Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Physical deconditioning, Prostate cancer metastatic, Tremor, Urinary retention, Urinary tract infection
Clinical narrative: Patient is a 82 y.o. male patient of MD admitted to HCF on 11/9/22 due to complaints of chills and weakness.    Per Admission Information: Patient is a 82 y.o. year-old male, who presented with chills and falls.  The history was obtained from the database and validated with the patient.  He is a 82 y.o. male who presents with a chief complaint of Chills and Fall.  Patient presents emergency department for generalized weakness and multiple falls since Saturday around 5 days ago.  Patient notes that he has had 2 falls since then.  Patient notes that one of the falls he did hit his forehead.  He notes that fall was about 4 days ago.  Patient denies headache, dizziness, nausea, vomiting, numbness, tingling, unilateral extremity weakness.  Patient denies worsening or increased cough and congestion.  Patient's family is at bedside and notes that he has a chronic cough as well as chronic diarrhea at baseline which has been unchanged.  Patient has had multiple hospital stays over the last several months and was recently discharged from a different HCF.  They note that the patient has had a steady decline since being discharged from his skilled nursing facility.Family notes that the patient has had a "tremor and shaking all over his body".  Patient states that it is because he feels cold all the time and he is shivering.  Patient notes that he has had a decubitus ulcer to the left buttock.   Hospital Course: Patient diagnosed with COVID-19 infection upon admission to hospital. Initial CXR showed slightly improved aeration at the lung bases; bilateral interstitial opacity persists which could be mild edema or atypical infection. Patient required 2L of O2 via NC initially, but is now on RA, which is his baseline. Patient on isolation until 11/19/22. Patient treated with IV Rocephin and IV Decadron. Patient initially hypoglycemic as well. All oral diabetic medications stopped and patient placed on sensitive SSI. BG has since normalized. Patient will restart Farxiga per home instructions upon discharge. Appetite has improved. Initial UA demonstrated UTI. UC showed E. Coli positive. Not susceptible to cipro. Will transition to oral macrobid. Patient completed three days of IV Rocephin. He will complete four days of macrobid for total of 7 days on antibiotics. He is encouraged to follow-up with his provider at office, whom he sees for his prostate cancer. Coumadin resumed at home dose. To follow with PCP on Monday for re-check of PT/INR and additional coumadin dosing. Patient seen by care manager. Will go home with HHC.    Patient in stable condition at time of discharge. Discharge education provided. Patient to follow-up with PCP on Monday.    Discharge Diagnoses: 1. Persistent hypoglycemia in setting of DM type 2 2. COVID-19 3. Deconditioning 4. Falls, multiple 5. DPU left coccyx POA 6. Morbid obesity BMI 41.44 7. Chronic Afib 8. Urinary retention 9. UTI, E. Coli 10. Follows at PCP office for metastatic prostate cancer (mets to bone and lymph) as well as malignant neoplasm of dome of urinary bladder.