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<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 Acute Care Trauma surgery service on
___ after sustaining multiple injuries including a fracture
in your neck, a fracture in your right arm, an injury to the
ligament in your knee, and a fracture in your midback. You were
evaluated by the spine doctors and your ___ spine was
surgically repaired in the operating room. You were taken to the
operating room with the hand surgery team and had your right
hand repaired. You were evaluated by the orthopedic surgery team
for your right knee injury and you should follow up in the
___ clinic for further evaluation and treatment.
You are now doing better, pain is better controlled, and you are
ready to be discharged to ..... to continue your recovery.
Please note the following discharge instructions:
Please call your doctor or nurse practitioner or return to the
Emergency Department for any of the following:
*You experience new chest pain, pressure, squeezing or
tightness.
*New or worsening cough, shortness of breath, or wheeze.
*If you are vomiting and cannot keep down fluids or your
medications.
*You are getting dehydrated due to continued vomiting, diarrhea,
or other reasons. Signs of dehydration include dry mouth, rapid
heartbeat, or feeling dizzy or faint when standing.
*You see blood or dark/black material when you vomit or have a
bowel movement.
*You experience burning when you urinate, have blood in your
urine, or experience a discharge.
*Your pain in not improving within ___ hours or is not gone
within 24 hours. Call or return immediately if your pain is
getting worse or changes location or moving to your chest or
back.
*You have shaking chills, or fever greater than 101.5 degrees
Fahrenheit or 38 degrees Celsius.
*Any change in your symptoms, or any new symptoms that concern
you.
Please resume all regular home medications, unless specifically
advised not to take a particular medication. Also, please take
any new medications as prescribed.
Please get plenty of rest, continue to ambulate several times
per day, and drink adequate amounts of fluids. Avoid lifting
weights greater than ___ lbs until you follow-up with your
surgeon.
Avoid driving or operating heavy machinery while taking pain
medications.
Incision Care:
*Please call your doctor or nurse practitioner if you have
increased pain, swelling, redness, or drainage from the incision
site.
*Avoid swimming and baths until your follow-up appointment.
*You may shower, and wash surgical incisions with a mild soap
and warm water. Gently pat the area dry.
*If you have staples, they will be removed at your follow-up
appointment.
*If you have steri-strips, they will fall off on their own.
Please remove any remaining strips ___ days after surgery.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
2. Acetaminophen (Liquid) 650 mg PO Q6H
3. Diazepam 5 mg PO TID:PRN anxiety
4. Lansoprazole Oral Disintegrating Tab 30 mg PO BID
RX *lansoprazole [Prevacid SoluTab] 30 mg 1 tablet(s) by mouth
twice a day Disp #*60 Tablet Refills:*0
5. Levothyroxine Sodium 100 mcg PO DAILY
6. Milk of Magnesia 30 mL PO Q12H:PRN constipation
7. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
8. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 1 tab by mouth twice a day Disp
#*60 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Food impaction
Esophageal stricture
Secondary:
Esophageal 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 came in because you had food stuck in your esophagus. You
had an endoscopy to remove the food. During the endoscopy the GI
doctors ___ of you esophagus. They dilated this
narrowing to open it.
During the next week you should eat only clear liquids. You can
also have a small amount of pudding. During this time you can
drink ensure to avoid losing weight. It will be important to
keep track of your calories. You can drink as much ensure as you
need to maintain your calories.
If you are tolerating a liquid diet without any issues, you can
advance your diet to soft solids (should be very soft) after one
week of liquid diet (___).
It will also be very important to follow up with the GI doctors
in ___.
It was a pleasure taking care of you and we're happy that you're
feeling better!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H:PRN fever, pain
2. Carvedilol 6.25 mg PO BID
3. Cholestyramine 4 gm PO BID
4. Ethanol 70% Catheter DWELL (Tunneled Access Line) 2 mL DWELL
DAILY
5. Fentanyl Patch 50 mcg/h TD Q72H
6. Gabapentin 300 mg PO BID
7. Gemfibrozil 600 mg PO DAILY
8. Heparin Flush (10 units/ml) 2 mL IV PRN line flush
9. Hyoscyamine SO4 (Time Release) 0.375 mg PO BID:PRN abdominal
pain
10. LOPERamide 2 mg PO QID:PRN diarrhea
11. Pantoprazole 40 mg PO Q24H
12. PredniSONE 10 mg PO DAILY
13. Ranitidine 150 mg PO DAILY
14. Bacitracin Ointment 1 Appl TP TID
RX *bacitracin zinc [Antibiotic (bacitracin zinc)] 500 unit/gram
Apply three times a day Disp #*1 Tube Refills:*0
15. HYDROmorphone (Dilaudid) ___ mg PO Q3H:PRN pain
16. Erythromycin 0.5% Ophth Oint 0.5 in RIGHT EYE TID eye pain
17. Multivitamins 1 TAB PO DAILY
18. Ethanol Locks
Ethanol 70% Catheter DWELL (Tunneled Access Line) 2 mL DWELL
DAILY
FOR PORT2 #1&2 Ethanol 70% Catheter DWELL (Tunneled Access Line)
2 mL DWELL DAILY per lumen Not for IV use. To be instilled into
central catheter port for local dwell. 2hr dwell.
19. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 10 mg 1 tablet(s) by mouth every four (4) hours
Disp #*60 Tablet Refills:*0
20. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin [Cipro] 500 mg 1 tablet(s) by mouth twice a
day Disp #*10 Tablet Refills:*0
21. Codeine Sulfate 60 mg PO Q6H:PRN diarrhea
22. Duloxetine 60 mg PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnosis
- Urethral leak secondary to prostate surgery
- Acute Kidney Injury
- Proteus and Kidney Bacterial Infection
- Strep Viridans Bacteremia (Contaminant)
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 fever and kidney injury
and were found to have a urinary leak from your prostate
surgery. We placed a foley catheter and you will follow-up on
___ in ___ clinic. You were also treated for a urinary
tract infection.</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/Fever
2. Dextromethorphan-Guaifenesin (Sugar Free) 5 mL PO Q6H:PRN
cough
RX *dextromethorphan-guaifenesin 100 mg-10 mg/5 mL 5 ml by mouth
every six (6) hours Refills:*0
3. OSELTAMivir 30 mg PO Q12H Duration: 5 Days
RX *oseltamivir 30 mg 1 capsule(s) by mouth every twelve (12)
hours Disp #*8 Capsule Refills:*0
4. Glargine 75 Units Bedtime
Humalog 12 Units Breakfast
Humalog 12 Units Lunch
Humalog 12 Units Dinner
5. Albuterol Inhaler 2 PUFF IH Q4H:PRN wheeze
6. amLODIPine 5 mg PO DAILY
7. Anastrozole 1 mg PO DAILY
8. Aspirin 81 mg PO DAILY
9. Atenolol 25 mg PO BID
10. Cetirizine 10 mg PO DAILY
11. Fish Oil (Omega 3) 1000 mg PO BID
12. fluticasone 2 PUFF IH DAILY
13. Gabapentin 300 mg PO DAILY
14. GlipiZIDE 10 mg PO BID
15. Magnesium Oxide 400 mg PO TID
16. Montelukast 10 mg PO DAILY
17. Multivitamins 1 TAB PO DAILY
18. Omeprazole 20 mg PO DAILY
19. Potassium Chloride 10 mEq oral TID
20. Rosuvastatin Calcium 10 mg PO QPM
21. Spironolactone 25 mg PO DAILY
22. Torsemide 20 mg PO DAILY
23. TraMADol 50 mg PO BID:PRN Pain - Moderate
24. Vitamin D 400 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Influenza B with respiratory symptoms
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were hospitalized for fevers and cough due to influenza.
You were treated with IV fluids and an anti-viral medication
(Tamiflu). Continue this medication for an additional 4 days to
reduce the duration of your illness. Drink plenty of fluids.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking part in your care while you were
hospitalized at ___. As you
know, you were admitted to rule out dangerous cardiac causes of
the chest pain you were having prior to admission. Fortunately,
subsequent testing showed that you did not have a heart attack,
though stress test showed some evidence of stable blockage in
the blood vessels supplying your heart. It seems that your chest
pain occured as a result of a condition called pericarditis.
Pericarditis involves inflammation of the tissue surrounding the
heart, though it can be challenging to identify the exact cause.
You were treated with ibuprofen, which helped to calm the
inflammation and relieve your chest pain. You should continue to
take the Ibuprofen as prescribed. You also had an echocardiogram
of your heart, which was normal.
Your blood pressure regimen was changed during this admission
due to slightly low blood pressures: Please STOP olmesartan
until directed to restart by your primary care provider ___
cardiologist. Please LOWER metoprolol succinate to 150mg daily.
Please note that you are now on multiple blood thinning
medications, including aspirin, clopidogrel (Plavix), and
ibuprofen. Please contact your doctor if notice blood in your
urine or stool, tarry stools, or excessive bleeding of any kind.
You also should seek medical attention if you strike your head.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*30 Capsule Refills:*0
2. Ondansetron 4 mg PO Q8H:PRN nausea
RX *ondansetron 4 mg 1 tablet(s) by mouth three times a day Disp
#*60 Tablet Refills:*0
3. Senna 8.6 mg PO BID:PRN constipation
RX *sennosides 8.6 mg 1 tab by mouth twice a day Disp #*30
Tablet Refills:*0
4. Fish Oil (Omega 3) 1000 mg PO DAILY
5. biotin UNK UNK oral UNK
Discharge Disposition:
Home
Discharge Diagnosis:
Hypercalcemia
___
Macrocytic anemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mrs. ___,
___ were hospitalized for kidney injury and high calcium levels.
This was treated with IV fluids and a few injections of
medication to lower your calcium levels. With these
interventions, your kidney function and calcium levels improved.
Your findings may be concerning for cancer. We have been in
contact with your PCP ___ see her soon after
discharge.
PLEASE MAKE SURE TO EAT AND DRINK PLENTY UPON RETURNING HOME.
THIS WILL BE VITAL IN THE RECOVERY OF YOUR KIDNEY FUNCTION.
It was a pleasure taking care of ___!
Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ferrous GLUCONATE 324 mg PO DAILY
2. Multivitamins 1 TAB PO DAILY
3. Vitamin D ___ UNIT PO DAILY
4. Carbamide Peroxide 6.5% ___ DROP AD BID Duration: 4 Days
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnoses:
================
- diverticular bleed
- elevated lactate
- acute anemia
Secondary Diagnoses:
================
- coronary artery disease, s/p bare metal stent
- hypertension
- gastroesophageal reflux disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure being a part of your care team at ___
___. You were admitted because you were
having bleeding from your bowel, which is the same as when you
have had bleeding in the past. We recommended performing a
procedure to stop the bleeding, but you preferred to wait and
see if the bleeding stopped on its own. Fortunately, you did not
have any more bleeding during your hospital stay.
Again, it was very nice to meet you, and 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. Doxycycline Hyclate 100 mg PO Q12H Duration: 9 Doses
RX *doxycycline hyclate 100 mg 1 tablet(s) by mouth every 12
hours Disp #*9 Tablet Refills:*0
2. Gabapentin 100 mg PO BID
3. Metoprolol Succinate XL 25 mg PO DAILY
4. Pantoprazole 40 mg PO Q24H
5. Tamsulosin 0.4 mg PO QHS
6. Vitamin D 1000 UNIT PO DAILY
7. Warfarin 2.5 mg PO DAILY16
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSES
Community acquired pneumonia
Acute hypoxemic respiratory failure
Acute uncomplicated urinary tract infection
Atrial fibrillation
SECONDARY DIAGNOSES
Gastroesophageal reflux disease
Peripheral neuropathy
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure to care for you at the ___
___.
Why did I come to the hospital?
- You came to the hospital because there was concern that you
aspirated while eating. You had fever, cough, and low blood
oxygen levels.
What happened while I was in the hospital?
- In the hospital, you were given IV antibiotics to treat a
presumed pneumonia. You were fed a modified diet as recommended
by the speech language pathology team during your last
admission.
What should I do once I leave the hospital?
- Be sure to finish your course of antibiotics, the last day
will be ___
We wish you the best!
Your ___ Care Team
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. Acetaminophen 650 mg PO Q8H:PRN Pain - Mild
Do not take more than 2000mg per day
2. Glargine 22 Units Bedtime
Insulin SC Sliding Scale using lispro Insulin
3. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Severe
4. Calcium 500 + D (calcium carbonate-vitamin D3) 500
mg(1,250mg) -400 unit oral DAILY
5. Ciprofloxacin HCl 500 mg PO Q12H Duration: 1 Dose
6. Fish Oil (Omega 3) 1000 mg PO DAILY
7. Gabapentin 300 mg PO TID
8. Linezolid ___ mg PO Q12H Duration: 1 Dose
9. LORazepam 1 mg PO Q8H:PRN anxiety
10. Omeprazole 20 mg PO DAILY
11. TraZODone 100 mg PO QHS
12. HELD- FLUoxetine 20 mg PO DAILY This medication was held.
Do not restart FLUoxetine until LINEZOLID IS COMPLETE
Discharge Disposition:
Home
Discharge Diagnosis:
perihepatic biloma
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please call Dr. ___ office at ___ for fever
greater than 101, chills, nausea, vomiting, diarrhea,
constipation, increased abdominal pain, pain not controlled by
your pain medication, swelling of the abdomen or ankles,
yellowing of the skin or eyes, inability to tolerate food,
fluids or medications, the drain insertion site has redness,
drainage or bleeding, or drain output stops or increases
significantly or any other concerning symptoms.
Complete 5 day course of ???( Linezolid and Ciprofloxacin.) Do
not take the Fluoxetine until Linezolid prescription completed.
Abdominal CT scan to reassess collection scheduled for ___.
Abdominal fluid collection drain-Catheter Flushing: Flush to
patient only with 10cc of sterile saline Once daily.
If there is pain with flushing this may mean that the abscess
cavity has collapsed. Notify Dr. ___ ___ ___
___ ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 10 mg PO DAILY
RX *amlodipine 10 mg 1 tablet(s) by mouth DAILY Disp #*30 Tablet
Refills:*2
2. Aspirin 81 mg PO DAILY
RX *aspirin [Aspir-81] 81 mg 1 tablet(s) by mouth DAILY Disp
#*30 Tablet Refills:*2
3. Atorvastatin 40 mg PO QPM
RX *atorvastatin 40 mg 1 tablet(s) by mouth QPM Disp #*30 Tablet
Refills:*2
4. Gabapentin 300 mg PO TID
RX *gabapentin 300 mg 1 capsule(s) by mouth three times a day
Disp #*90 Capsule Refills:*2
5. Lisinopril 20 mg PO DAILY
RX *lisinopril 20 mg 1 tablet(s) by mouth DAILY Disp #*30 Tablet
Refills:*2
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Left sided acute ischemic stroke (internal capsule, basal
ganglia)
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 hospitalized due to symptoms of right sided sensory
changes and weakness, resulting from an ACUTE ISCHEMIC STROKE, a
condition where a blood vessel providing oxygen and nutrients to
the brain is blocked by a clot. The brain is the part of your
body that controls and directs all the other parts of your body,
so damage to the brain from being deprived of its blood supply
can result in a variety of symptoms.
Stroke can have many different causes, so we assessed you for
medical conditions that might raise your risk of having stroke.
In order to prevent future strokes, we plan to modify those risk
factors. Your risk factors are: high blood pressure, high
cholesterol, PFO
We are changing your medications as follows:
-started baby aspirin for stroke prevention
-started atorvastatin for high cholesterol
-started amlodipine and lisinopril for high blood pressure
Please take your other medications as prescribed.
Please follow up with Neurology and your primary care physician
as listed below.
If you experience any of the symptoms below, please seek
emergency medical attention by calling Emergency Medical
Services (dialing 911). In particular, since stroke can recur,
please pay attention to the sudden onset and persistence of
these symptoms:
- Sudden partial or complete loss of vision
- Sudden loss of the ability to speak words from your mouth
- Sudden loss of the ability to understand others speaking to
you
- Sudden weakness of one side of the body
- Sudden drooping of one side of the face
- Sudden loss of sensation of one side of the body
Sincerely,
Your ___ Neurology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO Q6H:PRN fever/pain
2. Bisacodyl 10 mg PO/PR DAILY
3. Cepastat (Phenol) Lozenge 1 LOZ PO Q2H:PRN sore throat
4. Cyclobenzaprine 10 mg PO TID:PRN neck pain
RX *cyclobenzaprine 10 mg 1 tablet(s) by mouth every 8 hours
Disp #*90 Tablet Refills:*0
5. Docusate Sodium (Liquid) 100 mg PO BID
6. Famotidine 20 mg PO Q12H
RX *famotidine 20 mg 1 tablet(s) by mouth twice daily Disp #*60
Tablet Refills:*3
7. OxycoDONE (Immediate Release) 5 mg PO Q6H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth every 6 hours Disp #*90
Tablet Refills:*0
8. Senna 8.6 mg PO BID
9. Simethicone 40-80 mg PO QID:PRN gas pain
10. Sodium Chloride Nasal ___ SPRY NU TID:PRN stuffy nose
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Brain lesions
Cerebral vasogenic edema
Hydrocephalus
Pulmonary Emboli
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Discharge Instructions
Brain Tumor
Surgery
You underwent surgery to remove a brain lesion from your
brain.
You had a VP shunt placed for hydrocephalus. Your incision
should be kept dry until sutures or staples are removed.
Your shunt is a ___ Delta Valve which is NOT
programmable. It is MRI safe and needs no adjustment after a
MRI.
Please keep your incision dry until your staples are removed.
You may shower at this time but keep your incision dry.
It is best to keep your incision open to air but it is ok to
cover it when outside.
Call your surgeon if there are any signs of infection like
redness, fever, or drainage.
Activity
We recommend that you avoid heavy lifting, running, climbing,
or other strenuous exercise until your follow-up appointment.
You make take leisurely walks and slowly increase your
activity at your own pace once you are symptom free at rest.
___ try to do too much all at once.
No driving while taking any narcotic or sedating medication.
If you experienced a seizure while admitted, you are NOT
allowed to drive by law.
No contact sports until cleared by your neurosurgeon. You
should avoid contact sports for 6 months.
Medications
Please do NOT take any blood thinning medication (Aspirin,
Ibuprofen, Plavix, Coumadin) until cleared by the neurosurgeon.
You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
What You ___ Experience:
You may experience headaches and incisional pain.
You may also experience some post-operative swelling around
your face and eyes. This is normal after surgery and most
noticeable on the second and third day of surgery. You apply
ice or a cool or warm washcloth to your eyes to help with the
swelling. The swelling will be its worse in the morning after
laying flat from sleeping but decrease when up.
You may experience soreness with chewing. This is normal from
the surgery and will improve with time. Softer foods may be
easier during this time.
Feeling more tired or restlessness is also common.
Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
pain medications), try an over-the-counter stool softener.
When to Call Your Doctor at ___ for:
Severe pain, swelling, redness or drainage from the incision
site.
Fever greater than 101.5 degrees Fahrenheit
Nausea and/or vomiting
Extreme sleepiness and not being able to stay awake
Severe headaches not relieved by pain relievers
Seizures
Any new problems with your vision or ability to speak
Weakness or changes in sensation in your face, arms, or leg
Call ___ and go to the nearest Emergency Room if you experience
any of the following:
Sudden numbness or weakness in the face, arm, or leg
Sudden confusion or trouble speaking or understanding
Sudden trouble walking, dizziness, or loss of balance or
coordination
Sudden severe headaches with no known reason</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Dexamethasone 4 mg PO DAILY Duration: 4 Doses
This is dose # 1 of 3 tapered doses
RX *dexamethasone 4 mg 1 tablet(s) by mouth once a day Disp #*4
Tablet Refills:*0
2. Dexamethasone 2 mg PO DAILY Duration: 7 Doses
This is dose # 2 of 3 tapered doses
RX *dexamethasone 2 mg 1 tablet(s) by mouth once a day Disp #*7
Tablet Refills:*0
3. Dexamethasone 1 mg PO DAILY Duration: 7 Doses
This is dose # 3 of 3 tapered doses
RX *dexamethasone 1 mg 1 tablet(s) by mouth once a day Disp #*7
Tablet Refills:*0
4. Enoxaparin Sodium 90 mg SC Q12H
RX *enoxaparin 80 mg/0.8 mL 0.8 mL SC every twelve (12) hours
Disp #*60 Syringe Refills:*0
5. Furosemide 40 mg PO DAILY
RX *furosemide 40 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
6. Gabapentin 300 mg PO BID
RX *gabapentin 300 mg 1 capsule(s) by mouth twice a day Disp
#*60 Capsule Refills:*0
7. Humalog 4 Units Breakfast
Humalog 4 Units Lunch
Humalog 4 Units Dinner
NPH 10 Units Breakfast
Insulin SC Sliding Scale using HUM Insulin
RX *insulin lispro [Humalog KwikPen Insulin] 100 unit/mL AS DIR
see below Disp #*2 Syringe Refills:*0
RX *insulin NPH isoph U-100 human [Humulin N NPH Insulin
KwikPen] 100 unit/mL (3 mL) AS DIR 10 Units before breakfast
Disp #*1 Syringe Refills:*0
8. Labetalol 200 mg PO TID
RX *labetalol 200 mg 1 tablet(s) by mouth three times a day Disp
#*90 Tablet Refills:*0
9. LevETIRAcetam 500 mg PO BID
RX *levetiracetam [Keppra] 500 mg 1 tablet(s) by mouth twice a
day Disp #*60 Tablet Refills:*0
10. HELD- Sunitinib unknown PO Frequency is Unknown This
medication was held. Do not restart Sunitinib until you meet
with your new cancer doctor
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY:
-Presumed renal cell carcinoma with metastases to the brain,
lungs, and potentially pancreas
-Acute kidney injury
-Seizure
-Intracranial metastatic disease with cerebral edema
-Type 2 diabetes mellitus
-Acute on chronic anemia
-Hyperkalemia
SECONDARY:
-Hx of Deep vein thrombosis
-HTN
-RCC
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 were admitted to the hospital for a fall that you had,
which was probably a seizure.
WHAT HAPPENED WHEN YOU WERE IN THE HOSPITAL?
- You were found to have likely cancerous tumors in your brain
and lungs. The tumors in your brain bled, which caused the
likely seizure.
- You were evaluated by neurosurgery, radiation oncology,
medical oncology, and neuro-oncology. All teams agreed that the
best plan would be to start radiation therapy for the brain
lesions. You received this without issue.
- You were found to have worsening of your kidney function. It
is unclear why this happened. You needed to have a few sessions
of dialysis, and your kidneys recovered over time.
- You had a procedure to place a filter in the largest vein in
your body (IVC filter). This prevents blood clots from traveling
to your lungs.
- You were found to have diabetes this admission and were
started on insulin to treat this.
WHAT SHOULD YOU DO AFTER YOU LEAVE THE HOSPITAL?
- Continue to take all your medicines as prescribed and attend
your doctor's appointments.
- Please work on obtaining your medical records from the ___
and sending it to your cancer doctor's office. This will help
determine what future cancer treatments you should get.
- You were started on multiple new medications during this
hospitalization. Please continue to take these as prescribed.
- You were found to have a new diagnosis of diabetes. It is
important you monitor how much carbohydrates you are eating in
the day, track your blood sugars, and follow-up closely with
your new primary care physician regarding further treatment.
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. Acetaminophen 325-650 mg PO Q6H:PRN pain, headache, fever
2. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth q4hrs Disp #*30 Tablet
Refills:*0
3. Tamsulosin 0.4 mg PO QHS
RX *tamsulosin 0.4 mg 1 capsule(s) by mouth at bedtime Disp #*30
Capsule Refills:*0
4. Atorvastatin 10 mg PO QPM
5. fenofibrate 160 mg oral DAILY
6. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*30 Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
R ureteral stone
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>-You can expect to see occasional blood in your urine and to
possibly experience some urgency and frequency over the next
month; this may be related to the passage of stone fragments or
the indwelling ureteral stent (if there is one).
-The kidney stone may or may not have been removed AND/or there
may fragments/others still in the process of passing.
