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<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Apixaban 10 mg PO BID
RX *apixaban [Eliquis] 5 mg ___ tablet(s) by mouth twice a day
Disp #*70 Tablet Refills:*0
2. Tamsulosin 0.4 mg PO QHS
3. Aspirin 81 mg PO DAILY
4. Enalapril Maleate 5 mg PO DAILY
5. Klor-Con 10 (potassium chloride) 10 mEq oral DAILY
6. Levothyroxine Sodium 150 mcg PO 5X/WEEK (___)
Weekdays
7. Levothyroxine Sodium 175 mcg PO 2X/WEEK (___) ___ and
___
8. LORazepam 1 mg PO BID:PRN Anxiety
9. Omeprazole 20 mg PO BID
10. Simvastatin 20 mg PO QPM
11. HELD- Atenolol 50 mg PO DAILY This medication was held. Do
not restart Atenolol until blood pressure and heart rate is
followed up by primary care physician
___:
Home
Discharge Diagnosis:
Primary Diagnoses
=================
Orthostatic/vasovagal syncope
SMA dissection
Secondary Diagnoses
======================
Severe aortic stenosis
Hypertension
Diabetes
___
Hypothyroidism
Benign prostatic hyperplasia
Hyperlipidemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ after you had an
episode where you lost consciousness, were shaking, and vomited.
You first went to ___, where a CT of your head looked
normal but a potential blood clot in the vessels going to your
bowel was seen on a CT scan. To treat this, you were transferred
to our hospital.
When you arrived here, you felt fine, and had no abdominal pain,
chest pain, shortness of breath, or lightheadedness. However,
your labs did suggest you were dehydrated, so we started you on
fluids delivered through your vein. Meanwhile, the vascular
surgery team saw you and suggested we start you on a blood
thinner delivered through your vein. Because your blood pressure
was low initially, we did not give you your blood pressure
medications while you were in the hospital.
We also got a picture of your heart called an "Echo," which
showed that the valve through which blood flows from your heart
to your body is severely narrowed. You should follow up with
your cardiologist about this.
Finally, we got an ultrasound of the vessels in your belly,
which showed a small tear in one of the vessels. To avoid a clot
forming within this tear, we started you on a blood thinner
called XXX.... You should take this medication every day, and
follow up with our vascular surgeons in one month about any
further testing and whether you need to continue your blood
thinners. You should also start taking your aspirin every day.
When you go home, you should make sure to stay hydrated. You
should also follow up with your primary care doctor and
cardiologist.
It was a pleasure taking care of you!
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Combigan (brimonidine-timolol) 0.2-0.5 % ophthalmic BID to
RIGHT eye
2. Dolutegravir 50 mg PO DAILY
3. Emtricitabine-Tenofovir (Truvada) 1 TAB PO DAILY
4. PrednisoLONE Acetate 1% Ophth. Susp. 1 DROP LEFT EYE TID
5. Psyllium Wafer 1 WAF PO DAILY
6. Vancomycin 25mg/mL Ophth Soln 1 DROP LEFT EYE DAILY
7. ofloxacin 0.3 % ophthalmic DAILY to left eye
8. Acetaminophen 650 mg PO Q8H
Take as prescribed. Do not exceed more than 3 grams of
Acetaminophen in a 24 hour period.
9. Diazepam 5 mg PO Q6H:PRN spasm
Do not drive or drink alcohol while taking this medication.
10. Docusate Sodium 100 mg PO BID
11. Senna 8.6 mg PO BID
12. Polyethylene Glycol 17 g PO DAILY:PRN constipation
13. Omeprazole 20 mg PO DAILY
___ discontinue after steroids are stopped unless patient was
taking prior to admission.
14. Ondansetron 4 mg IV Q8H:PRN N/V
15. Heparin 5000 UNIT SC TID
___ discontinue once fully ambulatory.
16. Gabapentin 300 mg PO Q8H:PRN Leg pain
17. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
Do not drive or drink alcohol while taking this medication.
18. Methylprednisolone 4 mg PO DAILY
Start Medrol DosePak on discharge per instructions
Tapered dose - DOWN
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Lower back pain secondary herniated disc
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you in the hospital. You were
admitted with worsening lower back pain. An MRI of your spine
showed a herniated disc which is likely causing your pain. You
had surgery to remove this disc.
Please follow-up at the appointments listed below. Please see
the attached list for udpates to your home medications.
Please follow these instructions at discharge:
- Your dressing may come off on the second day after surgery.
- Your incision is closed with staples. You will need staple
removal in ___ days. Please keep your incision dry until
suture/staple removal.
- Do not apply any lotions or creams to the site.
- Please avoid swimming for two weeks after suture/staple
removal.
- Call your surgeon if there are any signs of infection like
redness, fever, or drainage.
Activity
- We recommend that you avoid heavy lifting, running, climbing,
or other strenuous exercise until your follow-up appointment.
- You make take leisurely walks and slowly increase your
activity at your own pace. ___ try to do too much all at once.
- No driving while taking any narcotic or sedating medication.
- No contact sports until cleared by your neurosurgeon.
Medications
- Please do NOT take any blood thinning medication (Aspirin,
Ibuprofen, Plavix, Coumadin) until cleared by the neurosurgeon.
- You may use Acetaminophen (Tylenol) for minor discomfort if
you are not otherwise restricted from taking this medication.
- It is important to increase fluid intake while taking pain
medications. We also recommend a stool softener like Colace.
Pain medications can cause constipation</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amoxicillin-Clavulanic Acid ___ mg PO Q12H Duration: 7 Days
RX *amoxicillin-pot clavulanate 875 mg-125 mg 1 tablet(s) by
mouth twice a day Disp #*9 Tablet Refills:*0
2. Benzonatate 100 mg PO TID:PRN cough
RX *benzonatate 100 mg 1 capsule(s) by mouth three times a day
Disp #*15 Capsule Refills:*0
3. GuaiFENesin 10 mL PO Q6H:PRN cough
RX *guaifenesin 100 mg/5 mL 10 ml by mouth every six (6) hours
Refills:*0
4. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild
5. Acetylcysteine 20% ___ mL NEB Q4H:PRN SOB
6. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB
7. ARIPiprazole 5 mg PO DAILY
8. Aspirin 81 mg PO DAILY
9. Atorvastatin 80 mg PO QPM
10. BusPIRone 30 mg PO BID
11. Chlorthalidone 12.5 mg PO DAILY
12. CloNIDine 0.2 mg PO Q6H
13. Diltiazem Extended-Release 360 mg PO DAILY
14. FLUoxetine 80 mg PO DAILY
15. glimepiride 2 mg oral QAM
16. LORazepam 1 mg PO Q8H:PRN Anxiety
17. Metoprolol Succinate XL 25 mg PO DAILY
18. Omeprazole 40 mg PO DAILY
19. Tiotropium Bromide 1 CAP IH DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
#Tracheitis
#Shortness of breath
Secondary:
#Diabetes mellitus
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 admitted to the hospital:
- You came to the hospital with shortness of breath and rapid
breathing.
What we did why you were here:
- Due to your shortness of breath, you spent a brief time ___ the
medical ICU before returning to the floor.
- You were treated with antibiotics and steroids for possible
tracheitis.
- You were also given a diuretic (Lasix) to remove fluid and
help your breathing.
- We managed your diabetes with insulin because the steroids
made your blood sugars significantly elevated.
What you need to do once you return home:
- Please take Augmentin (an antibiotic) until ___.
- Please follow-up at your scheduled appointments, especially
with your primary care doctor to discuss further management of
your diabetes. You should check your blood sugar each morning
and call your PCP if it is consistently greater than 250.
It was a pleasure taking care of you during this
hospitalization.
Sincerely,
___ 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. Glargine 6 Units Lunch
Insulin SC Sliding Scale using HUM Insulin
3. Senna 8.6 mg PO BID
4. Tacrolimus 2.5 mg PO Q12H
5. Acetaminophen 650 mg PO Q6H
Maximum 8 of the 325 mg tablets daily
6. Aspirin 81 mg PO DAILY
7. Cinacalcet 60 mg PO DAILY
8. Docusate Sodium 100 mg PO BID
9. Fluconazole 100 mg PO Q24H
10. Mycophenolate Mofetil 500 mg PO QID
11. Omeprazole 20 mg PO DAILY
12. Sodium Bicarbonate 650 mg PO BID
Listed as 10 grain
13. Sodium Polystyrene Sulfonate 15 gm PO DAILY:PRN elevated
potassium
14. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
15. ValGANCIclovir 450 mg PO DAILY
16. Vitamin D ___ UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Acute kidney injury
History of kidney transplant
Hyperglycemia
Retained ureteral stent
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please call the transplant clinic at ___ for fever of
101 or greater, chills, nausea, vomiting, diarrhea,
constipation, inability to tolerate food, fluids or medications,
yellowing of skin or eyes, increased abdominal pain, incisional
redness, drainage or bleeding, dizziness or weakness, decreased
urine output or dark, cloudy urine, swelling of abdomen or
ankles, weight gain of 3 pounds in a day or any other concerning
symptoms.
.
Bring your pill box and list of current medications to every
clinic visit.
.
You will have labwork drawn twice weekly as arranged by the
transplant clinic, with results to the transplant clinic (Fax
___ . CBC, Chem 10, AST, T Bili, Trough Tacro level,
Urinalysis.
.
*** On the days you have your labs drawn, do not take your
Tacrolimus until your labs are drawn. Bring your Tacrolimus with
you so you may take your medication as soon as your labwork has
been drawn.
.
Follow your medication card, keep it updated with any dosage
changes, and always bring your card with you to any clinic or
hospital visits.
.
Please measure and record your urine output in the "hat" and
urinal provided until you are instructed by the transplant
clinic that you can stop. Bring the record with you to your
transplant clinic follow up visits
.
You may shower. Allow the water to run over your incision and
pat area dry. No rubbing, no lotions or powder near the
incision. You may leave the incision open to the air. The
staples have been removed
.
No driving if taking narcotic pain medications
.
Avoid direct sun exposure. Wear protective clothing and a hat,
and always wear sunscreen with SPF 30 or higher when you go
outdoors.
.
Drink enough fluids to keep your urine light in color. Your
appetite will return with time. Eat small frequent meals, and
you may supplement with things like carnation instant breakfast
or Ensure.
.
Check your blood pressure at home. Report consistently elevated
values above 160 systolic to the transplant clinic.
.
Check blood sugars prior to meals as directed. Continue long and
short acting insulins per your discharge scales.
.
Do not increase, decrease, stop or start medications without
consultation with the transplant clinic at ___. There
are significant drug interactions with anti-rejection
medications which must be considered in medication management
following transplant.
.
Consult transplant binder, and there is always someone on call
at the transplant clinic with any questions that may arise</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q8H
2. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain - Severe
RX *oxycodone 5 mg 1 tablet(s) by mouth every 6 hours Disp #*30
Tablet Refills:*0
3. Gabapentin 600 mg PO QHS
4. Lactulose 30 mL PO TID
5. Nadolol 40 mg PO DAILY
6. Ertapenem Sodium 1 g IV 1X Duration: 1 Dose
Every 24 hours for ___ weeks (D1 ___
7. LOXO-101 Study Med 100 mg PO BID
8. Vancomycin Oral Liquid ___ mg PO QID
Take QID for 2 weeks and then transition to BID until 2 weeks
after last dose ertapenem
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Osteomyelitis of spine
C diff infection
Cirrhosis
Melanoma on study drug
Venous stasis bilateral
Morbid obesity
Failure to thrive in adult
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 failure at home after a recent hospital
stay for sepsis, osteomyelitis of the spine, and c difficile
colitis on the background of your melanoma and cirrhosis
history.
You were admitted, given some hydration, your usual home
medications including antibiotics, and you were provided with
nursing care. You improved.
You are being discharged to rehab to get stronger so you can go
home and take good care of yourself.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild
2. AcetaZOLamide 250 mg PO DAILY
3. Bumetanide 2 mg PO BID
4. Collagenase Ointment 1 Appl TP DAILY
5. Lactulose 15 mL PO BID
6. Latanoprost 0.005% Ophth. Soln. 1 DROP BOTH EYES QHS
7. Omeprazole 20 mg PO DAILY
8. Potassium Chloride 20 mEq PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnosis
- Community acquired pneumonia
Secondary Diagnoses:
- Acute on chronic diastolic heart failure
- Acute metabolic encephalopathy
- Alzheimers dementia
- Non healing right thigh ulceration
- Serofast state (history of latent syphilis)
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 be a part of your care team at ___
___. You were admitted to the hospital with
a cough and signs of an infection. You were treated with
antibiotics and started to get better. You were able to be
discharged home.
Please see below for your follow up appointments and
medications.
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. Linezolid ___ mg PO Q12H Duration: 5 Days
RX *linezolid ___ mg 1 tablet(s) by mouth twice a day Disp #*10
Tablet Refills:*0
2. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN SOB
3. Ferrous GLUCONATE 324 mg PO DAILY
4. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
5. Lovastatin 10 mg oral DAILY
6. Ranitidine 150 mg PO DAILY
7. sevelamer CARBONATE 2400 mg PO TID W/MEALS
8. Torsemide 20 mg PO EVERY OTHER DAY
9. Warfarin 2 mg PO DAILY16
10. Vitamin D 1000 UNIT PO DAILY
11. Levofloxacin 250 mg PO Q24H Duration: 5 Days
12. Metoprolol Succinate XL 12.5 mg PO DAILY
13. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation
Q4H:PRN sob
14. Tiotropium Bromide 1 CAP IH DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: Healthcare associated pneumonia with sepsis, hypoxemia
Secondary: Diastolic heart failure without exacerbation, CKD,
COPD, recurrent aspiration, CAD, HTN, Afib
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Lethargic but arousable.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ because you became slightly confused,
dizzy, and had low blood pressure. When you came in your blood
pressure got better when we gave you some IV fluids. You also
were found to have a new pneumonia on your chest xray, which is
why we discharged you on oral antibiotics, which you will
continue to take for five more days. You also had low blood
oxygen levels which improved with antibiotics, and will be going
home back on your home oxygen. You should call your doctor if
you have worsening shortness of breath, fever, confusion, or
anything that concerns you. We wish you all the best.
Sincerely,
Your care team at ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild
2. Bisacodyl 10 mg PO/PR DAILY Constipation
3. Calcium Carbonate 500 mg PO QID:PRN heartburn, stomach pain
4. Clopidogrel 75 mg PO DAILY to prevent stent thrombosis
5. Docusate Sodium 100 mg PO BID
6. HydrALAZINE 25 mg PO TID
7. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY
8. Pantoprazole 40 mg PO Q12H
9. PredniSONE 40 mg PO DAILY Duration: 4 Days
Last day ___. Sucralfate 1 gm PO QID Duration: 5 Days
Last day ___. Aspirin 81 mg PO DAILY
12. Atorvastatin 80 mg PO QPM
13. OxyCODONE (Immediate Release) 5 mg PO Q6H:PRN Pain - Severe
RX *oxycodone [Oxaydo] 5 mg 1 tablet(s) by mouth every six (6)
hours Disp #*12 Tablet Refills:*0
14. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary
=====
Type II NSTEMI
Duodenal Polyp
Gastric Ulcer
Anemia
Secondary
=========
Polyarthritis
New diagnosis of heart failure with reduced ejection fraction
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 to take care of you at ___.
WHY WAS I HERE?
You were admitted to the hospital because you had chest pain and
were found to have a very low blood count
WHAT WAS DONE WHILE YOU WERE IN THE HOSPITAL
- You were given blood transfusions to help improve your blood
count
- You had imaging of your heart which showed that your heart was
not pumping that well
- You had an upper endoscopy which showed that you had an ulcer
and a polyp which may have been the cause of your very low blood
count
- You had a cardiac catheterization which showed a blockage of
one of the arteries around the heart, so a stent was placed and
you were started on medications to help keep this artery open.
- You had pain and swelling in your joints and were treated with
steroids and pain medications.
WHAT SHOULD I DO WHEN I GET HOME?
1) Follow up with your Primary Care Doctor and Cardiologist
2) It is very important that you take your aspirin and plavix
every day
3) Please do not take indomethacin or any other NSAIDs
4) Weigh 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. Aspirin 81 mg PO DAILY
RX *aspirin [Adult Aspirin Regimen] 81 mg 1 tablet(s) by mouth
daily Disp #*30 Tablet Refills:*1
2. Lidocaine 5% Patch 1 PTCH TD QAM
RX *lidocaine [Aspercreme (lidocaine)] 4 % Apply one patch to
neck qam Disp #*30 Patch Refills:*0
3. Gabapentin 100 mg PO DAILY
RX *gabapentin 100 mg 1 capsule(s) by mouth daily Disp #*14
Capsule Refills:*0
4. Glargine 20 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
5. albuterol sulfate 90 mcg/actuation inhalation Q8H:PRN
6. ammonium lactate 12 % topical DAILY:PRN
7. Cyclopentolate 1% 1 DROP BOTH EYES DAILY
8. DULoxetine 40 mg PO DAILY
9. Fluticasone Propionate NASAL 2 SPRY NU DAILY
10. HydrALAZINE 25 mg PO Q6H
11. Isosorbide Mononitrate (Extended Release) 60 mg PO DAILY
12. Levothyroxine Sodium 112 mcg PO DAILY
13. Methadone 15 mg PO TID (no prescription given at
discharge)
14. Movantik (naloxegol) 25 mg oral DAILY
15. Mupirocin Ointment 2% 1 Appl TP DAILY:PRN infection
16. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN cp
17. Omeprazole 20 mg PO BID
18. Ondansetron 4 mg PO Q8H:PRN Nausea/Vomiting - First Line
19. PrednisoLONE Acetate 1% Ophth. Susp. 1 DROP LEFT EYE DAILY
20. Rosuvastatin Calcium 20 mg PO QPM
21. Sertraline 200 mg PO DAILY
22. Sucralfate 1 gm PO TID
23. Sumatriptan Succinate 50 mg PO PRN headache
24. Tamsulosin 0.8 mg PO QHS
25. Terbinafine 1% Cream 1 Appl TP BID:PRN fungal rash
26. TraZODone 150 mg PO QHS:PRN insomnia
27. urea 40 % topical DAILY:PRN
28. Vitamin D ___ UNIT PO EVERY OTHER WEEK
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis
==================
- C3-C4 Discitis/Osteomyelitis
Secondary diagnosis
====================
End-stage renal disease on hemodialysis
Chronic pain
Type 1 diabetes mellitus
Hypertension
Anxiety
Depression
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a privilege caring for you at ___.
WHY WAS I IN THE HOSPITAL?
- You were admitted to the hospital because you had a fall and
imaging showed a possible infection in your spine.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- We spoke to the radiologists about the imaging of your neck,
and they were very concerned for an infection of the bone.
- The interventional radiologists performed a bone biopsy.
- The infectious disease doctors recommended that ___ leave the
hospital without antibiotics at this time.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Please continue to take all of your medications as prescribed
and follow-up with your appointments (listed below).
- It is EXTREMELY important that you follow up with the
infectious disease doctors. ___ will discuss the results of
your bone biopsy and will determine whether you need antibiotics
to treat the possible infection in your neck.
- Please return to the hospital IMMEDIATELY if you develop
fevers, chills, worsening numbness/loss of sensation/or
inability to move your arms or legs, loss of your bowels (bowel
incontinence), inability to empty your bladder (urinary
retention), as these could be signs of spinal cord damage and
would require IMMEDIATE evaluation by the neurosurgeons.
- Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
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. Lorazepam 0.25 mg PO BID
RX *lorazepam 0.5 mg 0.5 (One half) tablet by mouth twice a day
Disp #*7 Tablet Refills:*0
2. TraZODone 25 mg PO HS
RX *trazodone 50 mg 0.5 (One half) tablet(s) by mouth at bedtime
Disp #*7 Tablet Refills:*0
3. Lidocaine 5% Patch 1 PTCH TD QAM chest wall pain
RX *lidocaine [Lidoderm] 5 % (700 mg/patch) 1 patch Daily Disp
#*30 Patch Refills:*0
4. Nicotine Patch 14 mg TD DAILY
RX *nicotine 14 mg/24 hour 1 patch daily Disp #*30 Patch
Refills:*0
5. Sertraline 200 mg PO DAILY
RX *sertraline 100 mg 2 tablet(s) by mouth Daily Disp #*7 Tablet
Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnoses:
Acute kidney injury
Secondary diagnoses:
Altered Mental Status
Rhabdomyolysis
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>Dear Ms. ___,
You were admitted to the ___
because you had lost consciousness. You were found to have
levels of a certain antidepressant in your blood that required
ICU care for a brief period of time. You also developed kidney
dysfunction and you had to be monitored closely. Your kidney
function improved.
If you are having chest wall pain you may take acetaminophen
(Tylenol), please do not take more than 3 grams (3,000mg) in one
day.
You were given prescriptions for a few days' doses of
sertraline, trazadone, and lorazepam. You should have your
medications adjusted at your follow up appointments.
Please follow up with the appointments that have been set up for
you below. You will be called for an appointment to evaluate
your liver. Please be sure to take all of your medications as
they are prescribed.
Thank you for allowing us to participate in your care.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Tiotropium Bromide 1 CAP IH DAILY
RX *tiotropium bromide [Spiriva with HandiHaler] 18 mcg 1 cap IH
once a day Disp #*30 Capsule Refills:*0
2. Torsemide 20 mg PO ___
RX *torsemide 20 mg 1 tablet(s) by mouth every other day Disp
#*30 Tablet Refills:*0
3. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN wheezing
RX *albuterol sulfate 2.5 mg/3 mL (0.083 %) 1 neb IH every 6
hours as needed Disp #*1 Vial Refills:*0
4. Aspirin 81 mg PO DAILY
RX *aspirin [Adult Low Dose Aspirin] 81 mg 1 tablet(s) by mouth
once a day Disp #*30 Tablet Refills:*0
5. Atorvastatin 80 mg PO QPM
RX *atorvastatin 80 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
6. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
RX *fluticasone propion-salmeterol [Advair Diskus] 250 mcg-50
mcg/dose 1 250-50 IH twice a day Disp #*1 Disk Refills:*0
7. MetFORMIN XR (Glucophage XR) 500 mg PO BID
RX *metformin 500 mg 1 inh by mouth twice a day Disp #*60 Tablet
Refills:*0
8. Metoprolol Tartrate 100 mg PO BID
RX *metoprolol tartrate 100 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
9. Sildenafil 20 mg PO TID
RX *sildenafil (pulm.hypertension) 20 mg 1 tablet(s) by mouth
three times a day Disp #*90 Tablet Refills:*0
10. Spironolactone 100 mg PO DAILY
RX *spironolactone 100 mg 1 tablet(s) by mouth once a day Disp
#*30 Tablet Refills:*0
11. Vitamin D ___ UNIT PO EVERY 4 WEEKS (MO)
12. Warfarin 1.5 mg PO 3X/WEEK (___)
RX *warfarin 3 mg 0.5 (One half) tablet(s) by mouth ___,
___ Disp #*3 Tablet Refills:*0
13. Warfarin 2 mg PO 4X/WEEK (___)
RX *warfarin 2 mg 1 tablet(s) by mouth ___,
___ Disp #*12 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis
Acute heart failure exacerbation
Interstitial lung disease
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 at the ___
___!
WHY WAS I IN THE HOSPITAL?
==========================
- You were having shortness of breath
WHAT HAPPENED IN THE HOSPITAL?
==============================
- You were given medicine to help remove the extra fluid in your
body
- You were given medicine to manage your atrial fibrillation
(irregular heart beat)
- You were seen by the pulmonology team who recommended that you
start a new inhaler
WHAT SHOULD I DO WHEN I GO HOME?
================================
- Please continue to take all of your medications as directed
- Please follow up with all the appointments scheduled with your
doctor, including your PCP on ___ and your pulmonologist.
- Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
Thank you for allowing us to be involved in your care, we wish
you all the best!
Your ___ Healthcare Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Azithromycin 250 mg PO DAILY Duration: 3 Doses
RX *azithromycin 250 mg 1 tablet(s) by mouth once a day Disp #*2
Tablet Refills:*0
2. Colchicine 0.6 mg PO BID Duration: 3 Months
RX *colchicine 0.6 mg 1 tablet(s) by mouth twice a day Disp #*60
Tablet Refills:*0
3. Ibuprofen 200 mg PO TID Duration: 1 Dose
RX *ibuprofen [___] 200 mg 1 tablet(s) by mouth three
times a day Disp #*45 Tablet Refills:*0
4. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth once a day Disp #*30
Capsule Refills:*0
5. amLODIPine 10 mg PO DAILY
6. Aspirin 325 mg PO DAILY
7. Atorvastatin 40 mg PO QPM
8. Chlorthalidone 25 mg PO DAILY
9. Lisinopril 40 mg PO DAILY
10. Loratadine 10 mg PO DAILY
11. MetFORMIN XR (Glucophage XR) ___ mg PO DAILY
12. Metoprolol Tartrate 100 mg PO BID
13. sAXagliptin 5 mg oral daily
14. Sertraline 100 mg PO DAILY
15. Triamcinolone Acetonide 0.025% Cream 1 Appl TP DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnosis
Pericardial effusion
Secondary Diagnosis:
Pneumonia
Obstructive sleep apnea
Hypertension
Diabetes Mellitus
Difficult Foley Placement
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>======================
DISCHARGE INSTRUCTIONS
======================
Dear Mr. ___,
It was a pleasure taking part in your care here at ___!
Why was I admitted to the hospital?
- There was fluid around your heart
What was done for me in the hospital?
- The fluid around your heart was drained.
- We treated you with antibiotics for an infection in your
lungs.
- You were evaluated by physical therapy and occupational
therapy, and they determined that you are safe to go home with
___ home services.
What should I do when I leave the hospital?
- Please take all of your medicines and attend all of your
follow-up appointments (appointment information below.)
We wish you the best of luck in your health!
Sincerely,
Your ___ Treatment Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler 2 PUFF IH BID
2. azelastine 137 mcg nasal BID
3. Fluticasone Propionate NASAL 2 SPRY NU BID
4. Itraconazole 300 mg PO Q12H
5. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation
INHALATION BID
6. Tudorza Pressair (aclidinium bromide) 400 mcg/actuation
inhalation BID
7. Aspirin 81 mg PO DAILY
8. molybdenum (bulk) 0 1 PO MOLYBDENUM GLYCINATE DAILY
as directed
9. Probiotic Complex
(L.acid-B.bifidum-B.animal-FOS;<br>lactobacillus combo no.6) 0 1
ORAL DAILY
as directed
Discharge Disposition:
Home
Discharge Diagnosis:
Left arm numbness
Elevated CK
Anxiety
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Hello Mr. ___,
It was a pleasure taking care you at the ___
___. You came because of arm pain. In the hospital
you received blood tests that ruled out heart, electrolyte or
acid-base problems. Furthermore, you received a CT scan of the
head which did not show any evidence of a stroke. A chest x-ray
also showed no signs of lung infection. This pain is likely due
to a self-limited nerve or muscle issue. Please continue seeing
your doctors and taking your medications as prescribed.</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/Fever
2. Dexamethasone 4 mg PO TID Duration: 7 Days
Taper:
4mg TID ___ BID ___
2mg BID ___ onward
3. Famotidine 20 mg PO BID
4. Ramelteon 8 mg PO QPM:PRN insomnia
5. Senna 8.6 mg PO BID
6. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
7. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Metastatic Brain lesions
Adenocarcinoma of the lung
RLE>RUE paresthesias and weakness
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 ___
___.
WHY WAS I IN THE HOSPITAL?
- You were admitted for weakness of the right side of your body
with numbness and tingling of your leg
WHAT HAPPENED TO ME IN THE HOSPITAL?
- We imaged your brain and found brain masses that were biopsied
and showed metastatic
- We started you on medications and treated the brain masses
with radiation
- We scheduled follow up with your new primary oncologist whom
you will see after rehab (details below)
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Continue to take all your medicines and keep your
appointments.
We wish you the best!
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Levofloxacin 750 mg PO DAILY Duration: 4 Days
RX *levofloxacin 750 mg 1 tablet(s) by mouth once a day Disp #*4
Tablet Refills:*0
2. Calcium Carbonate 500 mg PO DAILY
3. Ibuprofen 400 mg PO Q8H:PRN pain/fever
4. Multivitamins 1 TAB PO DAILY
5. Acetaminophen 650 mg PO Q6H:PRN pain or fever
RX *acetaminophen 325 mg 2 tablet(s) by mouth every six (6)
hours Disp #*60 Tablet Refills:*0
6. Guaifenesin ER 600 mg PO Q12H
RX *guaifenesin 600 mg 1 tablet(s) by mouth every twelve (12)
hours Disp #*15 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: pneumonia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
It was a pleasure taking care of you at ___. You were admitted
with a pneumonia and started on antibiotics. You will need to
complete a course of antibiotics as prescribed. Recommend an
x-ray to make sure it has completely resolved in 6 weeks.
Medication changes:
Please finish course of Levofloxacin</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
Do not take more than 4000mg in a single day. Wean as tolerated
RX *acetaminophen 325 mg ___ tablet(s) by mouth every ___ hours
Disp #*50 Tablet Refills:*0
2. Amoxicillin-Clavulanic Acid ___ mg PO Q8H
Continue for 5 days
RX *amoxicillin-pot clavulanate 500 mg-125 mg 1 tablet(s) by
mouth Three times a day Disp #*15 Tablet Refills:*0
3. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
Do not drive while taking
RX *oxycodone 5 mg 1 tablet(s) by mouth Every ___ hours Disp
#*30 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Stab wounds
Human bite
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You have three sutures closing your R pectoral wound. Drainage
from there is expected, please come back to clinic to have the
sutures removed.
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.
wound Care:
*Please call your doctor or nurse practitioner if you have
increased pain, swelling, redness, or drainage from the wound
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.
*You have sutures, they will be removed at your follow-up
appointment.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amitriptyline 50 mg PO HS
2. budesonide-formoterol 160-4.5 mcg/actuation INHALATION BID
3. Codeine Sulfate 30 mg PO Q4H:PRN Cough
4. Ranitidine 300 mg PO HS
5. HydrOXYzine 50 mg PO QHS
6. Furosemide 20 mg PO DAILY
7. Levothyroxine Sodium 175 mcg PO DAILY
8. dexlansoprazole 60 mg oral Daily
9. Potassium Chloride 10 mEq PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Right pleural effusion
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were seen for shortness of breath and fluid in your right
lung after your previous surgery. You had a right-sided
thoracentesis that removed 600 ml of fluid from your lung. Your
symptoms are stable and the thoracic surgery physicians are
comfortable with you going home.
* Continue to use your incentive spirometer 10 times an hour
while awake.
* Check your incisions daily and report any increased redness or
drainage. Cover the area with a gauze pad if it is draining.
* Your dressing may be removed in 48 hours. If it starts to
drain, cover it with a clean dry dressing and change it as
needed to keep site clean and dry.
* No driving while taking any form of narcotic pain medication.
* Take Tylenol in between your narcotic medicine if you still
are using narcotic pain medicine.
* Continue to stay well hydrated and eat well to heal your
incisions
* Shower daily. Wash incision with mild soap & water, rinse, pat
dry
* No tub bathing, swimming or hot tubs until incision healed
* No lotions or creams to incision site
* Walk ___ times a day and gradually increase your activity as
you can tolerate.
Call Dr. ___ ___ if you
experience:
-Fevers > 101 or chills
-Increased shortness of breath, chest pain or any other symptoms
that concern you.
You should resume taking all home medicines you were taking
before being seen in the hospital.
You may immediately resume your previous diet.
You may immediately resume your former level of activity.</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. Clopidogrel 75 mg PO DAILY
4. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
5. Methadone 40 mg PO TID
RX *methadone 40 mg 1 tab by mouth three times per day Disp #*20
Tablet Refills:*0
6. Metoprolol Tartrate 50 mg PO BID
7. PredniSONE 10 mg PO DAILY
8. Xopenex Neb 0.31 mg/3 mL inhalation daily
9. Lansoprazole Oral Disintegrating Tab 30 mg PO DAILY
10. Furosemide 40 mg PO DAILY
11. Oxazepam 30 mg PO HS
RX *oxazepam 30 mg 1 capsule(s) by mouth daily Disp #*10 Capsule
Refills:*0
12. Oxazepam 15 mg PO Q8H:PRN anxiety
RX *oxazepam 15 mg 1 capsule(s) by mouth every 8 hours Disp #*10
Capsule Refills:*0
13. Albuterol Inhaler 1 PUFF IH Q6H:PRN dyspnea
14. Pantoprazole 40 mg PO Q24H
15. Calcium Carbonate 1000 mg PO DAILY
RX *calcium carbonate 500 mg calcium (1,250 mg) 2 tablet(s) by
mouth daily Disp #*60 Tablet Refills:*0
16. Vitamin D 800 UNIT PO DAILY
RX *ergocalciferol (vitamin D2) 400 unit 2 tablet(s) by mouth
daily Disp #*60 Capsule Refills:*0
17. Fluconazole 100 mg PO Q24H
take until ___
RX *fluconazole 100 mg 1 tablet(s) by mouth daily Disp #*9
Tablet Refills:*0
18. Levofloxacin 750 mg PO DAILY
take until ___
RX *levofloxacin 750 mg 1 tablet(s) by mouth daily Disp #*1
Tablet Refills:*0
19. Baclofen 20 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
1. aspiration pneumonia
2. COPD exacerbation
*Anticipated rehab course less than 30 days*
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
It was a pleasure taking care of you at ___
___. You presented to us with altered mental status
and difficulty breathing. You were found to have an aspiration
pneumonia. We treated you with 7 days of antibiotics. We
continued all your home medications.
Please take you medications as instructed. Please attend all
your follow up appointments.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Clopidogrel 75 mg PO DAILY
2. Enalapril Maleate 10 mg PO DAILY
3. Enteric Coated Aspirin *NF* (aspirin) 325 mg Oral daily
4. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY
5. pitavastatin *NF* 4 mg Oral daily Reason for Ordering: Wish
to maintain preadmission medication while hospitalized, as there
is no acceptable substitute drug product available on formulary.
6. Metoprolol Succinate XL 50 mg PO DAILY
7. MetFORMIN (Glucophage) 850 mg PO TID
1. Clopidogrel 75 mg PO DAILY
2. Enalapril Maleate 10 mg PO DAILY
3. Enteric Coated Aspirin *NF* (aspirin) 325 mg Oral daily
4. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY
5. pitavastatin *NF* 4 mg Oral daily Reason for Ordering: Wish
to maintain preadmission medication while hospitalized, as there
is no acceptable substitute drug product available on formulary.
6. Metoprolol Succinate XL 50 mg PO DAILY
7. MetFORMIN (Glucophage) 850 mg PO TID
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis:
chest pain
Secondary diagnosis:
coronary artery disease
chronic systolic congestive heart failure
hypertension
hyperlipidemia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>It was a pleasure caring for you at ___. You were admitted
because you had chest pain that was concerning for a heart
attack. We looked at your heart's rhythm (electrocardiogram) and
determined that there were no changes from your prior study. We
also checked blood levels of chemicals that can sometimes be
elevated in heart attacks. You did not have any increase in
these chemicals.
You underwent a stress test that helps to decide whether or not
you will get a cardiac catheterization. There was no abnormality
on the stress test, and the probability that your chest pain is
due to your heart is very low. You do not need a catheterization
at this point.
There were no medication changes made during this admission
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. Cephalexin 500 mg PO TID
RX *cephalexin 500 mg 1 capsule(s) by mouth every eight (8)
hours Disp #*15 Capsule Refills:*0
2. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild/Fever
3. Allopurinol ___ mg PO DAILY
4. Aspirin 81 mg PO DAILY
5. Atorvastatin 80 mg PO QPM
6. Calcitriol 0.25 mcg PO DAILY
7. FoLIC Acid ___ mg PO DAILY
8. irbesartan 150 mg oral DAILY
9. Levothyroxine Sodium 88 mcg PO DAILY
10. Metoprolol Tartrate 25 mg PO BID
11. Nephrocaps 1 CAP PO DAILY
12. Omeprazole 20 mg PO DAILY
13. PreserVision AREDS (vitamins A,C,E-zinc-copper)
___ unit-mg-unit oral BID
14. Sodium Bicarbonate 650 mg PO QID
15. Tamsulosin 0.4 mg PO QHS
16. Torsemide 60 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
CKD Stage 5
Dialysis access incision infection
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Please call the access clinic at ___ if you have fevers
or chills, yourleft hand has increased pain, is cold, has blue
fingers, has numbness or tingling this may be a medical
emergency and you should call right away.
Please also monitor for increased incisional redness, drainage
or bleeding, arm swelling or increased pain or the development
of a foul odor on the dressing, at the access site or any other
concerning symptoms.
.
You should check the left arm access daily for a thrill (buzzing
sensation) and if this is not present, you should call the
access clinic right away.
.
Keep the left arm elevated on ___ pillows when sitting or lying
down to help swelling decrease.
.
The arm may be gently washed but do not submerge or soak the
arm. Keep the arm elevated when you are sitting or laying down
to help the swelling decrease. Dressing should be changed daily
and more often as needed. Please report increased drainage or
bleeding or if the wound develops a foul odor.
.
Do NOT allow any blood pressures or lab draws from the access
arm. No tight or constrictive clothing or jewelry to the access
arm and no lifting more than 10 pounds.
.
Continue home medications, dietary and fluid restrictions as you
have been instructed.
.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Dextromethorphan Polistirex ___ mg PO Q12H:PRN cough
RX *dextromethorphan polistirex ___ mg/5 mL 10 ml by mouth twice
a day Refills:*0
2. Lidocaine 5% Patch 2 PTCH TD QPM
RX *lidocaine 5 % Apply one patch qPM Disp #*30 Patch Refills:*0
3. Gabapentin 600 mg PO BID
RX *gabapentin 600 mg 1 tablet by mouth twice a day Disp #*60
Tablet Refills:*0
4. Tresiba FlexTouch U-100 (insulin degludec) 15 units
subcutaneous DAILY
5. Albuterol Inhaler 1 PUFF IH Q6H:PRN dyspnea, wheezing
6. amLODIPine 10 mg PO DAILY
7. Aspirin 81 mg PO DAILY
8. Atorvastatin 10 mg PO QPM
9. Calcitriol 0.5 mcg PO 3X/WEEK (___)
10. Ferric Citrate 420 mg PO TID W/MEALS
11. Fluticasone-Salmeterol Diskus (100/50) 1 INH IH BID
12. Labetalol 300 mg PO TID
13. Levothyroxine Sodium 25 mcg PO DAILY
14. LOPERamide 4 mg PO BID:PRN diarrhea
15. Losartan Potassium 50 mg PO DAILY
16. Montelukast 10 mg PO DAILY
17. NovoLOG Flexpen U-100 Insulin (insulin aspart U-100) 100
unit/mL (3 mL) subcutaneous DAILY
18. Omeprazole 20 mg PO DAILY
19. OxyCODONE--Acetaminophen (5mg-325mg) 1 TAB PO Q6H:PRN Pain
- Severe
20. PrednisoLONE Acetate 1% Ophth. Susp. 1 DROP RIGHT EYE QID
21. sevelamer CARBONATE 1600 mg PO TID W/MEALS
22. Torsemide 20 mg PO DAILY
23. Vitamin D ___ UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
==================
Hypoglycemia
SECONDARY DIAGNOSES:
====================
T1DM
ESRD
HTN
GERD
Neuropathy
Asthma
Grave's disease
HFpEF
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>======================
DISCHARGE INSTRUCTIONS
======================
Dear Ms. ___,
It was a pleasure caring for you at ___
___.
WHY WAS I IN THE HOSPITAL?
- You were found unresponsive due to low blood sugar.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- You were given sugar to bring your blood sugar back to normal
and briefly had a line into your leg bone because an IV could
not be obtained.
- You had dialysis while you were in the hospital
- You were seen by the ___ team who ultimately recommended
the following DISCHARGE INSULIN PLAN:
TAKE TRESIBA INSULIN 15 UNITS AT LUNCH TIME
TAKE NOVOLOG BEFORE BREAKFAST, LUNCH AND DINNER ACCORDING TO
THIS
SCALE
GLUCOSE BREAKFAST LUNCH DINNER BEDTIME
<100 0 0 0 0
101-150 4 4 6 0
151-200 5 5 6 0
___ 7 7 8 2
301-350 8 8 10 3
351-400 8 8 10 4
>400 10 10 12 5
IMPORTANT TO REMEMBER THE FOLLOWING:
1. CHECK BLOOD GLUCOSE BEFORE EATING BREAKFAST, LUNCH AND DINNER
AND AT BEDTIME.
2. IF YOU DO NOT PLAN ON EATING A MEAL USE THE "BEDTIME" INSULIN
CHART TO TREAT A BLOOD GLUCOSE THAT IS HIGH, ABOVE 200.
3. DO NOT TAKE NOVOLOG INSULIN SOONER THAN 2 HOURS APART- DOING
THIS MAY CAUSE LOW GLUCOSE
4. IF YOUR BLOOD GLUCOSE IS UNDER 100, CHEW ___ GLUCOSE TABLETS
OR DRINK 4 OZ. OF FRUIT JUICE. THEN CHECK 15 MINUTES LATER TO
CONFIRM YOUR BLOOD GLUCOSE HAS GONE UP.
5. FOLLOW UP AT ___ NEXT WEEK.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Continue to take all your medicines and keep your
appointments.
- Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
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. Ciprofloxacin HCl 250 mg PO Q12H Duration: 2 Doses
RX *ciprofloxacin HCl 250 mg 1 tablet(s) by mouth twice a day
Disp #*2 Tablet Refills:*0
2. Aspirin 81 mg PO DAILY
3. Atenolol 50 mg PO DAILY
4. Atorvastatin 40 mg PO QPM
5. CloNIDine 0.2 mg PO BID
6. Lisinopril 40 mg PO DAILY
7. Sildenafil 50-100 mg PO ONCE:PRN intercourse
8. Terazosin 4 mg PO QHS
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Acute Ischemic Stroke in anterior right frontal lobe deep white
matter
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were hospitalized due to symptoms of slurred speech
resulting from an ACUTE ISCHEMIC STROKE, a condition where a
blood vessel providing oxygen and nutrients to the brain is
blocked by a clot. The brain is the part of your body that
controls and directs all the other parts of your body, so damage
to the brain from being deprived of its blood supply can result
in a variety of symptoms.
Stroke can have many different causes, so we assessed you for
medical conditions that might raise your risk of having stroke.
In order to prevent future strokes, we plan to modify those risk
factors. Your risk factors are:
Hypertension, prior history of strokes, family history of
strokes, and smoking.
Of note, you were also found to have a urinary tract infection
and we would like you to take an antibiotic called Ciprofloxacin
HCl 250 mg twice for one more day.
Otherwise we are not making any changes to your medication at
this time. However, you were previously told that you should
switch to Plavix and we encourage you to discuss this with Dr.
___ neurologist.
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: [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking care of you at ___.
Why you were in the hospital:
- fever
What was done for you in the hospital:
- we obtained blood cultures and an x-ray which did not show any
signs of worsening infection
- we continued your vancomycin antibiotic course
What you should do after you leave the hospital:
- Please take your medications as detailed in the discharge
papers. If you have questions about which medications to take,
please contact your regular doctor to discuss.
- Please go to your follow up appointments as scheduled in the
discharge papers. Most of them already have a specific date &
time set. If there is no specific time specified, and you do not
hear from their office in ___ business days, please contact the
office to schedule an appointment.
- Please monitor for worsening symptoms. If you do not feel like
you are getting better or have any other concerns, please call
your doctor to discuss or return to the emergency room.
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. lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
2. hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO
DAILY (Daily).
3. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO Q 8H
(Every 8 Hours).
4. hydromorphone 2 mg Tablet Sig: ___ Tablets PO Q3H as needed
for pain.
Disp:*50 Tablet(s)* Refills:*0*
5. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day:
Take while using narcotic pain medication to prevent
constipation.
Disp:*60 Capsule(s)* Refills:*2*
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>Dear Ms. ___,
you were admitted for acute cholecystitis, which is an infection
of your gall bladder. You underwent an open cholecystectomy, or
removal of your gall bladder. You tolerated this well and are
ready to recover at home.
You can resume a regular diet.
Please take your pain medications as indicated. You can take
tylenol ___ addition to your pain medications as needed as well.
Do not take ___ over 4 grams per day of tylenol.
You should continue your regular activity, but do not lift over
10 pounds at least for 3 weeks.
You have steri strips (small bandages that help with wound
healing) on your wound. These will fall off on their own with
time. You may shower as needed. Pat the incision dry. You may
leave it open to air. You can start bathing or immersing your
wound underwater on ___ if so desired.
Your former drain stitch wound will slowly close on its own. It
is normal for it to leak a small amount of fluid. You can place
a dry dressing or bandaid on the wound until it becomes more
dry.
Your final pathology is still pending. This will be reviewed at
your follow up appointment, when scheduled by you.
It was a pleasure to take care of you. We wish you a speedy
recovery.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. LORazepam 0.5 mg PO Q2H:PRN anxiety or pain
RX *lorazepam [Ativan] 0.5 mg 0.5 (One half) mg by mouth Every 2
hours as needed Disp #*10 Tablet Refills:*0
2. Morphine Sulfate (Concentrated Oral Solution) 20 mg/mL 5 mg
PO Q1H:PRN Pain - Moderate
RX *morphine concentrate 100 mg/5 mL (20 mg/mL) 0.1 ml by mouth
as needed for shortness of breath Refills:*0
3. Scopolamine Patch 1 PTCH TD Q72H
4. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
5. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN SOB
6. Bisacodyl 10 mg PR QHS:PRN Constipation - Second Line
7. Budesonide 0.5 mg IH BID
8. Docusate Sodium 100 mg PO BID
9. DULoxetine ___ 60 mg PO DAILY
10. Gabapentin 100 mg PO TID
11. GuaiFENesin ER 600 mg PO Q12H
12. Ipratropium-Albuterol Neb 1 NEB NEB Q6H
13. melatonin 10 mg oral QHS
14. Polyethylene Glycol 17 g PO DAILY:PRN Constipation - First
Line
15. Senna 8.6 mg PO DAILY:PRN Constipation - First Line
Discharge Disposition:
Home with Service
Facility:
___
Discharge Diagnosis:
PRIMARY
==================================
Aspiration pneumonia
SECONDARY
==================================
COPD exacerbation
MR
___ anemia
Hypernatremia
Lactic acidosis
BPH
Dementia
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at ___!
Why were you admitted to the hospital?
=============================
- You were admitted to the ___ due to swallowing something
into your lungs, leading to infection of the lungs
What was done while you were at the hospital?
=============================
- You were admitted to the intensive care unit for this
swallowing into your lungs episode
- You were started on antibiotics
- You underwent a scan of your lungs which showed a big
infection of the lungs from swallowing contents into them
- You were continued on antibiotics focused on the infection in
your lungs
- The speech and swallow team also came to see you and
determined that there is risk associated with continuing to
eat/drink
- We had a goals of care discussion with your family, and
determined that you would like to be comfort focused care
- You will go home with hospice, focused on comfort care
What should you do when you leave the hospital?
=============================
- Enjoy your time at home with family
- We hope you are able to enjoy your 91st birthday with them
Yours sincerely,
The ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
You were admitted to ___ for
heart failure and uncontrolled blood pressure.
While you were in the hospital:
- we gave you IV then oral medications to help remove fluid
- we gave you medications to help control your blood pressure
- we gave medications to help with your allergies and eye
inflammation
- you had a repeat ultrasound of your heart that showed
decreasing pumping (lower ejection fraction)
- After extensive discussion of risk and benefit, you decided
you would not want a cardiac catheterization given your
reservations about risks associated. A pharmacological stress
test showed no reversible defect
Now that you are going home:
- weigh yourself every day and call your primary care doctor ___
cardiologist) if you gain more than 3 lbs in two days
- eat a low salt diet
- take your medications every day, if your run out please call
your primary care doctor
It was a pleasure taking care of you!
