Age: 78.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pleural effusion, Respiratory failure, SARS-CoV-2 test positive, Septic shock, Urinary tract infection
Clinical narrative: Discharge Diagnosis: Principal Problem:   Severe sepsis Active Problems:   UTI (urinary tract infection)   Essential hypertension   Type 2 diabetes mellitus with stage 2 chronic kidney disease, without long-term current use of insulin   Chronic combined systolic and diastolic heart failure       HPI:    Hospital Course: Patient was admitted with severe septic shock secondary to UTI and covid positive with respiratory failure due to CHF and what appears to be early ards.  He was progressed to need for intubation however he was DNR and family was called and agreed to honor his wishes.  He was transitioned to comfort care and passed.     TOD 1220. Cause of death, septic shock uti, CHF, COVID.        Consults:   None   Significant Diagnostic Studies:    Narrative & Impression PROCEDURE INFORMATION:  Exam: XR Chest  Exam date and time: 7/30/2022 2:06 AM  Age: 78 years old  Clinical indication: Shortness of breath  TECHNIQUE:  Imaging protocol: Radiologic exam of the chest.  Views: 1 view.  COMPARISON:  CR XR PORTABLE CHEST 7/15/2022 1:50 PM  FINDINGS:  Tubes, catheters and devices: Left-sided chest wall pacing device.  Lungs: See "Pleural spaces" finding.  Pleural spaces: Left basilar opacity, probably combination of pleural effusion  and adjacent atelectasis/consolidation.  Heart/Mediastinum: Stable enlargement of cardiac silhouette.  Bones/joints: Median sternotomy.  IMPRESSION IMPRESSION:  Left basilar opacity, probably combination of pleural effusion and adjacent  atelectasis/consolidation. Recommend imaging follow-up until complete  resolution.  THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED.         Disposition:  deceased    Discharge Condition:  deceased   Discharge Medications and Orders:   Current Discharge Medication List   CONTINUE these medications which have NOT CHANGED   Details rivaroxaban (XARELTO) 20 mg tablet Take 1 Tablet by mouth Once Daily. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: PAF (paroxysmal atrial fibrillation)   melatonin 10 mg Cap Take 1 Capsule by mouth.   hydrocortisone 2.5 % lotion Applied to lower legs and hands twice a day sparingly Qty: 240 mL, Refills: 1   Associated Diagnoses: Eczema, unspecified type   potassium chloride SA (KLOR-CON) 20 mEq tablet Take 1 Tablet by mouth Daily. Qty: 30 Tablet, Refills: 11   Associated Diagnoses: Hypokalemia   simvastatin (ZOCOR) 40 mg tablet Take 1 Tablet by mouth At bedtime. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: Pure hypercholesterolemia; Coronary artery disease due to lipid rich plaque   furosemide (LASIX) 40 mg tablet Take 1.5 Tabs by mouth Daily. Qty: 145 Tablet, Refills: 3   Associated Diagnoses: Acute on chronic systolic CHF (congestive heart failure)   glimepiride (AMARYL) 2 mg tablet Take 1 Tablet by mouth Every morning. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: Non-insulin dependent type 2 diabetes mellitus   carvediloL (COREG) 12.5 mg tablet Take 1 Tablet by mouth Twice a day. Qty: 180 Tablet, Refills: 3   Associated Diagnoses: Chronic combined systolic and diastolic heart failure; Essential hypertension   lisinopriL (PRINIVIL) 20 mg tablet Take 1 Tablet by mouth Daily. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: Essential hypertension   blood sugar diagnostic (ONETOUCH ULTRA TEST) test strips by Other route Daily. Qty: 50 Strip, Refills: 5   Associated Diagnoses: Type 2 diabetes mellitus with hyperglycemia   multivitamin (THERAGRAN) tablet Take 1 Tab by mouth Daily. Qty: 30 Tab, Refills: 0   Associated Diagnoses: Ventricular tachycardia   aspirin (ASPIRIN) 325 mg tablet Take 1 Tab by mouth Daily. Qty: 60 Tab, Refills: 5