-You may experience some pain associated with spasm of your
ureter.; This is normal. Take the narcotic pain medication as
prescribed if additional pain relief is needed.
-Ureteral stents MUST be removed or exchanged and therefore it
is IMPERATIVE that you follow-up as directed.
-Do not lift anything heavier than a phone book (10 pounds) for
2 weeks.
-You may continue to periodically see small amounts of blood in
your urine--this is normal and will gradually improve
-Resume all of your pre-admission medications, except HOLD
aspirin until you see your urologist in follow-up
-Colace has been prescribed to avoid post surgical constipation
and constipation related to narcotic pain medication.
Discontinue if loose stool or diarrhea develops. Colace is a
stool softener, NOT a laxative, and available over the counter.
The generic name is DOCUSATE SODIUM. It is recommended that you
use this medication.
-Do not eat constipating foods for ___ weeks, drink plenty of
fluids to keep hydrated
-No vigorous physical activity or sports for 2 weeks</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
RX *aspirin [Adult Low Dose Aspirin] 81 mg 81 mg by mouth daily
Disp #*60 Tablet Refills:*0
2. Dronabinol 2.5 mg PO BID
3. Enoxaparin Sodium 60 mg SC Q12H Duration: 30 Doses
Stop once INR is therapeutic (2.0-3.0) as instructed by
___ clinic.
RX *enoxaparin 60 mg/0.6 mL 60 mg SQ twice a day Disp #*60
Syringe Refills:*0
4. Acetaminophen 1000 mg PO Q6H
5. Fluconazole 400 mg PO Q24H
6. Multivitamins 1 TAB PO DAILY
7. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
Duration: 30 Doses
RX *oxycodone 10 mg 10 mg by mouth every ___ hrs Disp #*30
Tablet Refills:*0
8. TraZODone 100 mg PO HS insomnia
9. Warfarin 5 mg PO DAILY DVT Duration: 30 Doses
RX *warfarin 5 mg 5 mg by mouth daily Disp #*30 Tablet
Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Deep Venous Thrombosis
Discharge Condition:
Stable
Followup Instructions:
___ [/INST] </s><s>Division of Vascular and Endovascular Surgery
Lower Extremity Angioplasty/Stent Discharge Instructions
MEDICATION:
Take Aspirin 325mg (enteric coated) once daily
If instructed, take Plavix (Clopidogrel) 75mg once daily
Continue all other medications you were taking before surgery,
unless otherwise directed
You make take Tylenol or prescribed pain medications for any
post procedure pain or discomfort
WHAT TO EXPECT:
It is normal to have slight swelling of the legs:
Elevate your leg above the level of your heart with pillows
every ___ hours throughout the day and night
Avoid prolonged periods of standing or sitting without your
legs elevated
It is normal to feel tired and have a decreased appetite, your
appetite will return with time
Drink plenty of fluids and eat small frequent meals
It is important to eat nutritious food options (high fiber,
lean meats, vegetables/fruits, low fat, low cholesterol) to
maintain your strength and assist in wound healing
To avoid constipation: eat a high fiber diet and use stool
softener while taking pain medication
ACTIVITIES:
When you go home, you may walk and use stairs
You may shower (let the soapy water run over groin incision,
rinse and pat dry)
Your incision may be left uncovered, unless you have small
amounts of drainage from the wound, then place a dry dressing or
band aid over the area
No heavy lifting, pushing or pulling (greater than 5 lbs) for
1 week (to allow groin puncture to heal)
After 1 week, you may resume sexual activity
After 1 week, gradually increase your activities and distance
walked as you can tolerate
No driving until you are no longer taking pain medications
CALL THE OFFICE FOR: ___
Numbness, coldness or pain in lower extremities
Temperature greater than 101.5F for 24 hours
New or increased drainage from incision or white, yellow or
green drainage from incisions
Bleeding from groin puncture site
SUDDEN, SEVERE BLEEDING OR SWELLING (Groin puncture site)
Lie down, keep leg straight and have someone apply firm
pressure to area for 10 minutes. If bleeding stops, call
vascular office ___. If bleeding does not stop, call
___ for transfer to closest Emergency Room.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Carvedilol 25 mg PO BID
RX *carvedilol 25 mg 1 tablet(s) by mouth Twice a day Disp #*60
Tablet Refills:*0
2. darifenacin 15 mg oral daily
3. Escitalopram Oxalate 10 mg PO DAILY
4. Montelukast Sodium 10 mg PO DAILY
5. Multivitamins 1 TAB PO DAILY
6. Omeprazole 20 mg PO DAILY
7. Pravastatin 10 mg PO DAILY
8. Tamoxifen Citrate 20 mg PO DAILY
9. Tiotropium Bromide 1 CAP IH DAILY
10. Torsemide 5 mg PO DAILY
11. Acetaminophen 1000 mg PO Q8H
12. budesonide-formoterol 160-4.5 mcg/actuation INHALATION BID
13. Alendronate Sodium 70 mg PO QSAT
14. Calcium Citrate + D (calcium citrate-vitamin D3) 315-200
mg-unit oral daily
15. MetFORMIN (Glucophage) 850 mg PO BID
16. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation
q6hrs shortness of breath
17. ZyrTEC (cetirizine) 10 mg oral daily
18. Ibuprofen 400 mg PO Q8H Duration: 10 Days
RX *ibuprofen 400 mg 1 tablet(s) by mouth Every 8 hours Disp
#*30 Tablet Refills:*0
19. TraMADOL (Ultram) 25 mg PO Q6H:PRN pain
Please take only for severe breakthough pain. ___ cause
confusion.
RX *tramadol 50 mg 0.5 (One half) tablet(s) by mouth Every ___
hours Disp #*10 Tablet Refills:*0
20. Lidocaine 5% Patch 1 PTCH TD QAM
12 hours on and 12 hours off.
RX *lidocaine 5 % (700 mg/patch) 1 Patch, 12 hours on and 12
hours off Daily Disp #*15 Transdermal Patch Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
___ Diagnosis:
Back Pain, possible Sacroiliac pathology
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid ___
or cane).
Followup Instructions:
___ [/INST] </s><s>Ms ___,
It was a pleasure taking care of you while you were in the
hospital. You were admitted with back pain and concern for your
breathing. You were worked up for a cause you and you were felt
to have pain in your sacroiliac (SI) joint. You were seen by the
physical therapists in the hospital who agreed that the pain was
likely coming from there. They felt that you should continue
with home physical therapy. We also feel that she will do well
with an anti-inflammatory medication, ibuprofen, which should
help with the pain. We are also setting you up with an
appointment for the pain clinic as well to see if it would be
beneficial for an injection if you do not continue to improve.
Your breathing was also evaluated and you had a number of tests
to rule out several causes. Your oxygenation level was stable
when you walked and you did quite well. This may be a component
of deconditioning associated with this and should improve as you
are more active.
You were given several medications for your pain and you should
take them as directed. Please keep the appointments below.
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. Gabapentin 800 mg PO TID
2. Pantoprazole 40 mg PO Q24H
3. QUEtiapine Fumarate 200 mg PO QHS
4. Ranitidine 150 mg PO BID
5. Sertraline 100 mg PO DAILY
6. vancomycin 125 mg oral q6hrs Duration: 10 Days
RX *vancomycin 125 mg 1 capsule(s) by mouth every 6 hours Disp
#*40 Capsule Refills:*0
7. Atenolol 25 mg PO DAILY
RX *atenolol 25 mg 1 tablet(s) by mouth Daily Disp #*15 Tablet
Refills:*0
8. Albuterol Inhaler 2 PUFF IH Q6H:PRN wheezing, shortness of
breath
RX *albuterol sulfate 90 mcg 2 puffs every six (6) hours Disp
#*1 Inhaler Refills:*3
9. Enoxaparin Sodium 60 mg SC Q12H
Start: Today - ___, First Dose: Next Routine Administration
Time
to treat your clot in your vein.
RX *enoxaparin 60 mg/0.6 mL 60 mg SC Twice daily Disp #*14
Syringe Refills:*0
10. Warfarin 10 mg PO DAILY16 Duration: 7 Doses
RX *warfarin [Coumadin] 10 mg 1 tablet(s) by mouth Daily Disp
#*7 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
clostridium difficile colitis
alcohol withdrawal
DVT
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 alcohol withdrawal and for
medical clearance so you can enter a rehab program. You were
found to have c. difficile (C.Diff) colitis causing diarrhea
while you were here. You were treated for the C.Diff colitis
with vancomycin and also treated for alcohol withdrawal as well
as for the blood clot you have had previously.
You should continue the vancomycin tablets for 14 days:
vancomycin 125 mg by mouth every 6 hours, day 1- ___, and the
last day will be: ___.
You should continue to follow up with your doctor at ___ and
you should have labs drawn ___ at ___ (lab in ___
first floor lobby, Quest). Appt time and details below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H Duration: 3 Days
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice
a day Disp #*30 Capsule Refills:*0
3. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours
Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Left-sided rib fractures: ___
Splenic laceration
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted to the hospital after falling during which you
sustained multiple left-sided rib fractures and a laceration of
your spleen. You recovered in the hospital and are now
preparing for discharge to home with the following instructions:
* Your injury caused multiple 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
* Return to the Emergency Room right away for any acute
shortness of breath, increased pain or crackling sensation
around your ribs ( crepitus ).
Also, due to your splenic injury:
AVOID contact sports and/or any activity that may cause injury
to your abdominal area for the next ___ weeks.
*If you suddenly become dizzy, lightheaded, feeling as if you
are going to pass out go to the nearest Emergency Room as this
could be a sign that you are having inernal bleeding from your
liver or spleen injury.
*AVOID any blood thinners such as Motrin, Naprosyn, Indocin,
Aspirin, Coumadin or Plavix for at least ___ days unless
otherwise instructed by the MD/NP/PA.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin EC 81 mg PO DAILY
2. Atorvastatin 80 mg PO QPM
RX *atorvastatin 80 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*3
3. Clopidogrel 75 mg PO DAILY
DO NOT STOP unless TOLD TO BY ___
___ *clopidogrel 75 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*11
4. Furosemide 40 mg PO DAILY
RX *furosemide 40 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*3
5. Glargine 20 Units Breakfast
Humalog 6 Units Breakfast
Humalog 6 Units Lunch
Humalog 8 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
RX *insulin glargine [Lantus] 100 unit/mL AS DIR 20 Units before
BKFT; Disp #*2 Vial Refills:*1
RX *insulin lispro [Humalog] 100 unit/mL AS DIR Up to 12 Units
QID per sliding scale Disp #*1 Vial Refills:*0
RX *insulin syringe-needle U-100 [BD Insulin Syringe Ultra-Fine]
31 gauge x ___ for insulin injections up to five times a day 5
x daily Disp #*150 Syringe Refills:*1
6. Lisinopril 40 mg PO DAILY
RX *lisinopril 40 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*3
7. Metoprolol Succinate XL 100 mg PO DAILY
RX *metoprolol succinate 100 mg 1 tablet(s) by mouth daily in am
Disp #*30 Tablet Refills:*3
8. Metoprolol Succinate XL 50 mg PO QPM
RX *metoprolol succinate 50 mg 1 tablet(s) by mouth daily in pm
Disp #*30 Tablet Refills:*3
9. Cephalexin 500 mg PO Q8H Duration: 3 Doses
RX *cephalexin 500 mg 1 capsule(s) by mouth three times a day
Disp #*3 Capsule Refills:*0
10. Outpatient Lab Work
420.0
INR draw ___
RESULTS sent to: Dr. ___: ___ Fax: ___
11. Outpatient Lab Work
420.0
INR/ Chem 7 draw ___
RESULTS sent to: Dr. ___: ___ Fax: ___
12. MetFORMIN (Glucophage) 1000 mg PO BID
13. Warfarin 4 mg PO DAILY16
Dr. ___ will call you to tell you what to take after you have
your INR drawn
Discharge Disposition:
Home
Discharge Diagnosis:
ventricular tachycardia
acute coronary syndrome s/p DES to the LAD
poorly controlled diabete Type II
systolic heart failure (EF 30%)
LV thrombus (on coumadin)
s/p ICD placement ___
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 transferred to ___ for treatment of your chest
pain and arrythmia. You EKG was concerning and upon arrival you
were taken to the cardiac cathterization lab where a blockage
was found in the left anterior descending artery. A ___ was
placed to open the blockage successfully. Following the cardiac
cathterization an ultrasound of the heart called an
echocardiogram was done which revealed a clot in the left
ventricle which puts you at risk for stroke. You were started on
anticoagulation called coumadin which we are monitoring its
effectiveness by drawing a lab called an INR. Dr. ___ will call
you to dose your coumadin appropriately based on these labs. You
will receive lab slips for the outpatient lab work.
Because you had a lethal arrythmia called ventricular
tachycardia you needed an ICD, defibrillator which was placed in
the chest and will activate if you go into another lethal
arrythmia while at home. You have a follow up in the device
clinic to assess the site and the settings.
You now have a history of heart failure and need to weigh
yourself every day. If your weight goes up more than 3 pounds in
1 day or more than 5 pounds in 2 days please call Dr. ___. Your
weight on day of discharge is 295 pounds.
You have been started on insulin for your blood sugars which was
not well controlled on pills alone and have been given injection
teaching and wil have a follow up with ___ for care in the
next week.
You have been given an updated list of the medications you are
taking on discharge.
Activity restrictions per nursing.
It was a pleasure taking care of you this hospitalization. If
you have any queations related to your stay please feel free to
contact the heartline.</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 ___ with weakness in the setting of
multiple falls. We determined that your weakness was likely
related to the recent increase in doses of your diuretic
medications, and resulting decrease in your weight. We were able
to modulate your diuretic dose so that you would be able to stay
at your optimal weight, and not feel weak.
Upon discharge:
#You have an appointment to be seen by your PCP, ___
___ on ___ at 10:30AM (___).
#Please schedule an appointment to be seen by your cardiologist,
Dr. ___ (___), within two weeks of your
discharge.
It was a pleasure taking care of you!
We wish you all the best!
Your team at the ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. CARVedilol 12.5 mg PO BID
RX *carvedilol 12.5 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
2. Lisinopril 5 mg PO DAILY
RX *lisinopril 5 mg 1 tablet(s) by mouth Daily Disp #*30 Tablet
Refills:*0
3. LORazepam 1 mg PO TID
RX *lorazepam 1 mg 1 tab by mouth three times a day Disp #*90
Tablet Refills:*0
4. Warfarin 2 mg PO DAILY16
RX *warfarin [___] 2 mg 1 tablet(s) by mouth Daily Disp
#*30 Tablet Refills:*0
5. Warfarin 2 mg PO ONCE Duration: 1 Dose
6. Albuterol Inhaler 2 PUFF IH Q4H:PRN Wheezing/Shortness of
breath
7. Diltiazem Extended-Release 360 mg PO DAILY
8. DULoxetine 60 mg PO DAILY
9. Thiamine 100 mg PO DAILY
10.Outpatient Lab Work
Atrial fibrillation (ICD 10 I48.0)
INR to be collected on ___
Please fax results to ___ Anticoagulation Management Services
(___)
11.Durable Medical Equipment
Rolling Walker
Diagnosis: Unsteady gait
Prognosis: Good
Length of need: 13 months
Discharge Disposition:
Home With Service
Facility:
___
___:
Atrial fibrillation with RVR
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to the hospital from ___.
WHY WAS I ADMITTED?
- You were admitted because your heart rate was fast.
WHAT HAPPENED WHILE I WAS ADMITTED?
- We restarted your home medications that control heart rate.
- We evaluated you for an infection and did not find one.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Follow up with your doctors as listed in this packet.
- Take all of your medications as prescribed.
It was a pleasure caring for you!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Fluoxetine 20 mg PO DAILY
Give tonight, ___
2. Fluticasone Propionate 110mcg 2 PUFF IH BID:PRN wheezing
3. Zolpidem Tartrate 5 mg PO HS:PRN insomnia
4. Acetaminophen 1000 mg PO Q8H:PRN pain
use this before oxycodone
RX *acetaminophen 500 mg 2 tablet(s) by mouth every 8 hours Disp
#*30 Tablet Refills:*0
5. Levofloxacin 500 mg PO Q24H Duration: 6 Days
RX *levofloxacin [Levaquin] 500 mg 1 tablet(s) by mouth daily
Disp #*6 Tablet Refills:*0
6. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *metronidazole [Flagyl] 500 mg 1 tablet(s) by mouth every 8
hours Disp #*18 Tablet Refills:*0
7. Nicotine Patch 14 mg TD DAILY
RX *nicotine [Nicoderm CQ] 14 mg/24 hour 1 patch daily Disp #*30
Unit Refills:*0
8. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
please give APAP first, hold for respiratory rate below 10
RX *oxycodone 5 mg 1 tablet(s) by mouth every 6 hours Disp #*10
Tablet Refills:*0
9. Albuterol Inhaler 2 PUFF IH Q4H:PRN wheezing/SOB
10. Ondansetron 4 mg PO Q8H:PRN nausea
RX *ondansetron HCl 4 mg 1 tablet(s) by mouth every 8 hours Disp
#*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: diverticulitis
Secondary: fibromyalgia, depression, asthma, tobacco abuse
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted with diverticulitis, which is a minor
infection of your colon. This will improve with a week of
antibiotics and a bland diet. Try to eat bland foods such as
bananas, rice, applesauce, and toast for the next few days. You
will see your new primary care physician, ___
___.
The following medication changes were made:
START levofloxacin 500mg daily for the next 5 days for your
infection
START metronidazole 500mg three times daily ( every 8 hours) for
your infection
START nicotine patch for help quitting smoking (It is very
important that you quit smoking for your health!)
START tylenol ___ every 8 hours for pain (take this every 8
hours on a scheduled basis for 2 days, then take only if you
have pain)
START oxycodone 5mg every 6 hours as needed for SEVERE pain</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you at ___!
You came to us because of worsening lower extremity swelling
concerning for worsening heart failure. While you were here, we
did an ultrasound of your heart which revealed that its pumping
function was decreased, likely in the setting of you having
difficulty taking your medications.
We gave you water pills, first through your IV, then via an oral
route, to get rid of the excessive fluid and help you feel
better. You will be discharged on a water-pill called Torsemide,
you will alternate 20mg and 10mg every other day. Please weigh
yourself daily, and call your doctor if your weight goes up by
more than 3 lbs; you will likely have to double the dose of your
water pill if this happens. You will need to be seen in the
Heart failure clinic within one week. You should receive a phone
call with an appointment. If you do not hear from the heart
failure office, please be sure to call ___ to schedule
an appointment.
We also made some adjustments to your heart failure medications.
As you know, certain medications have been shown to have a
mortality benefit in people with heart failure, some by
preventing the heart muscles from changing size and shape in
response to cardiac disease or cardiac damage ("prevent
remodeling"), some by reducing the pressure against which the
heart needs to work. These medications include: metoprolol,
hydralazine, imdur. It is very important that you continue to
take these as prescribed! Other changes that we made to your
heart medicines include discontinuing your digoxin, as you were
having episodes of slow heart rates.
You will need your kidney function rechecked in one week.
Finally, we asked the rheumatologists to look at your hands.
They recommend continuing 15 mg prednisone daily for one week
followed by 10 mg daily until having ___ in outpatient
rheumatology. They also recommend continuing methotrexate 10 mg
weekly with folic acid supplementation.
Please take care, 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 500 mg PO Q6H:PRN Pain - Mild
2. Allopurinol ___ mg PO DAILY
3. Aspirin 81 mg PO DAILY
4. Atorvastatin 80 mg PO QPM
5. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
6. Cetirizine 10 mg PO DAILY:PRN allergies
7. Cinacalcet 30 mg PO DAILY
8. Docusate Sodium 100 mg PO BID
9. Metoprolol Tartrate 12.5 mg PO BID
10. Nephrocaps 1 CAP PO DAILY
11. Nitroglycerin SL 0.4 mg SL Q5MIN:PRN chest pain
12. Senna 8.6 mg PO BID:PRN constipation
13. sevelamer CARBONATE 800 mg PO TID W/MEALS
14. Vitamin D ___ UNIT PO 1X/WEEK (SA)
Discharge Disposition:
Extended Care
Discharge Diagnosis:
Atypical Chest 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. ___,
It was a pleasure to care for you at the ___ ___
___. You came to the hospital because you developed
chest pain. In the hospital, we performed blood tests and an EKG
to evaluate your heart. The results of the tests we performed
were all normal. We believe it is safe for you to return to your
nursing home facility.
Please be sure to follow up with your doctors as listed below,
to continue your scheduled dialysis sessions, and to continue to
take all of your home medications.
We wish you all the best!
-Your ___ care team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen ___ mg PO Q6H:PRN Pain - Mild
2. Aspirin EC 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*2
3. Pantoprazole 40 mg PO Q12H
RX *pantoprazole 40 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*2
4. Ranitidine 150 mg PO BID
RX *ranitidine HCl 150 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*2
5. TiCAGRELOR 90 mg PO BID
RX *ticagrelor [Brilinta] 90 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*2
6. TraMADol 50 mg PO Q4H:PRN pain
RX *tramadol [Ultram] 50 mg 1 tablet(s) by mouth Q6hr Disp #*30
Tablet Refills:*0
7. Levothyroxine Sodium 75 mcg PO DAILY
8. Pravastatin 10 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Left ICA aneurysm
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Embolization
Activity
You may gradually return to your normal activities, but we
recommend you take it easy for the next ___ hours to avoid
bleeding from your groin.
Heavy lifting, running, climbing, or other strenuous exercise
should be avoided for ten (10) days. This is to prevent bleeding
from your groin.
You make take leisurely walks and slowly increase your
activity at your own pace. ___ try to do too much all at once.
Do not go swimming or submerge yourself in water for five (5)
days after your procedure.
You make take a shower.
Medications
Resume your normal medications and begin new medications as
directed.
You are instructed by your doctor to take one ___ a day
and Brillinta two times per day. Do not take any other products
that have aspirin in them. If you are unsure of what products
contain Aspirin, as your pharmacist or call our office.
You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
If you take Metformin (Glucophage) you may start it again
three (3) days after your procedure.
Care of the Puncture Site
You will have a small bandage over the site.
Remove the bandage in 24 hours by soaking it with water and
gently peeling it off.
Keep the site clean with soap and water and dry it carefully.
You may use a band-aid if you wish.
What You ___ Experience:
Mild tenderness and bruising at the puncture site (groin).
Soreness in your arms from the intravenous lines.
Mild to moderate headaches that last several days to a few
weeks.
Fatigue is very normal
Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
pain medications), try an over-the-counter stool softener.
When to Call Your Doctor at ___ for:
Severe pain, swelling, redness or drainage from the puncture
site.
Fever greater than 101.5 degrees Fahrenheit
Constipation
Blood in your stool or urine
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</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aluminum-Magnesium Hydrox.-Simethicone ___ mL PO QID:PRN
epigastric pain
2. CARVedilol 25 mg PO BID
3. amLODIPine 10 mg PO DAILY
4. Aspirin 81 mg PO DAILY
5. Atorvastatin 80 mg PO QPM
6. Chlorthalidone 25 mg PO DAILY
7. Lisinopril 40 mg PO DAILY
8. MetFORMIN XR (Glucophage XR) 1000 mg PO DAILY
9. Omeprazole 20 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Noncardiac chest pain
Heart failure with newly reduced ejection fraction
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at ___
___.
WHY WAS I ADMITTED TO THE HOSPITAL?
- You were admitted to the hospital because of your chest pain
and abnormal stress test.
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
- Your lab tests, EKGs did not show a heart attack. While you
were in the hospital, we performed another stress test and an
ultrasound of the heart that showed it does not function as well
as previously.
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 isnt getting
better with rest or nitroglycerine 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.
- Weigh yourself every morning, call your doctor at
___
if your weight goes up more than 3 lbs.
- Your discharge weight: 214 lbs. You should use this as your
baseline after you leave the hospital.
- You will need further imaging of your heart, a test called a
CT Angiogram, to rule out potential of a blockage in your heart.
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. Outpatient Lab Work
Please check CBC on ___ and fax result to PCP ___
___ at (f) ___. Dr. ___ number is
___.
2. Gabapentin 600 mg PO TID
3. Omeprazole 40 mg PO BID
4. iron, carbonyl *NF* 0 unknown ORAL DAILY
5. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSES:
- Abnormal EKG
- Depression
- Anxiety
- Pseudoseizure
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 ___
for vertigo. Although you did not have a heart attack, you were
found to have EKG changes concerning for possible ischemia, or
heart disease, and you had a stress echocardiogram, which showed
possible ischemia. In order to better evaluate your heart, you
had a MIBI scan, which did not show evidence of heart disease.
With this result, we feel comfortable that you do not have a
significant blockage of one of your coronary arteries. We
started you on an aspirin and arranged outpatient ___ with
Dr. ___ at ___.
During your admission, you had a different sound over your left
carotid artery. As an outpatient, Dr. ___ will consider an
ultrasound of your carotid arteries to better evaluate their
blood flow.
You continued to show signs of anemia, although you had no
active bleeding. We recommend you have your anemia rechecked on
___. Please walk in to ___ or your regular
outpatient lab for the blood test.
During your admission, you also had symptoms of depression and
anxiety. You were seen by the Psychiatry consult service, who
determined it is safe for you to go home. It is very important
that you arrange ___ with Dr. ___ the next week
for further psychiatric care.
We made the following changes to your medications:
- START Aspirin 81 mg daily</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acyclovir 400 mg PO Q8H Duration: 5 Days
RX *acyclovir 400 mg 1 tablet(s) by mouth three times a day Disp
#*15 Tablet Refills:*0
2. Sulfameth/Trimethoprim DS 1 TAB PO BID Duration: 5 Days
RX *sulfamethoxazole-trimethoprim [Bactrim DS] 800 mg-160 mg 1
tablet(s) by mouth twice a day Disp #*10 Tablet Refills:*0
3. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
4. Enoxaparin Sodium 40 mg SC QPM
5. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN severe pain
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Recurrent rectal cancer s/p robotic proctectomy, diverting end
colostomy, perineal ___ flap
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 for monitoring, and you have been stable
during this admission and are OK to go back home. Please
continue with the instructions you were given at your prior
discharge (see below).
You may take over the counter oral Benadryl for itching. Do NOT
apply any creams, lotions, or ointments to your wounds.
You were admitted to the hospital after arRobotic
abdominoperineal resection for surgical management of your
recurrent rectal cancer. You have recovered from this procedure
well and you are now ready to return home. Samples of tissue
were taken and has been sent to the pathology department. You
will receive these pathology results at your follow-up
appointment. If there is an urgent need for the surgeon to
contact you regarding these results they will contact you before
this time.
You have a new colostomy. It is important to monitor the output
from this stoma. It is expected that the stool from this ostomy
will be solid and formed like regular stool. You should have ___
bowel movements daily. If you notice that you have not had any
stool from your stoma in ___ days, please call the office. You
may take an over the counter stool softener such as Colace if
you find that you are becoming constipated. Please watch the
appearance of the stoma (intestine that protrudes outside of
your abdomen), it should be beefy red/pink, if you notice that
the stoma is turning darker blue or purple, or dark red please
call the office for advice. The stoma may ooze small amounts of
blood at times when touched but this will improve over time. The
skin around the ostomy site should be kept clean and intact.
Monitor the skin around the stoma for any bulging or signs of
infection listed above. Please care for the ostomy as you have
been instructed by the ostomy nurses. ___ the skin around
the stoma for any bulging or signs of infection listed above.
You will be able to make an appointment with the ostomy nurse in
the clinic ___ weeks after surgery. Please call the ostomy
nurses clinic number which is listed in the ileostomy/colostomy
handout packet given to you by the nursing staff. You will also
have a visiting nurse at home for the next few weeks to help
monitor your ostomy until you are comfortable caring for it on
your own.
Currently your colostomy is allowing the surgery in your large
intestine or rectum to heal which does take some time. At your
follow-up appointment in the clinic, the surgeons will determine
the best time for the next step: reversal surgery. Until then,
the healthy intestine is still functioning as it normally would
and continue to produce mucus. Some of this mucus may leak or
you may feel as though you need to have a bowel movement. You
may sit on the toilet and empty this mucus as though you were
having a bowel movement or wear clothing that prevents leakage
of this material such as a disposable pad.
If you have any of the following symptoms please call the office
at ___:
fever greater than 101.5
increasing abdominal distension
increasing abdominal pain
nausea/vomiting
inability to tolerate food or liquids
prolonged loose stool
extended constipation
inability to urinate
Incisions:
* Please monitor your incision lines closely for signs of
infection: opening of the incision, increased redness, increased
pain, if you have a fever greater than 101, swelling of the
tissues around the incision line, drainage of
green/yellow/grey/white/thick drainage, increased pain at the
incision line, or increased warmth.
* You may shower with incisions and drain. Be sure the drain is
secured to you and not left dangling on the shower floor. Let
the warm water run over the incisions and ___ all areas
dry with a clean towel, and keep open to air but as clean and
dry as possible. If the incisions become irritated, you may
apply a dry sterile gauze dressing to the incision line. Please
follow-up with Dr. ___ questions related to your most
current surgery.
* Continue to monitor the flaps that were placed in your
___ area. These should remain warm and a similar color
to the rest of your skin. If you notice that these areas are
changing in color to: red, purplish, blue, black, or pale please
call Dr. ___ immediately.
* Please change position while in bed or in a chair frequently.
Please walk frequently. Please avoid sitting in a chair for the
time being. Please avoid frequent bending at the waist or
lifting anything greater than 5 pounds until cleared by Dr.
___. Please continue good hygiene.
* Please avoid smoking as this will result in poor blood supply
and healing to your surgical areas.
Pain
It is expected that you will have pain after surgery, this will
gradually improve over the first week or so you are home. You
should continue to take 2 Extra Strength Tylenol (___) for
pain every 8 hours around the clock. Please do not take more
than 3000mg of Tylenol in 24 hours or any other medications that
contain Tylenol such as cold medication. Do not drink alcohol
while taking Tylenol. You may also take Advil (Ibuprofen) 600mg
every 8 hours for 7 days, please take Advil with food. If these
medications are not controlling your pain to a point where you
can ambulate and perform minor tasks, you should take a dose of
the narcotic pain medication oxycodone. Please do not take
sedating medications or drink alcohol while taking the narcotic
pain medication. Do not drive while taking narcotic medications.
Activity
You may feel weak or "washed out" for up to 6 weeks after
surgery. Do not lift greater than a gallon of milk for 3 weeks.
At your post op appointment, your surgical team will clear you
for heavier exercise. In the meantime, you may climb stairs, and
go outside and walk. Please avoid traveling long distances until
you speak with your surgical team at your post-op visit. Again,
please do not drive while taking narcotic pain medications.
You will be discharged home on Lovenox injections to prevent
blood clots after surgery. You will take this for 30 days after
your surgery date, please finish the entire prescription. This
will be given once daily. Please follow all nursing teaching
instruction given by the nursing staff. Please monitor for any
signs of bleeding: fast heart rate, bloody bowel movements,
abdominal pain, bruising, feeling faint or weak. If you have any
of these symptoms please call our office or seek medical
attention. Avoid any contact activity while taking Lovenox.
Please take extra caution to avoid falling.
* Drain care:
1. Clean around the drain site(s), where the tubing exits the
skin, with soap and water.
2. Strip drain tubing, empty bulb(s), and record output(s) ___
times per day. Re-establish drain suction.
3. A written record of the daily output from each drain should
be brought to every follow-up appointment. Your drains will be
removed as soon as possible when the daily output tapers off to
an acceptable amount.
Thank you for allowing us to participate in your care, we wish
you all the best!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Levothyroxine Sodium 100 mcg PO DAILY
2. Multivitamins W/minerals 1 TAB PO DAILY
3. Vitamin D 400 UNIT PO DAILY
4. Albuterol Inhaler 2 PUFF IH Q6H:PRN cough
RX *albuterol sulfate [ProAir HFA] 90 mcg 2 puffs inhaled four
times a day Disp #*1 Inhaler Refills:*0
5. Benzonatate 100 mg PO TID:PRN cough
RX *benzonatate 200 mg 1 capsule(s) by mouth three times a day
Disp #*15 Capsule Refills:*0
6. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*15 Capsule Refills:*0
7. Calcium Carbonate 1000 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY:
- Splenic Marginal Cell Lymphoma
- Massive Splenomegaly
SECONDARY
- Hypothyroidism
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 taking care of you at ___. You were admitted
for lethargy and an abdominal mass. It was found that you had
significant splenomegaly and concerning lab abnormalities. You
were seen by Hematology specialists who performed a bone marrow
biopsy. Although the final results are not back, the
preliminary findings suggests a Splenic Marginal Cell Lymphoma.
This does not need to be treated during this hospitalization,
and instead, you will have the hematology doctors ___ the
___ as an outpatient. You have a scheduled hematology
appointmet at the time/office found below.
Please make sure to follow up with physicians as noted below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amphetamine-Dextroamphetamine XR 20 mg PO DAILY
2. Fludrocortisone Acetate 0.1 mg PO DAILY
3. Omeprazole 20 mg PO DAILY
4. Sertraline 150 mg PO DAILY
5. Simvastatin 20 mg PO QPM
6.Outpatient Physical Therapy
ICD-10 code: ___ deconditioning. Please evaluate and treat
for deconditioning and persistent shortness of breath.
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnosis
- Orthostatic hypotension secondary to adrenal insufficiency
Secondary Diagnosis
- Anemia
- OSA
- GERD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were hospitalized at ___.
Why did you come to the hospital?
=========================
- You were admitted to the hospital for worsening of your
orthostatic hypotension
What did we do for you?
=================
- We gave you IV fluids to increase your blood pressure.
- We tested your cortisol level, which was normal.
What do you need to do?
==================
- It is important that you follow-up with your outpatient doctor
for further management of your orthostatic hypotension. You
already have an appointment scheduled for ___
- It is important that you get an ultrasound of your heart
(echocardiogram), pulmonary function tests, and a CT of your
chest as an outpatient.
- You should follow up with ___ Neurology (appointment
information below)
- Please note you have both a PCP appointment and ___ capsule
endoscopy on ___, please call your PCP to verify if you should
get your endoscopy that morning.
It was a pleasure caring for you. We wish you the best!
Sincerely,
Your ___ Medicine Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. DiCYCLOmine 10 mg PO QID:PRN abdominal spasm/pain
2. Ferrous Sulfate 325 mg PO DAILY
3. Lorazepam 0.5 mg PO Q8H:PRN Anxiety
4. Mercaptopurine 150 mg PO DAILY
5. Pantoprazole 40 mg PO Q24H
6. Polyethylene Glycol 17 g PO DAILY constipation
7. PredniSONE 40 mg PO DAILY
8. Morphine Sulfate ___ 15 mg PO Q6H:PRN pain
RX *morphine 15 mg 1 tablet(s) by mouth every six (6) hours Disp
#*42 Tablet Refills:*0
9. Vitamin D 50,000 UNIT PO 1X/WEEK (FR)
10. Ondansetron 4 mg PO ONCE nausea Duration: 1 Dose
RX *ondansetron HCl [Zofran] 4 mg 1 tablet(s) by mouth every
eight (8) hours Disp #*21 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS
1. Biliary Colic
SECONDARY DIAGNOSIS
1. 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>Dear ___,
It was a pleasure caring for you at ___. You were admitted
with abdominal pain, nausea, and vomiting. We spoke with your
out-patient gastroenterologist and reviewed your imaging and
labs. Based on these findings, your presentation is most
consistent with debris near your gallbladder.
Please follow up at your follow up appointments listed below.
You can talk to Dr. ___ your surgeon about the possibility
of surgery in the future.
Thank you for choosing ___.
Sincerely,
Your ___ Team</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 BID:PRN wheezing, dyspnea
2. Aspirin 81 mg PO DAILY
3. Benzonatate 100 mg PO TID:PRN cough
4. Carvedilol 6.25 mg PO BID
5. Cetirizine 10 mg PO BID
6. ClonazePAM 0.5 mg PO QHS
7. Docusate Sodium 100 mg PO TID
8. Fluconazole 200 mg PO 2X/WEEK (___)
9. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
10. Gabapentin 100 mg PO TID
11. Gabapentin 200 mg PO QHS
12. Lisinopril 20 mg PO DAILY
13. Montelukast 10 mg PO DAILY
14. Multivitamins 1 TAB PO DAILY
15. Mycophenolate Mofetil 500 mg PO TID
16. Omeprazole 40 mg PO BID
17. Ondansetron 4 mg PO Q8H:PRN nausea
18. Polyethylene Glycol 17 g PO DAILY
19. QUEtiapine Fumarate 12.5 mg PO QHS
20. Senna 17.2 mg PO TID
21. Sodium Chloride Nasal ___ SPRY NU QID:PRN nasal stuffiness
22. Tiotropium Bromide 1 CAP IH DAILY
23. Vitamin D 1000 UNIT PO DAILY
24. Acetaminophen w/Codeine ___ TAB PO Q6H:PRN pain
25. azelastine 137 mcg (0.1 %) nasal BID
26. DiphenhydrAMINE 25 mg PO QHS:PRN pruritus
27. Furosemide 40 mg PO BID:PRN leg swelling
28. melatonin 3 mg oral DAILY
29. Mupirocin Ointment 2% 1 Appl TP TID
30. Moxifloxacin 400 mg OTHER DAILY
last day of antibiotics ___
RX *moxifloxacin 400 mg 1 tablet(s) by mouth daily Disp #*3
Tablet Refills:*0
31. Enoxaparin Sodium 50 mg SC Q12H
Start: Today - ___, First Dose: Next Routine Administration
Time
You must follow up with your hematologist Dr. ___ to cont
to be prescribed.
RX *enoxaparin 60 mg/0.6 mL 50 mg subcutaneously every 12 hours
Disp #*60 Syringe Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
deep vein thrombosis of the left lower extremity
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 a blood clot in your left leg and
cellulitis (infection) in your right leg. A hematologist was
consulted to help us manage your anticoagulation and recommended
enoxaparin (also known as lovenox). Your dose will be 50mg every
12 hours.
You will also be discharged on an antibiotic moxifloxacin, which
you should take once a day. your last day of antibiotics will be
___.
Be sure to follow up with your hematologist Dr. ___
cannot make an appointment for you because it is ___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Bisacodyl 10 mg PO DAILY:PRN constipation
RX *bisacodyl [Dulcolax] 5 mg 2 tablet,delayed release
(___) by mouth daily Disp #*30 Tablet Refills:*0
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice
daily Disp #*30 Capsule Refills:*0
3. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule,delayed ___ by
mouth daily Disp #*30 Capsule Refills:*0
4. Senna 1 TAB PO BID
RX *sennosides [___] 8.6 mg 1 tab by mouth twice daily
Disp #*30 Tablet Refills:*0
5. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN shortness of
breath
6. Dexamethasone 2 mg PO Q12H
RX *dexamethasone 2 mg 1 tablet(s) by mouth twice daily Disp
#*30 Tablet Refills:*0
7. Guaifenesin ER 600 mg PO Q12H:PRN cough, congestion
RX *guaifenesin 600 mg 1 tablet extended release(s) by mouth
twice daily Disp #*30 Tablet Refills:*0
8. HYDROmorphone (Dilaudid) 0.5 mg PO Q4H
RX *hydromorphone [Dilaudid] 1 mg/mL 0.5 (One half) ml by mouth
q4 Disp ___ Milliliter Refills:*0
9. Metoclopramide 5 mg PO TID
RX *metoclopramide HCl 5 mg 1 tablet by mouth three times daily
Disp #*30 Tablet Refills:*0
10. Polyethylene Glycol 17 g PO DAILY
RX *polyethylene glycol 3350 [Miralax] 17 gram/dose 17 grams by
mouth daily Disp #*1 Bottle Refills:*0
11. Prochlorperazine 10 mg PO Q6H:PRN nausea
RX *prochlorperazine maleate 10 mg 1 tablet(s) by mouth every 6
hours Disp #*30 Tablet Refills:*0
12. Prochlorperazine 25 mg PR Q12H:PRN nausea
RX *prochlorperazine 25 mg 1 Suppository(s) rectally twice daily
Disp #*30 Suppository Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Metastatic/Stage IV HCC
HCV cirrhosis
Discharge Condition:
Mental Status: Clear and coherent.
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>It was a pleasure taking care of you at ___. You were admitted
with abdominal pain, nausea, and vomiting that are most likely
related to your cancer. This cancer is called hepatocellular
carcinoma and is widely spread. As a result, we focused on
prioritizing your comfort and coming up with a regimen to treat
your symptoms that will hopefully allow you be at home.
Palliative care service was consulted and we have come up with
the following plan for your pain and nausea.
For pain: oral dilaudid
For nausea: compazine suppositories/tablets, reglan tablets,
decadron
Please see the appointments below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day) as needed for constipation.
Disp:*60 Capsule(s)* Refills:*0*
2. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO DAILY (Daily).
3. hydromorphone 2 mg Tablet Sig: One (1) Tablet PO every ___
hours as needed for pain for 3 days.
Disp:*6 Tablet(s)* Refills:*0*
Discharge Disposition:
Home
Discharge Diagnosis:
acute pancreatitis
history of chronic pancreatitis due to pancreas divisum
dyspepsia
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 ___ with epigastric abdominal pain and
found to have pancreatitis. You were placed on IV fluids, given
pain medications and a MRCP was taken of your abdomen. This
confirmed findings of pancreatitis. Your pain improved and your
diet was advanced slowly. You tolerated this well. You will be
discharged home with close follow up with GI and your PCP.
.
Medications Changes
-stop nortriptyline
-use oxycodone for moderate pain (about 30 pills that patiennt
has from prior prescription at home)
.
-New medications
-dilaudid 2 mg Q3H prn for severe pain</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth q4h prn Disp #*30
Tablet Refills:*1
1. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth q4h prn Disp #*30
Tablet Refills:*1
Discharge Disposition:
Home
Discharge Diagnosis:
acute cholecystitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted to the hospital with acute cholecystitis. You
were taken to the operating room and had your gallbladder
removed laparoscopically. You tolerated the procedure well and
are now being discharged home to continue your recovery with the
following instructions.
Please follow up in the Acute Care Surgery clinic at the
appointment listed below.
ACTIVITY:
o Do not drive until you have stopped taking pain medicine and
feel you could respond in an emergency.
o You may climb stairs.
o You may go outside, but avoid traveling long distances until
you see your surgeon at your next visit.
o Don't lift more than ___ lbs for 4 weeks. (This is about
the weight of a briefcase or a bag of groceries.) This applies
to lifting children, but they may sit on your lap.
o You may start some light exercise when you feel comfortable.
o You will need to stay out of bathtubs or swimming pools for a
time while your incision is healing. Ask your doctor when you
can resume tub baths or swimming.
HOW YOU MAY FEEL:
o You may feel weak or "washed out" for a couple of weeks. You
might want to nap often. Simple tasks may exhaust you.
o You may have a sore throat because of a tube that was in your
throat during surgery.
o You might have trouble concentrating or difficulty sleeping.
You might feel somewhat depressed.
o You could have a poor appetite for a while. Food may seem
unappealing.
o All of these feelings and reactions are normal and should go
away in a short time. If they do not, tell your surgeon.
YOUR INCISION:
o Tomorrow you may shower and remove the gauzes over your
incisions. Under these dressing you have small plastic bandages
called steri-strips. Do not remove steri-strips for 2 weeks.
(These are the thin paper strips that might be on your
incision.) But if they fall off before that that's okay).
o Your incisions may be slightly red around the stitches. This
is normal.
o You may gently wash away dried material around your incision.
o Avoid direct sun exposure to the incision area.
o Do not use any ointments on the incision unless you were told
otherwise.
o You may see a small amount of clear or light red fluid
staining your dressing or clothes. If the staining is severe,
please call your surgeon.
o You may shower. As noted above, ask your doctor when you may
resume tub baths or swimming.
YOUR BOWELS:
o Constipation is a common side effect of narcotic pain
medications. If needed, you may take a stool softener (such as
Colace, one capsule) or gentle laxative (such as milk of
magnesia, 1 tbs) twice a day. You can get both of these
medicines without a prescription.
o If you go 48 hours without a bowel movement, or have pain
moving the bowels, call your surgeon.
PAIN MANAGEMENT:
o It is normal to feel some discomfort/pain following abdominal
surgery. This pain is often described as "soreness".
o Your pain should get better day by day. If you find the pain
is getting worse instead of better, please contact your surgeon.
o You will receive a prescription for pain medicine to take by
mouth. It is important to take this medicine as directed. o Do
not take it more frequently than prescribed. Do not take more
medicine at one time than prescribed.
o Your pain medicine will work better if you take it before your
pain gets too severe.
o Talk with your surgeon about how long you will need to take
prescription pain medicine. Please don't take any other pain
medicine, including non-prescription pain medicine, unless your
surgeon has said its okay.
o If you are experiencing no pain, it is okay to skip a dose of
pain medicine.
o Remember to use your "cough pillow" for splinting when you
cough or when you are doing your deep breathing exercises.
If you experience any of the following, please contact your
surgeon:
- sharp pain or any severe pain that lasts several hours
- pain that is getting worse over time
- pain accompanied by fever of more than 101
- a drastic change in nature or quality of your pain
MEDICATIONS:
Take all the medicines you were on before the operation just as
you did before, unless you have been told differently.
If you have any questions about what medicine to take or not to
take, please call your surgeon.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 500 mg PO Q6H:PRN pain
2. Aspirin 81 mg PO DAILY
3. Atorvastatin 40 mg PO QPM
4. Carvedilol 12.5 mg PO BID
please hold the morning of dialysis days to prevent hypotension
during dialysis
5. Clopidogrel 75 mg PO DAILY
6. Glucagon 1 mg IM Q15MIN:PRN hypoglycemia protocol
7. Insulin SC
Sliding Scale
Fingerstick QACHS
Insulin SC Sliding Scale using HUM Insulin
8. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY
As per renal doctor, is to be given in evening
9. LACOSamide 200 mg PO BID
10. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES QHS
11. LevETIRAcetam 500 mg PO BID
12. LevETIRAcetam 500 mg PO 3X/WEEK (___)
13. Mirtazapine 7.5 mg PO QHS
14. Multivitamins 1 TAB PO DAILY
15. Pantoprazole 20 mg PO Q12H
16. Vitamin D ___ UNIT PO 1X/WEEK (___)
17. Albuterol Inhaler 2 PUFF IH Q8H:PRN wheezing
18. Nepro Carb Steady (nut.tx.impaired renal fxn,soy) 0.08-1.80
gram-kcal/mL oral TID between meals
19. Ranitidine 300 mg PO DAILY
20. Torsemide 40 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
#Nausea/Vomiting/Diarrhea
#Viral Gastroenteritis
#Seizure disorder
#End stage renal disease
#Hypertension
#Type 2 diabetes
#Peripheral vascular disease
Discharge Condition:
Discharge Condition: Stable
Mental Status: AOx3
Ambulatory Status: Rolling walker required (baseline)
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
You were admitted for concern that you were dehydrated from
nausea, vomiting, and diarrhea, which may have been due to a
virus. Fortunately, your symptoms resolved within 24 hours and
you felt well enough to return to rehab.
We wish you the best!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Atenolol 25 mg PO DAILY
3. Atorvastatin 20 mg PO DAILY
4. Fish Oil (Omega 3) 1000 mg PO BID
5. Lansoprazole Oral Disintegrating Tab 30 mg PO DAILY
6. Lorazepam 0.5 mg PO HS:PRN anxiety
7. Methylprednisolone 6 mg PO DAILY
8. Multivitamins 1 TAB PO DAILY
9. Nitroglycerin SL 0.3 mg SL PRN chest pain
10. Enoxaparin Sodium 80 mg SC Q12H
Start: ___, First Dose: Next Routine Administration Time
RX *enoxaparin 80 mg/0.8 mL 80 mg subcutaneous every twelve (12)
hours Disp #*14 Syringe Refills:*0
11. Warfarin 5 mg PO DAILY16
RX *warfarin 5 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
12. Calcium 500 (calcium carbonate) 500 mg calcium (1,250 mg)
oral Daily
13. flaxseed 1,000 mg oral Daily
14. Forteo (teriparatide) 20 mcg/dose - 600 mcg/2.4 mL
subcutaneous Daily
15. Humira (adalimumab) 40 mg/0.8 mL subcutaneous Every 14 days
16. Leucovorin Calcium 10 mg PO 1X/WEEK (___) ___ hoursa fter
MTX
17. Methotrexate 0.6 mg SC 1X/WEEK (___)
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS
1. Pulmonary Embolism
2. Coronary Artery Disease
SECONDARY DIAGNOSIS
1. Osteoarthritis
2. Gastroesophageal Reflux Disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___:
It was a pleasure caring for you at ___
___. You were admitted because you experienced
palpitations and your EKG was concerning. Imaging of your chest
showed small blood clots in your lungs. You were started on
medication (warfarin/coumadin) that thins your blood to prevent
further blood clots.