-Your ___ Inpatient Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
3. ranolazine 500 mg Tablet Extended Release 12 hr Sig: One (1)
Tablet Extended Release 12 hr PO Qday ().
4. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
5. metoprolol succinate 100 mg Tablet Extended Release 24 hr
Sig: One (1) Tablet Extended Release 24 hr PO DAILY (Daily).
6. lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).
7. tiotropium bromide 18 mcg Capsule, w/Inhalation Device Sig:
One (1) Cap Inhalation DAILY (Daily).
8. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
9. nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1) Tablet,
Sublingual Sublingual PRN (as needed) as needed for chest pain.
10. levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
11. glimepiride 1 mg Tablet Sig: One (1) Tablet PO once a day.
12. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H
(every 6 hours) as needed for pain.
13. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID
(2 times a day).
14. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day.
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis
- Coronary artery disease
- Unstable Angina
Secondary diagnosis
- Pulmonary hypertension
- Hypertension
- Hyperlipidemia
- Diabetes Mellitus Type 2
- Hypothyroidism s/p thyroid irradiation
- COPD
- 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 came to our hospital for scheduled catheterization of your
coronary arteries. She tolerated the procedure very well.
During the procedure, we opened up with a right sided coronary
artery with a drug eluting stent. You also underwent an
ultrasound of your legs, which did not reveal any blood clots.
We continued all your home medications, and you should be able
to go home today.
.
No changes were made to your home medication list.
.
It has been a pleasure taking care of you here at ___. We
wish you a speedy recovery.
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. Ascorbic Acid ___ mg PO DAILY
2. Lorazepam 1 mg PO BID
3. TraMADOL (Ultram) 50 mg PO DAILY:PRN pain
4. Venlafaxine XR 75 mg PO DAILY
5. Vitamin D 50,000 UNIT PO 1X/WEEK (___)
6. Amlodipine 5 mg PO DAILY
Hold for SBP <100
7. Glucosamine Sulf-Chondroitin *NF* (glucosamine ___
2KCl-chondroit) 500-400 mg Oral daily
8. Ciprofloxacin HCl 500 mg PO Q12H
The last day of medication is ___.
RX *Cipro 500 mg 1 Tablet(s) by mouth every 12 hours Disp #*20
Capsule Refills:*0
9. Chlorthalidone 50 mg PO DAILY
Hold for SBP <100
Discharge Disposition:
Home
Discharge Diagnosis:
Primary: sepsis from a urinary source (E. coli) with
pyelonephritis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>It was a pleasure caring for you during your hospitalization.
You were hospitalized for a urinary tract/kidney infection
called pyelonephritis. You will need to take an antibiotic
called ciprofloxacin until ___.
Physical therapy saw you and thought you would benefit from home
___, but you refused. You understood the risks of refusing
physical therapy at home.
We also found a lung nodule on your CAT scan. You will need to
talk to your primary care doctor about ___ repeat CAT scan.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H
RX *acetaminophen 500 mg 2 tablet(s) by mouth every 8 hours Disp
#*100 Tablet Refills:*0
2. Daptomycin 750 mg IV Q24H
RX *daptomycin 500 mg 1.5 Vials IV every 24 hours Disp #*63 Vial
Refills:*0
3. Docusate Sodium 100 mg PO BID
Stop taking if having loose stools
RX *docusate sodium 100 mg 1 capsule by mouth twice a day Disp
#*60 Capsule Refills:*2
4. Enoxaparin Sodium 40 mg SC DAILY
Take daily for 28 days
RX *enoxaparin 40 mg/0.4 mL 0.4 ml SC daily Disp #*28 Syringe
Refills:*0
5. OxyCODONE (Immediate Release) ___ mg PO Q3H:PRN Pain
Do not drive or consume alcohol while taking med
RX *oxycodone 10 mg ___ tablet(s) by mouth every 3 to 4 hours
Disp #*84 Tablet Refills:*0
6. Senna 8.6 mg PO BID
Stop taking if having loose stools
RX *sennosides 8.6 mg 1 tablet by mouth twice a day Disp #*60
Tablet Refills:*2
7. lactobacillus combination ___ billion cell oral DAILY
8. Multivitamins 1 TAB PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
left knee prosthetic joint 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>1. Please return to the emergency department or notify your
physician if you experience any of the following: severe pain
not relieved by medication, increased swelling, decreased
sensation, difficulty with movement, fevers greater than 101.5,
shaking chills, increasing redness or drainage from the incision
site, chest pain, shortness of breath or any other concerns.
2. Please follow up with your primary physician regarding this
admission and any new medications and refills.
3. Resume your home medications unless otherwise instructed.
4. You have been given medications for pain control. Please do
not drive, operate heavy machinery, or drink alcohol while
taking these medications. As your pain decreases, take fewer
tablets and increase the time between doses. This medication can
cause constipation, so you should drink plenty of water daily
and take a stool softener (such as Colace) as needed to prevent
this side effect. Call your surgeons office 3 days before you
are out of medication so that it can be refilled. These
medications cannot be called into your pharmacy and must be
picked up in the clinic or mailed to your house. Please allow
an extra 2 days if you would like your medication mailed to your
home.
5. You may not drive a car until cleared to do so by your
surgeon.
6. Please call your surgeon's office to schedule or confirm your
follow-up appointment in three (3) weeks.
7. SWELLING: Ice the operative joint 20 minutes at a time,
especially after activity or physical therapy. Do not place ice
directly on the skin. You may wrap the knee with an ace bandage
for added compression. Please DO NOT take any non-steroidal
anti-inflammatory medications (NSAIDs such as Celebrex,
ibuprofen, Advil, Aleve, Motrin, naproxen etc) until cleared by
your physician.
8. ANTICOAGULATION: Please continue Lovenox 40mg once daily for
4 weeks. If you were taking Aspirin prior to your surgery,
please hold dose until you complete your course of Lovenox
injections, then you can go back to your normal dosing.
9. WOUND CARE: Please remove Aquacel dressing on POD#7 after
surgery. It is okay to shower after surgery after 5 days but no
tub baths, swimming, or submerging your incision until after
your four (4) week checkup. Please place a dry sterile dressing
on the wound after aqaucel is removed each day if there is
drainage, otherwise leave it open to air. Check wound regularly
for signs of infection such as redness or thick yellow drainage.
Staples will be removed by your doctor at follow-up appointment
approximately 3 weeks after surgery.
10. ___ (once at home): Home ___, dressing changes as
instructed, and wound checks.
11. ACTIVITY: Non weight bearing on the operative extremity.
Mobilize with assistive devices (___). ROM ___
degrees in ___ brace at all time. No strenuous exercise or
heavy lifting until follow up appointment.
12. ___ CARE: Per protocol
13. WEEKLY LABS: draw on ___ and send result to ID RNs
at: ___ R.N.s at ___.
- CBC/DIFF
- CHEM 7
- LFTS
- ESR/CRP
**All questions regarding outpatient parenteral antibiotics
should be directed to the ___ R.N.s at
___ or to the on-call ID fellow when the clinic is
closed.
Physical Therapy:
non weight bearing ___ brace at all times (ROM ___ degrees)
mobilize frequently
Treatments Frequency:
Aquacel dressing to be removed on POD #7 (___),
then DSD prn drainage
Ice and elevate
*Staples will be removed at your first post-operative visit in
three(3)weeks*</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Apixaban 2.5 mg PO BID
RX *apixaban [Eliquis] 2.5 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
2. Fluticasone Propionate NASAL 1 SPRY NU DAILY
RX *fluticasone [24 Hour Allergy Relief] 50 mcg/actuation 1
spray nasally Daily Disp #*1 Spray Refills:*0
3. Aspirin 81 mg PO DAILY
4. Doxycycline Hyclate 100 mg PO DAILY
5. Furosemide 20 mg PO DAILY
6. ipratropium bromide 2 INH IH BID:PRN
7. LORazepam 1 mg PO QHS
8. Losartan Potassium 50 mg PO DAILY
9. Metoprolol Succinate XL 25 mg PO DAILY
10. Multivitamins 1 TAB PO DAILY
11. Sodium Chloride 3% Inhalation Soln 15 mL NEB BID:PRN
congestion
12. HELD- Prazosin 2 mg PO DAILY This medication was held. Do
not restart Prazosin until you discuss with your PCP and follow
up your blood pressures
13.Outpatient Lab Work
N17.9: Acute kidney injury
Please check chem-7 on ___. Please fax results to Pt's PCP,
___ (___).
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnosis:
* Community-acquired pneumonia
Secondary diagnoses:
* Atrial fibrillation with rapid ventricular response
* History of 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>================================================
MEDICINE Discharge Worksheet
================================================
Dear Mr. ___,
It was a pleasure taking part in your care here at ___!
Why was I admitted to the hospital?
- You were admitted for an infection in your lungs
("pneumonia,") that was complicated by abnormal heart rhythms.
What was done for me while I was in the hospital?
- We gave you antibiotics to treat your infection.
- We gave you medicines to slow your heart rate to a manageable
speed.
- Your medications were adjusted over several days in order to
ensure that you were tolerating them well.
What should I do when I leave the hospital?
- Please note any new medications in your discharge worksheet
below.
- Please note any appointments in your discharge worksheet
below.
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
standing dose
2. Docusate Sodium 100 mg PO BID
3. Enoxaparin Sodium 40 mg SC DAILY Duration: 2 Weeks
RX *enoxaparin 40 mg/0.4 mL 1 pre-filled syringe once a day Disp
#*14 Syringe Refills:*0
4. Gabapentin 800 mg PO Q8H pain
RX *gabapentin 800 mg 1 Tablet(s) by mouth three times a day
Disp #*42 Tablet Refills:*0
5. HYDROmorphone (Dilaudid) ___ mg PO Q3H:PRN pain
RX *hydromorphone 2 mg ___ Tablet(s) by mouth every 3 hours Disp
#*100 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
left foot navicular fracture
Discharge Condition:
stable
alert and oriented
ambulatory with crutches
Followup Instructions:
___ [/INST] </s><s>******SIGNS OF INFECTION**********
Please return to the emergency department or notify MD if you
should experience severe pain, increased swelling, decreased
sensation, difficulty with movement; fevers >101.5, chills,
redness or drainage at the incision site; chest pain, shortness
of breath or any other concerns.
-Wound Care: You can get the wound wet/take a shower starting
from 3 days post-op. No baths or swimming for at least 4 weeks.
Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment. No dressing is needed
if wound continued to be non-draining.
******WEIGHT-BEARING*******
non weight bearing left lower extremity, ambulate with crutches
******MEDICATIONS***********
- Resume your pre-hospital medications.
- You have been given medication for your pain control. Please
do not operate heavy machinery or drink alcohol when taking this
medication. As your pain improves please decrease the amount of
pain medication. This medication can cause constipation, so you
should drink ___ glasses of water daily and take a stool
softener (colace) to prevent this side effect.
-Medication refills cannot be written after 12 noon on ___.
*****ANTICOAGULATION******
- Take Lovenox for DVT prophylaxis until follow-up with Dr
___.
******FOLLOW-UP**********
Please follow up with Dr. ___ in 1 week for evaluation.
Call ___ to schedule appointment upon discharge.
Please follow up with your PCP regarding this admission and any
new medications/refills.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q8H
2. ClonazePAM 1 mg PO BID:PRN anxiety
3. Docusate Sodium 100 mg PO BID
4. Lidocaine 5% Patch 1 PTCH TD DAILY
5. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
6. Senna 1 TAB PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
Trauma: fall
Right rib fractures 3,4
small right pneumothorax
right knee pain
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>___ were admitted to the hospital after a 10 foot fall. ___
sustained right sided rib fractures and a small right
pneumothorax. Your rib cage pain with controlled with
intravenous analgesia, but later changed to oral agents. ___
also reported right knee pain and there was concern for
ligamentous injury. ___ had a brace applied. ___ were
evaluated by physical therapy and recommendations made for
discharge home with follow-up MRI to your right knee. Your
vital signs have been stable. ___ are preparing for discharge
home with the following instructions:
Your injury caused right sided rib fractures which can cause
severe pain and subsequently cause ___ to take shallow breaths
because of the pain.
* ___ should take your pain medication as directed to stay
ahead of the pain otherwise ___ 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 ___ 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.
* ___ will be more comfortable if ___ 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 ___
should take a stool softener twice daily and increase your fluid
and fiber intake if possible.
* Do NOT smoke
* If your doctor allows, non steroidal antiinflammatory drugs
are very effective in controlling pain ( ie, Ibuprofen, Motrin,
Advil, Aleve, Naprosyn) but they have their own set of side
effects so make sure your doctor approves.
* Return to the Emergency Room right away for any acute
shortness of breath, increased pain or crackling sensation
around your ribs ( crepitus ).
Additional instructions include:
Please call your doctor or return to the emergency room if ___
have any of the following:
* ___ experience new chest pain, pressure, squeezing or
tightness.
* New or worsening cough or wheezing.
* If ___ are vomiting and cannot keep in fluids or your
medications.
* ___ 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.
* ___ see blood or dark/black material when ___ vomit or have a
bowel movement.
* ___ have shaking chills, or a fever greater than 101.5 (F)
degrees or 38(C) degrees.
* Any serious change in your symptoms, or any new symptoms that
concern ___
Please follow up with your primary care provider for CT of chest
for pulmonary nodule and and recommended ultrasound for ?
hepatic cyst.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q6H:PRN Pain - Mild/Fever
2. Albuterol 0.083% Neb Soln 1 NEB IH Q2H:PRN sob/wheezing
3. Albuterol Inhaler 2 PUFF IH Q6H
4. Aspirin EC 81 mg PO DAILY
5. CefTRIAXone 2 gm IV Q24H
Last dose ___
6. Docusate Sodium 100 mg PO BID
7. Furosemide 40 mg PO BID
please reval clinically daily for when to decrease dose to home
dose of 20 mg daily
8. Polyethylene Glycol 17 g PO DAILY
9. Ranitidine 150 mg PO DAILY
10. Sarna Lotion 1 Appl TP QID:PRN chest rash
11. Senna 17.2 mg PO DAILY
12. TraMADol 50 mg PO Q12H:PRN Pain - Moderate
Reason for PRN duplicate override: Alternating agents for
similar severity
RX *tramadol 50 mg 1 tablet(s) by mouth BID prn Disp #*15 Tablet
Refills:*0
13. Atorvastatin 80 mg PO QPM
14. HydrALAZINE 10 mg PO Q 12 HR
15. Labetalol 200 mg PO BID
16. Potassium Chloride 20 mEq PO DAILY
Hold for >4.5
17. HELD- Propranolol 10 mg PO BID This medication was held. Do
not restart Propranolol until reevaluated by Cardiologist
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Coronary Artery Disease
Pericardial Effusion with Tamponade Physiology
ST Elevation Myocardial Infarction
Acute on Chronic Kidney Injury
Acute Hypoxic Respiratory Failure
Acute Heart Failure with preserved EF
Secondary Diagnosis:
Chronic Kidney Disease
Deviated Septum
Hyperlipidemia
Hypertension
Obesity
Obstructive sleep apnea
Discharge Condition:
Alert and oriented x3 nonfocal
Ambulating, gait steady
Sternal pain managed with oral analgesics
Sternal Incision - healing well, no erythema or drainage
Followup Instructions:
___ [/INST] </s><s>Please shower daily including washing incisions gently with mild
soap, no baths or swimming, and look at your incisions
Please NO lotions, cream, powder, or ointments to incisions
Each morning you should weigh yourself and then in the evening
take your temperature, these should be written down on the chart
No driving for approximately one month and while taking
narcotics, will be discussed at follow up appointment with
surgeon when you will be able to drive
No lifting more than 10 pounds for 10 weeks
Please call with any questions or concerns ___
**Please call cardiac surgery office with any questions or
concerns ___. Answering service will contact on call
person during off hours**</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q8H
2. Aluminum-Magnesium Hydrox.-Simethicone ___ ml PO Q6H:PRN
Dyspepsia
3. Bisacodyl 10 mg PO/PR DAILY:PRN Constipation
4. Ciprofloxacin HCl 250 mg PO Q12H Duration: 3 Days
RX *ciprofloxacin HCl 250 mg 1 tablet(s) by mouth Q12 hours Disp
#*2 Tablet Refills:*0
5. Diazepam - CIWA protocol ___ mg PO QHS, Q2 HOURS PRN CIWA
Scale Protocol; anxiety, agitation
Begin with 5mg and increase to 10 total if needed. HOLD for
somnolence, SpO2<92, RR<12
RX *diazepam 5 mg ___ tablet(s) by mouth qhs, q2 hr Disp #*10
Tablet Refills:*0
6. Docusate Sodium 100 mg PO BID
7. Enoxaparin Sodium 30 mg SC QPM
RX *enoxaparin 30 mg/0.3 mL 30 mg at bedtime Disp #*28 Syringe
Refills:*0
8. OxyCODONE (Immediate Release) ___ mg PO Q4H:PRN Pain
RX *oxycodone 5 mg ___ tablet(s) by mouth q4 hr PRN Disp #*15
Tablet Refills:*0
9. Thiamine 100 mg PO DAILY
10. FoLIC Acid 1 mg PO DAILY
11. Multivitamins 1 TAB PO DAILY
12. Omeprazole 40 mg PO DAILY
13. Sucralfate 1 gm PO TID
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Left periprosthetic femur fracture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week.
- Resume your regular activities as tolerated, but please follow
your weight bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
- Touch down weight bearing left lower extremity
MEDICATIONS:
- Please take all medications as prescribed by your physicians
at discharge.
- Continue all home medications unless specifically instructed
to stop by your surgeon.
- Do not drink alcohol, drive a motor vehicle, or operate
machinery while taking narcotic pain relievers.
- Narcotic pain relievers can cause constipation, so you should
drink eight 8oz glasses of water daily and take a stool softener
(colace) to prevent this side effect.
ANTICOAGULATION:
- Please take lovenox daily for 4 weeks
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- You may change DRY STERILE DRESSING daily as needed if any
drainage or if saturated. If no drainage may leave open to air
after post-operative day 7.
DANGER SIGNS:
Please call your PCP or surgeon's office and/or return to the
emergency department if you experience any of the following:
- Increasing pain that is not controlled with pain medications
- Increasing redness, swelling, drainage, or other concerning
changes in your incision
- Persistent or increasing numbness, tingling, or loss of
sensation
- Fever > 101.4
- Shaking chills
- Chest pain
- Shortness of breath
- Nausea or vomiting with an inability to keep food, liquid,
medications down
- Any other medical concerns
Physical Therapy:
Touch Down Weight Bearing Left Lower Extremity
Treatments Frequency:
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- You may change DRY STERILE DRESSING daily as needed if any
drainage or if saturated. If no drainage may leave open to air
after post-operative day 7.</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 325 mg 2 tablet(s) by mouth every six (6)
hours Disp #*100 Tablet Refills:*0
2. Docusate Sodium 100 mg PO BID
RX *docusate sodium [Colace] 100 mg 1 capsule(s) by mouth twice
a day Disp #*40 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 #*75 Tablet Refills:*0
4. Aspirin 325 mg PO DAILY Duration: 14 Days
RX *aspirin 325 mg 1 tablet(s) by mouth once a day Disp #*14
Tablet Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
Right femur fracture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week. - Resume your
regular activities as tolerated, but please follow your weight
bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
- Touch down weight bearing right leg
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 for 2 weeks. Please ambulate at least 5
times a day with crutches.
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- Clean dry dressing as needed - changed daily or as solied.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Divalproex (DELayed Release) 750 mg PO BID
RX *divalproex ___ mg 1.5 tablet(s) by mouth twice a day Disp
#*90 Tablet Refills:*0
2. Acetaminophen 325-650 mg PO Q6H:PRN Pain - Mild
3. Celecoxib 200 mg oral DAILY
4. Dexamethasone 2 mg PO QAM
5. Dexamethasone 2 mg PO Q1400
6. Diazepam 5 mg PO Q12H:PRN Pain
7. Losartan Potassium 100 mg PO DAILY
8. Nystatin Oral Suspension 5 mL PO QID
9. Ranitidine 150 mg PO BID
10. Simvastatin 10 mg PO QPM
11. TraMADol 50 mg PO Q6H:PRN Pain - Moderate
12. TraZODone 50 mg PO QHS:PRN Insomnia
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: Seizure, acute encephalopathy
Secondary: Adenocarcinoma of lung with brain metastases, ___
stomatitis, hypertension, hyperlipidemia, troponin elevation
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to ___ after a fall and mental status
changes which were thought to be due to a seizure. It is
believed that lowering the dose of your anti seizure medicine
combined with your recent immunologic therapy may have increased
your risk of seizure. MRI showed improvement in your brain
lesions, EEG showed no further seizures, but you remained
somewhat confused so a lumbar puncture was performed which looks
clear preliminarily, with evaluation for tumor cells pending.
You had no evidence of any infections. Your mental status
improved during your stay. You were switched to a new
anti-seizure medication and should follow up with your
oncologist as well as your new neuro-oncologist as below.
Please do not drive until you see Dr. ___ in neuro-oncology
on ___. He will help determine if driving is safe for you.
It was a pleasure caring for you,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acyclovir 400 mg PO Q12H
2. ClonazePAM 0.5 mg PO TID:PRN anxiety
3. Isoniazid ___ mg PO DAILY
4. LaMIVudine 100 mg PO DAILY
5. Mirtazapine 15 mg PO QHS
6. Ondansetron ___ mg PO Q8H:PRN nausea
7. Paroxetine 20 mg PO DAILY
8. Prochlorperazine 10 mg PO Q6H:PRN nausea
9. Pyridoxine 50 mg PO DAILY
10. Spironolactone 300 mg PO DAILY
11. Estradiol 4 mg PO DAILY
12. Acetaminophen 325 mg PO Q6H:PRN pain
RX *acetaminophen 325 mg 1 tablet(s) by mouth every 6 hours Disp
#*90 Tablet Refills:*0
13. OxycoDONE (Immediate Release) 10 mg PO Q6H:PRN pain
RX *oxycodone 5 mg ___ tablet(s) by mouth every six hours Disp
#*56 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY: DLBCL
SECONDARY: Nicotine dependence, Latent TB
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 meeting you and taking care of you. You were
admitted with subjective fevers and night sweats. We were
concerned that this represented progression of your diffuse
large B cell lymphoma so we obtained a staging CT scan. This
showed decrease in the size of your lymph nodes which was very
reassuring. You were monitored in the hospital and were stable
without fevers or signs of infection. We felt that it was safe
for you to go home and return for further outpatient
chemotherapy.You should continue your R-CHOP as an outpatient.
Your next appointment is on ___. It is VERY important
that you keep this appointment.
We wish you the best,
Your ___ team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you during your admission to ___
___. You were sent to the ___
from rehab for falls and worsening confusion. You were found to
have an elevated level of carbon dioxide in your blood, which
was caused by not using your BiPAP machine.
Your confusion improved when you were treated with the BIPAP
machine. It is very important that you use a BIPAP machine each
night to prevent this problem from returning in the future. You
can also sleep with your upper body elevated to help with this
problem. I have spoken with the company that will deliver your
machine. You should hear from them in a couple of days. If you
have not heard from them please call: ___ at
___.
You have worse swelling in your right leg compared to your left
leg. This is probably related to the deep vein thrombosis (DVT)
or blood clot that was diagnosed during your stay at rehab. You
were started on coumadin to protect you from clots in the
future.
You have congestive heart failure, for which you received
diuresis (water taken off). Please weigh yourself every morning,
and call your PCP if weight goes up more than 3 lbs.
Your insulin was reduced during your hospitalization because
your blood sugars were low. We expect your insulin will need
ongoing adjustment after you leave the hospital.
Per the urology team the dermabond over the surgical site on
your penis will come off naturally over the next few days. You
should keep the area clean. Dr. ___ will call you with the
results of your biopsy. If you have questions for Dr. ___
can reach him at ___.
