Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Pyrexia, Relapsing multiple sclerosis, Sepsis
Clinical narrative: Date of Admission: 12/13/2023   Date of Discharge: 12/19/2023   Issues to be Addressed at Follow-up: --Weaning of oxygen --Completion of dexamethasone --Isolation to end 12/21/23 --Follow up LFT's, CBC, Chem 7 --Chest Xray in 6 weeks    Pending Study Results at Discharge:  Unresulted Lab Orders    No orders found from 11/21/2023 to 12/22/2023.       Final Diagnoses:  Active Hospital Problems   Diagnosis   ? (Principal) SEPSIS WO ACUTE ORGAN DYSFUNCTION   ? ACUTE RESPIRATORY FAILURE   ? COVID-19 DISEASE   ? NONPROGRESSIVE RELAPSING MULTIPLE SCLEROSIS   ? OBSTRUCTIVE SLEEP APNEA       Date: 1/20/2021  Study Type: WatchPAT  pAHI: 56.9  BMI: 46.35   ESS: 3  Min SpO2: 84% SpO2<90%: 2.2 minutes  Severe Sleep Apnea.   ? HTN (HYPERTENSION)   ? SEVERE OBESITY (BMI >= 40)   ? HYPOTHYROIDISM         Discharge Disposition:  Home   Medications, instructions, follow up information: See patient Discharge Instructions/AVS.   Hospital Course and Significant Findings:               The patient is 45F with Hx of nonprogressive relapsing MS, hypertension, OSA, hypothyroidism and obesity who presented to Facility with fever, cough and shortness of breath and admitted for the management of COVID infection. Initially symptoms started 11/30 however initial tests negative at home.  Emprically treated with antibiotics. Completed 5 days of RDV. Oxygen demands reduced to 2 L NC.                Seen by PT               Transitioned to home care with temporary oxygen HHPT/RN. She will wean off oxygen outpatient.    Procedures:  CXR     Reason for Hospital Admission (Admitting Diagnosis):  Acute Respiratory Failure   Complications: none   Consults:  HOSPITAL MEDICINE - INITIAL INPATIENT CONSULTATION. HOSPITAL MEDICINE - ONGOING INPATIENT CONSULTATION. Smoker: No.   Condition on Discharge: stable   Code Status at Time of Discharge: Data unavailable       Note Details  Author  (D.O.) File Time 12/21/2023  9:13 PM Author Type PHYSICIAN (D.O.) Status Signed Last Editor  (D.O.) Specialty Hospital Medicine Hospital Acct #   Admit Date 12/13/2023  ED to Hosp-Admission (Discharged) on 12/13/2023  ED to Hosp-Admission (Discharged) on 12/13/2023   Detailed Report  Note shared with patient Additional Orders and Documentation   Results Imaging   Meds    Orders    Flowsheets   Encounter Info:  History, Allergies, Education, Care Plan, Detailed Report   Hospital Problem List   HYPOTHYROIDISM  SEVERE OBESITY (BMI >= 40)  HTN (HYPERTENSION)  OBSTRUCTIVE SLEEP APNEA  NONPROGRESSIVE RELAPSING MULTIPLE SCLEROSIS  SEPSIS WO ACUTE ORGAN DYSFUNCTION  ACUTE RESPIRATORY FAILURE  COVID-19 DISEASE Care Timeline  12/13   Admitted from ED 2356 12/19   Discharged 1330  Discharge   Home with Home Health   Discharge Instructions (AVS) (Printed 12/19/2023) Medication List at Discharge   acetaminophen 500 mg Take 1 to 2 tablets by mouth every 6 hours as needed for pain or fever. Do not exceed 6 tablets in 24 hours  benzonatate 100 mg Oral 3 TIMES A DAY AS NEEDED  cefpodoxime proxetil 200 mg Oral 2 TIMES A DAY  cyclobenzaprine HCl 10 mg Oral EVERY BEDTIME, And 1/2 tablet by mouth daily in the morning  dalfampridine 10 mg Take 1 tablet by mouth every 12 hours . Do not divide, crush, chew or dissolve tablets  dexamethasone 6 mg Oral DAILY  doxycycline monohydrate 100 mg Oral EVERY 12 HOURS  escitalopram oxalate 10 mg Oral DAILY  famotidine 20 mg Oral 2 TIMES A DAY  fluoride (sodium) 1.1 % Brush with a thin ribbon before bed. Floss and spit out. Do not rinse.  gabapentin 300 mg Oral EVERY BEDTIME  guaifenesin/dextromethorphan 10-100 mg/5 mL 10 mL Oral EVERY 4 HOURS AS NEEDED, for chest congestion. Do not exceed 6 doses in 24 hours  hydroxyzine HCl 25 mg Oral EVERY BEDTIME AS NEEDED  ibuprofen 800 mg Oral EVERY 6 HOURS AS NEEDED  ipratropium/albuterol sulfate 0.5 mg-3 mg(2.5 mg base)/3 mL 3 mL NEBULIZATION -UNSPEC EVERY 6 HOURS, (3 mL = 1 vial) as needed for shortness of breath or wheezing  levothyroxine sodium 150 mcg Oral DAILY  meloxicam 7.5 mg TAKE 1 TABLET ORALLY DAILY FOR 5 DAYS, THEN  1 TABLET ORALLY DAILY  AS NEEDED FOR PAIN. TAKE WITH FOOD  nebivolol HCl 10 mg Oral DAILY  ondansetron 4 mg Dissolve 1 tablet in mouth every 8 to 12 hours as needed for nausea or vomiting