A procedure to look at the vessels in your heart did not
demonstrate any significant blockages of your heart. An
ultrasound of your heart was also performed and showed mild
thickening of one wall of your heart, and mild stiffness of one
heart valve. You should have a repeat ultrasound in ___ years
for further evaluation.
Dr. ___ was notified of your need for
anti-coagulation due to the blood clots in your lungs. They will
monitor your INR (a measurement of how thin your blood is) as an
out-patient.
Thank you for choosing ___. We wish you the very best.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: No Medications
Discharge Disposition:
Home
Discharge Diagnosis:
Sickle cell pain crisis
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 recently admitted to the ___
___ pain, likely due to sickle cell crisis. There was no
concern for infection. You chose to leave against medical advice
to tend to a family emergency. Please seek immediately medical
care if you have any symptoms that are concerning. We urge you
to establish medical care with a primary care physician to
continue ongoing management of your sickle cell anemia. This
should help you maintain better control of your pain in the
future. You are always welcome to come back for medical care at
the ___.
We wish you the best,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H:PRN pain
2. Diltiazem Extended-Release 120 mg PO DAILY
3. Docusate Sodium 100 mg PO BID
4. Enoxaparin Sodium 90 mg SC Q12H
5. Rosuvastatin Calcium 40 mg PO DAILY
6. Levothyroxine Sodium 112 mcg PO DAILY
7. Metoprolol Succinate XL 100 mg PO DAILY
8. Aspirin 325 mg PO DAILY
RX *aspirin 325 mg 1 tablet,delayed release (___) by mouth
once a day Disp #*90 Tablet Refills:*3
9. esomeprazole magnesium *NF* 40 mg Oral BID
10. Rosuvastatin Calcium *NF* (rosuvastatin) 40 mg ORAL QD
11. Felodipine 10 mg PO DAILY
12. Lisinopril 40 mg PO DAILY
13. Vitamin B Complex 1 CAP PO DAILY
14. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours
Disp #*100 Tablet Refills:*0
15. Clopidogrel 75 mg PO DAILY
RX *clopidogrel 75 mg 1 tablet(s) by mouth once a day Disp #*90
Tablet Refills:*3
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Lung cancer
Arterial thrombus lower extremities
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>Vascular Surgery Discharge Instructions
- You were admitted with blood clots in your arterial system.
You underwent several operations to help restore blood flow to
your legs. You will need to be on an injectable blood thinner
(lovenox/enoxaparin) for the rest of your life.
WHAT TO EXPECT:
1. It is normal to feel tired, this will last for at least ___
weeks
You should get up out of bed every day and gradually increase
your activity each day
You may walk and you may go up and down stairs
Increase your activities as you can tolerate- do not do too
much right away!
2. It is normal to have some swelling of the leg
Elevate your leg above the level of your heart (use ___
pillows or a recliner) every ___ hours throughout the day and at
night
Avoid prolonged periods of standing or sitting without your
legs elevated
3. It is normal to have a decreased appetite, your appetite will
return with time
You will probably lose your taste for food and lose some
weight
Eat small frequent meals
It is important to eat nutritious food options (high fiber,
lean meats, vegetables/fruits, low fat, low cholesterol) to
maintain your strength and assist in wound healing
To avoid constipation: eat a high fiber diet and use stool
softener while taking pain medication
MEDICATION:
Take aspirin , plavix and lovenox as instructed
Follow your discharge medication instructions
ACTIVITIES:
No driving until post-op visit and you are no longer taking
pain medications
No heavy lifting, pushing or pulling (greater than 5 pounds)
until your post op visit
You may shower (unless you have stitches or foot incisions) no
direct spray on incision, let the soapy water run over incision,
rinse and pat dry
Your incision may be left uncovered, unless you have small
amounts of drainage from the wound, then place a dry dressing
over the area that is draining, as needed
CALL THE OFFICE FOR: ___
Redness that extends away from your incision
A sudden increase in pain that is not controlled with pain
medication
A sudden change in the ability to move or use your leg or the
ability to feel your leg
Temperature greater than 100.5F for 24 hours
Bleeding, new or increased drainage from incision or white,
yellow or green drainage from incisions</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 every 12 hours
Disp #*14 Tablet Refills:*0
2. Acetaminophen 500 mg PO Q6H:PRN Pain - Mild
3. Levothyroxine Sodium 125 mcg PO DAILY
4. Omeprazole 20 mg PO DAILY
5. Vitamin D 200 UNIT PO DAILY
6.Outpatient Physical Therapy
DME: Rolling walker
DX: pyelonephritis, deconditioning
Prognosis: good
Length of need; 13 months
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Bilateral hydronephrosis likely due to cancer recurrence
Septic shock due to urinary tract infection
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 sent in by your Urologist Dr. ___ worsening
kidney function. We think that this is due to a blockage of
your ureters, or the outflow tract of your kidneys due to a
recurrence of your cancer. We placed external drains to drain
your urine to the outside. We also treated you for a severe
urinary tract infection caused by the obstruction.
We are sending you home to resume visiting nurse services for
your new drains and physical therapy.
Please complete your entire course of antibiotics and return if
you have worsening fevers/chills, decreased output from your
drains, worsening abdominal/back pain, or if you have any other
concerns.
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: [/INST] </s><s>Dear Dr. ___ were hospitalized due to symptoms from a subdural hematoma.
During this hospitalization, ___ were found to be hypotensive
when standing. Due to this, we have recommended the following
changes to your home medications:
1) stop taking losartan
2) Please take your quinapril at night
Please also wear ___ stockings and an abdominal binder.
Please followup with Neurology, your cardiologist and your
primary care physician as listed below.
It has been recommended that ___ continue physical therapy at
home to help in your recovery and reduce your risk of further
falls.
It was a pleasure taking care of ___ this hospitalization.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. GuaiFENesin ___ mL PO Q6H:PRN cough
RX *guaifenesin 100 mg/5 mL ___ mL by mouth every six (6) hours
Refills:*0
2. amLODIPine 5 mg PO DAILY
RX *amlodipine 5 mg 1 tablet(s) by mouth Daily Disp #*30 Tablet
Refills:*0
3. Albuterol Inhaler 2 PUFF IH Q6H:PRN SOB/Wheeze
4. Allopurinol ___ mg PO EVERY OTHER DAY gout
5. Aspirin 81 mg PO DAILY
6. Atorvastatin 80 mg PO DAILY
7. Benzonatate 100 mg PO TID:PRN cough
8. Clopidogrel 75 mg PO DAILY
9. Cyanocobalamin 250 mcg PO DAILY
10. Docusate Sodium 100 mg PO BID:PRN constipation
11. Ezetimibe 10 mg PO DAILY
12. Famotidine 20 mg PO DAILY
13. Ferrous Sulfate 325 mg PO 3X/WEEK (___)
14. Finasteride 5 mg PO DAILY
15. FoLIC Acid 1 mg PO DAILY
16. Lansoprazole Oral Disintegrating Tab 30 mg PO BID
17. Metoprolol Tartrate 100 mg PO QAM
18. Metoprolol Tartrate 50 mg PO QPM
19. Multivitamins 1 TAB PO DAILY
20. Prochlorperazine 10 mg PO Q6H:PRN nausea
21. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation
inhalation BID
22. Tamsulosin 0.4 mg PO QHS
23. Tiotropium Bromide 1 CAP IH DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Small bowel obstruction
Aspiration pneumonia
Hypercalemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr ___,
You were admitted from clinic with high blood pressure. You were
found to have an obstruction in your small intestine and your
calcium level was too high. The bowel obstruction was most
likely due to "adhesions" or scar tissue in your abdomen from a
prior surgery. You were treated with bowel rest and a tube in
your nose to decompress you intestine. With this your
obstruction resolved. You were able to tolerate a diet. However,
unfortunately the small bowel obstruction returned. You refused
an NG tube and preferred to treat with bowel rest, IV fluids,
and antiemetics. With this you improved and were able to eat
normally again. It is very important you have at least one bowel
movement a day.
You were also found to have pneumonia that was likely caused by
vomit entering your lungs. You were treated with antibiotics for
this.
Please take your medications as instructed and follow up as
below. Weigh yourself every morning, call your doctor if your
weight goes up more than 3 lbs in a day.
Best of luck with your continued healing!
Take care,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Docusate Sodium 100 mg PO DAILY
Please administer with iron supplementation
2. Escitalopram Oxalate 20 mg PO DAILY
3. Ferrous Sulfate 325 mg PO DAILY
4. Furosemide 20 mg PO DAILY
5. Gabapentin 300 mg PO DAILY:PRN migraine
6. Lorazepam 1 mg PO BID
7. Ranitidine 150 mg PO BID
8. Warfarin 5 mg PO 4X/WEEK (___)
9. Warfarin 6 mg PO 3X/WEEK (___)
10. Digoxin 0.125 mg PO DAILY
RX *digoxin 125 mcg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*1
11. Aspirin 81 mg PO DAILY
12. Potassium Chloride 20 mEq PO DAILY Duration: 24 Hours
Hold for K > 4.5
13. Vitamin D ___ UNIT PO DAILY
14. Verapamil 180 mg PO BID
RX *verapamil 180 mg 1 capsule(s) by mouth twice a day Disp #*60
Capsule Refills:*0
15. Metoprolol Succinate XL 100 mg PO BID
RX *metoprolol succinate 100 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*1
16. Ondansetron 4 mg PO Q8H:PRN nausea
RX *ondansetron 4 mg 1 tablet(s) by mouth every eight (8) hours
Disp #*9 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Atrial fibrillation with rapid ventricular response
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___, thank you very much for giving us the
opportunity to take care of you.
You were admitted to the hospital for fatigue and weakness
likely resulting from fast irregular heart rate called atrial
fibrillation. We slowed your heart rate down with a number of
medications.
Please go to the ___ lab to pick up your ___ of hearts
monitor, this will help us monitor your heart rate when you are
having symptoms as an outpatient.
Given your history of fast and irregular heart rates, we will
start you on a new regimen of heart rate-controlling
medications.
New medications:
START Verapamil 180mg twice a day
START Metoprolol succinate 100mg twice a day
START Digoxin 0.125 mg once a day</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. BusPIRone 20 mg PO TID
2. Aspirin 81 mg PO DAILY
3. Fluoxetine 40 mg PO DAILY
4. Gabapentin 300 mg PO TID
5. LaMOTrigine 50 mg PO QAM
6. LaMOTrigine 100 mg PO QPM
7. QUEtiapine Fumarate 200 mg PO QHS
8. QUEtiapine Fumarate 25 mg PO Q6H:PRN anxiety
9. FoLIC Acid 1 mg PO DAILY
10. Lorazepam 1 mg PO TID W/MEALS
11. Multivitamins W/minerals 1 TAB PO DAILY
12. Thiamine 100 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
Primary:
Eating disorder (bulimia & anorexia)
Pseudoseizure
Secondary:
Generalized Anxiety Disorder
Mood Disorder NOS
Discharge Condition:
Mental Status: Oriented x 3, frequently tearful, becomes acutely
agitated intermittently when discussing discharge. Cooperative
with eating disorder protocol.
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 ___
___. You were admitted for hypotension, electrolyte
abnormalities, and seizure-like activity. While you were
admitted, you were first sent to the ICU and neurology service,
where you improved after getting fluids and blood pressure
raising medicines. Several EEGs were also done, showing no
evidence of seizures. You then were transferred to the Medicine
service for medical optimization. There you were started on the
eating disorder protocol while we monitored your electrolytes,
your vital signs, and your heart rhythms. On the day of
discharge, your electrolytes were within normal limits; your EKG
was normal; your blood pressure, blood glucose, and standing
weight were stable.
We wish you the best and take care.
Sincerely,
SIRS 4 Medical Service</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. clotrimazole 1 % Cream Sig: One (1) application Topical twice
a day.
2. diclofenac sodium 25 mg Tablet, Delayed Release (E.C.) Sig:
Two (2) Tablet, Delayed Release (E.C.) PO BID (2 times a day) as
needed for joint pain.
3. fluticasone 110 mcg/actuation Aerosol Sig: Two (2) Puff
Inhalation BID (2 times a day).
4. metoprolol succinate 100 mg Tablet Extended Release 24 hr
Sig: One (1) Tablet Extended Release 24 hr PO once a day.
5. diltiazem HCl 240 mg Capsule, Ext Release 24 hr Sig: One (1)
Capsule, Ext Release 24 hr PO once a day.
6. ferrous sulfate 300 mg (60 mg iron) Tablet Sig: One (1)
Tablet PO DAILY (Daily).
7. acetaminophen 500 mg Tablet Sig: ___ Tablets PO every six (6)
hours as needed for pain.
8. miconazole nitrate 2 % Powder Sig: One (1) Appl Topical TID
(3 times a day) as needed for rash.
9. losartan 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
10. furosemide 80 mg Tablet Sig: One (1) Tablet PO once a day.
11. ipratropium bromide 0.02 % Solution Sig: One (1) inhalation
Inhalation Q6H (every 6 hours).
12. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: One (1) inhalation Inhalation every six (6)
hours.
13. penicillin G potassium 20 million unit Recon Soln Sig: Four
(4) million units Injection Q4H (every 4 hours) for 23 days:
Continue through ___ .
14. oxycodone 5 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4
hours) as needed for breakthrough pain.
15. Outpatient Lab Work
Please draw WEEKLY: CBC w/diff, BUN/Cr, LFTs
All laboratory results should be faxed to Infectious disease
R.Ns. at ___
All questions regarding outpatient antibiotics should be
directed to the infectious disease R.Ns. at ___
or to on call MD in when clinic is closed
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Cellulitis
Bacteremia
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 ___,
You were admitted to the hospital for shortness of breath and
fevers, and you were found to have a significant leg infection
that had caused bacteria to enter your blood stream. You were
started on intravenous antibiotics, which helped to treat this
infection. You will need to stay on these antibiotics for at
least one month. While on these antibiotics, you will need labs
drawn weekly for monitoring.
Changes to your medications:
START penicillin G Potassium 4 Million Units IV every 4 hours
(until ___
INCREASE oxycodone to 10 mg every 4 hours as needed for leg pain
It was a pleasure to take care of you at ___!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H
RX *acetaminophen 650 mg 1 tablet(s) by mouth Every 6 hours Disp
#*60 Tablet Refills:*0
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth Twice a day
Disp #*30 Capsule Refills:*0
3. HYDROmorphone (Dilaudid) ___ mg PO Q4H:PRN pain
RX *hydromorphone 2 mg ___ tablet(s) by mouth Every 4 hours Disp
#*20 Tablet Refills:*0
4. Pantoprazole 40 mg PO Q24H
5. Ranitidine 150 mg PO DAILY
6. Senna 8.6 mg PO BID:PRN constipation
RX *sennosides [senna] 8.6 mg 1 capsule by mouth Twice a day
Disp #*30 Capsule Refills:*0
7. cefaDROXil 500 mg oral BID Duration: 14 Days
RX *cefadroxil 500 mg 1 capsule(s) by mouth Twice a day Disp
#*28 Capsule Refills:*0
8. Sulfameth/Trimethoprim DS 2 TAB PO BID Duration: 14 Days
RX *sulfamethoxazole-trimethoprim 800 mg-160 mg 2 tablet(s) by
mouth Twice a day Disp #*56 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Breast cellulitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted on ___ for observation/treatment of breast
cellulitis. Please follow these discharge instructions:
.
-Continue to monitor your breast area for continued improvement.
If the redness and swelling increase, please call the doctor's
office to report this.
-Should you have fevers and chills, please call the doctor's
office immediately to report.
-Continue your antibiotics until they are finished.
-You may consider eating a probiotic yogurt daily to replace the
'good' bacteria in your intestinal tract. If you cannot
tolerate yogurt then you may buy 'acidophilus' over the counter
as a supplement choice. Acidophilus is a 'friendly' bacteria
for your gut.
-If you start to experience excessive diarrhea, please call the
doctor's office to report this.
-Do not overexert yourself and no strenuous exercise for now.
-You may take either tylenol or advil (ibuprofen) for your
discomfort. Take as directed.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. LaMOTrigine 400 mg PO BID
RX *lamotrigine 200 mg 2 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*3
2. LeVETiracetam 1500 mg PO BID
RX *levetiracetam 500 mg 3 tablet(s) by mouth twice a day Disp
#*180 Tablet Refills:*3
3. Lorazepam 1 mg PO Q8H:PRN seizure
See above for taper schedule.
4. LACOSamide 150 mg PO BID
5. Lorazepam 1 mg PO PER ATTACHED SCHEDULE
RX *lorazepam 1 mg 1 tablet(s) by mouth attached schedule Disp
#*35 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Intractable Epilepsy
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to the hospital with increasing seizures. You
were seen by the neurology service. During this admission we
have monitored you with eeg, which showed an increase in the
frequency of your seizures. We have adjusted your medications
for better control. You were started on a new medication
(VIMPAT, also known as lacosamide). Your Trileptal and
acetazolamide were stopped. We have imaged your brain and did
not find any acute issues. You also had brain imaging which
shows a small area of abnormality in the temporal lobes. You
are being discharged in stable condition regarding these issues.
1. Please continue all your medications as directed by this
document.
2. Please schedule a follow up appointment with your primary
care doctor in ___ weeks.
3. A follow-up appointment has been scheduled for your with Dr.
___.
4. Continue Ativan taper as follows:
- Ativan 1mg three times daily for one week
- Ativan 1mg two times per day for one week
- STOP Ativan</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Sulfameth/Trimethoprim DS 2 TAB PO BID
RX *sulfamethoxazole-trimethoprim [Bactrim DS] 800 mg-160 mg 2
tablet(s) by mouth twice a day Disp #*28 Tablet Refills:*0
2. Cephalexin 500 mg PO Q6H
RX *cephalexin 500 mg 1 capsule(s) by mouth four times a day
Disp #*28 Capsule Refills:*0
3. Lisinopril 5 mg PO DAILY
4. Ketoconazole 2% 1 Appl TP BID
Apply in between toes twice a day.
RX *ketoconazole 2 % Apply in between toes twice a day. twice a
day Disp #*1 Tube Refills:*0
5. Aspirin 325 mg PO DAILY
RX *aspirin 325 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Cellulitis
Tinea Pedis
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 taking care of you here at ___. You were
admitted with a skin infection (cellulitis) of your right leg as
well as a fungal infection (tinea pedis) of your right foot. You
were seen by foot specialists (Podiatrists) and we treated you
with intravenous antibiotics (Vancomycin and Unasyn) and
antifungal cream (Ketoconazole). You were transitioned to oral
antibiotics (Bactrim and Keflex) on the day of discharge. You
should take these antibiotics for the next 7 days (to end on
___.
You should also continue to apply the anti-fungal cream
(Ketoconazole) for at least the next month.
While you were in the ER, you were noted to have an abnormal
heart rhythm (atrial fibrillation). You were treated with
medication that help bring the heart rhythm back to normal
(Diltiazem). We also started you on Aspirin 325mg daily. Please
speak with your doctor about whether you should continue taking
asprin.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
2. Gabapentin 100 mg PO TID
3. Levothyroxine Sodium 75 mcg PO DAILY
4. Omeprazole 40 mg PO DAILY
5. Simvastatin 10 mg PO QPM
6. Ciprofloxacin HCl 500 mg PO Q12H Duration: 10 Days
Take through ___.
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*19 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: septic shock; UTI; Ileocolitis secondary to
campylobacter infection
Secondary: Anemia; uterine prolapse; Hypothyroidism;
hypertension
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 ___ with an infection of your bowels and
your urine. Testing of your stool showed a gut infection called
campylobacter. This is usually caused by consuming undercooked
meats. Please be careful to consume only thoroughly cooked meats
in the future. Try to eat yogurt at every meal because this will
help your diarrhea get better.
We treated you with antibiotics and you improved. You will need
to keep taking this antibiotic (ciprofloxacin) through ___
___.
You also suffered from prolapse of your uterus. This needs to be
treated with a device called a pessary. It will be fitted by the
Uro-gynecologists at ___. You will need to call them as soon
as possible to make an appointment.
Please follow up with your primary care doctor for additional
treatment.
It was a pleasure taking care of you, best of luck.
Your ___ medical team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Insulin Pump SC (Self Administering Medication)Insulin
Aspart (Novolog) (non-formulary)
Basal rate maximum: 2 units/hr
Bolus minimum: 10 units
Target glucose: ___
Fingersticks: QAC and HS, Q3AM
2. Acetaminophen 650 mg PO Q4H:PRN Pain - Mild/Fever
3. Aspirin 81 mg PO DAILY
4. Atorvastatin 60 mg PO QPM
5. Calcitrate-Vitamin D (calcium citrate-vitamin D3) 315 mg-
250 unit oral DAILY
6. CycloSPORINE (Neoral) MODIFIED 75 mg PO Q12H
7. Estring (estradiol) 2 mg (7.5 mcg /24 hour) vaginal Every 90
days
8. Furosemide 20 mg PO DAILY:PRN Edema
9. Lactulose 60 mL PO BID:PRN Constipation
10. Levothyroxine Sodium 112 mcg PO DAILY
11. Lidocaine 5% Patch 1 PTCH TD QPM
12. Mycophenolate Mofetil 500 mg PO BID
13. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN Chest pain
14. PredniSONE 3 mg PO DAILY
15. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
16. Tamoxifen Citrate 20 mg PO DAILY
17. Tretinoin 0.025% Cream 1 Appl TP QHS
18. Vitamin D ___ UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS
================
Multi-drug resistant klebsiella urinary tract infection
SECONDAY DIAGNOSES
==================
Acute on chronic kidney injury
Type 1 diabetes
Anemia
Hypertension
Hyperlipidemia
History of breast cancer
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. ___,
WHY YOU WERE HERE
- You were having burning when you pee and feeling tired.
WHAT WE DID FOR YOU
- You were found to have the same urinary tract infection as
before
- You were treated with IV antibiotics which you will continue
on discharge
WHAT YOU SHOULD DO WHEN YOU LEAVE
- You will have nursing come to the house initially to help with
antibiotic infusions
- Please take your medications as below
- Follow up with your PCP, ___, and diabetes
doctor. You will also need to see a urologist
- Please continue your excellent care of your diabetes with your
insulin pump
- Please use bolus wizard for high sugars so adjustments to
insulin pump settings can be made as needed for uncontrolled
diabetes.
- Remember, treatment with insulin requires intensive, daily
monitoring of blood glucose levels to avoid toxicity including
severe low blood sugar
that can cause neurologic changes and, potentially, impaired or
loss of consciousness.
It was a pleasure caring for you!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth every 12 hours
Disp #*11 Tablet Refills:*0
2. Aspirin 81 mg PO DAILY
3. Atorvastatin 20 mg PO QPM
4. Carvedilol 25 mg PO BID
5. Fluticasone Propionate NASAL 2 SPRY NU DAILY
6. Furosemide 40 mg PO DAILY
7. Glargine 35 Units Breakfast
Glargine 50 Units Bedtime
Insulin SC Sliding Scale using Novolog Insulin
8. Ketoconazole 2% 1 Appl TP DAILY
9. liraglutide 0.6 mg/0.1 mL (18 mg/3 mL) subcutaneous DAILY
10. MetFORMIN (Glucophage) 850 mg PO TID
11. Multivitamins 1 TAB PO DAILY
12. Omeprazole 20 mg PO DAILY
13. HELD- Lisinopril 10 mg PO DAILY This medication was held.
Do not restart Lisinopril until your potassium normalizes and
your doctor tells you to restart
14. HELD- Spironolactone 25 mg PO DAILY This medication was
held. Do not restart Spironolactone until your potassium
normalizes and your doctor tells you to restart
15.Outpatient Lab Work
Please draw Chem 10 drawn before ___ and faxed
to Dr. ___ office at ___.