Best wishes,
Your Medicine Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Hydrochlorothiazide 25 mg PO DAILY
3. Lisinopril 20 mg PO DAILY
4.Outpatient Physical Therapy
Vestibular ___
H81.92
Discharge Disposition:
Home
Discharge Diagnosis:
Left sided peripheral vestibulopathy
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 feelings of dizziness and leaning
to the left while walking. You had some tests done, like a CT
scan of your head and the blood vessels in the head and neck,
which were unremarkable. Based on your neurological examination
and the symptoms you had told us, we believe that your balance
issues are due to an inner ear problem. This is referred to as a
peripheral vestibulopathy. Many things can cause this, we are
not sure of the exact one at this time. We do not think this is
Meniere's disease. This should improve with time. We had
physical therapy see you. You will undergo vestibular physical
therapy once you are out of the hospital, this will help your
vestibular (inner ear) system which is responsible for your
balance recover.
Sincerely,
Your ___ neurology team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. ALPRAZolam 0.25 mg PO TID:PRN Anxiety
RX *alprazolam 0.25 mg 1 tablet(s) by mouth three times a day
Disp #*21 Tablet Refills:*0
2. Vitamin D 1000 UNIT PO DAILY
RX *ergocalciferol (vitamin D2) 400 unit 2 tablet(s) by mouth
once a day Disp #*60 Tablet Refills:*2
Discharge Disposition:
Home
Discharge Diagnosis:
Multiple Sclerosis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>___ were admitted to the hospital because ___ had changes in
sensation and slight weakness in your legs.
WHAT HAPPENED WHILE ___ WERE IN THE HOSPITAL?
___ were admitted to the General Neurology service after
undergoing an MRI of your upper spine in the ED that revealed an
abnormal lesion. ___ underwent a spinal tap for further
evaluation with some labs pending. ___ underwent an MRI of your
Head which showed other lesions which with your clinical
symptoms is consistent with a diagnosis of MS. ___ were started
on IV steroids which produced some improvement in symptoms. Due
to this improvement, ___ were deemed stable for discharge home
with further treatment as outpatient.
WHAT DO ___ NEED TO DO WHEN ___ LEAVE THE HOSPITAL?
- Take all of your medications as prescribed (listed below)
- ___ can take Alprazolam as needed for anxiety in the near
future
- Please continue steroid infusions at the BI ___
over the next two days; ___ will be contacted ___ AM to arrange
for an infusion time that day
- Keep your follow up appointments with your doctors
- If ___ experience any of the danger signs listed below please
call your primary care doctor or come to the emergency
department immediately.
It was a pleasure participating in your care. We wish ___ the
best!
- Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Glargine 38 Units Breakfast
Insulin SC Sliding Scale using HUM Insulin
2. Acyclovir 400 mg PO Q12H
3. Cyanocobalamin 1000 mcg PO DAILY
4. Hydrochlorothiazide 25 mg PO DAILY
5. MetFORMIN (Glucophage) 500 mg PO BID
6. Metoprolol Succinate XL 50 mg PO DAILY
7. NIFEdipine (Extended Release) 30 mg PO DAILY
8. Omeprazole 40 mg PO BID
9. OxyCODONE (Immediate Release) 10 mg PO Q4H:PRN Pain -
Moderate
10. Pyridoxine 50 mg PO DAILY
11. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSIS
==================
MULTIPLE MYELOMA
ACUTE PAIN
SECONDARY DIAGNOSIS
=====================
STEROID INDUCED DIABETES
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 evaluation of acute chest and back pain
likely due to neupogen bony pain. You improved with pain
medication and underwent stem cell collection on ___ which you
tolerated..... Please follow up with Dr. ___ as stated 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. Citalopram 20 mg PO DAILY
2. Gabapentin 800 mg PO TID
3. Oxcarbazepine 300 mg PO TID
4. Omeprazole 20 mg PO DAILY
5. QUEtiapine Fumarate 200 mg PO QHS
6. QUEtiapine Fumarate 100 mg PO QAM
7. Vitamin D ___ UNIT PO DAILY
8. Methadone 72 mg PO DAILY
9. Labetalol 300 mg PO BID
10. HydrOXYzine 25 mg PO BID
11. Albuterol Inhaler 2 PUFF IH Q4H:PRN shortness of breath,
wheeze
12. Hydrochlorothiazide 50 mg PO DAILY
13. Qvar (beclomethasone dipropionate) 80 mcg/actuation
inhalation BID
14. Amoxicillin-Clavulanic Acid ___ mg PO Q8H
Last dose ___
RX *amoxicillin-pot clavulanate 500 mg-125 mg 1 tablet(s) by
mouth every eight (8) hours Disp #*5 Tablet Refills:*0
15. Lisinopril 5 mg PO DAILY
RX *lisinopril 5 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Multisubstance abuse (opiates, barbituates, benzodiazepines, and
cocaine) requiring intubation for somnolence and airway
protection.
Aspiration pneumonia.
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 being part of your care at ___. You were
admitted to the hospital due to somnolence and fevers. You were
initially intubated to help you breathe, but extubated very soon
afterward. You received antibiotics for a lung infection and
medications to help control withdrawal. You were having diarrhea
so we tested to see if you had an infection, which you did not.
After discharge, please follow up with your PCP and the
outpatient addictions program at ___. Please consider NA or AA
groups as you felt like these might be helpful. You should
complete the antibiotic (Augmentin) for your pneumonia which
will be finished on ___.
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. Levothyroxine Sodium 125 mcg PO DAILY
2. Multivitamins 1 TAB PO DAILY
3. OxycoDONE (Immediate Release) 5 mg PO Q8H:PRN neck pain
Hold for RR <10.
4. Calcium 500 + D *NF* (calcium carbonate-vitamin D3) 500
mg(1,250mg) -200 unit Oral daily
5. Diazepam 5 mg PO Q12H:PRN neck pain
6. Hydrocortisone 15 mg PO DAILY
RX *hydrocortisone [Cortef] 5 mg 3 tablet(s) by mouth Each
morning Disp #*90 Tablet Refills:*0
7. Hydrocortisone 5 mg PO QHS
RX *hydrocortisone [Cortef] 5 mg 1 tablet(s) by mouth Each
evening Disp #*30 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
myxedema coma / hypothyroidism
adrenal insufficiency
gait instability
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You were admitted with lethargy and instability while walking.
The cause of this is because you stopped taking your
medications. It is essential that you take your medications as
prescribed otherwise this problem may return.
You will need additional follow up to evaluate your lungs for
any evidence of cancer return. This can be done at your primary
care physician's office.
You were started on a new medication: hydrocortisone. You should
take 15mg every morning and 5mg every evening.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Enoxaparin Sodium 80 mg SC BID
Start: ___, First Dose: Next Routine Administration Time
RX *enoxaparin 80 mg/0.8 mL 1 syringe subcutaneously twice a day
Disp #*10 Syringe Refills:*0
RX *enoxaparin 80 mg/0.8 mL 1 syringe subcutaneously twice a day
Disp #*28 Syringe Refills:*0
2. Amlodipine 5 mg PO DAILY
3. Aspirin 81 mg PO DAILY
4. Atenolol 100 mg PO DAILY
5. Atorvastatin 80 mg PO QPM
6. Doxazosin 8 mg PO HS
7. Finasteride 5 mg PO DAILY
8. Lisinopril 40 mg PO DAILY
9. Omeprazole 40 mg PO DAILY
10. Gabapentin 200 mg PO DAILY
11. Minocycline 100 mg PO BID
RX *minocycline 100 mg 1 tablet(s) by mouth twice a day Disp
#*10 Tablet Refills:*0
12. Warfarin 5 mg PO DAILY16
RX *warfarin 5 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
TIA
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were hospitalized due to symptoms of slurred speech
resulting from an Transient Ischemic Attack, a condition where a
blood vessel providing oxygen and nutrients to the brain is
temporarily blocked. 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.
TIA's 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:
-Episodes of low blood pressure causing poor blood circulation
to your brain
-Being off of Coumadin
We are changing your medications as follows:
Coumadin 5mg daily - this dose may be readjusted as needed
depending on your INR levels.
Please take your other medications as prescribed.
Please followup with Neurology, vascular surgery, 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</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:
- NWB LLE;
Elevation
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 325mg daily for 14 days
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- No dressing is needed if wound continues to be non-draining.
- Splint must be left on until follow up appointment unless
otherwise instructed
- Do NOT get splint wet
DANGER SIGNS:
Please call your PCP or surgeon's office and/or return to the
emergency department if you experience any of the following:
- Increasing pain that is not controlled with pain medications
- Increasing redness, swelling, drainage, or other concerning
changes in your incision
- Persistent or increasing numbness, tingling, or loss of
sensation
- Fever > 101.4
- Shaking chills
- Chest pain
- Shortness of breath
- Nausea or vomiting with an inability to keep food, liquid,
medications down
- Any other medical concerns
FOLLOW UP:
Please follow up with your surgeon's team (Dr. ___, with
___, NP in the Orthopaedic Trauma Clinic ___
days post-operation for evaluation. Call ___ to
schedule appointment upon discharge.
Please follow up with your primary care doctor regarding this
admission within ___ weeks and for and any new
medications/refills.
Physical Therapy:
NWB LLE, in splint until follow-up.
Rest, elevation
Treatments Frequency:
cont splint until follow-up</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Vancomycin Oral Liquid ___ mg PO Q6H Duration: 7 Days
7 days left, last dose ___
RX *vancomycin [Firvanq] 50 mg/mL 125 mg by mouth every six (6)
hours Disp ___ Milliliter Refills:*0
2. Brimonidine Tartrate 0.15% Ophth. 1 DROP BOTH EYES Q8H
3. Dorzolamide 2% Ophth. Soln. 1 DROP BOTH EYES TID
4. Enalapril Maleate 20 mg PO DAILY
5. Labetalol 200 mg PO BID
6. Omeprazole 20 mg PO DAILY
7. Verapamil SR 240 mg PO Q24H
Discharge Disposition:
Home
Discharge Diagnosis:
small bowel obstruction
clostridium. difficile colitis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>You underwent removal of your gallbladder and you were
discharged home. You returned to the hospital with abdominal
pain, nausea, and vomiting. You underwent imaging and there was
concern for a small bowel obstruction. You were placed on bowel
rest and a ___ tube was placed for bowel decompression.
During this time, you also had an elevated white blood cell
count. A stool specimen was sent which returned as an
infection, clostridium difficile. You were started on a course
of vancomycin for C. Diff colitis and your white blood cell
count decreased. The ___ tube was removed and you
resumed a regular diet. Your vital signs have been stable and
you are preparing for discharge with the following instructions:
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.
*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. Complete course of vancomycin
as directed</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Albuterol Inhaler 2 PUFF IH Q6H:PRN SOB/wheezing
2. Duloxetine 60 mg PO DAILY
3. Furosemide 20 mg PO EVERY OTHER DAY
hold for SBP < 100
4. Hydrocortisone Enema 100 mg PR HS
5. Lisinopril 10 mg PO HS
hold for SBP < 100
6. Loperamide 2 mg PO TID:PRN diarrhea
7. Mesalamine (Rectal) ___AILY
8. Risperidone 1 mg PO HS
9. Nicotine Patch 21 mg TD DAILY
RX *nicotine 21 mg/24 hour apply one patch every 24 hours daily
Disp #*7 Each Refills:*0
10. Cimzia *NF* (certolizumab pegol) 400 mg/2 mL (200 mg/mL x 2)
Subcutaneous qMonth
Last dose ___
11. Oxycodone-Acetaminophen (5mg-325mg) 1 TAB PO QID:PRN pain
RX *oxycodone-acetaminophen [Percocet] 5 mg-325 mg 1 tablet(s)
by mouth q6 hours Disp #*30 Tablet Refills:*0
12. Symbicort *NF* (budesonide-formoterol) 160-4.5 mcg/actuation
INHALATION BID
13. Ciprofloxacin HCl 750 mg PO Q12H Duration: 6 Days
RX *ciprofloxacin 750 mg 1 tablet(s) by mouth twice a day Disp
#*12 Tablet Refills:*0
14. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H Duration: 6 Days
RX *metronidazole 500 mg 1 tablet(s) by mouth three times a day
Disp #*18 Tablet Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis: Crohn's flare
Secondary diagnoses: COPD
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you during your hospitalization
at ___. You were admitted with abdominal pain from a Crohn's
flare and were given steroid enemeas, antibiotics, IV fluids,
bowel rest and IV pain medication with improvement. You had a
sigmoidoscopy which showed active Crohn's disease and you should
follow up with Dr. ___ as indicated below.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN Pain - Mild/Fever
Do not take more than 4000mg acetaminophen in 24 hours
2. Amoxicillin-Clavulanic Acid ___ mg PO Q12H Duration: 10
Hours
3. Erythromycin 0.5% Ophth Oint 0.5 in BOTH EYES QHS
4. Polymyxin B -Trimethoprim Ophth Soln 1 DROP BOTH EYES QID
Duration: 1 Week
5. Atenolol 25 mg PO DAILY
6. Atorvastatin 80 mg PO QPM
7. Clopidogrel 75 mg PO DAILY
8. Famotidine 20 mg PO Q24H
9. Levemir U-100 Insulin (insulin detemir U-100) 100 unit/mL
subcutaneous ONCE
10. NovoLOG U-100 Insulin aspart (insulin aspart U-100) 100
unit/mL subcutaneous sliding scale
11. PARoxetine 20 mg PO DAILY
12. Warfarin 3.5 mg PO ONCE Duration: 1 Dose
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary Diagnosis: Peripheral arterial disease, Right foot
chronic wound
Secondary diagnosis: T2DM
neuropathy
PAD
prostate Ca ___
HLD
Endocarditis
CAD s/p MI (5x CABG ___
anxiety/depression
Sciatica
L Charcot foot
TIA ___ (carotid US ___ b/l carotid a. stenosis)
Discharge Condition:
Stable, alert and oriented x3, including with assistance
Followup Instructions:
___ [/INST] </s><s>It was a pleasure taking care of you at ___
___. You were admitted to the hospital after surgery
on your leg. This surgery was done to improve blood flow to
your leg. You tolerated the procedure well and are now ready to
be discharged from the hospital. Please follow the
recommendations below to ensure a speedy and uneventful
recovery.
Vascular bypass Surgery Discharge Instructions
What to except:
It is normal feel tired for ___ weeks after your surgery
It is normal to have leg swelling. Keep your leg elevated as
much as possible. This will decrease the swelling.
Your leg will feel tired and sore. This usually passes
within a few weeks.
Your incision will be sore, slightly raised, and pink. Any
drainage should decrease or stop with in the first 2 weeks.
If you are home, you will likely receive a visit from a
Visiting Nurse ___. Members of your health care team will
discuss this with you before you go home.
Medications:
Before you leave the hospital, you will be given a list of all
the medicine you should take at home. If a medication that you
normally take is not on the list or a medication that you do not
take is on the list please discuss it with the team!
It is very important that you take Aspirin every day! You
should never stop this medication before checking with your
surgeon
Pain Management:
It is normal to feel some discomfort/pain following surgery.
This pain is often described as soreness.
You may take Tylenol (acetaminophen ) as needed for pain.
You will also receive a prescription for stronger pain medicine,
if the Tylenol doesnt work, take prescription medicine.
Narcotic pain medication can be very constipating, please also
take a stool softner such as Colace. If constipation becomes a
problem, your pharmacist can suggest additional over the counter
medications.
Your pain medicine will work better if you take it before your
pain gets to severe.
Your pain should get better day by day. If you find the pain
is getting worse instead of better, please contact your surgeon.
Activity:
Do not drive until your surgeon says it is okay. In general,
driving is not allowed until
-the staples in your leg have been taken out
-your leg feels strong
-you have stopped taking pain medication and feel you could
respond in an emergency
Walking is good because it helps your muscles get stronger and
improves blood flow. Start with short walks. If you can, go a
little further each time, letting comfort be your guide.
Try not to go up and downstairs too much in the first weeks.
Use stairs only once or twice a day until your incision is fully
healed and you are back to your usual strength.
Avoid things that may constrict blood flow or put pressure on
your incision, such as tight shoes, socks or knee highs.
Do not take a tub bath or swim until your staples are removed
and your wound is healed.
When you sit, keep your leg elevated to reduce swelling.
If swelling in your leg is getting worse, lie down with your
leg up on a pillows. If your swelling continues, please call
your surgeon. You may be instructed to use special elastic
bandages or stockings.
Try not to sit in the same position for a long while. For
example, ___ go on a long car ride.
You may go outside. But avoid traveling long distances until
you see your surgeon at your next visit.
You may resume sexual activity after your incisions are well
healed.
Your incision
Your incision may be slightly red around the stitches or
staples. This is normal.
It is normal to have a small amount of clear or light red
fluid coming from your incision.
This will decrease and stop in a few days. If it does not stop,
or if you have a lot of fluid coming out., please call your
surgeon.
You may shower 48 hours after your surgery. Do not let the
shower spray right on the incision, Let the soapy water run
over the incision, then rinse. Gently pat the area dry. Do not
scrub the incision, Do not apply ointment or lotions to the
incision.
You do not need to cover the incision if there is no drainage,
If there is a small amount of drainage, put a small sterile
gauze or Bandaid over the incison.
It is normal to feel a firm ridge along the incision, This
will go away as your wound heals.
Avoid direct sun exposure to the incision area for 6 months.
This will help keep the scar from becoming discolored.
Over ___ months, your incision will fade and become less
prominent.
Diet and Bowels
It is normal to have a decreased appetite. Your appetite will
return over time. Follow a well-balanced, health healthy diet,
without too much salt and fat.
Prescription pain medicine might make you constipated. If
needed, you may take a stool softener (such as Colace) or gentle
laxative (ask your pharmacist for recommendations).
Drinking more fluid may also help.
If you go 48 hours without a bowel movement, or having pain
moving your bowels, call your primary care physician.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 325 mg PO DAILY
2. Memantine 5 mg PO DAILY
3. Metoprolol Succinate XL 25 mg PO DAILY
4. Docusate Sodium 100 mg PO BID
RX *docusate sodium 100 mg 1 capsule(s) by mouth twice a day
Disp #*60 Capsule Refills:*0
5. Vitamin D 400 UNIT PO DAILY
6. Fish Oil (Omega 3) 1000 mg PO BID
7. Calcium Carbonate 500 mg PO DAILY
8. Furosemide 20 mg PO 3X/WEEK (___)
9. Cephalexin 250 mg PO Q8H Duration: 2 Days
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary:
Symptomatic Bradycardia
Secondary:
Hairy Cell Leukemia
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Lethargic but arousable.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure caring for you at ___. You came to the
hospital because you were feeling very weak. We found that your
heart was beating very slow and you were having symptoms from
it. We stopped your metoprolol but your heart rate was still
slow. You then had a pacemaker implanted in order to increase
your heart rate and prevent the slow rate. Please follow up with
the appointments scheduled below.
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. BD Ultra-Fine Nano Pen Needle (pen needle, diabetic) 32
gauge x ___ miscellaneous QID
RX *pen needle, diabetic [BD Ultra-Fine Nano Pen Needle] 32
gauge X ___ use with insulin pen 5 times daily Disp #*400 Each
Refills:*1
2. chlorhexidine gluconate 4 % topical Other qWeek
RX *chlorhexidine gluconate 4 % apply to body once a week in
shower qWeek Refills:*2
3. Clindamycin 1% Solution 1 Appl TP BID Duration: 30 Days
RX *clindamycin phosphate 1 % apply to affected areas twice a
day Refills:*3
4. Clindamycin 300 mg PO Q6H
RX *clindamycin HCl 300 mg 1 capsule(s) by mouth four times a
day Disp #*40 Capsule Refills:*0
5. Glargine 40 Units Bedtime
Humalog 12 Units Breakfast
Humalog 12 Units Lunch
Humalog 12 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
RX *blood sugar diagnostic [FreeStyle Test] use to test sugar
up to 4 times daily up to 5 times daily Disp #*150 Strip
Refills:*0
RX *insulin glargine [Lantus Solostar U-100 Insulin] 100 unit/mL
(3 mL) AS DIR SQ 40 Units before BED; Disp #*5 Syringe
Refills:*3
RX *blood-glucose meter [FreeStyle Freedom] dispense one meter
Daily Disp #*1 Kit Refills:*0
RX *insulin lispro [Humalog KwikPen Insulin] 100 unit/mL AS DIR
SQ As per sliding scale and before meals Disp #*10 Syringe
Refills:*3
RX *lancets [ForaCare Lancets] 30 gauge use to check sugar up to
5 times daily Disp #*200 Each Refills:*0
6. Allopurinol ___ mg PO DAILY
7. amLODIPine 10 mg PO DAILY
8. Colchicine 0.6 mg PO DAILY
9. Hydrochlorothiazide 12.5 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Abscess, Cellulitis
Type 2 diabetes poorly controlled
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Mr. ___,
It was a pleasuring caring for you. You were admitted to help
treat the abscess in your arm/chest and to start insulin to have
your diabetes better controlled. It is important that you check
your sugar and give your insulin as instructed by the diabetes
team.
Please make sure you see your primary care doctor in follow-up
and finish the course of antibiotics.
You are leaving against the advice of your doctors. If you
notice very high (>400) or very low (<70) sugars, if you notice
spreading of the redness or fever or other symptoms that concern
you it is important that you seek medical care immediately.
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-Caff-Butalbital ___ TAB PO Q4H:PRN pain
Limit use to 15 days/month
2. Docusate Sodium 100 mg PO DAILY constipation
3. Gabapentin 300 mg PO TID
4. HYDROmorphone (Dilaudid) 2 mg PO Q8H:PRN Headache
5. OxyCODONE SR (OxyconTIN) 30 mg PO Q12H
6. Senna 8.6 mg PO BID:PRN constipation
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary diagnosis:
Left parietal intraparenchymal hemorrhage
Secondary diagnosis:
Hyperlipidemia
Headache
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 ___,
___ were hospitalized due to symptoms of headache resulting from
an brain bleed (intraparenchymal hemorrhage), a condition in
which a blood vessel providing oxygen and nutrients to the brain
bleeds. 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.
The cause of this brain bleed remained unclear at time of
discharge. High blood pressure can sometimes cause a brain
bleed; however, your blood pressure was normal while ___ were in
the hospital. ___ should have an MRI at the time and date
scheduled below to assess for resolution of the bleed and to
re-assess for any abnormalities that may have led to the bleed.
___ also had a severe headache throughout hospitalization. We
have discharged ___ with an aggressive pain control regimen.
Please follow-up with your primary care doctor regarding further
pain control.
Please followup with Neurology and your primary care physician
as listed below.
If ___ 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
___
- 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
- sudden difficulty pronouncing words (slurring of speech)
- sudden blurring or doubling of vision
- sudden onset of vertigo (sensation of your environment
spinning around ___
- sudden clumsiness of the arm and leg on one side or sudden
tendency to fall to one side (left or right)
- sudden severe headache accompanied by the inability to stay
awake
It was a pleasure providing ___ with care during this
hospitalization. We wish ___ all 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. Hydrochlorothiazide 25 mg PO DAILY
3. Omeprazole 40 mg PO DAILY
4. Sertraline 50 mg PO DAILY
5. Simvastatin 10 mg PO DAILY
6. Docusate Sodium 100 mg PO BID:PRN constipation
7. Lidocaine 5% Patch 1 PTCH TD DAILY
8. GlipiZIDE 5 mg PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Atypical chest pain
Morbid obesity (BMI=60)
Osteoarthritis of bilateral knees
Left knee pain due to pes aneserine bursitis
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 pleasure taking care of your at ___. You were admitted
with chest pain. You underwent nuclear heart studies which did
not show any evidence of heart attack. You also had left knee
pain, which was due to osteoarthritis and pes anserine bursitis.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 20 mg PO QPM
2. Carbidopa-Levodopa (___) 1.5 TAB PO TID
3. Lodosyn (carbidopa) 25 mg oral DAILY
4. melatonin 3 mg oral QHS
5. Metoprolol Succinate XL 12.5 mg PO DAILY
6. Multivitamins W/minerals 1 TAB PO DAILY
7. Omeprazole 40 mg PO DAILY
8. Polyethylene Glycol 17 g PO DAILY
9. Rasagiline 0.5 mg PO DAILY
10. Ipratropium Bromide Neb 1 NEB IH Q6H
RX *ipratropium bromide 0.2 mg/mL (0.02 %) 1 neb INH every 6
hours for 2 weeks and then as needed Disp #*90 Vial Refills:*0
11. Fluticasone Propionate 110mcg 2 PUFF IH BID
RX *fluticasone [Flovent HFA] 110 mcg/actuation 2 puff INH twice
daily Disp #*3 Inhaler Refills:*0
12. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN wheezing,
dyspnea, cough
RX *albuterol sulfate 2.5 mg/3 mL (0.083 %) 1 neb inh every 4
hours as needed Disp #*90 Vial Refills:*0
13. Spacer
Diagnosis: Bronchitis, reactive airways disease
Please use with fluticasone inhaler
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Bronchitis vs airway reactivity after infection
___ disease
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 for occasional wheezing and cough. There was
concern for pneumonia but your chest X-ray did not show
pneumonia and your symptoms quickly improved with nebulizers.
Antibiotics were stopped and you tolerated this just fine.
Overall, your presentation is most consistent with a post
infectious bronchitis or asthma like syndrome.
You were evaluated by speech and language pathology who felt you
would benefit from a ground diet with thin liquids to minimize
your risks of accidentally inhaling some of your food when you
eat (which can predispose to pneumonia and coughing fits).
You were deconditioned and had difficulty moving around and
physical therapy recommended going to a rehab facility. You did
not qualify for acute level rehab and so you and your family
elected to go home with maximal services in order to work on
getting stronger at home.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 325-650 mg PO Q6H:PRN pain
2. Albuterol Inhaler 1 PUFF IH Q6H:PRN SOB/wheeze
3. Amlodipine 10 mg PO DAILY
4. Aspirin 81 mg PO DAILY
5. Atorvastatin 20 mg PO HS
6. Bisacodyl 5 mg PO DAILY:PRN constipation
7. Carvedilol 50 mg PO BID
8. Clopidogrel 75 mg PO DAILY
9. Docusate Sodium 100 mg PO BID
10. Famotidine 20 mg PO DAILY
11. Humalog ___ 30 Units Breakfast
Humalog ___ 30 Units Dinner
12. Myfortic (mycophenolate sodium) 360 mg Oral BID
13. Polyethylene Glycol 17 g PO DAILY
14. Sulfameth/Trimethoprim SS 1 TAB PO DAILY
15. Tacrolimus 0.5 mg PO Q12H
16. Tacrolimus 2 mg PO Q12H
17. Vitamin D 50,000 UNIT PO 1X/WEEK (SA)
18. TraMADOL (Ultram) 50 mg PO BID:PRN breakthrough pain
RX *tramadol 50 mg 1 tablet(s) by mouth twice a day Disp #*10
Tablet Refills:*0
19. CloniDINE 0.2 mg PO BID
20. Furosemide 40 mg PO DAILY
21. Aluminum-Magnesium Hydrox.-Simethicone ___ mL PO QID:PRN
pain
Please do not take within 2 hours of mycophenolate.
RX *alum-mag hydroxide-simeth [Maalox Advanced] 200 mg-200 mg-20
mg/5 mL ___ mL by mouth four times a day Disp #*1 Bottle
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
Abdominal/back pain of uncertain etiology
Secondary:
End stage renal disease status post renal transplant
Diabetes ___
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>Dear Ms. ___,
It was a pleasure participating in your care at ___
___. You were admitted after you developed
left-sided back and abdominal pain. Imaging of your belly did
not show signs of infection or other clear explanation. You
were given medications to help with the pain and the nausea.
Ultimately, your pain improved and you were able to tolerate
meals. You may continue to take the pain medications you
received in the hospital as needed at home as your pain
continues to improve.
Please continue your home medications, including furosemide
(Lasix), when you return home. If you find that you are eating
and drinking poorly again, please contact the kidney clinic
(___) to discuss whether your furosemide dose should be
adjusted.
Please have your blood drawn on ___. You can come
to the lab and have your routine transplant labs drawn. It is
important that you have your blood drawn on that day, especially
since your tacrolimus dose may need to be adjusted based on the
level seen.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ciprofloxacin HCl 750 mg PO Q12H urinary tract infection
RX *ciprofloxacin HCl 750 mg 1 tablet(s) by mouth every twelve
(12) hours Disp #*20 Tablet Refills:*0
2. Acetaminophen 650 mg PO Q8H:PRN Pain - Mild/Fever
RX *acetaminophen [8HR Muscle Aches-Pain] 650 mg 1 tablet(s) by
mouth q8 Disp #*30 Tablet Refills:*0
3. Glargine 18 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
RX *blood sugar diagnostic [Blood Glucose Test] use for blood
sugar monioring 4x dialy Disp #*200 Strip Refills:*0
RX *insulin glargine [Lantus Solostar U-100 Insulin] 100 unit/mL
(3 mL) ___ Units before BED; Disp #*3 Syringe Refills:*0
RX *blood-glucose meter [Blood Glucose Monitoring] blood sugar
monitoring 4X day Disp #*1 Kit Refills:*0
RX *lancets [BD Microtainer Lancet] 30 gauge use for glucose
monitoring Disp #*200 Each Refills:*0
4. Aspirin 81 mg PO DAILY
RX *aspirin 81 mg 81 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
5. Atorvastatin 80 mg PO QPM
RX *atorvastatin 80 mg 1 tablet(s) by mouth qpm Disp #*30 Tablet
Refills:*0
6. Bisacodyl 10 mg PR QHS:PRN Constipation - Second Line
7. Byetta (exenatide) 10 mcg/dose(250 mcg/mL) 2.4 mL
subcutaneous BID
RX *exenatide [Byetta] 10 mcg/0.04 mL per dose (250 mcg/mL) 2.4
mL 10 mcg twice a day Disp #*1 Syringe Refills:*0
8. Clopidogrel 75 mg PO DAILY
RX *clopidogrel 75 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
9. Gabapentin 300 mg PO TID
RX *gabapentin 300 mg 1 capsule(s) by mouth three times a day
Disp #*90 Capsule Refills:*0
10. GlipiZIDE 10 mg PO BID diabetes
RX *glipizide 10 mg 1 tablet(s) by mouth twice a day Disp #*60
Tablet Refills:*0
11. Isosorbide Mononitrate (Extended Release) 30 mg PO DAILY
RX *isosorbide mononitrate 30 mg 1 tablet(s) by mouth once a day
Disp #*30 Tablet Refills:*0
12. Lidocaine 5% Patch 1 PTCH TD QAM
13. LORazepam 0.5 mg PO BID:PRN anxiety
RX *lorazepam [Ativan] 0.5 mg 1 tablet(s) by mouth twice a day
Disp #*10 Tablet Refills:*0
14. melatonin 3 mg oral QHS
15. MetFORMIN (Glucophage) 1000 mg PO BID
RX *metformin [Fortamet] 1,000 mg 1 tablet(s) by mouth twice a
day Disp #*60 Tablet Refills:*0
16. Metoprolol Succinate XL 50 mg PO DAILY
RX *metoprolol succinate [Kapspargo Sprinkle] 50 mg 1 capsule(s)
by mouth once a day Disp #*30 Capsule Refills:*0
17. Milk of Magnesia 30 mL PO Q12H:PRN Constipation - Second
Line
18. Multivitamins 1 TAB PO DAILY
19. Nitroglycerin SL 0.3 mg SL Q5MIN:PRN chest pain
RX *nitroglycerin 0.4 mg 1 tablet(s) sublingually q5min Disp
#*15 Tablet Refills:*0
20. Pantoprazole 40 mg PO Q24H
RX *pantoprazole 40 mg 1 tablet(s) by mouth q24h Disp #*30
Tablet Refills:*0
21. Tamsulosin 0.4 mg PO QHS
RX *tamsulosin [Flomax] 0.4 mg 1 capsule(s) by mouth at bedtime
Disp #*30 Capsule Refills:*0
22. TraMADol 75 mg PO Q6H:PRN Pain - Moderate
RX *tramadol [Ultram] 50 mg 1.5 tablet(s) by mouth every six (6)
hours Disp #*30 Tablet Refills:*0
23.bedside Commode
Drop arm, no diagnosis: ambulatory dysfunction
physical function: good
length of need: 13 months
24.Standard Manual Wheelchair
Standard Manual Wheelchair, Seat and back cushion, Elevating
leg rests, Anti tip and brake extensions
Dx: Ambulatory dysfunction
Px: good
___ 13 months
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Diabetes, type II
Coronary artery disease
Anxiety
Knee osteoarthritis
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>Mr. ___,
You were admitted to the hospital for chest discomfort and
anxiety while at rehab. We made adjustments in your blood
pressure regimen to help in case the chest pain was due to heart
disease. We also adjusted your insulin regimen since you had
elevated blood sugars. You should continue your home regimen at
discharge.
Your urine studies revealed elevation in WBC concerning for a
urinary tract infection. You are prescribed 10 days of
Ciprofloxacin antibiotics.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Gabapentin 300 mg PO BID IN AM AND MID DAY
RX *gabapentin 300 mg 1 to 2 capsule(s) by mouth three times a
day Disp #*90 Capsule Refills:*0
2. Tizanidine 4 mg PO BID:PRN spasms
RX *tizanidine 4 mg 1 tablet(s) by mouth twice a day Disp #*20
Tablet Refills:*0
3. Acetaminophen 1000 mg PO Q8H
4. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
5. Docusate Sodium 100 mg PO BID
6. HYDROmorphone (Dilaudid) 4 mg PO Q6H:PRN ___ - Severe
7. Polyethylene Glycol 17 g PO DAILY:PRN constipation
8. Senna 8.6 mg PO BID:PRN constipation
Discharge Disposition:
Home
Discharge Diagnosis:
fluid collection of thoracic spine surgical bed
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 lumbar back ___ and left
lower extremity ___. Your discharge instructions are largely
unchanged since your recent hospitalization from ___ -
___.
Recent Surgery on ___
**you recently underwent complete removal of your spinal cord
stimulator (leads and pulse generator)on ___
**you subsequently underwent laminectomy from T8-T10 with
removal of scar and hematoma from the epidural space on ___
Your incision was closed with staples and sutures which were
removed on ___ while you were admitted.
--- ON ___ you underwent Ultra Sound guided aspiration of
your ___ fluid collection. 40ml of clear fluid was
removed and sent for culture and analysis. Your dressings to the
site of this aspiration have been removed, and your skin is
healing well.
Activity
You may gradually return to your normal activities, but we
recommend you take it easy for the next ___ hours.
Heavy lifting, running, climbing, or other strenuous exercise
should be avoided until your follow-up appointment.
You may take leisurely walks and slowly increase your activity
at your own pace. ___ try to do too much too soon.
Do not go swimming or submerge yourself in water for four
weeks
The dressing covering your incision(s) has been removed. You
may use a damp washcloth to remove any dried blood or iodine
from your skin but do not scrub directly on your incisions.
You may take a shower and get your incision wet but remember
to pat them dry afterwards.
___ and Medications
Resume your home ___ medications. Since you are already
prescribed ___ medicines and are followed by the ___ Clinic,
you should plan to resume your ___ Clinic home ___ medication
regimen. Prescriptions for gabapentin and tizanadine have been
provided to you following this admission per the recommendations
of the inpatient ___ Service. Please be sure to attend your
outpatient follow-up appointment with Dr. ___ as outlined
below.
You should use Acetaminophen (Tylenol) as well.
Do not take any anti-inflammatory medicines such as Motrin,
Aspirin, Advil, or Ibuprofen etc. until follow up.
What You ___ Experience:
Mild tenderness along the incisions.
Constipation is common. Be sure to drink plenty of fluids and
eat a high-fiber diet. If you are taking narcotics (prescription
___ medications), try an over-the-counter stool softener,
prescriptions for stool softener have also been provided to you.
Gabapentin, increasing dose:
---- You may up-titrate/increase your dose of gabapentin as
needed for ___. You are currently taking 300mg gabapentin in
the morning and mid day, with 600mg at bedtime. In ___ days if
you are not suffering from side-effects including increased
drowsiness, you may increase your morning dose to 600mg. In an
additional ___ days, if you are not suffering from side-effects
including increased drowsiness, you may increase your midday
dose to 600mg. Therefore in ___ days, you may increase your
dosing regimen to 600mg in the morning, midday, and at bedtime.
Do not increase your dose of gabapentin to greater than 600mg
three times a day.
Call Your Doctor at ___ for:
severe headache, or headaches that are worst when sitting up
or standing, and are better when laying flat.
Severe ___, swelling, redness or drainage from the incision
site.
Fever greater than 101.5 degrees Fahrenheit
Severe Constipation
Blood in your stool or urine
Nausea and/or vomiting
Extreme sleepiness
Severe headaches not relieved by ___ 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. Acetaminophen 325-650 mg PO Q6H:PRN pain/fever
2. Artificial Tears ___ DROP BOTH EYES DAILY
3. Atorvastatin 40 mg PO DAILY
4. Baclofen 5 mg PO TID spasm
5. Bisacodyl 10 mg PO/PR DAILY:PRN constipation
6. Citalopram 20 mg PO DAILY
7. FoLIC Acid 1 mg PO DAILY
8. Fondaparinux 2.5 mg SC DAILY
9. Ipratropium Bromide Neb 1 NEB IH Q6H:PRN wheeze, SOB
10. LACOSamide 200 mg PO BID
11. Polyethylene Glycol 17 g PO DAILY:PRN constipation
12. Pregabalin 50 mg PO DAILY
13. Pregabalin 150 mg PO QPM
14. Senna 1 TAB PO BID:PRN constipation
15. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB wheeze
16. Calcium Carbonate 500 mg PO QID:PRN GI upset
17. Guaifenesin ___ mL PO Q6H:PRN cough
18. Lorazepam 0.5 mg PO Q4H:PRN seizures
19. Multivitamins W/minerals 1 TAB PO DAILY
20. Omeprazole 20 mg PO DAILY
21. OxycoDONE (Immediate Release) ___ mg PO Q6H:PRN pain
22. TraZODone 25 mg PO HS insomnia
23. Vitamin D 1000 UNIT PO DAILY
24. Vancomycin 1000 mg IV Q 12H
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Confusion
Discharge Condition:
Discharge condition: fair
Mental status: back to baseline
Ambulatory status: activity as tolerated
Neuro exam: non-focal
Followup Instructions:
___ [/INST] </s><s>Dear Ms ___,
It was a pleasure taking care of you during your stay. You were
brought to the hospital because of confusion. We think your
confusion may be due to either an infection or seizure.
There are some medication changes:
- We ADDED VANCOMYCIN IV one gram every 12 hours for treatment
of urinay tract infection. The last dose will be on ___.
Please take the rest of your medications as previously
prescribed.
Please call your doctor or go to the nearest emergency room if
you experience any of the danger signs listed below</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amoxicillin 500 mg PO Q8H Duration: 7 Days
RX *amoxicillin 500 mg 1 capsule(s) by mouth three times a day
Disp #*25 Capsule Refills:*0
2. Atorvastatin 40 mg PO QPM
RX *atorvastatin 40 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
3. CARVedilol 3.125 mg PO BID
RX *carvedilol 3.125 mg 1 tablet(s) by mouth twice a day Disp
#*60 Tablet Refills:*0
4. Lisinopril 10 mg PO DAILY
RX *lisinopril 10 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
5. Spironolactone 25 mg PO DAILY
RX *spironolactone [Aldactone] 25 mg 1 tablet(s) by mouth once a
day Disp #*30 Tablet Refills:*0
6. Torsemide 30 mg PO DAILY
RX *torsemide 20 mg 1.5 tablet(s) by mouth once a day Disp #*45
Tablet Refills:*0
7. Vitamin A ___ UNIT PO DAILY
Continue to take your same home dose of Vitamin A
8. Acetaminophen 500 mg PO Q6H:PRN Pain - Mild/Fever
9. ___ Gold (pot bicarb-sod bicarb-cit ac)
344-1,050-1,000 mg oral Q6H:PRN
10. Combigan (brimonidine-timolol) 0.2-0.5 % ophthalmic (eye)
BID
11. FLUoxetine 5 mg PO DAILY
12. Loratadine 10 mg PO DAILY
13. Lumigan (bimatoprost) 0.01 % ophthalmic (eye) QHS
14. MetFORMIN (Glucophage) 1000 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
Bradycardic arrest
Vasovagal syncope
Heart Failure with Moderately Preserved EF
Diabetes Mellitus
Cirrhosis
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to the hospital because you lost consciousness
and required CPR during a dental procedure. You were found to
have decreased heart squeeze function, also called heart
failure. Please see below for more information on your
hospitalization. It was a pleasure participating in your care!
What happened while you were in the hospital?
- You received medicine through your IV to remove excess fluid
- You were seen by an allergist
What should you do after leaving the hospital?
- Please take your medications as listed below and follow up at
the listed appointments.
- Please weigh yourself every morning at the same time with the
same amount of clothing. If your weight goes up or down by more
than 3 lb in one day or 5 lb in one week, please contact your
doctor ___.
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. Fluticasone Propionate 110mcg 2 PUFF IH BID
2. Gabapentin 600 mg PO BID
3. Gabapentin 300 mg PO DAILY
4. HYDROmorphone (Dilaudid) ___ mg PO Q8H:PRN pain
5. Levothyroxine Sodium 112 mcg PO 6X/WEEK (___)
6. Levothyroxine Sodium 224 mcg PO 1X/WEEK (___)
7. Omeprazole 20 mg PO DAILY
8. Sertraline 100 mg PO DAILY
9. Ipratropium-Albuterol Neb 1 NEB NEB Q4H
10. Ipratropium Bromide MDI 2 PUFF IH Q6H:PRN shortness of
breath
11. Tiotropium Bromide 1 CAP IH DAILY
RX *tiotropium bromide [Spiriva with HandiHaler] 18 mcg 1 CAP
INH daily Disp #*30 Capsule Refills:*0
12. Levofloxacin 500 mg PO ONCE Duration: 1 Dose
Take on ___.
RX *levofloxacin [Levaquin] 500 mg 1 tablet(s) by mouth once
Disp #*1 Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
Recurrent aspiration
COPD exacerbation
New diagnosis of squamous cell carcinoma in lung (source
unclear)
Secondary:
Multiple lung nodules on CT concerning for malignancy
Chronic obstructive lung disease
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear. Ms. ___,
It was a pleasure taking part in your care at ___. You were
admitted becaue of low oxygen at home. You needed to have a
breathing tube to help you breathe. We found that one of the
lobes of your right lung was collapsed, which was most likely a
result of aspiration into that area. You were also treated with
antibiotics for possible pneumonia and steroids for possible
COPD exacerbation contributing to your symptoms. We were able to
take the breathing tube out quickly and you were stable on your
home oxygen of 4 Liters.
We discussed with you, as have prior physicians, that you
continue to apsirate will all food types. You wish to continue
to eat, and to reduce the risk of aspiration as much as we are
able, you can eat liquids that are nectar-thickened and pureed
foods.
You also had a biopsy of the mass in your left lung as an
outpatient, and the results showed cancer. This is most likely
lung cancer, and given that you have multiple spots in both
lungs, it is advanced. You should talk to your primary care
physician after discharge who will refer you to an oncologist.
The oncologist will discuss any further imaging that is
necessary. They will also discuss how to progress going forward,
but we did discuss with you that given your other illnesses,
chemotherapy options may be limited.
You were seen by physical therapy, who felt you were at your
baseline physical activity level and safe to return home with
your daughter and physical therapy at home.
We wish you the best,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>You were admitted to the hospital with confusion. This was most
likely due to dehydration and high sugar levels from your
steroids. Please continue to take all of your medications, we
have started you on insulin.</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. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN SOB
3. Albuterol Inhaler ___ PUFF IH Q4H:PRN Wheezing
4. Aspirin 121.5 mg PO DAILY
5. Bisacodyl 10 mg PR QHS
6. BuPROPion 150 mg PO BID
7. Chlorhexidine Gluconate 0.12% Oral Rinse 15 mL ORAL BID
8. ClonazePAM 1 mg PO QHS
9. Docusate Sodium 100 mg PO BID
10. Fleet Enema ___AILY:PRN constipation
11. Ipratropium Bromide MDI ___ PUFF IH Q4H:PRN wheeze
12. Ipratropium-Albuterol Neb 1 NEB NEB Q6H
13. Lactulose 15 mL PO DAILY
14. Mineral Oil ___ mL PO DAILY:PRN constipation
15. Multivitamins 1 TAB PO DAILY
16. OxycoDONE Liquid 15 mg PO Q4H:PRN Pain - Moderate
hold for increased sedation, resp. rate <8
17. Polyethylene Glycol 17 g PO DAILY
18. QUEtiapine Fumarate 25 mg PO BID
19. Senna 8.6 mg PO BID
20. Silver Sulfadiazine 1% Cream 1 Appl TP DAILY to left hand
eschar
21. Thiamine 100 mg PO DAILY
22. Verapamil 40 mg PO Q8H hold for SBP <90 or HR <60
hold for systolic blood pressure <110, hr <60
23. Simvastatin 10 mg PO QPM
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Trauma:
[] Bilateral lower long bone fractures
[] Bilateral, open, comminuted lower extremity wounds
[] Multiple pelvic fractures: comminuted fracture of the left
iliac wing and fractures of the left superior and inferior pubic
rami, with minimal diastasis of the left SI joint and pubic
symphysis
[] Subacute fractures of the right sixth and seventh ribs
posteriorly
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Bedbound.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to ___ for
bilateral lower extremity fractures and underwent Right tibial
and femoral nail, L tibia ORIF, tracheostomy, G-tube placement.
You are recovering well and are now ready for discharge. Please
follow the instructions below to continue your recovery:
General Surgery:
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.
Wound care instructions:
*For the left lower extremity you will need daily dressing
changes that consist of warm soap and water applied with 4x4
sterile gauze. This should be allowed to dry and followed by
thin layer of A&D ointment over which xeroform should be applied
over the wound. Next please take ___ sterile gauze 4x4's and
unfold them to create large area with multiple layers of
dressing. Place this over the xeroform bandages. Lastly, wrap
the extremity in Webril gauze.
*For the right lower extremity you will need daily dressing
changes that consist of xeroform applied to wounds followed by
___ sterile gauze 4x4's and unfold and layer them to create
large area with multiple layers of dressing. Lastly, wrap the
extremity in Webril gauze.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Omeprazole 20 mg PO DAILY
2. Simvastatin 20 mg PO DAILY
3. Amlodipine 5 mg PO DAILY
4. Carvedilol 25 mg PO BID
5. Furosemide 80 mg PO BID
6. Insulin SC
Sliding Scale
Fingerstick QACHS
Insulin SC Sliding Scale using HUM Insulin
7. Nephrocaps 1 CAP PO DAILY
8. PredniSONE 40 mg PO DAILY
9. sevelamer CARBONATE 800 mg PO TID W/MEALS
10. Calcium with Vitamin D (calcium carbonate-vitamin D3) 600
mg(1,500mg) -400 unit Oral daily
11. Aspirin 81 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
Chest pain
Hypertensive urgency
Kidney failure
Anemia
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 being part of your care team at ___. You
were evaluated for chest pain and kidney failure. Your chest
pain resolved shortly after arriving at the hospital and did not
return. We ran several tests to determine the cause of your
kidney failure and it appears to have occurred gradually over
the past few years. You will need to continue the dialysis
sessions which you started at the hospital three times/week and
follow up with your kidney doctor to discuss further management.
It was a pleasure taking care of you.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. albuterol sulfate 90 mcg/actuation HFA Aerosol Inhaler Sig:
Two (2) Inhalation every four (4) hours.
2. pravastatin 20 mg Tablet Sig: Two (2) Tablet ___
(___).
3. azathioprine 50 mg Tablet Sig: Three (3) Tablet ___
(___).
4. citalopram 20 mg Tablet Sig: 1.5 Tablets ___.
5. fentanyl 50 mcg/hr Patch 72 hr Sig: One (1) Transdermal Q72H
(every 72 hours): Please add 12 mcg patch as well.
6. fentanyl 12 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr
Transdermal Q72H (every 72 hours) for 1 doses: In addition to 50
mcg patch.
7. gabapentin 800 mg Tablet Sig: One (1) Tablet ___ three times a
day.
8. DuoNeb 0.5 mg-3 mg(2.5 mg base)/3 mL Solution for
Nebulization Sig: One (1) Inhalation every six (6) hours.
