Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Essential hypertension, Hyponatraemia, Mental status changes, Metabolic encephalopathy, Procalcitonin increased
Clinical narrative: Admit Date:  6/24/2022   Discharge Date:   6/28/2022   Discharge Diagnosis:  Principal Problem:   Metabolic encephalopathy Active Problems:   Hyponatremia   Alcoholism   COVID-19 virus infection   Essential hypertension   Type 2 diabetes mellitus without complication     Hospital Course:  77 year old male was admitted for mental status changes from severe hyponatremia from beer potomania. He also tested (+) for Covid-19 infection. Procalcitonin was elevated on admission and he was given empiric antibiotics for SIRS. He was monitored with CIWA protocol. Na gradually improved to 135 today. He remains asymptomatic. He had received Covid-19 vaccine booster previously. He was not hypoxic. He was discharged home today in stable condition. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.9 °F (36.6 °C) Heart Rate (Monitor): 122 Pulse: 100 BP: (!) 139/99 Respirations: 17 SpO2: 99 % O2 Flow Rate (l/min): 0 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: no edema Neuro: alert, normal strength and tone    Consults:  CONSULT ED SOCIAL WORK IP CONSULT TO NEPHROLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO SOCIAL WORK IP CONSULT TO WELLNESS RECOVERY APRN   Significant Diagnostic Studies:   CT chest   Operations: none   Disposition:  Home    Discharge Condition:  Fair    Discharge Medications:   Discharge Medication List as of 6/28/2022 11:02 AM   START taking these medications   Details fluconazole (DIFLUCAN) 100 mg tablet Take 1 Tablet by mouth Once Daily for 3 days., Disp-3 Tablet, R-0, Normal   phosphorus (K PHOS NEUTRAL) 250 mg Take 1 Tablet by mouth Three times a day for 7 days., Disp-21 Tablet, R-0, Normal     CONTINUE these medications which have NOT CHANGED   Details cholecalciferol, vitamin D3, (VITAMIN D3) 400 unit Tab tablet Take 1 Tablet by mouth Once Daily., Disp-30 Tablet, R-0, Normal   glipiZIDE (GLUCOTROL) 5 mg ER tablet Take 1 Tablet by mouth Every morning., Disp-30 Tablet, R-0, Print   multivitamin with folic acid (THERA) tablet Take 1 Tablet by mouth Once Daily., Disp-30 Tablet, R-0, Print   tamsulosin (FLOMAX) 0.4 mg capsule Take 1 Capsule by mouth Once Daily., Disp-30 Capsule, R-0, Print   apixaban (ELIQUIS) 5 mg tablet Take 5 mg by mouth Twice a day., Historical Med   atorvastatin (LIPITOR) 20 mg tablet Take 20 mg by mouth At bedtime., Historical Med   traZODone (DESYREL) 100 mg tablet Take 100 mg by mouth At bedtime., Historical Med   sacubitriL-valsartan (ENTRESTO) 24-26 mg per tablet Take 1 Tablet by mouth Twice a day., Disp-60 Tablet, R-5, Normal   carvediloL (COREG) 3.125 mg Take 1 Tablet by mouth Twice a day., Disp-60 Tablet, R-5, Normal   folic acid (FOLVITE) 1 mg tablet Take 1 Tablet by mouth Once Daily., Disp-90 Tablet, R-3, Normal   busPIRone (BUSPAR) 30 mg tablet Take 1 Tablet by mouth Twice a day., Disp-60 Tablet, R-3, Normal   famotidine (PEPCID) 20 mg tablet Take 1 Tablet by mouth Twice a day., Disp-60 Tablet, R-2, Normal   dapagliflozin (FARXIGA) 10 mg tablet Take 1 Tablet by mouth Every morning., Disp-30 Tablet, R-3, Normal   magnesium chloride (SLOW-MAG) 64 mg DR tablet Take 1 Tablet by mouth Twice a day., Disp-60 Tablet, R-0, Print   DULoxetine (CYMBALTA) 30 mg DR capsule Take 1 Capsule by mouth Daily., Disp-30 Capsule, R-3, Normal   QUEtiapine (SEROQUEL) 100 mg tablet Take 1 Tablet by mouth At bedtime., Disp-30 Tablet, R-3, Normal   albuterol (VENTOLIN HFA) 90 mcg/Actuation inhaler Take 2 Puffs by inhalation Every 4 hours as needed (wheezing)., Disp-1 Each, R-3, Normal   potassium chloride (KLOR-CON) 10 mEq tab Take 1 Tablet by mouth Daily., Disp-30 Tablet, R-3, Normal   thiamine mononitrate 100 mg tablet Take 1 Tablet by mouth Daily., Disp-90 Tablet, R-11, Normal   aspirin 81 mg chewable tablet Take 1 Tablet by mouth Daily., Disp-30 Tablet, R-11, Normal     STOP taking these medications     amoxicillin (AMOXIL) 500 mg capsule Comments:  Reason for Stopping:        Lactobacillus rhamnosus GG (CULTURELLE) 15 billion cell sprinkle capsule Comments:  Reason for Stopping:        polyethylene glycol 3350 (MIRALAX) 17 gram packet Comments:  Reason for Stopping:        Bumetanide 2 mg tablet Comments:  Reason for Stopping: