Age: 101.0
Sex: F
Vaccine: COVID19
Symptoms: Hypoacusis, Mobility decreased, Protein urine present, Pyrexia, Rhinorrhoea
Clinical narrative: COVID+ 12/23/22  Vaccination Status - J&J x2 No d/c summary available at this time. 12/23/22 H&P:  CHIEF COMPLAINT:    Weakness, COVID ASSESSMENT / PLAN: Weakness COVID-19  Similar episode 2 years ago with COVID, requiring rehab stay.  Family would like her to go to a new facility on Wednesday, but will need to ensure she is able to have appropriate care at that time. They are willing to accept her after 5 days of isolation per daughter. With her COVID she is currently oxygenating well on room air and will continue supportive care. - Consult PT/OT - Monitor oxygen saturation - Lovenox for DVT prophylaxis - Tessalon and Mucinex p.r.n. for symptomatic control Allergies - Continue home Claritin GERD - Continue PPI Diet: General diet GI prophylaxis: Protonix DVT prophylaxis: Lovenox Code: DNR/DNI Disposition:  Observation for weakness from COVID, consult PT/OT MD HISTORY OF PRESENT ILLNESS: Patient is a 102 y.o. female with limited PMHx who presents today with worsening weakness and a positive home COVID test. She was in her normal state of health yesterday.  She lives in a condo and has 24 hour caregiver support at the condo.  With the holidays her caregivers are taking a short break and she went to live at her daughter and son's house.  Today when she woke up she was markedly weak and unable to get out of bed which is not her normal self.  With this change in her physical health she took a COVID at home test which was noted to be positive.  Given her marked weakness and inability to be cared for at home she was brought into the emergency room for further evaluation. In the emergency room she was not hypoxic.  Normal white blood cell count, creatinine was 0.85 and glucose mildly elevated 113. Urinalysis showed trace protein but was otherwise unremarkable.  COVID testing was positive again.  No chest x-ray obtained given normal oxygenation levels.  Unfortunately her weakness prohibited her from safe discharge home and she was admitted to General Medicine under observation for further management. Currently she continues to feel weak.  Quite hard of hearing and most history was obtained through daughter and son at bedside.  She has chronic runny nose for 75 years which is unchanged.  No other complaints at this time.  12/24/22 General medicine progress note:Chief compliant: weakness ASSESSMENT/PLAN: Weakness COVID-19  Similar episode 2 years ago with COVID, requiring rehab stay.  Family would like her to go to a new facility on Wednesday, but will need to ensure she is able to have appropriate care at that time. They are willing to accept her after 5 days of isolation per daughter. With her COVID she is currently oxygenating well on room air and will continue supportive care. - PT/OT rec home with 24h supervision - Monitor oxygen saturation - Lovenox for DVT prophylaxis - Tessalon and Mucinex p.r.n. for symptomatic control - labs in AM with procal, CXR   Allergies - Continue home Claritin   GERD - Continue PPI   Diet: General diet GI prophylaxis: Protonix DVT prophylaxis: Lovenox Code: DNR/DNI VTE PROPHYLAXIS: Sub Q Heparin / Lovenox. Encourage early mobilization.  SUBJECTIVE:  VSS Denies DIB Tolerating intake Using many blankets when fever was noted overnight