9. lansoprazole 30 mg Tablet,Rapid Dissolve, ___ Sig: One (1)
Tablet,Rapid Dissolve, ___ ___.
10. levothyroxine 25 mcg Tablet Sig: One (1) Tablet ___
(___).
11. metoclopramide 5 mg/5 mL Solution Sig: 2.5 mg ___ QIDACHS (4
times a day (before meals and at bedtime)).
12. morphine 10 mg/5 mL Solution Sig: Ten (10) mg ___ every six
(6) hours as needed for Mild pain.
13. morphine 10 mg/5 mL Solution Sig: ___ (25) mg ___
every six (6) hours as needed for pain.
14. Med
Mucomyst neb 300 mg q6 prn
15. potassium chloride 20 mEq Packet Sig: Two (2) ___ once a
day.
16. prednisone 10 mg Tablet Sig: ASDIR Tablet ___ once a day:
30mg ___ for two days, then 20 mg for two days, then 10 mg
___.
17. quetiapine 25 mg Tablet Sig: Four (4) Tablet ___
(___).
18. risperidone 1 mg Tablet Sig: One (1) Tablet ___ every six (6)
hours as needed for agitation.
19. sulfamethoxazole-trimethoprim 800-160 mg Tablet Sig: One (1)
Tablet ___ MWF (___).
20. trazodone 50 mg Tablet Sig: 0.5 Tablet ___ HS (at bedtime) as
needed for insomnia.
21. acetaminophen 650 mg/20.3 mL Solution Sig: One (1) ___ Q6H
(every 6 hours).
22. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
___.
23. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal
___.
24. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable
Sig: One (1) Tablet, Chewable ___ TID W/MEALS (3 TIMES A DAY WITH
MEALS).
25. Vitamin D3 1,000 unit Capsule Sig: One (1) Capsule ___ once a
day.
26. docusate sodium 50 mg/5 mL Liquid Sig: One (1) ___ BID (2
times a day).
27. senna 8.6 mg Tablet Sig: One (1) Tablet ___ BID (2 times a
day).
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary Diagnosis
Churg ___ syndrome
Chronic musculoskeletal pain
Secondary Diagnoses
COPD
Esophageal dysmotility
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
Thank you for coming to the ___
___. You were admitted because you were having shortness of
breath. We believe this is related to your churg ___
syndrome. We increased your prednisone dose. You will need to
taper the dose of prednisone and follow up with your
pulmonologist as directed. We are glad that you are feeling
better. We also increased the dose of your fentanyl patch and
adjusted the dose of morphine.
Medication recommendations
-Please take 30 mg prednisone ___ for 2 days then 20 mg ___
for two days then 10 mg ___ until you follow up with your
pulmonologist
-Please increase Fentanyl patch to 62 mg
-Please take ___ mg morphine Q6 hours as needed for pain</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Pravastatin 80 mg PO QPM
2. Pantoprazole 40 mg PO Q12H
3. Carvedilol 25 mg PO BID
4. Fish Oil (Omega 3) 1000 mg PO DAILY
5. garlic 2,000 mg oral DAILY
6. Sildenafil 20 mg PO DAILY:PRN erectile dysfunction
7. Aspirin 81 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
Gastrointestinal bleed
Diverticulosis
Anemia
Thrombocytopenia
SECONDARY DIAGNOSES:
Cardiomyopathy, non-ischemic
Ischemic stroke
Hypertension
Urinary incontinence
Erectile dysfunction
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you at ___
___. You were admitted because of blood in your
stool. Because your blood counts were low, you were treated in
the intensive care unit and given 4 units of blood. You
underwent an upper endoscopy, which showed erosions in the
stomach and small intestine, but no active bleeding. You also
underwent a colonoscopy, which showed diverticulosis. The exact
source of the bleeding was not found. Your bleeding stopped, and
your blood counts started to rise again. We added a new
medication to your list, pantoprazole, which will help prevent
future bleeding. We also temporarily stopped two of your blood
pressure medications, amlodipine and lisinopril, because your
blood pressure was normal in the hospital. We suggest that you
touch base with your primary care doctor about when to restart
these medicines. Finally, we started you on aspirin to help
prevent future strokes.
Best wishes,
Your ___ care team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 40 mg PO QPM
2. CARVedilol 25 mg PO BID
3. Lisinopril 20 mg PO QHS
4. amLODIPine 10 mg PO DAILY
5. Clopidogrel 75 mg PO DAILY
6. Isosorbide Mononitrate (Extended Release) 120 mg PO DAILY
7. Pantoprazole 40 mg PO Q24H
8. Tamsulosin 0.4 mg PO QHS
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS
Acute diastolic 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 Mr ___,
It was a pleasure taking care of you at ___
___.
WHY WAS I ADMITTED TO THE HOSPITAL?
- You were admitted to the hospital because you had shortness of
breath when exerting yourself.
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
- We found that you had too much fluid on your lungs. We gave
you medication to remove this fluid.
WHAT SHOULD I DO WHEN I GO HOME?
- You should continue to take your medications as prescribed.
- You should attend the appointments listed below.
- Please weigh yourself every day, and if your weight goes up by
more than 3 lbs, please call your doctor.
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. Allopurinol ___ mg PO DAILY
2. Aspirin 325 mg PO DAILY
3. Carvedilol 3.125 mg PO BID
4. Gabapentin 300 mg PO TID
5. GlipiZIDE 5 mg PO DAILY
6. Glargine 20 Units Breakfast
Glargine 20 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
7. Losartan Potassium 50 mg PO DAILY
8. Omeprazole 40 mg PO BID
9. Simvastatin 40 mg PO QPM
10. Thiamine 100 mg PO DAILY
11. Aquaphor Ointment 1 Appl TP TID:PRN breakdown to groin
RX *white petrolatum [Aquaphor with Natural Healing] 41 % 1
application three times a day Refills:*3
12. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin HCl 500 mg 1 tablet(s) by mouth q 12 hours
Disp #*14 Tablet Refills:*0
13. Fexofenadine 60 mg PO BID
RX *fexofenadine 60 mg 1 tablet(s) by mouth twice a day Disp
#*30 Tablet Refills:*2
14. Triamcinolone Acetonide 0.1% Cream 1 Appl TP BID
RX *triamcinolone acetonide 0.1 % Apply to rash on arm and legs
twice a day Refills:*2
15. Clotrimazole Cream 1 Appl TP BID
RX *clotrimazole 1 % Apply to groin twice a day Disp #*30 Gram
Gram Refills:*2
16. Clindamycin 300 mg PO Q8H
RX *clindamycin HCl 300 mg 1 capsule(s) by mouth q 8 hours Disp
#*21 Capsule Refills:*0
17. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain
RX *oxycodone 5 mg ___ capsule(s) by mouth q 4 to 6 hours Disp
#*30 Capsule Refills:*0
18. walker Use to remain weightbearing to R heel DAILY
RX *walker Use to remain weightbearing to R heel DAILY Disp #*1
Each Refills:*0
19. wheelchair Use for long distances miscellaneous DAILY
RX *wheelchair Use for long distances Daily Disp #*1 Each
Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
R foot 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>Dear Mr. ___,
It was a pleasure taking care of you at ___. You were admitted
to the Podiatric Surgery service due to a R foot infection. You
were given IV antibiotics while here and taken to the OR twice
for debridements. You are being discharged home with the
following instructions:
ACTIVITY:
There are restrictions on activity. Please remain weightbearing
to your R heel until your follow up appointment. Please do not
place weight on the front of your R foot. You should keep this
site elevated when ever possible (above the level of the heart!)
No driving until cleared by your Surgeon.
PLEASE CALL US IMMEDIATELY FOR ANY OF THE FOLLOWING PROBLEMS:
Redness ___ or drainage from your leg wound(s).
New pain, numbness or discoloration of your foot or toes.
Watch for signs and symptoms of infection. These are: a fever
greater than 101 degrees, chills, increased redness, or pus
draining from the incision site. If you experience any of these
or bleeding at the incision site, CALL THE DOCTOR.
Exercise:
Limit strenuous activity for 6 weeks.
No heavy lifting greater than 20 pounds for the next ___ days.
Try to keep leg elevated when able.
BATHING/SHOWERING:
You may shower immediately upon coming home, but you must keep
your dressing CLEAN, DRY and INTACT. You can use a shower bag
taped around your ankle/leg or hang your foot/leg outside of the
bathtub.
Avoid taking a tub bath, swimming, or soaking ___ a hot tub for 4
weeks after surgery or until cleared by your physician.
Both of your foot dressings will need to be changed daily. Can
apply betadine and a dressing
MEDICATIONS:
Unless told otherwise you should resume taking all of the
medications you were taking before surgery.
Remember that narcotic pain meds can be constipating and you
should increase the fluid and bulk foods ___ your diet. (Check
with your physician if you have fluid restrictions.) If you feel
that you are constipated, do not strain at the toilet. You may
use over the counter Metamucil or Milk of Magnesia. Appetite
suppression may occur; this will improve with time. Eat small
balanced meals throughout the day.
You were also given creams for your rash as well as a medication
called Fexofenadine to continue taking as your rash continues to
improve.
DIET:
There are no special restrictions on your diet postoperatively.
Poor appetite is not unusual for several weeks and small,
frequent meals may be preferred.
FOLLOW-UP APPOINTMENT:
Be sure to keep your medical appointments.
If a follow up appointment was not made prior to your discharge,
please call the office on the first working day after your
discharge from the hospital to schedule a follow-up visit. This
should be scheduled on the calendar for seven to fourteen days
after discharge. Normal office hours are ___
through ___.
PLEASE FEEL FREE TO CALL THE OFFICE WITH ANY OTHER CONCERNS OR
QUESTIONS THAT MIGHT ARISE.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO once a day.
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
Discharge Disposition:
Home
Discharge Diagnosis:
Primary:
severe microcytic anemia
iron deficiency
bradycardia
ulcerations near the ileo-colonic anastamosis
severe pulmonary hypertension
Secondary:
atrial fibrillation / atrial flutter
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 sent to the hospital because you had very low levels of
red blood cells (severe anemia). You likely have had a chronic
slow bleed from your gastrointestinal tract. You received blood
transfusions, and your blood levels remained stable. You were
also treated with IV iron because your body iron levels were
very low. You had two studies to find the location of this
bleed, which showed that you had ulcers near the part of your
colon that was operated on previously. There was some blood
oozing from these ulcers, which were cauterized to stop the
bleeding. After you had your studies, your condition was
discussed by Dr. ___ Dr. ___ felt that you should
go home on a baby aspirin daily and re-address your need for
blood thinners at you appointment with them next ___.
We have made the following changes to your medications:
Please STOP taking dabigatran (Pradaxa). Do not restart this
medication until instructed by your doctor.
Please START taking aspirin 81 mg tabs (enteric coated), 1 tab
by mouth daily.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amoxicillin 1000 mg PO Q8H Duration: 6 Days
RX *amoxicillin 500 mg 2 tablet(s) by mouth three times daily
Disp #*36 Tablet Refills:*0
2. Atorvastatin 20 mg PO QPM
RX *atorvastatin 20 mg 1 tablet(s) by mouth every evening Disp
#*30 Tablet Refills:*0
3. Sodium Bicarbonate 1300 mg PO BID
RX *sodium bicarbonate 650 mg 2 tablet(s) by mouth twice daily
Disp #*180 Tablet Refills:*0
4. Aspirin 81 mg PO DAILY
5. Levothyroxine Sodium 100 mcg PO DAILY
6. Metoprolol Succinate XL 25 mg PO DAILY
7. Mirtazapine 7.5 mg PO QHS
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Urinary tract infection
Sepsis
Metabolic acidosis
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 with a severe urinary tract infection with
sepsis. You were treated with fluids, antibiotics, and other
supportive medications and you improved. It was recommended you
go to rehab but you refused. You are being discharged home with
services at your request.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Gabapentin 600 mg PO QID
2. Omeprazole 40 mg PO BID
3. Quetiapine Fumarate 100 mg PO QHS
4. Vitamin D 1000 UNIT PO DAILY
5. Levofloxacin 750 mg PO DAILY Duration: 6 Days
RX *levofloxacin 750 mg 1 tablet(s) by mouth once a day Disp #*6
Tablet Refills:*0
6. BuPROPion 100 mg PO BID
7. Fluoxetine 20 mg PO DAILY
8. Outpatient Lab Work
please have labs drawn 1 week (CBC) and fax to PCP ___
___ (f) Dr. ___ ___ (p)
Discharge Disposition:
Home
Discharge Diagnosis:
community acquired pneumonia
anemia
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 complaints of chest pain,
fatigue, muscle aches and fevers. You were found to have a
pneumonia. You were treated with antibiotics and you improved.
You will be sent home to complete a 7 day course of antibiotics,
last dose should be on ___. Please see your PCP ___ ___
weeks of discharge.
.
Medication changes-see below</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Benzonatate 100 mg PO TID Cough
RX *benzonatate 100 mg 1 capsule(s) by mouth three times per day
as needed for cough Disp #*15 Capsule Refills:*0
2. Omeprazole 20 mg PO DAILY
RX *omeprazole 20 mg 1 capsule(s) by mouth in the morning before
you eat Disp #*30 Capsule Refills:*0
3. Ramelteon 8 mg PO QHS:PRN insominia
RX *ramelteon [Rozerem] 8 mg 1 tablet(s) by mouth at bedtime as
needed for insomnia Disp #*10 Tablet Refills:*0
4. CloNIDine 0.1 mg PO TID
Discharge Disposition:
Home
Discharge Diagnosis:
Salicylate Toxicity, resolved
Respiratory alkalsosis, anion gap metabolic acidosis, resolved
Community acquired pneumonia
Encephalopathy, improved
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 had
toxicity from taking too much aspirin.
WHAT WAS DONE FOR YOU?
- You presented to the hospital in respiratory distress and had
a breathing tube placed. You were initially in the medical
intensive care unit and you were treated for aspirin toxicity.
You fortunately suffered no serious consequences from aspirin
toxicity. You had some confusion during your hospital stay but
this improved significantly.
- You were treated for a pneumonia with antibiotics and these
were finished before you were discharged.
WHAT TO DO NEXT?
- Please take all of your medicines as instructed. Please
follow up with your primary care providers as scheduled.
- You were given prescriptions for cough medicine (pill called
tessalon pearls/benzonatate) to take as needed. You should also
try robitussin which you can buy at the local pharmacy at night
for your cough.
- You were started on a heart burn medicine called omeprazole.
It was a pleasure taking care of you,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Calcitrate-Vitamin D (calcium citrate-vitamin D3) 315-250
mg-unit oral DAILY
2. minoxidil 2 % topical DAILY
3. Prempro (conj estrog-medroxyprogest ace) 0.3-1.5 mg oral
DAILY
4. Ranitidine 75 mg PO BID
5. Spironolactone 200 mg PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Gallstone pancreatitis and 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 ___ with gallstone pancreatitis and also
gall stone cholecystitis. Your labs were with very elevated
lipase and LFTs. Due to your not having many symptoms and
imaging without evidence of a blockage at this time, it was
discussed that removal of your gall bladder is the best course
of action at this time.</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 privilege caring for you at ___
___.
WHY WAS I IN THE HOSPITAL?
- You came to the hospital because of abdominal pain.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- We performed imaging that showed that intestines were being
compressed from your cancer, causing obstruction.
- We gave you pain medication, and allow your intestines to
rest.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Continue to take all your medicines and keep your
appointments.
- Please ensure that you follow-up with the outpatient
oncologist next ___. This is absolutely essential.
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. Furosemide 80 mg PO BID
2. Levothyroxine Sodium 125 mcg PO 6X/WEEK (___)
3. Levothyroxine Sodium 62.5 mcg PO 1X/WEEK (___)
4. Acetaminophen 325 mg PO Q6H:PRN Pain - Mild/Fever
5. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN shortness of
breath/wheezing
6. Aspirin 81 mg PO DAILY
7. Atorvastatin 80 mg PO QPM
8. Bisacodyl 10 mg PR QHS:PRN constipation
9. Docusate Sodium 100 mg PO DAILY
10. Finasteride 5 mg PO DAILY
11. Iron Polysaccharides Complex ___ mg PO DAILY
12. Lactulose 15 mL PO DAILY
13. Lidocaine 5% Ointment 1 Appl TP QID
14. Lidocaine 5% Patch 1 PTCH TD QAM
15. Lidocaine 5% Patch 1 PTCH TD QAM
16. Midodrine 10 mg PO TID
17. Milk of Magnesia 30 mL PO DAILY:PRN constipation
18. Pantoprazole 40 mg PO Q12H
19. Potassium Chloride 40 mEq PO DAILY
20. ProAir HFA (albuterol sulfate) 90 mcg/actuation inhalation
Q4H:PRN wheezing/shortness of breath
21. Tamsulosin 0.4 mg PO QHS
22. Tiotropium Bromide 1 CAP IH DAILY
23. Warfarin 2.5 mg PO DAILY16
24. HELD- Allopurinol ___ mg PO DAILY This medication was held.
Do not restart Allopurinol until kidney function has normalized.
25. HELD- Gabapentin 100 mg PO QHS This medication was held. Do
not restart Gabapentin until kidney function normalizes.
26. HELD- Ranexa (ranolazine) 500 mg oral BID This medication
was held. Do not restart Ranexa until resolution of hypotension.
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSES:
=========================
Acute exacerbation of Chronic Diastolic Heart Failure
Acute kidney injury on chronic kidney disease
Severe aortic stenosis
Atrial fibrillation
Anemia
Hypothyroidism
Coronary artery disease
SECONDARY DIAGNOSES:
=========================
COPD
Peripheral neuropathy
Benign prostatic hypertrophy
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 taking care of you! You were admitted with
shortness of breath and cough. We determined that you were in
heart failure, a condition in which your heart does not pump
effectively. As a result fluid builds up throughout your body,
including in your lungs. We treated you with intravenous
diuretics to eliminate this fluid, and you improved.
Please take all medications as directed and try your best to
keep all of your scheduled appointments.
Please check your weights daily. If you gain greater than 3lbs
in 24hrs or 5lbs in 48hrs, please contact your doctor. Your
weight at discharge was 90.8 kg or 200 pounds.
We wish you the best!
Your ___ Cardiology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 1000 mg PO Q8H:PRN pain
2. Atenolol 50 mg PO BID
3. Donepezil 5 mg PO BID
4. Levothyroxine Sodium 50 mcg PO DAILY
5. Lidocaine 5% Ointment 1 Appl TP DAILY:PRN knee pain
6. Lorazepam 0.5 mg PO QHS:PRN insomnia
7. Omeprazole 20 mg PO DAILY
8. TraMADOL (Ultram) 50 mg PO BID:PRN knee pain
9. TraZODone 50 mg PO QHS:PRN insomnia
10. Azithromycin 250 mg PO Q24H Duration: 2 Days
RX *azithromycin 250 mg 1 tablet(s) by mouth daily Disp #*2
Tablet Refills:*0
11. iodoquinol-HC ___ % topical unknown
12. nystatin 100,000 unit/gram topical BID:PRN affected area
13. Patanol (olopatadine) 0.1 % ophthalmic BID
14. Triamcinolone Acetonide 0.1% Cream 1 Appl TP BID
15. Cefpodoxime Proxetil 400 mg PO Q12H Duration: 4 Days
RX *cefpodoxime 200 mg 2 tablet(s) by mouth every 12 hours Disp
#*16 Tablet Refills:*0
16. Furosemide 20 mg PO DAILY
RX *furosemide 20 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary Diagnosis:
Community Acquired Pneumonia
Pulmonary Edema
Acute exacerbation of 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 Ms. ___,
It has been a pleasure taking care of you at ___.
Why was I here?
- You were admitted for with cough and found to have a
pneumonia.
- You also had some fluid in your lungs.
What was done for me in the hospital?
- You were started on antibiotics for your pneumonia.
- You were given an IV medication to remove extra fluid from
your lungs and make you urinate more frequently. You will take
the same medication in a pill form when you go home. You will
get a new prescription for this medication (furosemide).
- You will have an ultrasound of your heart done on ___ at
10AM at ___
building. Please make sure you keep this appointment.
What should I do when I leave the hospital?
- You should take all of your medications.
- You should attend your appointments. Please bring someone with
you to your appointments who speaks both ___ and ___.
- Please weigh yourself every morning. If you gain more than
3lbs from the previous day, please call your doctor. If you
weigh more than 3lbs less than the previous day, do not take
your Lasix. Please record the days when you do not take your
Lasix.
Sincerely,
Your ___ Team
Estimada Sra ___,
Ha sido un placer cuidar de que en ___.
¿Por qué estaba aquí?
- ___ fue admitido para ___.
¿Qué se hizo para mí ___ hospital?
- ___ se iniciaron en los antibióticos para una pneumonía.
- Se ___ una medicación IV para eliminar el exceso de líquido
de ___ y te hacen orinar con más frecuencia.
- Tendrá una ecografía del corazón hecho el jueves a las 10 am
¿Qué ___ cuando ___ hospital?
- Debe tomar todos sus medicamentos.
- ___ debe asistir a sus citas. Por favor, que alguien lo
acompañe a sus citas que habla español e Inglés.
- Por favor, ___ mañana. Si ___ más de 3 libras
desde el día anterior, por favor ___ médico. Si ___
pesa más de 3 libras menos que el día anterior, no tome ___
Lasix. Por favor, ___ los días en ___ no ___ Lasix.
Sinceramente,
___ ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. PredniSONE 40 mg PO DAILY
RX *prednisone 20 mg 2 tablet(s) by mouth daily Disp #*6 Tablet
Refills:*0
2. Albuterol Inhaler 2 PUFF IH Q6H:PRN shortness of breath
3. Atorvastatin 20 mg PO QPM
4. Benzonatate 100 mg PO TID cough
5. Lisinopril 10 mg PO DAILY
6. Omeprazole 20 mg PO BID
Discharge Disposition:
Home
Discharge Diagnosis:
-Acute Asthma Exacerbation
-Acute Dyspnea
-ACS r/o
Discharge Condition:
Good
Alert and Oriented x3
Ambulatory without assistance
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
You were admitted to the hospital with shortness of breath
likely from an asthma flare. We treated you with nebulizers and
steroids and you got better day by day. When you leave the
hospital you should see Dr. ___ in clinic on ___ as
planned. You should continue an additional 3 days of oral
steroids upon discharge. You should have Pulmonary function
tests (PFTS) to formally diagnose your likely asthma. You should
continue to use your albuterol inhaler every 6 hours while you
feel short of breath. Dr. ___ will go over your Echo results
with you. It was a pleasure taking care of you.
Best Regards,
___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Levothyroxine Sodium 50 mcg PO 4X/WEEK (___)
3. Levothyroxine Sodium 75 mcg PO 3X/WEEK (___)
4. Quinapril 10 mg PO BID
5. Simvastatin 40 mg PO QPM
6. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis: benign positional paroxysmal vertigo
Secondary diagnoses: hypertension, hypothyroidism
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You were admitted to the hospital with dizziness. We got a CT
scan of your head which did not show any stroke. Your dizziness
was most likely from your vertigo.
Physical therapy evaluated you and felt that you'd benefit from
vestibular physical therapy (special therapy to help with your
dizziness).
If this does not help, please contact your doctor, as you might
want to try meclizine.
It was a pleasure caring for you!
We wish you the very best.
-- Your care team at ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atorvastatin 80 mg PO DAILY
2. Calcium Carbonate 500 mg PO QHS
3. Docusate Sodium 100 mg PO QAM
4. Senna 1 TAB PO HS
5. Vitamin D 1000 UNIT PO DAILY
6. Warfarin 5 mg PO DAILY16
7. LeVETiracetam 250 mg PO BID
RX *levetiracetam 250 mg Take 1 tablet by mouth twice daily Disp
#*30 Tablet Refills:*0
8. Citalopram 20 mg PO DAILY
9. Lisinopril 5 mg PO DAILY
10. QUEtiapine Fumarate 12.5 mg PO QHS:PRN sleep
Discharge Disposition:
Home With Service
Facility:
___
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 Ms. ___,
It was a pleasure taking care of you at the ___
___. You were admitted to the hospital
because you lost consciousness. We believe that you experienced
a seizure causing you do pass out. We started you on an
anti-seizure medication. Please go to all of your follow-up
appointments.
