to a blood clot in your lungs, called a "pulmonary embolus."
You were started on treatment for this with a medication called
___ ("Eliquis"), which you will need to take twice daily
every day for at least 6 months. Do not stop this medication
until you told to do so by your Oncologist (Dr. ___. As we
discussed, ___ increases your risk of bleeding, so please
seek immediate medical attention if you develop blood in your
stool, dark black tarry stool ("melena"), or vomiting blood.
Because you have started this medication that can increase your
risk of bleeding, we would advise that you STOP taking aspirin.
For your upset stomach, we recommend that you continue to work
with your primary care doctor and your primary GI doctor to
hopefully get this feeling better. You have an appointment
scheduled with Dr. ___ in the ___ GI clinic on this
___ at 09:20 AM.
For the burning sensation in your legs, we recommend that you
discuss this again with your primary care doctor for further
evaluation and potential treatment.
It was a pleasure caring for you while you were in the hospital,
and we wish you a full and speedy recovery.
Sincerely,
The ___ Medicine Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 5 mg PO DAILY
RX *amlodipine 5 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*3
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice
a day Disp #*60 Capsule Refills:*1
3. Polyethylene Glycol 17 g PO DAILY:PRN Constipation - Third
Line
RX *polyethylene glycol 3350 [ClearLax] 17 gram/dose 1 dose by
mouth once a day Disp #*30 Dose Pack Refills:*0
4. Senna 8.6 mg PO BID:PRN Constipation - First Line
RX *sennosides [Senokot] 8.6 mg 1 Tab by mouth twice a day Disp
#*60 Tablet Refills:*1
5. Atorvastatin 20 mg PO QPM
RX *atorvastatin 20 mg 1 tablet(s) by mouth at bedtime Disp #*5
Tablet Refills:*0
6. Creon 12 1 CAP PO TID W/MEALS
RX *lipase-protease-amylase [Creon] 12,000 unit-38,000
unit-60,000 unit 1 capsule(s) by mouth three times a day Disp
#*20 Capsule Refills:*0
7. Dofetilide 50 mcg PO Q12H
RX *dofetilide 250 mcg 1 capsule(s) by mouth twice a day Disp
#*10 Capsule Refills:*0
8. Lisinopril 40 mg PO DAILY
RX *lisinopril 40 mg 1 tablet(s) by mouth once a day Disp #*5
Tablet Refills:*0
9. LORazepam 0.5 mg PO Q4H:PRN anxiety
RX *lorazepam [Ativan] 0.5 mg 1 Tab by mouth once a day Disp #*2
Tablet Refills:*0
10. Metoprolol Succinate XL 25 mg PO DAILY
RX *metoprolol succinate 25 mg 1 tablet(s) by mouth once a day
Disp #*5 Tablet Refills:*0
11. HELD- Apixaban 2.5 mg PO BID This medication was held. Do
not restart Apixaban until Please hold until repeat CT head in
two weeks from ___ to indicate resolution of hemorrage
before restarting
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Convexal subarachnoid hemorrhage
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 due to a headache resulting from an acute
subarachnoid hemorrhage, a condition where a blood vessel
providing oxygen and nutrients to the brain ruptures and spills
blood into the area around your brain. 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 blood and irritation can
result in a variety of symptoms.
Stroke can have many different causes. We think that your brain
bleed was the result of a condition called Cerebral Amyloid
Angiopathy, which means that you have proteins (Amyloid) that
deposit in the small blood vessels in your brain and weakens the
walls. This means that the blood vessels are more likely to
rupture. We think this is the case because your brain imaging
showed evidence of old bleeds in various areas, which can happen
when you have this condition.
Since you had bleeding around your brain, you should stop taking
your anticoagulation (Eliquis) for 2 weeks. You should follow up
with your PCP, who will get a CT scan of your head to make sure
the bleeding has resolved. At that time, if the bleeding has
resorbed, it is ok for you to start the Eliquis again at a low
dose. Your PCP ___ give you more instructions about this.
We are changing your medications as follows:
- STOP taking Eliquis. Follow up with your PCP before
restarting.
- We are starting you on a bowel regimen to prevent you from
straining when you go to the bathroom. This includes senna,
Colace, and MiraLAX. If you are having loose stools stop taking
these medications. You can take the senna and Colace regularly
to keep your stools soft. You can take MiraLAX when you are
still constipated and need additional support. Please follow-up
with your primary care provider for the optimal bowel regimen.
- START taking amlodipine 5mg. Your blood pressure was elevated
while you were in the hospital. It is very important to control
your blood pressure as you recently had a brain bleed. Please
take all your blood pressure medicines as prescribed. If you
want to buy a home blood pressure automatic monitor to check
your pressures at home, you can do so. If your blood pressure
remains consistently above 160 systolic (the top number), please
call your primary care doctor.
Please take your other medications as prescribed.
Please follow up with Neurology and your primary care physician
as listed below.
If you experience any of the symptoms below, please seek
emergency medical attention by calling Emergency Medical
Services (dialing 911). In particular, since stroke can recur,
please pay attention to the sudden onset and persistence of
these symptoms:
- Sudden partial or complete loss of vision
- Sudden loss of the ability to speak words from your mouth
- Sudden loss of the ability to understand others speaking to
you
- Sudden weakness of one side of the body
- Sudden drooping of one side of the face
- Sudden loss of sensation of one side of the body
Thank you for letting us be part of your care.