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis
Hyperkalemia
Urinary tract infection
Secondary Diagnosis
Diabetes ___ on CKD
Hypertension
chronic diastolic congestive heart failure
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
You were admitted to the hospital because the potassium level in
your blood was found to be high. This was felt to be due to the
lisinopril and spironolactone that you were taking. These
medications were stopped and you were given insulin, sugar, and
diuretics to decrease the potassium but it remained high. The
kidney team was consulted and they recommended some tests to
determine why your potassium remained high. These tests were
done and were still not back when you were discharged. You were
also given a medication that binds potassium in your intestine
(kayexalate) and this helped to decrease your potassium. You
should follow up with the kidney doctors as ___ outpatient to
follow up on these labs. You may need an additional medication
to treat the underlying cause of your high potassium. During
your hospitalization, it was also found that you had worsening
kidney function, which improved back to baseline at discharge.
It was also found that you had a bladder infection and you were
treated with an antibiotic (ciprofloxacin), which you should
continue taking after discharge and take your last dose on ___.
In addition your blood sugars were high during your
hospitalization. You should continue taking liraglutide,
metformin, glargine 35 units in the morning, 50 units at
bedtime, and follow up with endocrinology after discharge to
determine if your medications need to be changed.
It was a pleasure taking care of you. We wish you the best!
-Your ___ Care Team
TRANSITIONAL ISSUES
====================
-You should NOT take spironolactone and lisinopril at home until
you follow up with the kidney doctors
-___ should continue taking ciprofloxacin through ___
-You should continue to take a low-potassium diet until told
otherwise by your doctor ___ low potassium diet sheet attached)
-You will need labs drawn within 48 hours, which you have a
prescription for.
-You will need to follow up with Nephrology (Dr. ___
___ clinic ___ to follow up hyperkalemia. Please
call them on ___ to schedule this.
-You will need to follow up with your cardiologist given the
medication changes
-Your blood sugars were high during your hospitalization. You
should follow up with endocrinology (though patient says he does
not want endocrine follow up)
-Stopped medications: lisinopril, spironolactone
-New medications: Ciprofloxacin ___nd ___
-Labs pending at discharge: Renin, ___, IgG1234, Ova and
Parasites culture</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
You came to ___ with weakness due to a problem with your
pacemaker. We did a procedure to place a new pacemaker which
went very well. Please continue to follow with your outpatient
doctors.
It was a pleasure taking care of you, best of luck.
Your ___ medical team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Glargine 30 Units Bedtime
Humalog 10 Units Breakfast
Humalog 10 Units Lunch
Humalog 10 Units Dinner
2. amLODIPine 7.5 mg PO DAILY
3. Aspirin 81 mg PO DAILY
4. Darunavir 600 mg PO BID
5. Etravirine 200 mg PO BID
6. Ferrous Sulfate 325 mg PO DAILY
7. Fish Oil (Omega 3) 1200 mg PO BID
8. Fluticasone Propionate NASAL 1 SPRY NU DAILY
9. Furosemide 20 mg PO DAILY
10. Gabapentin 300 mg PO QHS
11. Isosorbide Mononitrate (Extended Release) 240 mg PO DAILY
12. Ketoconazole 2% 1 Appl TP BID
13. LaMIVudine 300 mg PO DAILY
14. Levothyroxine Sodium 150 mcg PO DAILY
15. LOPERamide 2 mg PO QID:PRN PRN
16. Nadolol 80 mg PO DAILY
17. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN PRN
18. Pantoprazole 40 mg PO Q24H
19. Pravastatin 80 mg PO QPM
20. Raltegravir 400 mg PO BID
21. Rifaximin 550 mg PO BID
22. RiTONAvir 100 mg PO BID
23. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
24.Outpatient Lab Work
Name/contact: Name: ___
___ ASSOCIATES OF ___, ___,
___. Phone: ___. Fax: ___
Labs: CBC, chem 7
ICD-10: D64.9, N17.9
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: chest pain
Secondary: acute kidney injury, HIV, cirrhosis, anemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure treating you at the ___
___! You were admitted for chest pain. For your chest
pain, we did some tests to see if you were having a heart
attack. We feel reassured that your symptoms resolved with your
regular home medications and additional nitroglycerin. For your
flank pain, we performed some tests to evaluate your abdomen and
kidneys. Your ultrasound showed small kidney stones that are not
obstructing your urine outflow, no signs of urine backing up to
your kidneys, and no signs of ascites (fluid in your abdomen).
You also have no signs of a urinary tract infection, including
no evidence of gonorrhea or chlamydia. We held your home
furosemide while you were here, but you should restart this upon
leaving the hospital. Please have your kidney function and blood
counts checked in one week.
You will have follow-up appointments with your primary care
physician, ___, hepatologist, and palliative care (see
below).
There have been no changes to your medications. Please continue
to take your medications as prescribed. If you have any concerns
about your medications, please contact your PCP.
Additionally, you should weigh yourself every morning, and
contact your cardiologist if you gain more than three pounds in
one day or notice worsening swelling in your feet and legs.
Best,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you. You came to the hospital
because you were having abdominal pain. We found that you had an
infection in the fluid in your abdomen, and we gave you
antibiotics to treat this. We also took fluid out of your
abdomen, and you felt better. We did not give you your water
pills while you were in the hospital in order to protect your
kidneys, but we restarted them at discharge.
New/Changed Medications:
- Start Ciprofloxacin 500 mg daily to prevent infections in your
abdomen
- Insulin decreased to 20 units NPH in the morning and 20 units
NPH at night because your blood sugars were low
- Lasix changed from 40 mg twice per day to 80 mg daily
- Carafate stopped as it is no longer needed
Please continue to take your medications as prescribed and
follow up with your liver doctors.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Alteplase 1mg/2mL ( Clearance ie. PICC, tunneled access
line, PA ) 1 mg IV ONCE MR1 Duration: 1 Dose
use if needed to clear PICC
2. Aluminum-Magnesium Hydrox.-Simethicone ___ mL PO QID:PRN
gerd
3. Bisacodyl ___AILY constipation
4. Enoxaparin Sodium 50 mg SC Q12H
5. Senna 8.6 mg PO BID
6. Sodium Chloride 0.9% Flush ___ mL IV DAILY and PRN, line
flush
7. Vitamin D ___ UNIT PO 1X/WEEK (___)
8. Furosemide 20 mg PO DAILY
9. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours
Disp #*30 Tablet Refills:*0
10. Cyanocobalamin 100 mcg PO DAILY
11. Exemestane 25 mg PO DAILY
12. Morphine SR (MS ___ 60 mg PO Q12H
RX *morphine [MS ___ 60 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*30 Tablet Refills:*0
13. Prochlorperazine 10 mg PO Q6H:PRN nausea/vomiting
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
small bowel obstruction
health care acquire pneumonia
Hypoxia
history of pulmonary embolism
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to ___ due to small bowel obstruction for
which you needed a nasogastric tube and we gave you nutrition
though an Iv route. You were also seen by surgery during the
hospital stay
You were also treated for pneumonia with a course of
antibiotics.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atenolol 50 mg PO DAILY
2. Fluoxetine 60 mg PO DAILY
3. Furosemide 20 mg PO DAILY
4. Lactulose 30 mL PO TID
titrate to ___ bowel movements a day
5. Mesalamine 500 mg PO TID
6. Pantoprazole 40 mg PO Q24H
7. Rifaximin 550 mg PO BID
8. Spironolactone 50 mg PO DAILY
9. Acetaminophen 650 mg PO Q8H pain
10. Ondansetron 4 mg PO Q8H:PRN nausea
11. Loperamide 2 mg PO TID:PRN Diarrhea
ONLY USE THIS IF YOU ARE HAVING MORE THAN 5 BOWEL MOVEMENTS
DAILY.
12. Zolpidem Tartrate 5 mg PO HS:PRN insomnia
DO NOT DRIVE OR OPERATE MACHINERY WHILE ON THIS.
RX *zolpidem 5 mg ___ tablet(s) by mouth at bedtime Disp #*5
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY:
hepatic encephalopathy
insomnia
SECONDARY:
hepatitis C cirrhosis
depression
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 due to confusion, which possibly represented
"hepatic encephalopathy," or confusion due to liver disease.
Your exam and vital signs were reassuring, and a medical workup
showed that you do not have an infection. You slept well
overnight and are much more oriented so you are being discharged
home.
We increased your Lactulose dose to prevent confusion; you
should increase or decrease the frequency of the medication to
ensure that you have ___ bowel movements daily. Please do not
take Loperamide unless you are having >5 bowel movements in a
day.
In addition, we are giving you a small supply of Ambien
(Zolpidem) to be used in the case of severe insomnia. You can
try ___ tab and if that doesn't work you can take the other ___
tab.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. LevETIRAcetam 1000 mg PO Q12H
RX *levetiracetam 1,000 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*60 Tablet Refills:*0
2. ClonazePAM 1 mg PO QID:PRN anti seizure
RX *clonazepam 1 mg 1 tablet(s) by mouth four times a day Disp
#*28 Tablet Refills:*0
3. ClonazePAM 0.25 mg PO BID
4. FLUoxetine 40 mg PO DAILY
RX *fluoxetine 40 mg 1 capsule(s) by mouth Daily Disp #*28
Capsule Refills:*0
5. LamoTRIgine 150 mg PO QAM
RX *lamotrigine 150 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
6. LamoTRIgine 175 mg PO QPM
RX *lamotrigine 25 mg 1 tablet(s) by mouth QPM Disp #*30 Tablet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS: seizure
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
You were admitted to the ___ because you experienced a
seizure. You were brought to the Intensive Care Unit for careful
monitoring, EEG, and adjustment of your seizure medications. The
neurologists followed you in the hospital. When you leave the
hospital, continue taking all of your seizure medications
without skipping any doses. Please do not drive for at least 6
months. This is very important. Please follow up with your
neurologist appointment as written below.
It was a pleasure taking care of you and we wish you all the
best!
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amlodipine 5 mg PO DAILY
2. HydrOXYzine 50 mg PO BID itching
3. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin [Cipro] 500 mg 1 tablet(s) by mouth every
twelve (12) hours Disp #*4 Tablet Refills:*0
4. Sodium Chloride Nasal ___ SPRY NU BID:PRN nasal congestion
5. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *metronidazole [Flagyl] 500 mg 1 tablet(s) by mouth every
eight (8) hours Disp #*6 Tablet Refills:*0
6. Ondansetron ___ mg PO Q8H:PRN nausea
RX *ondansetron 4 mg ___ tablet(s) by mouth every twelve (12)
hours Disp #*6 Tablet Refills:*0
7. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth every six (6) hours
Disp #*30 Tablet Refills:*0
8. Omeprazole 20 mg PO DAILY
9. Oxymetazoline 1 SPRY NU BID:PRN nasal congestion
10. pioglitazone-metformin *NF* ___ mg Oral qd
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
1. Common bile duct stricture
2. Hepatic hilum mass
3. Pancreatic tail mass
4. Mediastinal lymphadenopathy
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 surgery service at ___ for diagnostic
work up on your common bile duct stricture and
hepatic/pancreatic mass. You underwent palcement of the two PTBD
drains. You have done well in the post operative period and are
now safe to return home to complete your recovery with the
following instructions:
.
Call Dr. ___ office at ___ if you have any
questions or concerns. During off hours: call Operator at
___ and ask to ___ team.
.
Please call Dr. ___ if you experience 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 large drain output, 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.
.
PTBD Drain Care x 2:
*Please look at the site every day for signs of infection
(increased redness or pain, swelling, odor, yellow or bloody
discharge, warm to touch, fever).
*If the drain is connected to a collection container, please
note color, consistency, and amount of fluid in the drain. Call
the doctor, ___, or ___ nurse if the amount
increases significantly or changes in character. Be sure to
empty the drain frequently. Record the output, if instructed to
do so.
*Wash the area gently with warm, soapy water or ___ strength
hydrogen peroxide followed by saline rinse, pat dry, and place a
drain sponge. Change daily and as needed.
*Keep the insertion site clean and dry otherwise.
*Avoid swimming, baths, hot tubs; do not submerge yourself in
water.
*Make sure to keep the drain attached securely to your body to
prevent pulling or</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Ms. ___,
WHY WERE YOU ADMITTED?
-You initially presented to the hospital on ___ and were
found to be in diabetic ketoacidosis
WHAT HAPPENED WHILE YOU WERE IN THE HOSPITAL?
-You are found to have a urinary tract infection which likely
precipitated your diabetic ketoacidosis.
- You were also found to have some evidence of damage to your
heart. We do not think that this is an active heart attack at
this time, but sometimes illnesses can cause your heart to work
harder and therefore cause damage.
-You briefly had a feeding tube, but this was removed and you
were eating well prior to discharge.
-You completed a course of antibiotics for your infection
WHAT SHOULD YOU DO WHEN YOU LEAVE THE HOSPITAL?
-Due to deconditioning in the hospital, you are discharged to
rehab
-We decided to change one of your blood pressure medications
-Your cardiologist will contact you to schedule an appointment
so that you can be seen as an outpatient. You may benefit from
an outpatient catheterization in the future.
-We will continue dialysis on a ___, and ___
schedule
-We encourage you to eat as much as you can to improve your
nutrition and strength
You are going to:
___ & Nursing
___
It was a pleasure taking care of you! We wish you all the best.
- Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN pain
2. Albuterol Inhaler 2 PUFF IH Q6H:PRN SOB
3. Aspirin 81 mg PO DAILY
4. Bisacodyl ___AILY:PRN constipation
5. Calcium Carbonate 1250 mg PO HS
6. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
7. Levothyroxine Sodium 37.5 mcg PO DAILY
8. Lisinopril 2.5 mg PO DAILY
9. Metoprolol Succinate XL 75 mg PO DAILY
10. Montelukast Sodium 10 mg PO QHS
11. Omeprazole 40 mg PO Q12
12. Ondansetron 8 mg PO Q8H:PRN nausea
13. Pravastatin 80 mg PO HS
14. Tiotropium Bromide 1 CAP IH DAILY
15. Vitamin D 1000 UNIT PO DAILY
16. Creon *NF* (lipase-protease-amylase) 6,000-19,000 -30,000
unit Oral TID w meals
17. magnesium hydroxide *NF* 311 mg ORAL DAILY PRN constipation
18. Cyclobenzaprine 5 mg PO TID:PRN groin pain
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary: Groin muscle strain, hyponatremia
Secondary: Pancreatic cancer, urinary tract infection
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you during your time at ___
___. You came to us because of left
groin pain. You were evaluated by Surgery and their impression
was that your pain was most likely due to a muscle strain. Your
pain improved significantly with pain medications and muscle
relaxants. We are sending you back to your rehab with a
prescription for a muscle relaxant in case you have any more
problems with groin pain.
While you were here we also managed your low sodium level. For
this, we continued to limit the amount of fluids you were
taking. You should continue to do this at rehab but you will be
able to drink a little more than you had been previously.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. sertraline 100 mg Tablet Sig: One (1) Tablet PO once a day.
2. esomeprazole magnesium 40 mg Capsule, Delayed Release(E.C.)
Sig: One (1) Capsule, Delayed Release(E.C.) PO twice a day.
3. levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
5. ascorbic acid ___ mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
6. cholecalciferol (vitamin D3) 1,000 unit Tablet Sig: One (1)
Tablet PO once a day: take at least two hours apart from
ciprofloxacin.
7. multivitamin Tablet Sig: One (1) Tablet PO once a day.
8. lactobacillus acidophilus Capsule Sig: One (1) Capsule PO
once a day.
9. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
10. guaifenesin 100 mg/5 mL Syrup Sig: ___ MLs PO Q6H (every 6
hours) as needed for cough.
11. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: Two (2) nebs Inhalation Q6H (every 6 hours) as
needed for wheezing, SOB for 7 days: take standing for seven
days tehn use as needed.
12. ciprofloxacin 500 mg Tablet Sig: One (1) Tablet PO twice a
day for 6 days: Last day ___.
13. metronidazole 500 mg Tablet Sig: One (1) Tablet PO three
times a day for 6 days: take with food. Do not use alcohol with
this medication as it can make you sick. Last day ___
14. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO once a day: HOLD UNTIL
___ then can be restarted.
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Acute hepatitis likely due to biliary obstruction and
cholangitis
CAD, native
GERD
Hypothyroidism
Anemia of chronic 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>You were admitted with abdominal pain, nausea and vomiting.
Testing and imaging showed an acute liver injury likely due to a
blockage of your bile duct and resultant liver injury as well as
low blood pressures due to infection. You were treated with
antibiotics with some stabilization and then went on to have a
procedure to open your bile duct. The reason for the narrowing
of your bile duct is not clear though there is some concern
about a mass obstructing the opening of the bile duct. Samples
have been taken of this area and the results are pending.
Medication Changes:
-Started ciprofloxacin and metronidazole to treat a probable
bile duct infection. You will complete a total of 10 days of
therapy after the procedure to reopen your bile duct.
-Held Atorvastatin (LIPITOR) until liver enzyme abnormalities
resolve
-Started albuterol for possible exacerbation of underlying
asthma or URI related reactive airway disease
-Held Aspirin until seven days after sphincterotomy to prevent
bleeding (can be restarted ___</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 two times per
day Disp #*60 Tablet Refills:*0
2. Metoprolol Succinate XL 25 mg PO DAILY
Take once a day.
RX *metoprolol succinate 25 mg 1 tablet(s) by mouth every day
Disp #*30 Tablet Refills:*0
3. coenzyme Q10 unknown oral DAILY
4. Multivitamins 1 TAB PO DAILY
5. omega-3s-dha-epa-fish oil 1000 mg PO DAILY
6. Omeprazole 40 mg PO DAILY
7. Rosuvastatin Calcium 5 mg PO QPM
8. Vitamin B Complex 1 CAP PO DAILY
9. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnoses
===============
Atrial fibrillation
Secondary diagnoses
==================
Hypertension
Peptic ulcer disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to ___ after you were found
to have an abnormal heart rhythm called atrial fibrillation that
was making your heart race and was causing you to be short of
breath. After being treated with a heart medication, your heart
rhythm went back to normal. While you were in the hospital, we
switched your bisopropol to a similar medication called
metoprolol, that you will take once a day from now on. This
medication will control your heart rate as well as your blood
pressure. We also started you on a blood thinner called Eliquis,
which you will also take twice a day.
You should follow up with your primary care physician and your
neurologist within a week of leaving the hospital.
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: [/INST] </s><s>INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week.
- Resume your regular activities as tolerated, but please follow
your weight bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
- Touch down weight bearing in Right lower extremity
MEDICATIONS:
- Please take all medications as prescribed by your physicians
at discharge.
- Continue all home medications unless specifically instructed
to stop by your surgeon.
- Do not drink alcohol, drive a motor vehicle, or operate
machinery while taking narcotic pain relievers.
- Narcotic pain relievers can cause constipation, so you should
drink eight 8oz glasses of water daily and take a stool softener
(colace) to prevent this side effect.
ANTICOAGULATION:
- Please take Aspirin daily for 4 weeks
WOUND CARE:
- You may shower but do NOT get cast wet. Your cast must be left
on until follow up appointment unless otherwise instructed.
- 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.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. CloniDINE 0.2 mg PO TID
RX *clonidine HCl [Catapres] 0.2 mg 1 tablet(s) by mouth three
times a day Disp #*42 Tablet Refills:*0
2. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
3. Gabapentin 600 mg PO TID
RX *gabapentin 600 mg 1 tablet(s) by mouth three times a day
Disp #*42 Tablet Refills:*0
4. LeVETiracetam 500 mg PO BID
RX *levetiracetam [Keppra] 500 mg 1 tablet(s) by mouth twice a
day Disp #*60 Tablet Refills:*0
5. Multivitamins 1 TAB PO DAILY
RX *multivitamin 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
6. OLANZapine 10 mg PO BID
RX *olanzapine 10 mg 1 tablet(s) by mouth twice a day Disp #*28
Tablet Refills:*0
7. Thiamine 100 mg PO DAILY
RX *thiamine HCl 100 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnoses:
alcohol abuse
cellulitis
possible pnuemonia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
It was a pleasure taking care of you at the ___
___. You were admitted for chest pain. A
scan of your chest showed that there was no lung clot. It showed
a possible pneumonia. You were treated for this pneumonia and
you continued treatment for your skin infection. You completed
your antibiotic treatment while here.
We are discharging you to a day program to help you with your
alcohol addiction. You have an appointment at ___ on
___ with your PCP.
We wish you all the best</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen-Caff-Butalbital ___ TAB PO Q8H:PRN Headache
2. Albuterol Inhaler ___ PUFF IH Q6H:PRN shortness of breath
3. Amitriptyline 100 mg PO QHS
4. amLODIPine 5 mg PO DAILY
5. Creon 12 4 CAP PO TID W/MEALS
6. Ketorolac 30 mg IM Q6H:PRN Pain - Severe
7. LamoTRIgine 200 mg PO DAILY
8. Lisinopril 40 mg PO DAILY
9. LORazepam 1 mg PO Q6H:PRN anxiety/nausea
10. Omeprazole 20 mg PO BID
11. Promethazine 25 mg PO Q8H:PRN severe nausea
12. QUEtiapine Fumarate 400 mg PO BID
13. TraMADol 100 mg PO BID
14. TraMADol 50 mg PO TID:PRN Pain - Moderate
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis
=============
Acute on chronic pancreatitis
Secondary Diagnoses
================
Hypertension
Normocytic Anemia
Anxiety
Depression
Migraine headaches
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 ___
because you were having abdominal pain and vomiting from your
chronic pancreatitis. You were given intravenous fluids and
medications to control your pain and nausea using the protocol
that you discussed with your primary care doctor. During your
hospital course, your pain improved and you were able to
tolerate a solid food diet without feeling nauseous. You were
discharged with a plan to take the oral pain medications that
you take at home.
We recommend that you follow up with your primary care doctor
after leaving the hospital.
You should call your doctor or return to the emergency
department if you develop worsening abdominal pain, fevers,
chills, bloody stools, vomiting, diarrhea, or are unable to eat
food without feeling nausea or vomiting.
It was a pleasure caring for you here at ___, and we wish you
the best in your recovery.
Sincerely,
Your ___ Medicine Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amoxicillin-Clavulanic Acid ___ mg PO Q12H
RX *amoxicillin-pot clavulanate 875 mg-125 mg 1 tablet(s) by
mouth twice a day Disp #*14 Tablet Refills:*0
2. Polyethylene Glycol 17 g PO DAILY
RX *polyethylene glycol 3350 [Miralax] 17 gram/dose 17 g by
mouth twice a day Refills:*1
3. Metoprolol Succinate XL 50 mg PO DAILY
RX *metoprolol succinate 50 mg 1 tablet(s) by mouth Daily Disp
#*30 Tablet Refills:*1
4. Acetaminophen 325-650 mg PO Q6H:PRN Pain - Mild
Reason for PRN duplicate override: Alternating agents for
similar severity
5. Alendronate Sodium 70 mg PO QTHUR
6. Ascorbic Acid ___ mg PO DAILY
7. Ferrous Sulfate 325 mg PO DAILY
8. Fluticasone Propionate NASAL 1 SPRY NU DAILY
9. Furosemide 20 mg PO DAILY
10. Lidocaine 5% Patch 1 PTCH TD QAM
11. Pantoprazole 40 mg PO Q12H
12. Spironolactone 50 mg PO DAILY
13. Sucralfate 1 gm PO TID
14. Ursodiol 600 mg PO BID
15. HELD- Ciprofloxacin HCl 500 mg PO DAILY This medication was
held. Do not restart Ciprofloxacin HCl until you have finished
taking AUGMENTIN.
16. HELD- Losartan Potassium 25 mg PO DAILY This medication was
held. Do not restart Losartan Potassium until you see your PCP
and have your blood pressure checked.
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY:
=================
liver microabscess
atrial fibrillation with rapid ventricular response
SECONDARY:
===================
hepatocellular carcinoma
primary biliary cirrhosis
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 fevers and malaise. We
did a CT scan of your abdomen which showed a possible infection
around the area you were treated for your cancer. We discussed
this at our liver cancer conference and felt that the best
course of action would be to discharge you on antibiotics. You
are being discharged on an antibiotic called Augmentin which you
should take for 1 week.
When you were admitted to the hospital you were also found to
have a rapid heart rate and irregular rhythm called atrial
fibrillation. We increased one of your home medications,
metoprolol, to help control your heart rate. You will need to
discuss starting a blood thinner with your primary care doctor.
At the time of your discharge, your heart was no longer in
atrial fibrillation.
We made several changes to your medications which are detailed
in your discharge paperwork. You should review this carefully
and go over it with your visiting nurse to make sure you are
taking the correct medications. You should also follow-up with
your doctors as detailed below.
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. Ciprofloxacin HCl 500 mg PO Q24H
RX *ciprofloxacin 500 mg 1 tablet(s) by mouth once a day Disp
#*30 Tablet Refills:*0
2. Vitamin D 50,000 UNIT PO 1X/WEEK (___) Duration: 12 Weeks
RX *ergocalciferol (vitamin D2) [Vitamin D2] 50,000 unit 1
capsule(s) by mouth once a week Disp #*12 Capsule Refills:*0
3. Acetaminophen 500 mg PO Q6H:PRN pain
4. Amlodipine 5 mg PO DAILY
5. Furosemide 20 mg PO BID
RX *furosemide 20 mg 1 tablet(s) by mouth twice a day Disp #*60
Tablet Refills:*0
6. Magnesium Oxide 400 mg PO BID
7. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
8. Spironolactone 50 mg PO BID
RX *spironolactone 50 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
9. Omeprazole 20 mg PO DAILY
Take this medication 30 minutes before breakfast
RX *omeprazole 20 mg 1 capsule(s) by mouth once a day Disp #*30
Capsule Refills:*11
10. Metoprolol Succinate XL 37.5 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Ascites
Spontaneous Bacterial Periotonitis (SBP)
Hepatitis C
Alcoholic Cirrhosis
Hepatocellular Carcinoma
Secondary:
Hypertension
Chronic Back Pain
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you during your hospitalization at
the ___. As you know you were
admitted with abdominal distension and an elevated white count.
You were treated for an infection of the fluid in your abdomen
called spontaneous bacterial peritonitis (SBP) with five days of
intravenous antibiotics. You were also given albumin to help
reduce the fluid in your abdomen. Fluid from your abdomen was
removed with a procedure called a therapeutic parenthesis.
Finally, you had a screening test for dilated blood vessels in
your esophagus and stomach (called varices) using a tube with a
camera called an EGD. At the time of discharge, your abdominal
swelling improved and your white count levels returned to
normal.
Please take your medications as instructed. Please followup with
your primary care physician and hepatologist Dr. ___.
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
2. Aspirin 325 mg PO DAILY
3. Cetirizine 10 mg PO DAILY
4. Docusate Sodium 100 mg PO BID
5. Duloxetine 20 mg PO DAILY
6. Fish Oil (Omega 3) 1000 mg PO BID
7. Lidocaine 5% Patch 1 PTCH TD QAM
8. Metoprolol Succinate XL 50 mg PO DAILY
9. Omeprazole 20 mg PO DAILY
10. Potassium Chloride 10 mEq PO DAILY
11. PredniSONE 5 mg PO DAILY
12. Ropinirole 3.5 mg PO QPM
13. Rosuvastatin Calcium 40 mg PO QPM
14. Vitamin D ___ UNIT PO DAILY
15. Warfarin 4 mg PO 3X/WEEK (___)
16. Warfarin 2 mg PO 4X/WEEK (___)
17. albuterol sulfate 90 mcg/actuation inhalation Q6H:PRN cough,
wheeze
18. budesonide-formoterol 160-4.5 mcg/actuation inhalation BID
19. Cyanocobalamin 1000 mcg IM/SC 1XMONTH
20. MetFORMIN (Glucophage) 500 mg PO BID
21. Zinc Sulfate 220 mg PO DAILY
22. Torsemide 10 mg PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis:
Lymphedema
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 were admitted to the hospital for leg swelling. Our vascular
surgeons saw you and recommended changes in your leg wraps. They
recommend using juxtalite to compress your legs. We also
coordinated with home nursing so that we can hopefully prevent
you from having to come back into the hospital again.
Your medications were unchanged. The details of your follow up
appointments are given below.
It was a pleasure taking care of you.
Sincerely,
Your ___ Cardiology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Ms. ___,
You were admitted to ___
because you were short of breath and your mouth hurt.
While you were here:
-We extracted your teeth
-We gave you the IV water pill to improve your breathing
-You felt better by the time you left the hospital
When you go home:
-Please continue all medications as directed
-Please follow-up with the below doctors
-___ yourself every morning, call MD if weight goes up more
than 3 lbs.
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. Amlodipine 10 mg PO DAILY
2. Atenolol 25 mg PO DAILY
3. Dipyridamole-Aspirin 1 CAP PO BID
4. Omeprazole 20 mg PO BID
5. Simethicone 40 mg PO TID
6. Artificial Tears ___ DROP BOTH EYES PRN dry eyes
7. Avapro *NF* (irbesartan) 300 mg Oral daily
8. Calcium 600 + D(3) *NF* (calcium carbonate-vitamin D3) 1 tab
ORAL BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: Lightheadedness
Secondary: none
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 ___,
___ was a pleasure taking care of you at ___
___. You were admitted for treatment of your
lightheadedness and evaluation by physical therapy and
occupational therapy. Our ___ team felt that you were safe to
go home with additional treatments there.
Also, while you were here you were evaluted by the surgeons who
work with the surgeon who performed your recent carpal tunnel
release. They felt that the surgical site on your left hand was
healing well and is without any evidence of infection.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ciprofloxacin HCl 500 mg PO Q12H
Take until ___.
2. Enoxaparin Sodium 60 mg SC Q12H
Start: Today - ___, First Dose: Next Routine Administration
Time
3. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
Take until ___.
4. Pantoprazole 40 mg PO Q12H
5. Acetaminophen 325-650 mg PO Q6H:PRN pain
6. Multivitamins 1 TAB PO DAILY
7. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
UTI
Wound infection
Pancreatic leak
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>You were admitted to the surgery service at ___ for fevers.
You improved on antibiotic therapy and are now safe to be
discharged to rehab to complete your recovery with the following
instructions:
.
Please call Dr. ___ office at ___ if you have any
questions or concerns.
.
Please resume all regular home medications, unless specifically
advised not to take a particular medication. Also, please take
any new medications as prescribed. You need to take the
antibiotics (ciprofloxacin and metronidazole) until ___ to
treat your infection.
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, who will instruct you further regarding activity
restrictions.
Avoid driving or operating heavy machinery while taking pain
medications.
Please follow-up with your surgeon and Primary Care Provider
(PCP) as advised.
.
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 surgical wound was opened and packed with wet-to-dry
dressing, which needs to be changed three times a day.
*You have steri-strips. They will fall off on their own. Please
remove any remaining strips ___ days after surgery.
JP Drain Care:
*Please look at the site every day for signs of infection
(increased redness or pain, swelling, odor, yellow or bloody
discharge, warm to touch, fever).
*Maintain suction of the bulb.
*Note color, consistency, and amount of fluid in the drain. Call
the doctor, ___, or ___ nurse if the amount
increases significantly or changes in character.
*Be sure to empty the drain frequently. Record the output, if
instructed to do so.
*You may shower; wash the area gently with warm, soapy water.
*Keep the insertion site clean and dry otherwise.
*Avoid swimming, baths, hot tubs; do not submerge yourself in
water.
*Make sure to keep the drain attached securely to your body to
prevent pulling or dislocation.
.
G/J-tube: Keep G-tube capped. J-tube with cycling tubefeed,
flush tube Q6H with 30 cc of tap water. Monitor for signs and
symptoms of occlusion or dislocation. Change drain sponge daily.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Omeprazole 20 mg PO DAILY
2. Clindamycin 450 mg PO TID Duration: 7 Days
Please take three times per day for seven days
RX *clindamycin HCl 150 mg 3 capsule(s) by mouth three times
daily Disp #*63 Capsule Refills:*0
3. Ibuprofen 400 mg PO Q6H:PRN pain
4. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO Q6H:PRN pain
Duration: 28 Doses
Please do not take with other medications containing Tylenol
(Acetominophen)
RX *oxycodone-acetaminophen 5 mg-325 mg 1 tablet(s) by mouth
every 6 hours only as needed for pain Disp #*20 Tablet
Refills:*0
5. Aspirin 81 mg PO DAILY
6. Clobetasol Propionate 0.05% Ointment 1 Appl TP ASDIR
7. Ketoconazole Shampoo 1 Appl TP ASDIR
8. Klor-Con M10 (potassium chloride) 10 mEq oral BID
9. MetFORMIN XR (Glucophage XR) 500 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Right hallux cellulitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
Thank you for allowing us to participate in your care during
your recent stay at ___. You were hospitalized for a right
toe skin infection. During your stay, you were treated with IV
antibiotics prior to being switched to oral antibiotics. Your
toe improved throughout your stay, and you were able to walk on
it prior to discharge.
During your stay we also had you speak with social work, who
provided you with a list of therapists. It is important to call
and make an appointment to see one of these therapists when you
return home. You will also have follow up with rheumatology, in
order to reestablish care and reevaluate many of your other
concerns.
You will be discharged on oral antibiotics (clindamycin).
Please take as directed. If you notice that your toe is
worsening, it is important that you return to care. You are
scheduled for an appointment with Podiatry in 1 weeks time to
evaluate your progress.
You were also seen by vascular surgery during your stay to
evaluate for blood flow to your legs. The studies that they did
looked appropriate, however, you will need to follow up with Dr.
___ in ___ in 1 months time.
While hospitalized your atenolol and triamterene-HCTZ were
stopped. Please follow up with your PCP prior to restarting
these medications.</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: 12 Days
RX *ciprofloxacin HCl [Cipro] 500 mg 1 tablet(s) by mouth Twice
daily Disp #*24 Tablet Refills:*0
2. Allopurinol ___ mg PO DAILY
3. Docusate Sodium 100 mg PO BID
4. Dolutegravir 50 mg PO DAILY
5. LORazepam 0.5 mg PO BID:PRN anxiety
6. Milrinone 0.5 mcg/kg/min IV DRIP INFUSION
7. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain -
Moderate
8. rilpivirine 25 mg oral DAILY
9. Simethicone 80 mg PO QID:PRN abdominal pain
10. Spironolactone 25 mg PO BID
11. Torsemide 100 mg PO BID
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
==================
#Infected ___ site cellulitis
SECONDARY DIAGNOSIS:
====================
#Chronic systolic heart failure on Palliative Milrinone
___ on CKD
#HIV
#Gout
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. Please read
through the following information.
WHY WAS I ADMITTED TO THE HOSPITAL?
You were admitted to the hospital because you had discomfort and
white color discharge from the site of insertion of your central
line port.
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
- You central line was removed.
- We sent for blood and wound cultures. The catheter was also
sent for culture.
- The wound site was infected; however, we did not find evidence
of an infection in your blood stream, which is good news!!
- You were started on IV antibiotics initially and transitioned
to oral antibiotics on discharge.
- A new central line was inserted on ___
WHAT DO YOU NEED TO DO WHEN YOU LEAVE THE HOSPITAL?
- Take all of your medications as prescribed (listed below)
- Take ciprofloxacin 500mg twice daily (last day: ___
- Follow up with your doctors as listed below
- Weigh yourself every morning. Your weight on discharge is 77.2
kg (170.1 pounds). Please seek medical attention if your weight
goes up more than 3 pounds in 2 days or 5 pounds in one week.
- Seek medical attention if you have new or concerning symptoms
or you develop swelling in your legs, abdominal distention, or
shortness of breath at night.
We wish you the best!
-Your ___ Care Team
- Heart failure service fax number ___</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. Calcium Carbonate 500 mg PO QID:PRN Reflux
3. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg ONE capsule(s) by mouth
twice a day Disp #*60 Capsule Refills:*2
4. Senna 17.2 mg PO QHS
RX *sennosides [Senokot] 8.6 mg ___ TABS by mouth DAILY Disp
#*60 Tablet Refills:*2
5. Carbidopa-Levodopa (___) 1.5 TAB PO QID
6. coenzyme Q10 100 mg oral DAILY
7. Ferrous Sulfate 325 mg PO DAILY
8. Multivitamins 1 TAB PO DAILY
9. Propranolol 20 mg PO QID
10. Selegiline HCl 5 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
Benign prostatic hyperplasia, urinary retention and recalcitrant
gross hematuria.
Ileus, post-operative
Bleeding disorder concerning for ___ 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>-ALWAYS follow-up with your referring provider ___ your PCP
to discuss and review your post-operative course and
medications. Any NEW medications should also be reviewed with
your pharmacist.
-Resume your pre-admission medications except as noted AND you
note that you NO longer need to take medications that shrink
your prostate (Hytrin, Avodart, Flomax, etc.)
-You may take ibuprofen and the prescribed narcotic together for
pain control. FIRST, use Tylenol and Ibuprofen. Add the
prescribed narcotic (examples: Oxycodone, Dilaudid,
Hydromorphone) for break through pain that is >4 on the pain
scale.
-The maximum dose of Tylenol (ACETAMINOPHEN) is 3- 4 grams (from
ALL sources) PER DAY.
-Ibuprofen should always be taken with food. If you develop
stomach pain or note black stool, stop the Ibuprofen. Ibuprofen
works best when taken around the clock.
-For your safety and the safety of others; PLEASE DO NOT drive,
operate dangerous machinery, or consume alcohol while taking
narcotic pain medications.
-Do NOT drive while Foley catheter is in place.
-AVOID lifting/pushing/pulling items heavier than 10 pounds (or
3 kilos; about a gallon of milk) or participate in high
intensity physical activity (which includes intercourse) until
you are cleared by your Urologist in follow-up. Generally about
FOUR weeks. Light household chores are generally ok. Do not
vacuum.
-No DRIVING for THREE WEEKS or until you are cleared by your
Urologist
-Do not drive or drink alcohol while taking narcotics and do not
operate dangerous machinery
-You may be given prescriptions for a stool softener ___ a
gentle laxative. These are over-the-counter medications that
may be health care spending account reimbursable.
-Colace (docusate sodium) may have been prescribed to avoid
post-surgical constipation or constipation related to use of
narcotic pain medications. Discontinue if loose stool or
diarrhea develops. Colace is a stool-softener, NOT a laxative.
-Senokot (or any gentle laxative) may have been prescribed to
further minimize your risk of constipation.
-You may shower 2 days after surgery, but do not tub bathe,
swim, soak, or scrub incision for 2 weeks
-If you had a drain removed from your abdomen, bandage strips
called steristrips have been applied to close the wound. Allow
these bandage strips to fall off on their own ___ days).
PLEASE REMOVE any remaining dressings w/ gauze within 2 days of
discharge. You may get the steristrips wet.
-resume regular home diet and remember to drink plenty of fluids
to keep hydrated and to minimize risk of constipation. For the
first few days at home, you should eat SMALL PORTIONS. Avoid
high fat, bulky or fried foods.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
RX *acetaminophen [Acetaminophen Extra Strength] 500 mg ___
tablet(s) by mouth every six (6) hours Disp #*50 Tablet
Refills:*0
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*60 Capsule Refills:*0
3. Ibuprofen 600 mg PO Q6H:PRN Pain - Mild
Reason for PRN duplicate override: Alternating agents for
similar severity
RX *ibuprofen 600 mg 1 tablet(s) by mouth every six (6) hours
Disp #*50 Tablet Refills:*0
4. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Severe
RX *oxycodone 5 mg 1 tablet(s) by mouth every four (4) hours
Disp #*20 Tablet Refills:*0
5. Polyethylene Glycol 17 g PO DAILY
RX *polyethylene glycol 3350 [Miralax] 17 gram/dose 1 dose by
mouth once a day Refills:*0
6. BuPROPion XL (Once Daily) 300 mg PO DAILY
7. ClonazePAM 1 mg PO TID
8. Linzess (linaCLOtide) 290 mcg oral DAILY
9. Topiramate (Topamax) 150 mg PO QHS
10. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Ruptured Ovarian Cyst
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to the hospital with abdominal pain and an
elevated white blood cell count which is a marker of infection.
You had an ultrasound that was concerning for in an infection in
your abdomen. You were taken to the operating room and found to
have a normal gallbladder but appeared to have a ruptured
ovarian cyst. The OBGYN team was consulted during surgery and
send samples from the fluid to the lab to test for bacteria. You
then had a CT scan which showed an ovarian cyst/mass. You will
need to follow-up with the Ob/Gyn service for further management
of this, pending culture results.
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 follow up in the Acute Care Surgery clinic at the
appointment listed below.
ACTIVITY:
o Do not drive until you have stopped taking pain medicine and
feel you could respond in an emergency.
o You may climb stairs.
o You may go outside, but avoid traveling long distances until
you see your surgeon at your next visit.
o Don't lift more than ___ lbs for 4 weeks. (This is about
the weight of a briefcase or a bag of groceries.) This applies
to lifting children, but they may sit on your lap.
o You may start some light exercise when you feel comfortable.
o You will need to stay out of bathtubs or swimming pools for a
time while your incision is healing. Ask your doctor when you
can resume tub baths or swimming.
HOW YOU MAY FEEL:
o You may feel weak or "washed out" for a couple of weeks. You
might want to nap often. Simple tasks may exhaust you.
o You may have a sore throat because of a tube that was in your
throat during surgery.
o You might have trouble concentrating or difficulty sleeping.
You might feel somewhat depressed.
o You could have a poor appetite for a while. Food may seem
unappealing.
o All of these feelings and reactions are normal and should go
away in a short time. If they do not, tell your surgeon.
YOUR INCISION:
o Tomorrow you may shower and remove the gauzes over your
incisions. Under these dressing you have small plastic bandages
called steri-strips. Do not remove steri-strips for 2 weeks.
(These are the thin paper strips that might be on your
incision.) But if they fall off before that that's okay).
o Your incisions may be slightly red around the stitches. This
is normal.
o You may gently wash away dried material around your incision.
o Avoid direct sun exposure to the incision area.
o Do not use any ointments on the incision unless you were told
otherwise.
o You may see a small amount of clear or light red fluid
staining your dressing or clothes. If the staining is severe,
please call your surgeon.
o You may shower. As noted above, ask your doctor when you may
resume tub baths or swimming.
YOUR BOWELS:
o Constipation is a common side effect of narcotic pain
medications. If needed, you may take a stool softener (such as
Colace, one capsule) or gentle laxative (such as milk of
magnesia, 1 tbs) twice a day. You can get both of these
medicines without a prescription.
o If you go 48 hours without a bowel movement, or have pain
moving the bowels, call your surgeon.
PAIN MANAGEMENT:
o It is normal to feel some discomfort/pain following abdominal
surgery. This pain is often described as "soreness".
o Your pain should get better day by day. If you find the pain
is getting worse instead of better, please contact your surgeon.
o You will receive a prescription for pain medicine to take by
mouth. It is important to take this medicine as directed. o Do
not take it more frequently than prescribed. Do not take more
medicine at one time than prescribed.
o Your pain medicine will work better if you take it before your
pain gets too severe.
o Talk with your surgeon about how long you will need to take
prescription pain medicine. Please don't take any other pain
medicine, including non-prescription pain medicine, unless your
surgeon has said its okay.
o If you are experiencing no pain, it is okay to skip a dose of
pain medicine.
o Remember to use your "cough pillow" for splinting when you
cough or when you are doing your deep breathing exercises.
If you experience any of the following, please contact your
surgeon:
- sharp pain or any severe pain that lasts several hours
- pain that is getting worse over time
- pain accompanied by fever of more than 101
- a drastic change in nature or quality of your pain
MEDICATIONS:
Take all the medicines you were on before the operation just as
you did before, unless you have been told differently.
If you have any questions about what medicine to take or not to
take, please call your surgeon.
Best Wishes,
Your ___ Surgery Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. LevETIRAcetam 1000 mg PO Q12H
RX *levetiracetam 1,000 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*60 Tablet Refills:*0
2. Acetaminophen 325 mg PO Q6H:PRN Pain - Mild/Fever
3. Atorvastatin 80 mg PO QPM
4. Metoprolol Succinate XL 100 mg PO DAILY
5. PredniSONE 10 mg PO DAILY
6. Sertraline 100 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Seizure
Metastatic melanoma
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You came in after you had a seizure at home. We believe this was
due to a small spot of cancer on your brain. We started you on a
new medication to prevent further seizures.
You were also seen by our neuro-oncologist Dr. ___
recommended radiation treatment. You had your planning session
here in the hospital and will need to return next week for your
treatment.
We are working on scheduling follow up with the neuro-oncologist
Dr. ___. You should also follow up with Dr. ___
leaving the hospital.
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. Acetaminophen 325 mg PO Q6H
2. Amlodipine 5 mg PO DAILY
3. Aquaphor Ointment 1 Appl TP TID:PRN dry skin
4. Erythromycin 0.5% Ophth Oint 0.5 in BOTH EYES QHS
5. Fluticasone Propionate 110mcg 2 PUFF IH BID
6. Glargine 40 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
7. LaMIVudine 100 mg PO DAILY
8. Levothyroxine Sodium 150 mcg PO DAILY
9. Sertraline 100 mg PO DAILY
10. Valsartan 160 mg PO BID
11. Artificial Tears ___ DROP BOTH EYES DAILY
12. Morphine SR (MS ___ 15 mg PO Q12H
Hold for sedation or RR < 12
RX *morphine [MS ___ 15 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*30 Tablet Refills:*0
13. Morphine Sulfate ___ 7.5 mg PO Q6H:PRN pain
Give for breakthrough pain, hold for sedation or RR < 12
RX *morphine 15 mg 0.5 (One half) tablet(s) by mouth every six
(6) hours Disp #*30 Tablet Refills:*0
14. Docusate Sodium 100 mg PO BID
15. OLANZapine (Disintegrating Tablet) 2.5 mg PO DAILY
agitation/anxiety/hallucinations
16. Senna 8.6 mg PO BID
17. albuterol sulfate 2.5 mg /3 mL (0.083 %) inhalation Q6H:PRN
SOB , wheeze
18. Carvedilol 6.25 mg PO BID
19. Disulfiram 250 mg PO DAILY
20. esomeprazole magnesium 40 mg oral daily
21. nystatin 100,000 unit/gram topical BID
22. Dexamethasone 8 mg PO Q12H Duration: 1 Dose
RX *dexamethasone 2 mg ASDIR tablet(s) by mouth ASDIR Disp #*28
Tablet Refills:*0
23. Ondansetron 4 mg PO Q8H:PRN nausea
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary Diagnosis:
1. ___ Nerve Palsy
2. Metastatic breast cancer
Secondary Diagnosis:
1. Diabetes
2. Hypertension
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 during your admission to ___
___. You were admitted for
evaluation and management of cancer with brain involvement. You
were given whole brain radiation and steroids to help alleviate
your symptoms. You will need to continue the steroids after
discharge, but the dose will be slowly decreased. Follow up
appointments have been scheduled with your primary care
physician as well as your oncologist. Please take your
medications and keep your follow up appointments as scheduled.
We wish you all the best.
- Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. amLODIPine 10 mg PO DAILY
RX *amlodipine 10 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
2. FoLIC Acid 1 mg PO DAILY
RX *folic acid 1 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
3. Multivitamins W/minerals 1 TAB PO DAILY
RX *multivitamin,tx-minerals 1 tablet(s) by mouth once a day
Disp #*30 Tablet Refills:*0
4. Thiamine 100 mg PO DAILY
RX *thiamine HCl (vitamin B1) 100 mg 1 tablet(s) by mouth once a
day Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis: alcoholic hepatitis with decompensated
cirrhosis, severe malnutrition, alcohol use disorder
Secondary diagnosis: tobacco use disorder, coagulopathy
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 were admitted to the hospital for chest pain, side pain,
and abdominal pain and you also had a very sick liver
WHAT HAPPENED WHEN YOU WERE IN THE HOSPITAL?