All the best,
Your ___ Team
- Atenolol was stopped during this hospitalization. Please
discuss with PCP whether to restart this. (Blood pressure was
low)
- Take warfarin 3mg today ___, then restart 5mg on ___</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Amoxicillin-Clavulanic Acid ___ mg PO Q12H
2. Ursodiol 500 mg PO BID
3. Ondansetron 4 mg PO Q8H:PRN nausea
4. Docusate Sodium 100 mg PO BID:PRN constipation
Discharge Disposition:
Home
Discharge Diagnosis:
Abdominal pain; suspected 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>Please call or come to the Emergency Room if you experience
fever (>101.5F) or chills, recurrent or worsening abdominal
pain, abdominal distension, bilious or bloody emesis, chest
pain, shortness of breath, blood per rectum, or any other
symptoms of acute concern.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. BuPROPion (Sustained Release) 100 mg PO Q12H
2. Gabapentin 800 mg PO TID
3. Symbicort (budesonide-formoterol) 160-4.5 mcg/actuation
inhalation BID
4. Ferrous Sulfate 325 mg PO TID
This medication can cause constipation. You can take a laxative
if this occurs.
RX *ferrous sulfate 325 mg (65 mg iron) 1 tablet(s) by mouth
three times a day Disp #*90 Tablet Refills:*0
5. Albuterol Inhaler 2 PUFF IH Q4H:PRN SOB
6. Amlodipine 5 mg PO DAILY
7. Cyanocobalamin 1000 mcg PO DAILY
8. estradiol-levonorgestrel 0.045-0.015 mg/24 hr transdermal
QWeekly
9. eszopiclone 1.5 mg oral QHS
10. Ipratropium-Albuterol Inhalation Spray 1 INH IH Q6H:PRN SOB
11. Metoprolol Succinate XL 50 mg PO DAILY
12. Naltrexone 50 mg PO QHS
13. Pantoprazole 40 mg PO Q24H
14. Amoxicillin-Clavulanic Acid ___ mg PO Q12H
END ___
RX *amoxicillin-pot clavulanate 875 mg-125 mg 1 tablet(s) by
mouth every twelve (12) hours Disp #*5 Tablet Refills:*0
15. Torsemide 30 mg PO DAILY
16. MetFORMIN XR (Glucophage XR) 1000 mg PO DAILY
Do Not Crush
RX *metformin 1,000 mg 1 tablet(s) by mouth daily Disp #*30
Tablet Refills:*0
17. TraZODone 50 mg PO QHS:PRN insomnia
RX *trazodone 50 mg 1 tablet(s) by mouth QHS:prn Disp #*15
Tablet Refills:*0
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary:
Acute diastolic congestive heart failure
Urinary tract infection
Diabetes Mellitus type 2
Anemia
Secondary:
Hypertension
COPD (on home O2 2.5L)
Fibrotic liver
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 ___ for lower leg swelling and 10
pound weight gain over the past couple of weeks. You were found
to have decompensated heart failure, which caused fluid to back
up and accumulate in your legs. We gave you furosemide and then
torsemide, which were effective in getting rid of that extra
fluid.
In the hospital, your lab tests showed that you have high
glucose levels, and they've been high for some time. You were
diagnosed with diabetes type 2 and given insulin here. When you
go home, you can take metformin for your diabetes. With
metformin, you do not need to monitor your blood glucose levels
daily. If you would like to learn more about your diagnosis,
there are also many helpful resources at ___
(___).
In addition, we found that you had a urinary tract infection,
which we treated with antibiotics. You also had low iron
levels, which caused anemia, and we gave you iron supplements.
When you go home, you will be started on several medications:
torsemide 30mg once a day for your heart (increased from your
original dose), metformin 1000mg once a day for diabetes,
Augmentin 875mg twice a day for the urinary tract infection
(last day ___, and iron supplements.
All of your medications are detailed in your discharge
medication list. You should review this carefully and take it
with you to any follow up appointments.
The details of your follow up appointments are given below.
It was a pleasure taking care of you.
Sincerely,
Your ___ Cardiology and Medicine Teams</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>Discharge Instructions:
INSTRUCTIONS AFTER ORTHOPAEDIC SURGERY:
- You were in the hospital for orthopedic surgery. It is normal
to feel tired or "washed out" after surgery, and this feeling
should improve over the first few days to week.
- Resume your regular activities as tolerated, but please follow
your weight bearing precautions strictly at all times.
ACTIVITY AND WEIGHT BEARING:
- Non weight bearing
MEDICATIONS:
- Please take all medications as prescribed by your physicians
at discharge.
- Continue all home medications unless specifically instructed
to stop by your surgeon.
- Do not drink alcohol, drive a motor vehicle, or operate
machinery while taking narcotic pain relievers.
- Narcotic pain relievers can cause constipation, so you should
drink eight 8oz glasses of water daily and take a stool softener
(colace) to prevent this side effect.
ANTICOAGULATION:
- No pharmacologic DVT prophylaxis necessary. Please ambulate as
much as possible to prevent blood clots
WOUND CARE:
- You may shower. No baths or swimming for at least 4 weeks.
- Any stitches or staples that need to be removed will be taken
out at your 2-week follow up appointment.
- Please remain in your dressing and do not change unless it is
visibly soaked or falling off.
- Splint must be left on until follow up appointment unless
otherwise instructed
- Do NOT get splint wet</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>======================
DISCHARGE INSTRUCTIONS
======================
Dear ___,
It was a pleasure caring for you at ___
___.
WHY WAS I IN THE HOSPITAL?
- You had an asthma exacerbation causing you to have difficulty
breathing.
WHAT HAPPENED TO ME IN THE HOSPITAL?
- You received multiple medications to treat the exacerbation
and make sure that your body was receiving adequate oxygen and
that your lungs improved so that it is safe for you to be at
home.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
- Continue to take all your medicines and keep your
appointments.
- Followup with your outpatient doctor in order to make sure you
are able to get all of your prescriptions and take them
faithfully. You are in the process of getting extra health
insurance that will cover more of your costs, and in the
meantime we have given you enough prescriptions to cover you
until then.
We wish you the best!
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: [/INST] </s><s>You were seen in the hospital for new abdominal pain. Imaging of
your abdomen was performed and showed a mass in the upper
portion of your left kidney. The shape of this mass is
concerning for kidney cancer. Following discharge, it is
important that you follow up in ___ clinic to discuss
treatment options for this mass. You may need further testing
and possibly surgery.
The urologists are in the process of arranging an appointment
for you in the ___. Someone should be in touch with
you soon about a date and time. IMPORTANT: If you have not heard
from someone in ___ by ___ at noon,
please call the clinic at ___ and ask about the status
of your appointment. It is important that you be seen in clinic
within ___ weeks of discharge.
It is possible the pain you experienced was due to a gallbladder
problem. If you experience recurrence of this pain, or have
nausea/vomiting or fevers/chills, we encourage you to call your
primary care doctor or proceed to the Emergency Room.</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 to care for you at the ___
___.
Why did you ___ to the hospital?
- You were found unconscious by staff at your assisted living
facility ___). Upon waking up, you were confused and
brought to the hospital for further evaluation.
What did you receive in the hospital?
- On presentation you were found to have a possible urinary
tract infection, and you were started on an IV antibiotic.
- Because you did not have any symptoms, we decided to stop the
antibiotic after 1 day.
- To make sure your heart didn't cause you to go unconscious, we
monitored your heart rhythm.
- Our physical therapists recommended that you go to rehab to
get stronger.
What should you do once you leave the hospital?
- You should follow up with your primary care provider which
will be arranged by the rehabilitation facility.
- If you notice any pain on urination, lightheadedness or
dizziness please return to the emergency department.
We wish you the ___!
Your ___ treatment team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed for Pain.
Disp:*25 Tablet(s)* Refills:*0*
2. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every
6 hours) as needed for Pain: Do not exceed 4000 mg per 24 hour
period.
3. levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
5. sertraline 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
6. zolpidem 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime)
as needed for Insomnia.
7. bupropion HCl 300 mg Tablet Extended Release 24 hr Sig: One
(1) Tablet Extended Release 24 hr PO once a day.
8. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO twice
a day: Take while requiring pain medication; discontinue with
loose bowel movements.
Disp:*60 Capsule(s)* Refills:*0*
9. senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day as
needed for constipation.
Disp:*60 Tablet(s)* Refills:*0*
Discharge Disposition:
Home
Discharge Diagnosis:
Acute cholecytitis
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 chest and abdominal pain
attributable to acute cholecytitis. You subsequently underwent
a laparascopic cholecystectomy and recovered in the hospital.
You are now preparing for discharge to home with the following
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. Acetaminophen 500 mg PO Q8H:PRN pain
2. Atenolol 50 mg PO DAILY
RX *atenolol 50 mg 1 tablet(s) by mouth daily Disp #*60 Tablet
Refills:*2
3. FoLIC Acid 1 mg PO DAILY
4. Lorazepam 0.5 mg PO BID:PRN nausea
5. Omeprazole 40 mg PO DAILY
6. Sulfameth/Trimethoprim DS 1 TAB PO 3X/WEEK (___)
7. Vitamin D 50,000 UNIT PO 1X/WEEK (SA)
8. Vitamin D 1000 UNIT PO DAILY
9. EPINEPHrine (EpiPEN) 0.3 mg IM ONCE MR1 Duration: 1 Dose
10. Magnesium Oxide 280 mg PO BID
11. MetFORMIN (Glucophage) 500 mg PO BID
12. Multivitamins W/minerals 1 TAB PO DAILY
13. Ondansetron 8 mg PO Q8H:PRN nausea
14. Potassium Chloride 10 mEq PO DAILY
15. TraMADOL (Ultram) 50 mg PO Q6H:PRN headache/ pain
RX *tramadol [Ultram] 50 mg 1 tablet(s) by mouth every 6hrs Disp
#*30 Tablet Refills:*0
16. Fexofenadine 120 mg PO DAILY
17. Acyclovir 400 mg PO Q8H
RX *acyclovir 400 mg 1 tablet(s) by mouth every 8 hrs Disp #*60
Tablet Refills:*2
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Hodgkins Lymphoma
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Ms. ___,
You were admitted because you had left side pain in the back of
your head and thighs. We were concerned about shingles due to
the type of pain you were having and the appearance of some
rashes on those regions. We did further biospy of the rash and
found out that this pain may be related to your chemotherapy
brentuximab. We were also concerned about the diarrhea you had
during your admission but this has seemed to resolve. We also
thought that the diarrhea may be related to your chemotherapy in
concert with other medications you are taking. We consulted with
neurology about your symptoms and it would be best if you follow
up with an outpatient neurology provider for further assessment
and management of this pain. We discussed with you taking
neurontin, lyrica or receiving injections to help alleviate your
pain and you did not want to do this at this time. We completed
further imaging of your head and neck today and your outpatient
provider, Dr. ___ follow up with you regarding the
results.
It was a pleasure taking care of you. Do not hesistate to
contact us if you have any questions or concerns about your
care. Please refer to below for follow up appointments with your
outpatient provider.</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Citalopram 20 mg PO DAILY
2. FoLIC Acid 1 mg PO DAILY
3. Furosemide 40 mg PO DAILY
4. Lactulose 15 mL PO TID
5. Midodrine 15 mg PO TID
6. Multivitamins 1 TAB PO DAILY
7. OLANZapine 5 mg PO QAM
8. OLANZapine 10 mg PO HS
9. Rifaximin 550 mg PO BID
10. Simethicone 40-80 mg PO QID:PRN gas
11. Spironolactone 50 mg PO QAM
12. Thiamine 100 mg PO DAILY
13. Zinc Sulfate 220 mg PO DAILY
14. Clindamycin 450 mg PO Q8H
RX *clindamycin HCl 150 mg 3 capsule(s) by mouth every 8hours
Disp #*57 Capsule Refills:*0
15. Calcium Citrate + D (calcium citrate-vitamin D3) 315-200
mg-unit oral BID
16. Ciprofloxacin HCl 500 mg PO Q24H
17. lidocaine 5 %(700 mg/patch) topical ONCE
18. Nepro Carb Steady (nut.tx.impaired renal fxn,soy) 0.08-1.80
gram-kcal/mL oral daily
19. HumaLOG Mix ___ (insulin lispro protam-lispro) 100 unit/mL
(75-25) SUBCUTANEOUS DAILY
45 units with breakfast
30 units with dinner
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
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. ___,
You were admitted to the hospital because you were confused and
having fevers. You were first admitted to the ICU because your
blood pressure was very low. The cause of your symptoms was a
skin infection of your right leg. You were started on
antibiotics and your symptoms revolved. We will send you home
with a antibiotics to take through ___. It is very
important that you follow up on the appointments listed below.
It was a pleasure to be a part of your care!
Your ___ treatment team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Fluticasone-Salmeterol Diskus (250/50) 1 INH IH BID
2. Lorazepam 2 mg PO Q8H:PRN anxiety
3. Sertraline 50 mg PO BID
4. traZODONE 100 mg PO HS
5. Albuterol Inhaler ___ PUFF IH Q6H:PRN SOB
6. DiphenhydrAMINE 50 mg PO Q8H
Please give dose 30 minutes prior to vancomycin doses to prevent
allergic reaction.
RX *diphenhydramine HCl [Allergy Medicine] 25 mg 2 tablet(s) by
mouth TID PRN itching Disp #*30 Tablet Refills:*0
7. Nicotine Patch 14 mg TD DAILY
RX *nicotine [Nicoderm CQ] 14 mg/24 hour 1 patch daily Disp #*28
Each Refills:*0
8. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin [Cipro] 500 mg 1 tablet(s) by mouth twice a
day Disp #*22 Tablet Refills:*0
9. Linezolid ___ mg PO Q12H
RX *linezolid [Zyvox] 600 mg 1 tablet(s) by mouth twice a day
Disp #*23 Tablet Refills:*0
10. Voriconazole 200 mg PO Q12H Duration: 12 Doses
RX *voriconazole 200 mg 1 tablet(s) by mouth twice a day Disp
#*22 Tablet Refills:*0
11. Outpatient Lab Work
CBC, Chem10, AST/ALT/Alk phos/T.bili twice a week
PLEASE FAX RESULTS TO ___ ID department at ___
Discharge Disposition:
Home
Discharge Diagnosis:
Severe Sepsis
Polymicrobial bacteremia
Fungemia
Discharge Condition:
mental status: alert, oriented, coherent, clear
ambulatory status: ambulates independently
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure taking part in your care at ___
___.
You were admitted for a an infection in your blood. There were
multiple different types of bacteria growing in your blood. It
is likely that the cause of this serious infection was
contamination of your PICC line. There was no evidence of any
abdominal infection, urinary tract infection, pneumonia, or any
other source of infection. Also, there is no evidence of
infection spreading to the heart based on the ultrasound of your
heart that you had performed while you were in the hospital. You
are being treated with three oral antibiotics, ciprofloxacin,
linezolid, and voriconazole. Your infection has improved
significantly during your admission and the oral antibiotics
have been working well. You should take these antibiotics until
___.
It is important that you go to a lab to have your blood drawn
twice a week. For your information, the results should be faxed
to the infectious disease department at ___
___.
I wish you all the best in the future, and a speedy recovery!</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Atenolol 25 mg PO DAILY
RX *atenolol 25 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*1
2. Torsemide 10 mg PO DAILY
3. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN wheezing, dyspnea
4. ALPRAZolam 1 mg PO QHS
5. Aspirin 81 mg PO DAILY
6. Atorvastatin 80 mg PO QPM
7. Bisacodyl 10 mg PO/PR DAILY
8. BuPROPion XL (Once Daily) 300 mg PO DAILY
9. HYDROmorphone (Dilaudid) 2 mg PO Q4H:PRN Pain - Moderate
10. Ipratropium-Albuterol Neb 1 NEB NEB Q6H wheezing, dyspnea
11. Levothyroxine Sodium 125 mcg PO DAILY
12. Lidocaine 5% Patch 3 PTCH TD QAM
13. Omeprazole 20 mg PO BID GERD
14. TiCAGRELOR 90 mg PO BID prevent stent thrombosis
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary diagnoses:
# Palpitations - frequent premature ventricular contractions
# Heart failure with recovered ejection fraction
Secondary diagnoses:
# Depression / anxiety
# Rib fracture secondary to CPR
# Hypertension
# Anemia
# Hypothyroidism
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 ___
___.
WHY WAS I ADMITTED TO THE HOSPITAL?
- You were admitted to the hospital because you had palpitations
and a 4 pound weight increase.
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
- You were monitored and found to have frequent extra beats.
Electrophysiology recommended increasing your beta-blocker
medication to better control your palpitations and continue to
use your heart monitor.
- You were initially started on a medication called
spironolactone for your heart failure, but this was stopped
after we increased your atenolol
WHAT SHOULD I DO WHEN I GO HOME?
- You should continue to take your medications as prescribed.
Please take 2 of your atenolol tablets (25mg total) until you
run out, and then use new prescription
- You should attend the appointments listed below.
- Weigh yourself every morning, call your doctor, or the
Heartline at ___ if your weight goes up more than 3
lbs.
- 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.
- Your discharge weight: 79.2kg. You should use this as your
baseline after you leave the hospital.
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. Docusate Sodium 100 mg PO BID
please hold for loose stool
3. Enoxaparin Sodium 30 mg SC Q12H Duration: 3 Weeks
Start: ___, First Dose: Next Routine Administration Time
RX *enoxaparin 30 mg/0.3 mL 30 mg SC every twelve (12) hours
Disp #*56 Syringe Refills:*0
4. LeVETiracetam 1500 mg PO BID
RX *levetiracetam 1,000 mg 1.5 tablet(s) by mouth twice a day
Disp #*30 Tablet Refills:*0
5. OxycoDONE (Immediate Release) ___ mg PO Q4H:PRN pain
do NOT drink alcohol or drive while taking this medication
RX *oxycodone 5 mg ___ tablet(s) by mouth every four (4) hours
Disp #*40 Tablet Refills:*0
6. Senna 8.6 mg PO BID:PRN constipation
7. Albuterol 0.083% Neb Soln 1 NEB IH Q4H:PRN SOB, wheezing
Discharge Disposition:
Home
Discharge Diagnosis:
Motor Vehicle Collision
Left 6th rib fracture
Left pneumothorax
Right acetabular fracture
Left impacted/comminuted distal radial fracture
Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - requires assistance or aid (walker
or cane).
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
You presented to ___ on ___ after suffering a motor
vehicle collision. You were found to have a rib fracture, left
lung puncture, a right hip fracture and a left radius fracture.
You were admitted to the Trauma/Acute Care Surgery team for
further medical treatment.
On admission, you were noted to have seizure activity and
Neurology was consulted. You were started on Keppra and it is
recommended you continue to take this medication for at least
the next 6 (six) months. Please do NOT drive for six months.
You have a follow-up appointment scheduled with the outpatient
Neurology clinic.
You were evaluated by the Orthopaedics and Plastics teams. On
___, you were taken to the Operating Room and underwent
surgery for your right hip fracture. On ___, you had
surgery to repair your left radius fracture. You tolerated
these procedures well.
You have worked with Physical and Occupational Therapy who
recommend your discharge to rehab. You are tolerating a regular
diet and your pain is controlled. You are now medically cleared
to be discharged to rehab to continue your recovery.
Please note the following discharge instructions:
* Your injury caused a left rib fracture which can cause severe
pain and subsequently cause you to take shallow breaths because
of the pain.
* You should take your pain medication as directed to stay ahead
of the pain otherwise you won't be able to take deep breaths. If
the pain medication is too sedating take half the dose and
notify your physician.
* Pneumonia is a complication of rib fractures. In order to
decrease your risk you must use your incentive spirometer 4
times every hour while awake. This will help expand the small
airways in your lungs and assist in coughing up secretions that
pool in the lungs.
* You will be more comfortable if you use a cough pillow to hold
against your chest and guard your rib cage while coughing and
deep breathing.
* Symptomatic relief with ice packs or heating pads for short
periods may ease the pain.
* Narcotic pain medication can cause constipation therefore you
should take a stool softener twice daily and increase your fluid
and fiber intake if possible.
* Do NOT smoke
* If your doctor allows, non-steroidal ___ drugs
are very effective in controlling pain ( ie, Ibuprofen, Motrin,
Advil, Aleve, Naprosyn) but they have their own set of side
effects so make sure your doctor approves.
* Return to the Emergency Room right away for any acute
shortness of breath, increased pain or crackling sensation
around your ribs (crepitus).
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. Azithromycin 250 mg PO DAILY Duration: 4 Doses
RX *azithromycin 250 mg 1 tablet(s) by mouth daily Disp #*3
Tablet Refills:*0
2. Fluticasone-Salmeterol Diskus (500/50) 1 INH IH BID
RX *fluticasone-salmeterol [Advair Diskus] 500 mcg-50 mcg/dose 1
INH IH twice a day Disp #*1 Disk Refills:*0
3. Tiotropium Bromide 1 CAP IH DAILY
RX *tiotropium bromide [Spiriva with HandiHaler] 18 mcg 1
capsule IH daily Disp #*30 Capsule Refills:*0
4. Albuterol Inhaler 1 PUFF IH Q6H:PRN SOB
5. alfuzosin 10 mg oral DAILY
6. amLODIPine 2.5 mg PO DAILY
7. Aspirin 81 mg PO DAILY
8. Atorvastatin 80 mg PO QPM
9. Furosemide 40 mg PO DAILY
10. Losartan Potassium 100 mg PO DAILY
11. Metoprolol Succinate XL 75 mg PO DAILY
12. Omeprazole 20 mg PO DAILY
13. Vitamin D 1000 UNIT PO DAILY
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY DIAGNOSES:
==================
Asthma
COPD exacerbation
Heart failure with preserved ejection fraction
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.
Followup Instructions:
___ [/INST] </s><s>Dear Mr. ___,
It was a pleasure taking care of you!
Why you were admitted:
-you had worsening shortness of breath and an exacerbation of
your chronic lung disease
What we did for you:
-We changed some of your medications to better treat your lung
disease.
Your next steps:
- Please complete your course of azithromycin antibiotics. It is
scheduled to end on ___.
- Please take all of your medications as prescribed.
- Please attend your scheduled follow-up appointments
- Weigh yourself every morning, call MD if weight goes up more
than 3 lbs.
We wish you the best!
Your ___ Medicine Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Ertapenem Sodium 1 g IV DAILY Duration: 8 Days
RX *ertapenem [Invanz] 1 gram 1 g IV daily Disp #*8 Vial
Refills:*0
2. Ethanol 70% Catheter DWELL (Tunneled Access Line) 2 mL DWELL
DAILY
3. Ethanol 70% Catheter DWELL (Tunneled Access Line) 2 mL DWELL
DAILY
Not for IV use. To be instilled into central catheter port for
local dwell
4. Ethanol Lock
Ethanol 70% Catheter DWELL (Tunneled Access Line) 2 mL DWELL
DAILY for 2 hours max per line
5. Ethanol Lock
Ethanol 70% Catheter DWELL (Tunneled Access Line) 2 mL DWELL
DAILY for 2 hours max per line
6. Fluconazole 400 mg IV Q24H
RX *fluconazole in NaCl (iso-osm) 400 mg/200 mL 400 mg IV once a
day Disp #*8 Intravenous Bag Refills:*0
7. Sodium Chloride 0.9% Flush 10 mL IV DAILY and PRN, line
flush
RX *sodium chloride 0.9 % 0.9 % 10 mL IV Daily Disp #*30 Syringe
Refills:*0
8. Heparin Flush (10 units/ml) 2 mL IV DAILY and PRN, line flush
RX *heparin lock flush (porcine) [heparin lock flush] 10 unit/mL
2 mL IV Daily Disp #*30 Syringe Refills:*0
9. BusPIRone 15 mg PO BID
10. Fentanyl Patch 25 mcg/h TD Q72H
RX *fentanyl 25 mcg/hour apply to skin one patch for 72 hours
Q72H Disp #*10 Patch Refills:*0
11. Lidocaine 5% Patch 2 PTCH TD QAM
12. Memantine 10 mg PO BID
13. Methylnaltrexone 12 mg SUBCUT EVERY OTHER DAY
14. Pyridostigmine Bromide Syrup 30 mg PO TID
15. HYDROmorphone (Dilaudid) 2 mg PO Q6H:PRN pain
RX *hydromorphone 2 mg 1 tablet(s) by mouth Q6H:PRN Disp #*80
Tablet Refills:*0
16. Metoprolol Succinate XL 100 mg PO DAILY
17. mucositis & stomatitis combo 1 10 ml oral QID:PRN mucosities
18. Pantoprazole 40 mg PO Q12H
19. vedolizumab 300 mg injection EVERY 2 WEEKS
20. Vivonex RTF (nut.tx.impaired digest fxn,soy) ___
gram-kcal/mL oral OTHER
Discharge Disposition:
Home
Discharge Diagnosis:
Primary Diagnosis:
================
Bacteremia
Fungemia
Secondary Diagnosis:
====================
Eosinophilic gastrointestinal disease
Peptic ulcer disease
Postural orthostatic tachycardia syndrome
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 treating you. You were admitted for a fever
and chills, and were found to have bacteria and fungus in your
blood stream. You were treated with antibiotics and antifungal
medications and your condition improved. Additionally, we
removed your Hickman line and replaced it with a new silicone
catheter on the right. We have also replaced your J tube. You
have been discharged with continued IV antibiotics, which you
must take until ___. It is imperative that you
continue to take these antibiotics, and that you followup with
your GI team and you PCP.
