Age: 86.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Osteopenia, Osteoporosis, Pathological fracture, Pneumonia viral, Polymyalgia rheumatica
Clinical narrative: 86 year old female with pmh htn who was admitted for covid 19, acute respiratory failure. Please see h and p for details.   The following issues were addressed:   1. Covid 19 virus infection/viral pneumonia - vaccinated - ct chest shows ground glass pulmonary infiltrates in a pattern highly suggestive of Covid 19 pneumonitis  - status post remdesivir - received iv hydrocortisone, transitioned to iv decadron while in hospital - will discharge on oral decadron to complete course - continue zinc, vit c - needs repeat imaging as outpatient with pcp to ensure resolution   2. Viral sepsis (temp 95.7, respiratory rate 25), poa - afebrile > past 24 hours   3. Acute hypoxic respiratory failure - will discharge on 1L at rest,   3. Acute hypoxic respiratory failure - will discharge on 1L at rest, 4L with ambulation as determined by walking oximetry   4. Polymyalgia rheumatica - on prednisone at time of admission - resume 1/16/22   5. Hypertension, uncontrolled - continue hydralazine, metoprolol, lisinopril, hctz - continue prn clonidine as outlined below - patient to monitor blood pressure at home - record, bring to appointment with pcp/discuss with virtual hospital - may need further adjustment of medications as outpatient with pcp   6. Anxiety - started prn hydroxyzine as outlined below   Dispo - PT recommends home health, will be arranged prior to discharge as well as virtual hospital   START taking these medications   Details benzonatate (TESSALON) 100 MG capsule Take 1 capsule by mouth 3 (three) times daily as needed for Cough.   cloNIDine (CATAPRES) 0.1 MG tablet Take 1 tablet by mouth 3 (three) times daily as needed (sbp >170 or dbp >100).   dexamethasone (DECADRON) 6 MG tablet Take 1 tablet by mouth daily with breakfast Take last dose on 1/15/22.   dextromethorphan polistirex ER (DELSYM) 30 MG/5ML liquid Take 5 mLs by mouth every 12 (twelve) hours as needed for Cough.   hydroCHLOROthiazide (HYDRODIURIL) 12.5 MG tablet Take 1 tablet by mouth daily.   hydrOXYzine (ATARAX) 10 MG tablet Take 1 tablet by mouth 3 (three) times daily as needed for Anxiety.   lisinopril (PRINIVIL) 40 MG tablet Take 1 tablet by mouth daily.   sennosides (SENOKOT) 8.6 MG TABS Take 1 tablet by mouth daily as needed (constipation).   vitamin C (VITAMIN C) 500 MG tablet Take 1 tablet by mouth daily.   zinc sulfate (ZINCATE) 220 (50 Zn) MG capsule Take 1 capsule by mouth daily.     CONTINUE these medications which have CHANGED   Details hydrALAZINE (APRESOLINE) 100 MG tablet Take 1 tablet by mouth every 8 (eight) hours.   metoprolol, TOPROL-XL, 25 MG 24 hr tablet Take 3 tablets by mouth daily.   predniSONE (DELTASONE) 1 MG tablet Take 6 tablets by mouth daily Resume 1/16/22.     CONTINUE these medications which have NOT CHANGED   B Complex CAPS Take 1 tablet by mouth daily.   Calcium Citrate-Vitamin D (CALCIUM CITRATE + D PO) Take 1 tablet by mouth daily    Cholecalciferol (VITAMIN D3) 2000 UNITS capsule Take 2,000 Units by mouth daily.   FIBER ADULT GUMMIES PO Take by mouth daily   ibandronate (BONIVA) 150 MG tablet Take 1 tablet by mouth every 30 (thirty) days.   Associated Diagnoses: Age-related osteoporosis with current pathological fracture, initial encounter   MAGNESIUM PO Take 1 tablet by mouth.   Multiple Vitamin (MULTIVITAMIN) tablet Take 1 tablet by mouth daily.   Omega-3 Fatty Acids (FISH OIL) 1000 MG CAPS Take 2,000 mg by mouth daily    Arthritis     NECK  Frequent PVCs 06/2018 Goiter colloid, toxic, nodular October 2015   Ultrasound and followed by biopsy. PATIENT DENIES THYROID ISSUES  H/O cardiovascular stress test 7/2012   DR.  History of chicken pox     MEASLES, MUMPS AS A CHILD History of fracture     RIGHT SMALL FINGER  History of pleurisy     1/9/14  Hypertension    Left bundle branch block (LBBB) 06/2018  Lumbar radiculopathy    LVH (left ventricular hypertrophy) 06/2018   Echocardiogram mild mitral aortic regurgitation  Mobitz type 1 second degree AV block 06/2018  Nocturnal leg cramps    Obstructive sleep apnea     Hypoxia  uses CPAP  Osteopenia    PVC (premature ventricular contraction) 03/2017  Renal cell cancer (CMS/HCC) 2014  Varicose veins