- To help your liver heal, you required nutrition and vitamins,
and we gave this to you through a tube
- We put a tube through your nose that went into your stomach to
help your liver
- You removed the tube because it was making you sneeze and
cough
- We explained that it is very important for you to have this
tube in through your nose to help your nutrition
- You were very concerned about your employment status and your
children, and you wanted to go to work even though we said it
was very dangerous to leave the hospital
- You communicated your understanding of the risks associated
with your liver disease and understand that you need to avoid
alcohol and focus on nutrition to recover
- With all the information we gave you, you decided to leave the
hospital despite our recommendation
WHAT SHOULD YOU DO AFTER YOU LEAVE THE HOSPITAL?
- Please avoid drinking alcohol as it is extremely harmful to
your liver
- Continue to take all your medicines as prescribed below.
- Show up to your appointments as listed below.
- It is very important to keep track of your health.
- If you notice your skin or your eyes turning yellow, you need
to go to the hospital
- If you start feeling nauseous or start vomiting, you need to
go to the hospital
- If you notice your belly becoming bigger or you have trouble
breathing, you need to go to the hospital
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. albuterol sulfate 90 mcg/actuation inhalation ___ puffs qid
prn wheezing
2. Aspirin 81 mg PO DAILY
3. Calcitriol 0.25 mcg PO EVERY OTHER DAY
4. Carvedilol 12.5 mg PO BID
5. Colchicine 0.6 mg PO EVERY ___ DAY
6. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
7. Glargine 34 Units Bedtime
Novolog 15 Units Breakfast
Novolog 15 Units Lunch
Novolog 15 Units Dinner
Insulin SC Sliding Scale using Novolog Insulin
8. Pantoprazole 40 mg PO Q24H
9. Pravastatin 80 mg PO DAILY
10. Vitamin D ___ UNIT PO DAILY
11. Amiodarone 200 mg PO BID
12. Allopurinol ___ mg PO DAILY
13. HydrALAzine 100 mg PO TID
14. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY
15. Lisinopril 5 mg PO DAILY
16. Torsemide 40 mg PO DAILY
17. Warfarin 7.5 mg PO DAILY16
18. Acetaminophen 1000 mg PO Q8H:PRN pain
19. Artificial Tears Preserv. Free ___ DROP BOTH EYES PRN dry
eyes
20. Cephalexin 500 mg PO Q8H
21. Bisacodyl 10 mg PO DAILY:PRN constipation
22. Docusate Sodium 200 mg PO BID
23. Lidocaine 5% Patch 1 PTCH TD QAM
24. Mexiletine 150 mg PO Q8H
25. Polyethylene Glycol 17 g PO DAILY
26. Senna 17.2 mg PO HS
27. Simethicone 40-80 mg PO QID:PRN gas pains
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Active:
- tachybrady syndrome
- systolic CHF
- acute kidney injury
- hypertension
Chronic
- IDDM
- CAD
- atrial fibrillation
- GERD
- 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>Mr ___,
It was a pleasure treating you during this hospitalization. You
were aditted initially for a syncopal episode. You were found to
have an abnormal heart rhythm and had a pacemaker lead replaced.
You also experienced a heart arrhythmia known as ventricular
tachycardia. This arrhythmia likely caused an acute-on-chronic
injury to your kidney. You were started on both amiodarone and
mexilitine to control these abnormal rhythms. In addition, you
were found to have an exacerbation of your heart failure and
treated with diuresis to remove fluid. Your blood pressure was
quite high through out much of your hospital stay and we
adjusted your medications accordingly to control your blood
pressure.
Please Weigh yourself every morning, call MD if weight goes up
more than 3 lbs. Your weight upon discharge is 101.9 kg.
All the best for a speedy recovery!
Sincerely,
___ Treatment Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*2
2. Sorafenib 200 mg PO Q12H
3. Furosemide 40 mg PO DAILY
4. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain -
Moderate
5. OxyCODONE SR (OxyconTIN) 10 mg PO Q8H
6. Spironolactone 100 mg PO DAILY
7. Albuterol Inhaler 2 PUFF IH Q6H:PRN sob
8. Amitriptyline 25 mg PO QHS
9. Atorvastatin 10 mg PO QPM
10. Bisacodyl 10 mg PO DAILY:PRN constipation
11. Dolutegravir 50 mg PO DAILY
12. Emtricitabine-Tenofovir alafen (200mg-25mg) *DESCOVY* 1 TAB
PO DAILY
13. Lactulose 30 mL PO QID
14. Magnesium Oxide 800 mg PO BID
15. Rifaximin 550 mg PO DAILY
16. Vitamin D 800 UNIT PO DAILY
17.Outpatient Lab Work
Obtain CBC, chemistry and transaminases with total bilirubin.
ICD ___
Please fax to ___ at ___ and Dr.
___ ___
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY:
========
Spontaneous bacterial peritonitis
HCV cirrhosis
Metastatic HCC c/b left acromion fracture
HIV
Refractory ascites
SECONDARY:
==========
Hypertension
PTSD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at ___
___.
WHY WERE YOU IN THE HOSPITAL?
- You were transferred to ___ because of worsening abdominal
pain. The pain was severe enough to wake you from sleep.
WHAT HAPPENED IN THE HOSPITAL?
- You had another diagnostic paracentesis performed which showed
an infection in your abdomen.
- You were given antibiotics to treat the infection and your
pain improved.
- You had a shoulder X-ray which showed that there was some
progression of the lytic lesion in the acromion of your left
shoulder.
- Your pain medications were increased to better control your
pain.
- You had another paracentesis performed to make sure that the
infection in your abdomen got better. This showed that the
infection is gone.
WHAT SHOULD YOU DO AFTER LEAVING THE HOSPITAL?
- You should continue to take all of your medications as
prescribed.
- You can now start the chemotherapy medicine that was
prescribed previously.
- You should follow up with your doctors as ___ below.
- IF you notice the size of your belly increasing, call your
liver doctor to discuss increasing the frequency of your Lasix
or scheduling an appointment to have fluid taken off.
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. Nystatin Oral Suspension 5 mL PO QID thrush
continue for 48 hours after symptoms resolve
RX *nystatin 100,000 unit/mL 5 mL by mouth four times a day Disp
#*1 Bottle Refills:*2
2. Metoclopramide 10 mg PO QIDACHS Duration: 2 Days
please stop taking this medication on ___ in preparation for
your appointment on ___
RX *metoclopramide HCl 10 mg 1 tablet(s) by mouth every eight
(8) hours Disp #*30 Tablet Refills:*0
3. Acetaminophen 650 mg PO Q6H:PRN pain
do not exceed 3000mg/day
4. Albuterol Inhaler 1 PUFF IH Q6H:PRN sob
5. Aspirin 325 mg PO DAILY
6. Bisacodyl 10 mg PO DAILY:PRN CONSTIPATION
7. Docusate Sodium 100 mg PO BID
HOLD FOR DIARRHEA
8. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
9. Insulin SC
Sliding Scale
Insulin SC Sliding Scale using HUM Insulin
10. Isosorbide Mononitrate 30 mg PO DAILY
hold for BP<100
11. Metoprolol Succinate XL 200 mg PO DAILY
12. Nitrofurantoin (Macrodantin) 100 mg PO BID Duration: 4 Doses
13. Senna 1 TAB PO BID
14. Valsartan 80 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Nausea
Vomiting
Oral Thrush
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 a ___. You were admitted
for nausea and vomiting. We performed a work up to evaluate you
for an infection or a problem related to your surgery and
unfortunately we did not find any cause for your nausea and
vomiting but there does not appear to be any life threatening
condition that wound require immediate surgery or continued
admission. We gave you a medication called reglan for your
nausea and will send you home with a prescription for this
medication. While you were in the ___ we had the
gastroenterologist evaluate you and they perfromed a endoscopy
to look at you stomach and upper intestines. This was normal. We
scheduled you for a out patient gastric emptying study for
___ to further investigate your nausea and vomiting. In
preparation for your appointment on ___, please do not eat
or drink anything after midnight on ___. You should not take
any oxycodone when you get home. Please also stop taking your
Reglan on ___ night in preparation for your appointment on
___. You also had poorly controlled blood sugar. We
controlled you with a long lasting type of insulin. Please
continue your usual insulin dose at home but it is very
important you follow up with your primary doctor to improve your
blood sugar control. Elevated blood sugar can contribue to your
intenstinal symptoms. We also treated you for a thrush infection
in your mouth. This is caused by a fungus. Please use the
nystatin as directed.
Follow up: See your scheduled appointments below and please
follow up with your primary doctor as soon as possible.</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. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN SOB
3. Artificial Tears ___ DROP BOTH EYES PRN dryness
4. Aspirin 81 mg PO DAILY
5. Baclofen 5 mg PO TID
6. Carbidopa-Levodopa (___) 1 TAB PO TID
7. Clonazepam 0.5 mg PO BID
8. Docusate Sodium 150 mg PO DAILY:PRN constipation
9. Escitalopram Oxalate 20 mg PO DAILY
10. Guaifenesin ___ mL PO Q6H:PRN cough
11. Haloperidol 1 mg PO QAM
12. Ipratropium Bromide Neb 1 NEB IH Q4H:PRN sob
13. Levothyroxine Sodium 75 mcg PO DAILY
14. Lorazepam 1 mg PO Q4H:PRN andiety
15. Multivitamins 1 TAB PO DAILY
16. Ranitidine 150 mg PO BID
17. Simvastatin 5 mg PO DAILY
18. Vitamin D 400 UNIT PO BID
19. Levofloxacin 750 mg PO DAILY
ending ___
RX *levofloxacin 750 mg 1 tablet(s) by mouth daily Disp #*2
Tablet Refills:*0
20. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
ending in the evening of ___
RX *metronidazole 500 mg 1 tablet(s) by mouth three times a day
Disp #*17 Tablet Refills:*0
21. Bismuth Subsalicylate 0 mL PO Frequency is Unknown
22. calcium carbonate-vitamin D2 *NF* 600 mg calcium- 200 unit
Oral BID
23. Carvedilol 6.25 mg PO BID
24. Clotrimazole Cream 1 Appl TP PRN rash
25. Divalproex (DELayed Release) 250 mg PO BID
26. Furosemide 40 mg PO DAILY
27. Haloperidol 2 mg PO QPM
28. Loperamide 0 mg PO Frequency is Unknown
29. Neomycin-Polymyxin-Bacitracin 0 Appl TP Frequency is Unknown
30. Nystatin Cream 1 Appl TP 5X/DAY
31. Nystatin-Triamcinolone Cream 1 Appl TP BID:PRN rash
32. Outpatient Lab Work
please check HCT on ___ at ___'s office
33. Isosource *NF* (food supplement, lactose-free) 1 can Oral 5x
daily
Discharge Disposition:
Home
Discharge Diagnosis:
left thigh hematoma
left lower lobe pneumonia, possibly aspiration
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were transferred to our hospital for evaluation of some
bleeding into your left thigh which had been progressing over
the past week. You were evaluated by our surgery team and there
was no reason to surgically fix this bleed. We monitored your
blood counts for a few days and they were stable. You are safe
to return home but you should probably be supported with a less
constricting ___ lift harness to prevent further trauma.
The following changes were made to your medications:
1. START LEVOFLOXACIN 750mg daily for ___ and ___. START FLAGYL 500mg three times a day ending in the evening of
___
Please continue all other previously prescribed medications</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. PredniSONE 40 mg PO DAILY
2. Azathioprine 50 mg PO DAILY
RX *azathioprine 50 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*1
3. Cholestyramine 4 gm PO BID
RX *cholestyramine (with sugar) 4 gram 4 gm by mouth twice a day
Disp #*60 Packet Refills:*1
4. Sarna Lotion 1 Appl TP TID:PRN itching
RX *camphor-menthol [Sarna Anti-Itch] 0.5 %-0.5 % Apply to
affected area as needed daily Disp #*1 Tube Refills:*0
5. Simethicone 40-80 mg PO QID:PRN gas, bloating
RX *simethicone 80 mg 1 tablet by mouth QID:prn Disp #*30 Tablet
Refills:*1
6. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation
Q4H:prn sob/wheezing
7. Symbicort (budesonide-formoterol) 80-4.5 mcg/actuation
inhalation daily
8. TraMADOL (Ultram) 50 mg PO Q6H:PRN pain
RX *tramadol [Ultram] 50 mg 1 tablet(s) by mouth Q6H:prn Disp
#*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis: autoimmune hepatitis
Secondary diagnosis: asthma
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you during your stay at ___
___. You were admitted because your
liver doctor was concerned about your liver function. You were
started on a new medication called Imuran in addition to the
prednisone in order to control your liver disease. You liver
function numbers improved while you were here. Please continue
both of these medications.
Thank you for allowing us to participate in your care.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler 1 PUFF IH Q6H:PRN sob
2. Aspirin 81 mg PO DAILY
3. Fluticasone Propionate 110mcg 2 PUFF IH BID
4. Oxcarbazepine 150 mg PO BID
5. Vitamin D 50,000 UNIT PO 1X/WEEK (___)
6. dalfampridine 10 mg oral BID
7. dimethyl fumarate 240 mg oral BID
8. oxybutynin chloride 15 mg oral daily
9. Levofloxacin 750 mg PO Q24H Duration: 5 Days
___
RX *levofloxacin 750 mg 1 tablet(s) by mouth daily Disp #*1
Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis
1. multiple sclerosis exacerbation
2. community acquired 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 Ms. ___,
It was a pleasure caring for you at ___
___. You were admitted for an exacerbation of your MS
in the setting of a pneumonia. You were treated for pneumonia
with antibiotics and for MS with steroids and you got better. At
discharged you felt much stronger and were discharged home.
It is important that you take all medications as prescribed, and
keep all follow up appointments.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO TID:PRN pain
2. Amiodarone 200 mg PO DAILY
3. Aspirin 81 mg PO DAILY
4. Cinacalcet 90 mg PO DAILY
5. Citalopram 20 mg PO DAILY
6. Docusate Sodium 100 mg PO BID:PRN constipation
7. Finasteride 5 mg PO DAILY
8. Gabapentin 100 mg PO TID
9. HYDROmorphone (Dilaudid) 2 mg PO Q4H:PRN pain
10. Levothyroxine Sodium 50 mcg PO DAILY
11. Mirtazapine 15 mg PO QHS
12. Nephrocaps 1 CAP PO DAILY
13. Pantoprazole 40 mg PO Q24H
14. Polyethylene Glycol 17 g PO DAILY
15. Pramipexole 0.125 mg PO DAILY
16. Senna 17.2 mg PO BID:PRN constipation
17. sevelamer CARBONATE 3200 mg PO TID W/MEALS
18. Simvastatin 10 mg PO QPM
19. Vancomycin 1000 mg IV HD PROTOCOL
20. Zolpidem Tartrate 2.5 mg PO QHS:PRN insomnia
21. CefTAZidime 1 g IV POST HD (___) MWF
IF ON HD, administer dose on the ward after patient returns from
each hemodialysis session.
22. Epoetin Alfa ___ UNIT IV ONCE Duration: 1 Dose
23. Midodrine 5 mg PO DAILY
24. TraMADOL (Ultram) 25 mg PO Q6H:PRN pain
25. Bisacodyl 10 mg PR QHS:PRN constipation
26. FoLIC Acid 1 mg PO DAILY
27. ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL
inhalation Q6H:PRN SOB, wheeze
28. Lidocaine 5% Ointment 1 Appl TP BID:PRN ankle pain
29. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN angina
30. Renal Caps (B complex with C#20-folic acid) 1 mg oral DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
left lower extremity non-healing ulceration and infection
Discharge Condition:
Level of Consciousness: Alert and interactive.
Mental Status: Confused - sometimes.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Mr ___,
You were admitted to the hospital with infection of your non
healing left great toe ulcer. Your infection and pain did not
improve with medications and antibiotics so we need to remove
the infected tissue in the OR. You needed to return to the OR
for closure of the stump after the infection improved. You are
now doing well and are ready to be discharge to rehab. Please
follow the instructions below to insure a speedy recovery.
DIVISION OF VASCULAR AND ENDOVASCULAR SURGERY
LOWER EXTREMITY AMPUTATION
DISCHARGE INSTRUCTIONS
ACTIVITY
You should keep your amputation site elevated and straight
whenever possible. This will prevent swelling of the stump and
maintain flexibility in your joint.
It is very important that you put no weight or pressure on
your stump with activity or at rest to allow the wound to heal
properly.
You may use the opposite foot for transfers and pivots, if
applicable. It will take time to learn to use a walker and
learn to transfer into and out of a wheelchair.
BATHING/SHOWERING:
You may shower when you feel strong enough but no tub baths or
pools until the incision is fully healed.
After your shower, gently dry the incision well. Do not rub
the area.
WOUND CARE:
Please keep the wound clean and dry. It is very important that
there is no pressure on the stump. If there is no drainage,
you may leave the incision open to air.
Your staples will remain in your stump for at least 4 weeks.
At your followup appointment, we will see if the incision has
healed enough to remove the staples.
Before you can be fitted for prosthesis (a man-made limb to
replace the limb that was removed) your incision needs to be
fully healed.
CALL THE OFFICE FOR: ___
Opening, bleeding or drainage or odor from your stump incision
Redness, swelling or warmth in your stump.
Fever greater than 101 degrees, chills, or worsening
incisional/stump pain
YOUR VASCULAR SURGEON WILL DETERMINE WHEN/IF THE STAPLES ARE
READY TO BE REMOVED FROM YOUR STUMP! IF THERE ARE ANY
QUESTIONS ABOUT THIS, YOUR OTHER PROVIDERS SHOULD CALL THE
VASCULAR SURGERY OFFICE AT ___ TO DISCUSS. THE
STAPLES WILL BE REMOVED IN THE OFFICE AT YOUR FOLLOWUP
APPOINTMENT.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 325 mg PO DAILY
2. Atenolol 25 mg PO DAILY
3. Docusate Sodium 100 mg PO BID:PRN Constipation
4. Fetzima (levomilnacipran) 80 mg oral qAM
RX *levomilnacipran [Fetzima] 80 mg 1 capsule(s) by mouth daily
Disp #*30 Capsule Refills:*0
5. LaMOTrigine 250 mg PO DAILY
6. Simvastatin 20 mg PO QPM
7. Thiamine 100 mg PO DAILY
8. Adderall (dextroamphetamine-amphetamine) 2.5 mg oral daily
RX *dextroamphetamine-amphetamine [Amphetamine Salt Combo] 5 mg
0.5 (One half) tablet(s) by mouth twice a day Disp #*7 Tablet
Refills:*0
9. Adderall (dextroamphetamine-amphetamine) 2.5 mg ORAL DAILY
10. Amlodipine 10 mg PO DAILY
RX *amlodipine 10 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
11. Hydrochlorothiazide 12.5 mg PO DAILY
RX *hydrochlorothiazide 12.5 mg 1 tablet(s) by mouth daily Disp
#*30 Tablet Refills:*0
12. Mirtazapine 7.5 mg PO HS
RX *mirtazapine 7.5 mg 1 tablet(s) by mouth at bedtime Disp #*30
Tablet Refills:*0
13. RISperidone 1 mg PO HS
RX *risperidone 1 mg 1 tablet(s) by mouth at bedtime Disp #*30
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Mood disorder NOS
Alcohol use disorder, in remission
Discharge Condition:
*VS: T 97.8 BP 111/75 HR 86 RR 16 Sat 99% on RA
Neurological:
*station and gait: normal station, normal gait
*tone and strength: good tone, ___ strength
*Appearance: thin, elderly woman, in casual clothes
Behavior: cooperative, responsive
*Mood and Affect: 'alright' / mood congruent
*Thought process: linear, logical, goal-oriented
*Thought Content: no AV hallucinations, no SI/HI
*Judgment and Insight: fair/fair
Cognition: intact
*Attention, *orientation, and executive function: fair
*Memory: fair
*Fund of knowledge: fair
*Speech: normal rate and prosody, fluent
*Language: no paraphasic errors, appropriate, native ___
speaker
Followup Instructions:
___ [/INST] </s><s>-Please follow up with all outpatient appointments as listed -
take this discharge paperwork to your appointments.
-Please continue all medications as directed.
-Please avoid abusing alcohol and any drugs--whether
prescription drugs or illegal drugs--as this can further worsen
your medical and psychiatric illnesses.
-Please contact your outpatient psychiatrist or other providers
if you have any concerns.
-Please call ___ or go to your nearest emergency room if you
feel unsafe in any way and are unable to immediately reach your
health care providers.
*It was a pleasure to have worked with you, and we wish you the
best of health.*</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atenolol 25 mg PO DAILY
2. Pantoprazole 40 mg PO Q24H
3. Potassium Chloride 20 mEq PO BID
4. Acetaminophen 650 mg PO Q6H:PRN pain
5. Ciprofloxacin HCl 500 mg PO Q12H
last dose ___. Heparin 5000 UNIT SC TID
7. Aspirin 325 mg PO DAILY
8. Calcitriol 0.25 mcg PO MWF
9. Calcium Carbonate 1200 mg PO DAILY
10. Fexofenadine 120 mg PO DAILY
11. Fish Oil (Omega 3) ___ mg PO BID
12. Gabapentin 1200 mg PO BID
13. Gabapentin 600 mg PO DAILY
14. Hydrocortisone (Rectal) 2.5% Cream ___ID:PRN
hemorrhoids
15. Multivitamins 1 TAB PO DAILY
16. Simvastatin 20 mg PO HS
17. Triamcinolone Acetonide 0.1% Ointment 1 Appl TP TID:PRN
elbow skin itch
18. Ursodiol 900 mg PO QAM
19. Ursodiol 600 mg PO QPM
20. Verapamil SR 120 mg PO Q24H
21. Vitamin D ___ UNIT PO DAILY
22. Torsemide 20 mg PO X2 DAILY
23. moxifloxacin 0.5 % OPHTHALMIC TID conjunctivitis Duration: 1
Week
last dose ___
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
GI bleed
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>___ were admitted to the hospital with GI bleeding. ___ were
monitored in the intensive care unit. ___ required blood
transfusions and ___ required medication to support your blood
pressure. On further testing ___ were found to have bleeding
from ___ ileum and ___ had embolization to the vessel where the
bleeding was recurrring. Despite this, the bleeding continued
and the surgery team was consulted. ___ were taken to the
operating room for an exploratory laparotomy, and a resection of
the part of the bowel which was bleeding. Your hematocrit has
been stable and ___ have had no further bleeding. Your vitgal
signs have been stable. ___ were seen by physical therapy and
recommendations made for discharge to a rehabilitation faciity.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Mr. ___,
You were hospitalized due to concern for tuberculosis. You were
found to have pneumonia, you will complete a course of
antibiotics for community acquired pneumonia.
Please follow-up with pulmonary and your primary care physician
after discharge. We wish you all the best in your recovery.
Best wishes,
Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Guaifenesin-CODEINE Phosphate ___ mL PO Q6H:PRN cough
RX *codeine-guaifenesin 10 mg-100 mg/5 mL 5 mL by mouth every
six (6) hours Refills:*0
2. Levofloxacin 750 mg PO Q24H
RX *levofloxacin 750 mg 1 tablet(s) by mouth once a day Disp #*4
Tablet Refills:*0
3. Atorvastatin 20 mg PO QPM
4. Fluticasone Propionate NASAL 2 SPRY NU DAILY
5. Hydrochlorothiazide 25 mg PO DAILY
6. Levothyroxine Sodium 125 mcg PO DAILY
7. LORazepam 0.5 mg PO QHS:PRN anxiety/insomnia
8. MetFORMIN XR (Glucophage XR) 500 mg PO QPM
Do Not Crush
9. OLANZapine 10 mg PO PRN breakthrough nausea
10. Ondansetron 8 mg PO Q8H:PRN nausea
Discharge Disposition:
Home
Discharge Diagnosis:
Acute viral bronchitis
Community Acquired Pneumonia
Breast cancer
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 with a viral infection that was complicated by
a pneumonia. ___ fortunately are not having issues with your
breathing and stopped having fevers once we started antibiotics.