Thank you for allowing us to participate in your care.
Sincerely,
Your ___ Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Atorvastatin 40 mg PO QPM
3. Loratadine 10 mg PO DAILY
4. Mirtazapine 15 mg PO QHS
5. Omeprazole 20 mg PO DAILY
6. Tiotropium Bromide 1 CAP IH DAILY
7. Metoprolol Succinate XL 50 mg PO DAILY
RX *metoprolol succinate 50 mg 1 tablet(s) by mouth daily Disp
#*30 Tablet Refills:*0
8. Advair HFA (fluticasone-salmeterol) 230-21 mcg/actuation
inhalation BID
9. Albuterol Inhaler 2 PUFF IH Q6H:PRN dyspnea
10. Qvar (beclomethasone dipropionate) 80 mcg/actuation
inhalation DAILY
11. Lisinopril 5 mg PO DAILY
RX *lisinopril 5 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
12. Enoxaparin Sodium 80 mg SC DAILY
Start: ___, First Dose: Next Routine Administration Time
RX *enoxaparin 80 mg/0.8 mL 80 mg subcutaneous daily Disp #*15
Syringe Refills:*0
13. Warfarin 5 mg PO DAILY16
RX *warfarin 5 mg 1 tablet(s) by mouth daily Disp #*30 Tablet
Refills:*0
14. Furosemide 20 mg PO 3X/WEEK (___)
RX *furosemide 20 mg 1 tablet(s) by mouth 3 times a week (___)
Disp #*30 Tablet Refills:*0
15. Outpatient Physical Therapy
Straight Cane
Dx: Stress induced cardiomyopathy
Prognosis: good
Length of Need: 13 mo
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
PRIMARY:
==========
- Takotsubo (stress induced) cardiomyopathy
- COPD
SECONDARY:
===========
- Coronary artery disease
- hyperlipidemia
- GERD
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 ___
worsening shortness of breath.
WHAT HAPPENED DURING YOUR HOSPITAL STAY?
==========================================
- You were given medications to help you breath (nebulizers),
antibiotics due to initial concern for infection, and diuretics
to help you urinate.
- You were placed on a mask to help you breath. Lab tests showed
signs of heart dysfunction and an echo/ultrasound showed that
your heart was not pumping well. You were observed in the
cardiac intensive care unit overnight.
- Once your breathing improved with nebulizers and diuretics,
you were taken for a cardiac catheterization to evaluate the
vessels of the heart. Ultimately, there was mild to moderate
narrowing, but not enough to explain the changes. We believe
you have "stress induced cardiomyopathy" which can be treated
with medications.
- You were started medications to help your heart as well as a
blood thinner called Coumadin to help prevent strokes from this
heart dysfunction in the future.
- Once you were deemed stable on your new regimen you were
discharged.
WHAT SHOULD YOU DO FOLLOWING DISCHARGE?
=========================================
- You should take all of your medications as prescribed.
-- You should give yourself the Enoxaparin injections once a
day, until you are told to stop (once Coumadin levels are
appropriate).
- You should get blood draws to confirm Coumadin levels are
appropriate. These can be done at the ___
___. Please get your blood drawn next on ___.
- You should attend appointments with your PCP and cardiologist,
scheduled below.
It was a pleasure taking care of you during your hospital stay.
If you have any questions about the care you received, please do
not hesitate to ask.
Sincerely,
Your Inpatient ___ Cardiology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Fluticasone Propionate NASAL 2 SPRY NU BID
2. Glucagon 1 mg IM ONCE MR1 hypoglycemia protocol Duration: 1
Dose
3. Glucose Gel 15 g PO PRN hypoglycemia protocol
4. Ramelteon 8 mg PO QHS insomnia
5. Sodium Chloride Nasal ___ SPRY NU TID:PRN nasaldryness
6. Glargine 25 Units Breakfast
Glargine 25 Units Bedtime
Insulin SC Sliding Scale using HUM Insulin
7. Warfarin 10 mg PO DAILY16
8. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild/Fever
9. Aspirin 81 mg PO DAILY
10. Atorvastatin 40 mg PO QPM
11. Furosemide 80 mg PO QAM
12. Furosemide 40 mg PO QPM
13. Gabapentin 600 mg PO QHS
14. MetFORMIN XR (Glucophage XR) 1000 mg PO BID
15. Metoprolol Tartrate 50 mg PO BID
16. Omeprazole 40 mg PO BID
17. HELD- Metolazone 2.5 mg PO DAILY This medication was held.
Do not restart Metolazone until discussing with your doctor
18. HELD- Potassium Chloride 40 mEq PO TID This medication was
held. Do not restart Potassium Chloride until discussing with
your doctor
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Post- Polypectomy hemorrhage
Anemia
Delirium
S/P mechanical valve on Warfarin
Type 2 diabetes
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>================================================
Discharge Worksheet
================================================
Dear Mr. ___,
You came to ___ because you were having bloody bowel
movements. You received multiple units of blood and had two
colonoscopies with placement of clips. Your bleeding stopped and
you were started on a heparin drip for your mechanical valves
and started on your home dose of Coumadin. Once your INR was in
the therapeutic range your heparin was discontinued. Your blood
counts remained stable. You were also treated for congestive
heart failure which was likely caused by the blood transfusions.
Your insulin doses were decreased because you are eating less.
You should continue to monitor your sugars. You will be
discharged to rehab to improve your functional status.
It was a pleasure participating in your 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 650 mg PO Q6H:PRN Pain - Mild/Fever
Reason for PRN duplicate override: Alternating agents for
similar severity
2. Lansoprazole Oral Disintegrating Tab 30 mg PO DAILY
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
Aspiration pneumonia
Acute hypoxic respiratory failure
Discharge Condition:
Mental Status: Confused - sometimes.
Level of Consciousness: Alert and interactive.
Activity Status: Out of Bed with assistance to chair or
wheelchair.
Followup Instructions:
___ [/INST] </s><s>Dear Ms. ___,
It was a pleasure caring for you while you were admitted to ___
___.
WHY WERE YOU ADMITTED TO THE HOSPITAL?
You were having pain in your abdomen.
WHAT HAPPENED WHILE YOU WERE IN THE HOSPITAL?
- We put in a breathing tube to put a camera down into your
stomach
- We found that you have a large hernia of your stomach
- You received antibiotics and supportive treatment because you
were having trouble breathing after food went down the wrong
pipe (aspiration)
- Our speech therapists did tests to evaluate your safety for
eating and recommended a modified way of eating that will be
safer for your
WHAT SHOULD YOU DO WHEN YOU GO HOME?
- Eat ___ small meals daily
- Always stay upright for an hour after your meals
- Only eat food that has been pureed
Sincerely,
Your ___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Acetaminophen 650 mg PO Q6H:PRN Pain - Mild
2. Acetylcysteine 20% ___ mL NEB Q4H:PRN thick secreations
3. Bisacodyl 10 mg PR QHS:PRN constipation
4. DiphenhydrAMINE 50 mg IV Q6H:PRN allergic reaction
5. Docusate Sodium 100 mg PO BID
6. EPINEPHrine (EpiPEN) 0.3 mg IM Q1H:PRN allergic reaction
7. Heparin 2500 UNIT SC BID
8. Ipratropium Bromide Neb 1 NEB IH Q6H sob
9. Ipratropium-Albuterol Neb 1 NEB NEB Q6H:PRN SOB
10. Meropenem Desensitization 1000 mg IV Q8H
end ___
This is the maintenance dose to follow the last tapered dose
11. Miconazole Powder 2% 1 Appl TP TID:PRN excoriation
12. Ondansetron 4 mg IV Q8H:PRN nausea
13. Sarna Lotion 1 Appl TP QID:PRN itching
14. Senna 17.2 mg PO QHS
15. Sodium Chloride 0.9% Flush ___ mL IV DAILY and PRN, line
flush
16. Valproic Acid ___ mg PO QHS
17. amLODIPine 10 mg PO DAILY
18. Clopidogrel 75 mg PO DAILY
19. LevETIRAcetam 750 mg PO DAILY
20. LevETIRAcetam 500 mg PO QPM
21. Metoprolol Tartrate 150 mg PO DAILY
22. Sertraline 75 mg PO DAILY
23. TraMADol 50 mg PO TID W/MEALS
RX *tramadol 50 mg 1 tablet(s) by mouth TID W/MEALS Disp #*21
Tablet Refills:*0
Discharge Disposition:
Extended Care
Facility:
___
___ Diagnosis:
VP Shunt infection
Exposed shunt Hardware
Aspiration Pneumonitis
Dysphagia
Carotid Stenosis
Chronic Pressure Ulcer (present prior to admission)
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>Discharge Instructions
Ventriculoperitoneal Shunt Infection and Removal of shunt
Surgery
You had surgery to have your VP shunt removed. Your incisions
should be kept dry until sutures or staples are removed.
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
You have been discharged on Keppra (Levetiracetam) and Valproic
Acid. These medications help to prevent seizures. Please
continue these medication as indicated on your discharge
instruction. It is important that you take these medications
consistently and on time.
You have been discharged on Meropenem. This medication is for
treating infection. Please continue this medication as indicated
on your discharge instruction. It is important that this
medication is given consistently and on time, as you needed to
undergo desensitization to this medication.
You may use Acetaminophen (Tylenol) for minor discomfort if you
are not otherwise restricted from taking this medication.
What You ___ Experience:
Headache or pain along your incision.
Some neck tenderness along the shunt tubing.
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. Amlodipine 10 mg PO DAILY
2. CloniDINE 0.2 mg PO BID
3. HydrALAzine 100 mg PO Q6H
RX *hydralazine 100 mg 1 tablet(s) by mouth every six (6) hours
Disp #*90 Tablet Refills:*0
4. Isosorbide Mononitrate (Extended Release) 90 mg PO DAILY
RX *isosorbide mononitrate 30 mg 3 tablet extended release 24
hr(s) by mouth once a day Disp #*90 Tablet Refills:*0
5. Labetalol 400 mg PO TID
RX *labetalol 200 mg 2 tablet(s) by mouth three times a day Disp
#*180 Tablet Refills:*0
6. Lisinopril 40 mg PO DAILY
RX *lisinopril 40 mg 1 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
7. Simethicone 80 mg PO QID
RX *simethicone 80 mg 1 tab by mouth four times a day Disp #*30
Tablet Refills:*0
8. Torsemide 20 mg PO DAILY
RX *torsemide 20 mg 2 tablet(s) by mouth once a day Disp #*30
Tablet Refills:*0
9. Ciprofloxacin HCl 500 mg PO Q12H
RX *ciprofloxacin [Cipro] 500 mg 1 tablet(s) by mouth twice a
day Disp #*30 Tablet Refills:*0
10. MetRONIDAZOLE (FLagyl) 500 mg PO Q8H
RX *metronidazole [Flagyl] 500 mg 1 tablet(s) by mouth every
eight (8) hours Disp #*12 Tablet Refills:*0
11. OxycoDONE (Immediate Release) 5 mg PO Q6H:PRN pain
RX *oxycodone 5 mg 1 tablet(s) by mouth every six (6) hours Disp
#*15 Tablet Refills:*0
12. Aspirin 81 mg PO DAILY
13. Vitamin D 50,000 UNIT PO 1X/WEEK (___)
Discharge Disposition:
Home With Service
Facility:
___
Discharge Diagnosis:
Primary: Small bowel obstruction, hypertensive urgency, acute on
chronic kidney disease, Cryoglobulinemia
Secondary: hepatitis C, chronic systolic 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 ___,
___ was pleasure taking care of you at ___
___. You were initially admitted to the ICU for
treatment of your small bowel obstruciton (SBO) and very
elevated blood pressure. You underwent a surgical operation to
relieve your SBO, and you tolerated this procedure well. You
were able to eat and drink and have normal bowel movements prior
to discharge. While you were having your SBO, you also developed
some acute decrease in your kidney function. This gradually
improved as your condition improved.
You were found to have an infection in your belly called
peritonitis. For this you are on treatment with two antibiotics,
one called ciprofloxacin and one called flagyl. You will take
ciprofloxacin twice a day for 4 more days, then daily ongoing.
You will take flagyl three times per day for 4 more days, then
stop.
For treatment of your very elevated blood pressure you required
high doses of IV blood pressure medications. Your blood pressure
gradually decreased. You were transitioned to oral blood
pressure medicaitons prior to discharge. It appears that you
have very elevated blood pressure at baseline, and your blood
pressure was at your baseline prior to discharge. Please
continue to take these blood pressure medications after you are
discharged from the hospital. Also, please discuss with your PCP
if you require any additional work-up of your high blood
pressure as an outpatient. Despite your elevated blood pressure,
you did not have any symptoms. If you develop symptoms of
headache, vision changes, or any other symptoms that concern you
while your blood pressure is very elevated, please return to the
Emergency Department immediately.
For your cryoglobulinemia you were evaluated by the phresis
team. They felt that you would benefit from phresis treatments.
A large dialysis line was placed in your neck vein, and you were
started on phresis. You will need to follow up with your renal
doctors to determine if you need any additional treatments after
discharge.
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. Allopurinol ___ mg PO DAILY
2. Aspirin 81 mg PO DAILY
3. Carvedilol 25 mg PO BID
4. Ferrous GLUCONATE 324 mg PO DAILY
5. Fluticasone Propionate NASAL 2 SPRY NU DAILY:PRN congestion
6. Gabapentin 300 mg PO DAILY
7. HydrALAzine 50 mg PO TID
8. Isosorbide Dinitrate 40 mg PO Q8H
9. Simvastatin 20 mg PO DAILY
10. Sodium Bicarbonate 650 mg PO BID
11. Valsartan 160 mg PO BID
12. Vitamin D 50,000 UNIT PO 1X/WEEK (MO)
13. Amlodipine 5 mg PO DAILY
14. Clonidine Patch 0.3 mg/24 hr 1 PTCH TD QMON
15. Acetaminophen 1000 mg PO Q8H pain
Discharge Disposition:
Extended Care
Facility:
___
Discharge Diagnosis:
Primary
L4 burst fracture
Hypertensive Emergency/Urgency
Hypernatremia
Acute on chronic kidney injury
Discharge Condition:
Activity Status: Ambulatory - requires assistance or aid (walker
or cane) with LSO BRACE.
Level of Consciousness: Alert and interactive.
Mental Status: Clear and coherent.
Followup Instructions:
___ [/INST] </s><s>Dear ___,
___ were admitted after falling at home. ___ were found to have
a fracture(a break in the bone) of one of your back bones. ___
were seen by the bone surgeons and were given a brace(support
structure) to wear when out of bed. ___ were seen by our
physical therapy team who recommended continuing your care at a
rehabilitation facility. Your blood pressure was very elevated
and we increased the dose of your home valsartan/clonidine and
started ___ on amlodipine. Given some signs of kidney injury,
home lasix(water pill) held on discharge to rehab. The providers
at the rehabilitation facility will restart the water pill when
appropriate.
Sincerely,
___ Care Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Aspirin 81 mg PO DAILY
2. Atorvastatin 80 mg PO HS
3. Chlorthalidone 25 mg PO DAILY
4. Clopidogrel 75 mg PO DAILY
5. Diltiazem Extended-Release 180 mg PO DAILY
6. FoLIC Acid 1 mg PO DAILY
7. Isosorbide Mononitrate (Extended Release) 180 mg PO DAILY
8. Losartan Potassium 50 mg PO DAILY
9. Metoprolol Succinate XL 100 mg PO BID
10. Multivitamins 1 TAB PO DAILY
11. ranolazine 500 mg ORAL BID
12. Vitamin D 5000 UNIT PO DAILY
13. Lantus (insulin glargine) 40 units SUBCUTANEOUS QAM
14. Lantus (insulin glargine) 30 units SUBCUTANEOUS QPM
15. liraglutide 0.6 mg/0.1 mL (18 mg/3 mL) subcutaneous daily
16. MetFORMIN (Glucophage) 1000 mg PO QAM
17. MetFORMIN (Glucophage) 500 mg PO NOON
18. MetFORMIN (Glucophage) 1000 mg PO HS
Discharge Disposition:
Home
Discharge Diagnosis:
PRIMARY DIAGNOSIS:
Chest pain
SECONDARY DIAGNOSIS:
DM Type 2
HTN
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 chest pain. Your chest
pain resolved with medication and you had a cardiac
catheterization which showed no new blockages in the coronary
arteries of the heart, which is reassuring that your chest and
back pain is unlikely related to a new heart attack.
It is very important that you continue to take all your
medications as prescribed. All of your medications are detailed
in your discharge medication list. You should review this
carefully and take it with you to any follow up appointments.
The details of your follow up appointments are given below, for
primary care ___ and cardiology ___.
It was a pleasure taking care of you.
Sincerely,
Your ___ Cardiology Team</s> |
<s>[INST] <<SYS>> Act as a health expert <</SYS>> create discharge instructions of the following text: 1. Apixaban 5 mg PO BID
RX *apixaban [Eliquis] 5 mg 1 tablet(s) by mouth twice a day
Disp #*60 Tablet Refills:*0
2. Glargine 28 Units Bedtime
___ 10 Units Breakfast
___ 10 Units Lunch
___ 10 Units Dinner
Insulin SC Sliding Scale using HUM Insulin
RX *insulin glargine [Lantus Solostar U-100 Insulin] 100 unit/mL
(3 mL) AS DIR 28 Units before BED; Disp #*10 Syringe Refills:*0
RX *insulin lispro 100 unit/mL AS DIR Up to 10 Units each per
meal Disp #*10 Syringe Refills:*0
3. Omeprazole 40 mg PO BID
RX *omeprazole 40 mg 1 capsule(s) by mouth twice a day Disp #*60
Capsule Refills:*0
4. OxyCODONE (Immediate Release) 5 mg PO Q8H:PRN Pain -
Moderate Duration: 3 Doses
RX *oxycodone 5 mg 1 tablet(s) by mouth once a day Disp #*3
Capsule Refills:*0
5. Apixaban 10 mg PO BID DVT Duration: 5 Days
RX *apixaban [Eliquis] 5 mg 2 tablet(s) by mouth twice a day
Disp #*14 Tablet Refills:*0
6. Creon 12 6 CAP PO TID W/MEALS
RX *lipase-protease-amylase [Creon] 12,000 unit-38,000
unit-60,000 unit 6 capsule(s) by mouth TID with meals Disp #*540
Capsule Refills:*0
7. Gabapentin 300 mg PO TID
RX *gabapentin 300 mg 1 capsule(s) by mouth three times a day
Disp #*90 Capsule Refills:*0
8. Levothyroxine Sodium 75 mcg PO DAILY
RX *levothyroxine 75 mcg 1 tablet(s) by mouth once a day Disp
#*30 Tablet Refills:*0
9. Vitamin D ___ UNIT PO 1X/WEEK (TH)
RX *ergocalciferol (vitamin D2) 50,000 unit 1 capsule(s) by
mouth once a week Disp #*4 Capsule Refills:*0
Discharge Disposition:
Home
Discharge Diagnosis:
Primary diagnosis: duodenal ulcer
Secondary diagnosis: proximal iliofemoral 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. ___,
It was a privilege taking care of you at ___
___.
WHY WAS I ADMITTED TO THE HOSPITAL?
===================================
-Bloody diarrhea and bloody vomit
WHAT HAPPENED WHILE I WAS IN THE HOSPITAL?
==========================================
- You were given blood through a transfusion while you were in
the ICU because your red blood cell counts were low.
- Our gastroenterology team did an imaging study where they
looked inside your stomach with a camera to look for a source of
bleeding. During that procedure an ulcer was found in your
duodenum, which was likely the source of the bleeding and
stomach pain. You were started on a medication called
Pantoprazole to reduce the acid production in your stomach,
which should help the ulcer heal. You were also started on
another medication to help the ulcer heal, called sucralfate.
- Your blood sugar was very elevated on admission (over 900). We
started you on an insulin drip to bring down the sugar and
ketones in your blood while you were on the intensive care unit.
When you left the ICU, you were seen by the diabetes specialist
team who started you on a new insulin regimen for better blood
sugar control.
- Due to the pain you were having in your stomach, we started
you on a pain control regimen with acetaminophen and Oxycodone.
- You were found to have a large clot in your iliac and femoral
veins. You were started on an increased dose of the blood
thinner you were on before your GI bleed, called Apixaban.
WHAT SHOULD I DO AFTER I LEAVE THE HOSPITAL?
============================================
- Please continue to take all your medications and follow up
with your doctors at your ___ appointments.
- Please take the new insulin regimen prescribed to you by our
diabetes team
- Please take your increased dose of apixaban (10mg twice a day)
until the end of the day on ___. At this point you
will be transitioned to a lower dose (5mg twice a day)
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. LevETIRAcetam 2250 mg PO BID
RX *levetiracetam 750 mg 3 tablet(s) by mouth twice a day Disp
#*180 Tablet Refills:*2
2. Nitrofurantoin Monohyd (MacroBID) 100 mg PO Q12H Duration: 5
Days
RX *nitrofurantoin monohyd/m-cryst 100 mg 1 capsule(s) by mouth
twice a day Disp #*10 Capsule Refills:*0
3. OXcarbazepine 1200 mg PO QHS
RX *oxcarbazepine 600 mg 2 tablet(s) by mouth at night Disp #*60
Tablet Refills:*2
4. OXcarbazepine 900 mg PO QAM
RX *oxcarbazepine 300 mg 3 tablet(s) by mouth in the morning
Disp #*90 Tablet Refills:*2
5. FoLIC Acid 1 mg PO DAILY
6. Multivitamins 1 TAB PO DAILY
Discharge Disposition:
Home
Discharge Diagnosis:
Focal seizures
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 hospitalized because you had greatly increased seizure
frequency at home. This was likely caused by a combination of
your recent lack of sleep, your pregnancy, and a urinary tract
infection. Keppra was increased to 2250 mg twice a day.
Tripleptal was increased to 900 mg in the morning and 1200 mg at
night. You were seen to have multiple seizures overnight that
was recorded on the EEG monitor.
We strongly encouraged you to stay in the hospital for another
night for seizure monitoring while we are adjusting your
medication. Risks of undertreated seizures include prolonged
seizures, which can lead to breathing or heart problems, and
sometimes death (Sudden unexpected death in epilepsy patients).
You understood the risks of going home, despite our advice that
you stay for optimization of your seizure control. Please come
back to the hospital or go to the nearest ED if you experience
more than your typical seizures per day.
As you know, please avoid any activities that could be dangerous
if you were to have a seizure during them including but not
limited to swimming alone, cooking near a hot stove, operating
heavy machinery, driving for 6 months from most recent seizure
as per ___ law.
Sincerely,
Your ___ neurology team</s> |