We wish you the best,
Your ___ Neurology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO Q6H:PRN pain
2. Docusate Sodium (Liquid) 100 mg PO BID constipation
3. Heparin 5000 UNIT SC TID
4. LeVETiracetam 1000 mg PO BID
5. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
6. Polyethylene Glycol 17 g PO DAILY:PRN constipation
7. Senna 8.6 mg PO BID:PRN constipation
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Closed head injury
Left frontal contusion
Altered mental status
Respiratory failure
Diffuse axonal injury
Pneumonia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Activity
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.
You make take a shower 3 days after surgery.
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 have difficulty paying attention, concentrating, and
remembering new information.
Emotional and/or behavioral difficulties are common.
Feeling more tired, restlessness, irritability, and mood
swings are also common.
Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
pain medications), try an over-the-counter stool softener.
Headaches:
Headache is one of the most common symptoms after traumatic
brain injury. Headaches can be long-lasting.
Most headaches are not dangerous but you should call your
doctor if the headache gets worse, develop arm or leg weakness,
increased sleepiness, and/or have nausea or vomiting with a
headache.
Mild pain medications may be helpful with these headaches but
avoid taking pain medications on a daily basis unless prescribed
by your doctor.
There are other things that can be done to help with your
headaches: avoid caffeine, get enough sleep, daily exercise,
relaxation/ meditation, massage, acupuncture, heat or ice packs.
More Information about Brain Injuries:
You were given information about headaches after TBI and the
impact that TBI can have on your family.
If you would like to read more about other topics such as:
sleeping, driving, cognitive problems, emotional problems,
fatigue, seizures, return to school, depression, balance, or/and
sexuality after TBI, please ask our staff for this information
or visit ___
When to Call Your Doctor at ___ for:
Severe pain, swelling, redness or drainage from the incision
site.
Fever greater than 101.5 degrees Fahrenheit
Nausea and/or vomiting
Extreme sleepiness and not being able to stay awake
Severe headaches not relieved by pain relievers
Seizures
Any new problems with your vision or ability to speak
Weakness or changes in sensation in your face, arms, or leg
Call ___ and go to the nearest Emergency Room if you experience
any of the following:
Sudden numbness or weakness in the face, arm, or leg
Sudden confusion or trouble speaking or understanding
Sudden trouble walking, dizziness, or loss of balance or
coordination
Sudden severe headaches with no known reason</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Micafungin 100 mg IV Q24H
RX *micafungin [Mycamine] 100 mg 100 mg IV daily Disp #*9 Bag
Refills:*0
2. Allopurinol ___ mg PO DAILY
3. Aspirin 81 mg PO DAILY
4. Bisacodyl 10 mg PO DAILY:PRN constipation
5. Calcium Carbonate 1250 mg PO DAILY
6. Cyanocobalamin 500 mcg PO DAILY
7. Dabigatran Etexilate 150 mg PO BID
8. Docusate Sodium 100 mg PO DAILY:PRN constipation
9. Furosemide 40 mg PO DAILY
RX *furosemide 40 mg 1 tablet(s) by mouth daily Disp #*14 Tablet
Refills:*0
10. Glargine 5 Units Bedtime
11. Omeprazole 40 mg PO DAILY
12. OxycoDONE (Immediate Release) 5 mg PO Q6H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth every 6 hours Disp #*30
Tablet Refills:*0
13. Senna 1 TAB PO BID:PRN constipation
14. Simvastatin 40 mg PO DAILY
15. Vitamin D 5000 UNIT PO DAILY
16. Pioglitazone 45 mg PO DAILY
17. niacinamide ___ unknown ORAL QDAY
18. MetFORMIN (Glucophage) 1000 mg PO BID
19. LOPERamide 2 mg PO DAILY:PRN diarrhea
20. lanreotide 90 mg/0.3 mL Subcutaneous Qmonth
21. LamISIL (terbinafine) 250 mg Oral Qweek
22. Fish Oil (Omega 3) 3600 mg PO DAILY
23. Creon 12 24,000 unit PO TID W/MEALS
24. coenzyme Q10 200 mg Oral daily
25. Ursodiol 300 mg PO BID
RX *ursodiol 300 mg 1 capsule(s) by mouth twice a day Disp #*60
Capsule Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
1) Biliary sepsis
2) Fungemia
3) 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 caring for you at ___. You were admitted to
the ICU with sepsis and were treated with antibiotics (which you
completed during the admission). You had an ERCP which
visualized your stents, however they unfortunately could not be
removed. You then had an additional stent placed and drainage by
Interventional Radiology, in addition to paracentesis which
removed fluid from your abdomen. Due to low blood pressure after
this procedure, you were briefly transfered to the Intensive
Care Unit as a precaution.
Blood cultures taken from after the procedure were then found to
be growing ___ species, and you were started on an
anti-fungal medication. This medication needs to be given
intravenously, and you had a PICC line placed prior to
discharge.
On this admission, we also gradually worked to take of excess
fluid that you had accumulated during your recent
hospitalizations. You have multiple follow-up appointments
scheduled, which are listed below.
Please note that we have stopped your rifaximin, you should not
take this drug after discharge. We have also increased the dose
of your lasix from 20 to 40 daily and started you on a
medication called Ursodiol which will help your liver drain.
Thank you for allowing us to participate in your care.</s> |