___ will be able to continue to recover at home. Please continue
your antibiotic through ___.
It was pleasure to take care of ___.
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>-Continue to slowly increase po intake as tolerated
-Please take Bactrim and Keflex daily as prescribed for ten
days.
-No heavy lifting or strenuous activity for at least one week
-Return to the clinic for follow up with Dr. ___ in
___ days</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H
RX *acetaminophen 500 mg 2 tablet(s) by mouth every six (6)
hours Disp #*84 Tablet Refills:*0
2. Cefpodoxime Proxetil 200 mg PO Q12H
RX *cefpodoxime 200 mg 1 tablet(s) by mouth twice a day Disp
#*28 Tablet Refills:*0
3. Ibuprofen 600 mg PO Q8H
RX *ibuprofen 600 mg 1 tablet(s) by mouth every eight (8) hours
Disp #*42 Tablet Refills:*0
4. MetroNIDAZOLE 500 mg PO Q8H
RX *metronidazole 500 mg 1 tablet(s) by mouth every eight (8)
hours Disp #*42 Tablet Refills:*0
5. Naloxone 0.04 mg IV ONCE MR1:PRN Somnolence, desats, apneic
Duration: 1 Dose
RX *naloxone [Narcan] 4 mg/actuation 4 mg As needed Disp #*1
Spray Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
==================
Left dorsal hand abscess
Cellulitis
Secondary diagnosis:
===================
Active IV drug use
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
Thank you for coming to ___!
Why were you admitted?
- You were admitted for worsening left hand pain and swelling
- You were found to have a left dorsal hand abscess and
cellulitis
What happened while you were ___ the hospital?
- You had an incision and drainage ___ the OR
- We gave you IV antibiotics for your infection
- We recommended that you stay for IV antibiotics, but you
declined. We switched you to two new oral antibiotics on
discharge.
- You had a normal chest x-ray at bedside
- We also recommended that you stay to have your hand swelling
monitored, since the pressure ___ your hand can increase
significantly and cause loss of pulse and sensation. This is
known as compartment syndrome. It is possible that you could
even lose your hand. However, you declined to stay for serial
surgery exam monitoring and accept this risk.
What should you do when you leave the hospital?
- It is important for you to continue taking these antibiotics.
We recommend that you take them until your hand surgery
appointment. They will tell you how long to continue them. We
have given you a two week supply.
- We recommend that you follow up with your PCP or ___ ___
clinic.
- We also recommend that you keep your hand wound clean and dry.
It was a pleasure taking care of you! We wish you all the best.
- Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Finasteride 5 mg PO DAILY
2. LevETIRAcetam 750 mg PO BID
3. Warfarin 7.5 mg PO DAILY16
Discharge Disposition:
Home
Discharge Diagnosis:
Musculoskeletal chest pain
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 ___,
You came to the hospital because you were having chest pain. All
your tests for signs of blood clots in your lungs did not show
any clots. You were started on heparin to thin your blood as we
were restarting you on Coumadin, but you left against medical
advance before your INR was at a safely thin level.
When you leave, it is important you find a primary care provider
to help with your blood disorder. You are at high risk of future
clots.
We wish you the best of luck,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth Every four hours as
needed for pain Disp #*30 Tablet Refills:*0
2. Calcium Citrate + D (calcium citrate-vitamin D3) 0 MG ORAL
DAILY
3. Ferrous Sulfate 325 mg PO DAILY
4. Iron Plus Vitamin C (iron fum-vit C-ascorbate sod) 65 mg
iron- 125 mg Oral Daily
5. Lorazepam 1 mg PO BID
6. Multivitamins W/minerals 1 TAB PO DAILY
7. Mupirocin Nasal Ointment 2% 1 Appl NU BID
8. Nortriptyline 100 mg PO HS
9. Quetiapine extended-release 150 mg PO BID
10. SymlinPen 60 (pramlintide) 1,500 mcg/1.5 mL Subcutaneous TID
11. Vitamin B-12 (cyanocobalamin (vitamin B-12)) 1,000 mcg Oral
Weekly
12. Docusate Sodium 100 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
G-tube malfunction
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 after
tripping on your G-tube and we were concerned that you might
have dislodged your G-tube, or worse, suffered a perforation.
We performed a G-tube sinogram and contrast was seen to enter
your stomach without difficulty. We restarted your tube feeds
which you tolerated well. You may need repositioning of your
G-tube by Dr. ___ in clinic.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Allopurinol ___ mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Atorvastatin 80 mg PO DAILY
4. Digoxin 0.125 mg PO DAILY
5. Docusate Sodium 100 mg PO BID
6. Dronabinol 2.5 mg PO TID
7. FoLIC Acid 1 mg PO DAILY
8. HYDROmorphone (Dilaudid) ___ mg PO Q3H:PRN pain
hold for sedation, rr<10
9. Lorazepam 0.5 mg PO HS:PRN insomnia
RX *Ativan 0.5 mg 1 tablet by mouth at night Disp #*30 Tablet
Refills:*0
10. Omeprazole 20 mg PO DAILY
11. PredniSONE 5 mg PO EVERY OTHER DAY
starting ___
12. Prochlorperazine 10 mg PO Q6H:PRN nausea
13. Senna 1 TAB PO BID:PRN constipation
14. Sulfameth/Trimethoprim DS 1 TAB PO QMOWEFR
15. Tamsulosin 0.4 mg PO HS
16. Thiamine 100 mg PO DAILY
17. Mirtazapine 15 mg PO HS
RX *mirtazapine 15 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
18. Morphine SR (MS ___ 60 mg PO Q8H
hold for sedation, rr<12
RX *morphine 60 mg 1 tablet(s) by mouth every 8 hours Disp #*90
Tablet Refills:*0
19. fenofibrate nanocrystallized *NF* 145 mg Oral daily
20. Lactulose 30 mL PO Q8H:PRN constipation
hold for loose stools
21. magnesium chloride *NF* 64 mg Oral TID
take 2 tablets 3 times a day
22. Ondansetron 8 mg PO Q8H:PRN nausea
RX *ondansetron HCl 8 mg 1 tablet(s) by mouth every 8 hours Disp
#*30 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
-Back/hip pain
Seconday:
-Metastatic non-small cell lung cancer
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 ___ of you during this admission. You
were admitted for severe back and hip pain. MRI of your spine
showed some enhancement of your spinal cord, so we followed up
with an MRI of your brain and checked your spinal fluid. Both of
these were normal. The MRI of your hips was also normal. We
changed your pain medications by stopping your fentanyl patch
and starting you on a new medicine MS ___. Your pain
improved.
Please make the following changes to your medications:
-START MS ___
-STOP the Fentanyl Patch
-STOP Olanzapine
-DECREASE your Prednisone dose to 5mg every other day starting
___
Resume the other medications you were taking prior to this
admission.
Please remember to take your dexamethasone starting on ___
___ prior to starting chemotherapy.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. donepezil 10 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
2. levothyroxine 125 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
3. Apriso 0.375 gram Capsule, Ext Release 24 hr Sig: Two (2)
Capsule, Ext Release 24 hr PO once a day.
4. mirtazapine 15 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime).
5. phenobarbital 30 mg Tablet Sig: Two (2) Tablet PO TID (3
times a day).
6. phenytoin sodium extended 100 mg Capsule Sig: One (1) Capsule
PO TID (3 times a day).
7. risperidone 0.25 mg Tablet Sig: One (1) Tablet PO BID (2
times a day): ___ use another tablet PRN agitation x1 4 hours
after last dose.
8. acetaminophen 650 mg Tablet Extended Release Sig: One (1)
Tablet Extended Release PO every eight (8) hours.
9. warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4
___.
10. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for constipation.
11. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID
(2 times a day).
12. Lasix 80 mg Tablet Sig: One (1) Tablet PO once a day.
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary: Mechanical fall. Asymptomatic bacteriuria.
Secondary: Advanced ___ Body Dementia.
Discharge Condition:
Mental Status: Confused - always.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
___ were admitted to ___ after a fall at home. The fall was
felt to be consistent with a mechanical fall. Evaluation with
CAT scan of head and neck showed no new abnormalities. ___ were
initially treated for a urinary tract infection, however further
evaluation showed that ___ had no infection.
It was also noted that your decubitus ulcer was unchanged.
Finally, your coumadin was temporarily held due to high levels
of INR.
___ were discharged to a skilled nursing facility with hopes of
improving your strength and ability to move around to prevent
further falls. This was discussed and decided upon with your
daughter.
The following changes were made to your medications:
Should ___ develop any symptoms concerning to ___, please call
the doctor on call and Dr. ___, ___.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
RX *bisacodyl 5 mg 2 tablet(s) by mouth daily prn Disp #*30
Tablet Refills:*0
2. Fentanyl Patch 37 mcg/h TD Q72H
RX *fentanyl 37.5 mcg/hour Use 1 patch for pain q72 hours Disp
#*10 Patch Refills:*0
3. OxycoDONE Liquid 10 mg PO Q3H:PRN Pain - Moderate
Reason for PRN duplicate override: Alternating agents for
similar severity
RX *oxycodone 5 mg/5 mL 10 mg by mouth q3 hours prn Refills:*0
4. Aluminum-Magnesium Hydrox.-Simethicone 15 mL PO BID:PRN
Heartburn
RX *alum-mag hydroxide-simeth 200 mg-200 mg-20 mg/5 mL 15 mL by
mouth BID prn Disp #*1 Package Refills:*0
5. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*60 Capsule Refills:*0
6. Ondansetron 4 mg PO Q8H:PRN Nausea
RX *ondansetron 4 mg 1 tablet(s) by mouth q8 hours prn Disp #*60
Tablet Refills:*0
7. Polyethylene Glycol 17 g PO DAILY:PRN Constipation
RX *polyethylene glycol 3350 17 gram/dose 1 powder(s) by mouth
daily prn Refills:*0
8. Prochlorperazine 10 mg PO Q8H:PRN Nausea
RX *prochlorperazine maleate 10 mg 1 tablet(s) by mouth q8 hours
prn Disp #*60 Tablet Refills:*0
9. Senna 8.6 mg PO BID
RX *sennosides [senna] 8.6 mg 8.6 mg by mouth twice a day Disp
#*60 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary
=======
Recurrent ascites
Secondary
=======
Metastatic gastric cancer
Moderate protein malnutrition
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You came to hospital because you were having increasing swelling
and pain in your stomach.
While you were here, you had the extra fluid on your stomach
removed and had a feeding tube placed. You kept getting more
fluid in your stomach, so a permanent drain was placed in your
stomach to help drain it. You also were able to eat food by
mouth, so your feeding tube was removed. You also received
radiation to your cancer.
Because of your worsening cancer and worsening health, you were
discharged home with help from hospice.
When you leave the hospital, you should make sure to take your
medications as prescribed.
If you have any worsening abdominal pain, nausea, vomiting,
fevers or chills, please call you hospice care team to help
figure out the best plan.
It was our pleasure to take care of you, and 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. DULoxetine 20 mg PO DAILY
2. TraMADol 50 mg PO BID:PRN pain
3. Vitamin D ___ UNIT PO 1X/WEEK (TH)
4. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth twice daily
Disp #*14 Tablet Refills:*0
5. Ibuprofen 600 mg PO BID:PRN pain
RX *ibuprofen 600 mg 1 tablet(s) by mouth every ___ hours Disp
#*20 Tablet Refills:*0
6. Naproxen 500 mg PO EVERY OTHER DAY
7. Acetaminophen 500 mg PO Q8H
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
1. Acute complicated pyelonephritis
2. Nephrolithiasis
3. Myofascial pain syndrome
Secondary diagnoses:
1. Tension-type headache
2. Anemia
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 symptoms of back pain,
headache and urinary frequency. Based on a urine analysis and
blood tests you were found to have kidney infection
(pyelonephritis). You were treated initially with the antibiotic
ceftriaxone, though you will take ciprofloxacin when you go
home. An ultrasound of your kidneys showed that there was no
stone blocking your urinary tract, but there were small stones
in both your kidneys. We recommend that you see an outpatient
urologist because it is important to make sure that the
infection is cleared from those stones.
We also gave you a pain reliever for your headache, and this
improved by the time you went home.
Please continue your antibiotics through ___ and keep all
your follow-up appointments.
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. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
2. Ciprofloxacin HCl 500 mg PO Q12H Duration: 3 Days
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*6 Tablet Refills:*0
3. Collagenase Ointment 1 Appl TP DAILY to sacral decub
RX *collagenase clostridium histo. [Santyl] 250 unit/gram Apply
to sacral decubitus ulcer Daily Disp #*1 Tube Refills:*1
4. Docusate Sodium 100 mg PO BID:PRN constipation
5. Baclofen 10 mg PO TID
6. Caltrate + D3 Plus Minerals (Ca carb-D3-mag ___
300 mg-800 unit -25 mg-0.5 mg oral BID
7. CarBAMazepine 200 mg PO TID
8. Triamterene-HCTZ (37.5/25) 1 CAP PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
___ pancreatitis
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 ___
___. You were admitted to the hospital with
gallstone disease. You were taken to the operating room and had
your gallbladder removed laparoscopically. During this
operation, there was concern for a retained bile duct stone and
so you underwent an ERCP to help open and clear your bile ducts.
You were started on a course of an antibiotic called
Ciprofloxacin which you will continue to take at home.
You were noted to have skin breakdown on your backside and a
medication called Santyl (collagenase) was ordered to help with
wound healing. You will have a Visiting Nurse come to your home
to help you with wound care.
You are now tolerating a regular diet and your pain is better
controlled. You are now ready to be discharged home to continue
your recovery. Please follow the discharge instructions below
to ensure a safe recovery at home:
Please follow up in the Acute Care Surgery clinic at the
appointment listed below.
ACTIVITY:
o Do not drive until you have stopped taking pain medicine and
feel you could respond in an emergency.
o You may climb stairs.
o You may go outside, but avoid traveling long distances until
you see your surgeon at your next visit.
o Don't lift more than ___ lbs for 4 weeks. (This is about
the weight of a briefcase or a bag of groceries.) This applies
to lifting children, but they may sit on your lap.
o You may start some light exercise when you feel comfortable.
o You will need to stay out of bathtubs or swimming pools for a
time while your incision is healing. Ask your doctor when you
can resume tub baths or swimming.
HOW YOU MAY FEEL:
o You may feel weak or "washed out" for a couple of weeks. You
might want to nap often. Simple tasks may exhaust you.
o You may have a sore throat because of a tube that was in your
throat during surgery.
o You might have trouble concentrating or difficulty sleeping.
You might feel somewhat depressed.
o You could have a poor appetite for a while. Food may seem
unappealing.
o All of these feelings and reactions are normal and should go
away in a short time. If they do not, tell your surgeon.
YOUR INCISION:
o Tomorrow you may shower and remove the gauzes over your
incisions. Under these dressing you have small plastic bandages
called steri-strips. Do not remove steri-strips for 2 weeks.
(These are the thin paper strips that might be on your
incision.) But if they fall off before that that's okay).
o Your incisions may be slightly red around the stitches. This
is normal.
o You may gently wash away dried material around your incision.
o Avoid direct sun exposure to the incision area.
o Do not use any ointments on the incision unless you were told
otherwise.
o You may see a small amount of clear or light red fluid
staining your dressing or clothes. If the staining is severe,
please call your surgeon.
o You may shower. As noted above, ask your doctor when you may
resume tub baths or swimming.
YOUR BOWELS:
o Constipation is a common side effect of narcotic pain
medications. If needed, you may take a stool softener (such as
Colace, one capsule) or gentle laxative (such as milk of
magnesia, 1 tbs) twice a day. You can get both of these
medicines without a prescription.
o If you go 48 hours without a bowel movement, or have pain
moving the bowels, call your surgeon.
PAIN MANAGEMENT:
o It is normal to feel some discomfort/pain following abdominal
surgery. This pain is often described as "soreness".
o Your pain should get better day by day. If you find the pain
is getting worse instead of better, please contact your surgeon.
o You will receive a prescription for pain medicine to take by
mouth. It is important to take this medicine as directed. o Do
not take it more frequently than prescribed. Do not take more
medicine at one time than prescribed.
o Your pain medicine will work better if you take it before your
pain gets too severe.
o Talk with your surgeon about how long you will need to take
prescription pain medicine. Please don't take any other pain
medicine, including non-prescription pain medicine, unless your
surgeon has said its okay.
o If you are experiencing no pain, it is okay to skip a dose of
pain medicine.
o Remember to use your "cough pillow" for splinting when you
cough or when you are doing your deep breathing exercises.
If you experience any of the following, please contact your
surgeon:
- sharp pain or any severe pain that lasts several hours
- pain that is getting worse over time
- pain accompanied by fever of more than 101
- a drastic change in nature or quality of your pain
MEDICATIONS:
Take all the medicines you were on before the operation just as
you did before, unless you have been told differently.
If you have any questions about what medicine to take or not to
take, please call your surgeon.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
do not take more than 3000mg of Tylenol in 24 hours or drink
alcohol while taking this medication
2. betamethasone, augmented 0.05 % topical EVERY OTHER DAY
one application to pyoderma ulcers with ostomy changes
RX *betamethasone, augmented 0.05 % one application to pyoderma
ulcers with ileostomy changes every other day Refills:*0
3. BuPROPion (Sustained Release) 150 mg PO BID
4. FoLIC Acid 1 mg PO DAILY
5. Lisinopril 10 mg PO DAILY
6. Methotrexate 25 mg PO 1X/WEEK (TH)
7. Multivitamins 1 TAB PO DAILY
8. Omeprazole 10 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Parastomal Hernia causing small bowel obstruction
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 a small bowel obstruction
related to a parastomal hernia which is next to your stoma. You
were given bowel rest and intravenous fluids and a nasogastric
tube was placed in your stomach to decompress your bowels. Your
obstruction has subsequently resolved after conservative
management. You have tolerated a regular diet, are passing gas
and your pain is controlled with pain medications by mouth. You
may return home to finish your recovery. The parastomal hernia
will need to be repaired and Dr. ___ like to do this in
the near future. Our office will be in touch with you to discuss
this.
You should continue to care for the stoma as you have been at
home. Please wear the stoma belt provided to you by the wound
ostomy nurses. ___ is important to continue the pyoderma
treatment you were doing prior to admission. There is a new
steroid ointment that should be applied to the ulcers next to
your ileostomy when you change your ileostomy appliance.
If you have any of the following symptoms please call the office
for advice or go to the emergency room if severe: increasing
abdominal distension, increasing abdominal pain, nausea,
vomiting, inability to tolerate food or liquids, prolonged loose
stool, or extended constipation.
Thank you for allowing us to participate in your care! Our hope
is that you will have a quick return to your life and usual
activities.
Good luck!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ascorbic Acid ___ mg PO DAILY
2. Calcium Carbonate ___ mg PO DAILY
3. Multivitamins 1 TAB PO DAILY
4. Vitamin D ___ UNIT PO DAILY
5. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg 1 capsule(s) by mouth every 6 hours Disp #*20
Capsule Refills:*0
RX *oxycodone 5 mg 1 tablet(s) by mouth every 4 hours Disp #*25
Tablet Refills:*0
6. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin 500 mg 1 tablet(s) by mouth twice a day Disp
#*8 Tablet Refills:*0
7. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *metronidazole 500 mg 1 tablet(s) by mouth three times a day
Disp #*12 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
acute gangrenous appendicitis
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 management of abdominal
pain. You were found to have acute gangrenous appendicitis. You
underwent an open ileocectomy. You are at risk of developing an
intraabdominal abscess, so please beware of any fevers or
abdominal pain.
You will be discharge with 4 more days of antibiotics. Please
take as directed.
Please refer to the following directions below regarding
post-operative management.
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:
___ services will be provided to manage your abdominal wound.
*Please call your doctor or nurse practitioner if you have
increased pain, swelling, redness, or drainage from the incision
site.
*You may shower, and wash surgical incisions with a mild soap
and warm water. Gently pat the area dry.
*Staples will be removed at your follow-up appointment.
Sincerely,
___ acute care surgery</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Chlorhexidine Gluconate 0.12% Oral Rinse 15 mL ORAL BID
RX *chlorhexidine gluconate 0.12 % 15 mL oral rinse twice a day
Disp #*2 Bottle Refills:*2
2. Acetaminophen 650 mg PO Q6H
3. Cephalexin 500 mg PO Q12H
RX *cephalexin 500 mg 1 tablet(s) by mouth twice a day Disp #*14
Capsule Refills:*0
4. Docusate Sodium 100 mg PO BID
RX *docusate sodium [___] 100 mg 1 tablet(s) by mouth twice a
day Disp #*28 Capsule Refills:*0
5. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth q4-6h Disp #*40 Tablet
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
trauma: right manbibular fracture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted to the hospital after you were punched in the
jaw. You sustained a fracture to your mandible. You were taken
to the operating room to have it repaired. Your vital signs
have been stable. You are now preparing for discharge home with
the following instructions:
Wound care: Do not disturb or probe the surgical area with any
objects. The sutures placed in your mouth are usually the type
that self dissolve. If you have any sutures on the skin of your
face or neck, your surgeon will remove them on the day of your
first follow up appointment. SMOKING is detrimental to healing
and will cause complications.
Bleeding: Intermittent bleeding or oozing overnight is normal.
Placing fresh gauze over the area and biting on the gauze for
___ minutes at a time may control the bleeding. If you had
nasal surgery, you may have occasional slow oozing from your
nostril for the first ___ days. Bleeding should never be severe.
If bleeding persists or is severe or uncontrollable, please call
our office immediately. If it is after normal business hours,
please come to the emergency room and request that the oral
surgery resident on call be paged.
___: Normal healing after oral surgery should be as follows:
the first ___ days after surgery, are generally the most
uncomfortable and there is usually significant swelling. After
the first week, you should be more comfortable. The remainder of
your postoperative course should be gradual, steady improvement.
If you do not see continued improvement, please call our office.
Physical activity: It is recommended that you not perform any
strenuous physical activity for a few weeks after surgery. Do
not lift any heavy loads and avoid physical sports unless you
obtain permission from your surgeon.
Swelling & Ice applications: Swelling is often associated with
surgery. Swelling can be minimized by using a cold pack, ice bag
or a bag of frozen peas wrapped in a towel, with firm
application to face and neck areas. This should be applied 20
minutes on and 20 minutes off during the first ___ days after
surgery. If you have been given medicine to control the
swelling, be sure to take it as directed.
Hot applications: Starting on the ___ or ___ day after surgery,
you may apply warm compresses to the skin over the areas of
swelling (hot water bottle wrapped in a towel, etc), for 20
minutes on and 20 min off to help soothe tender areas and help
to decrease swelling and stiffness. Please use caution when
applying ice or heat to your face as certain areas may feel numb
after surgery and extremes of temperature may cause serious
damage.
Tooth brushing: Begin your normal oral hygiene the day after
surgery. Soreness and swelling may nor permit vigorous brushing,
but please make every effort to clean your teeth with the bounds
of comfort. Any toothpaste is acceptable. Please remember that
your gums may be numb after surgery. To avoid injury to the gums
during brushing, use a child size toothbrush and brush in front
of a mirror staying only on teeth.
Mouth rinses: Keeping your mouth clean after surgery is
essential. Use 1 teaspoon of salt dissolved in an 8 ounce glass
of warm water and gently rinse with portions of the solution,
taking 5 min to use the entire glassful. Repeat as often as you
like, but you should do this at least 4 times each day. If your
surgeon has prescribed a specific rinse, use as directed.
Showering: You may shower ___ days after surgery, but please ask
your surgeon about this. If you have any incisions on the skin
of your face or body, you should cover them with a water
resistant dressing while showering. DO NOT SOAK SURGICAL SITES.
This will avoid getting the area excessively wet. As you may
physically feel weak after surgery, initially avoid extreme hot
or cold showers, as these may cause some patients to pass out.
Also it is a good idea to make sure someone is available to
assist you in case if you may need help.</s> |