Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Chronic obstructive pulmonary disease, Condition aggravated, Cough, Culture urine positive
Clinical narrative: Narrative: ADMISSION DATE: 09/04/2021 DISCHARGE DATE: 09/14/2021 DISCHARGE TYPE: Regular PRINCIPAL DIAGNOSIS (Reason for admission after study): Acute Hypoxic Respiratory Failure: Improving course. Acute Exacerbation of COPD: secondary to mucous plugging Covid 19 infection: + 9/4/21 Multiple Pulmonary nodules - multiple pulmonary nodules since 2017 with currently enlarging LLL nodule Acute UTI d/t Pseudomonas aeruginosa: ADDITIONAL DIAGNOSES: ASCAD Depression/ anxiety: DM Type II: HLD: HISTORY OF PRESENT ILLNESS: Patient is a 72 year old with a PMH notable for CAD COPD PROSTATECTOMEY 8/23/21 admitted via ED for Covid with severe diarrhea and multiple comorbidities. Patient who just had a radical suprapubic prostatectomy on 8/23/2021 for which she was discharged on Aug 30 presents with a 3-day history of severe diarrhea, some abdominal cramping and generalized body aches. Patient apparently spent some time in the ICU postoperatively due to a combination of volume overload combined with COPD. He reports having a chronic cough productive of sputum but no respiratory distress. He does have chronic COPD he feels is mostly at his baseline. Patient does have a CT scan scheduled for tomorrow (Sunday) at 10 AM due to some change in the size of some nodules noted on imaging. HOSPITAL COURSE: Acute Hypoxic Respiratory Failure: Improving course. - Likely multifactorial from COPD exacerbation, mucous plugging, COVID 19. - Anticipate d/c home. No home O2 is needed. Acute Exacerbation of COPD: secondary to mucous plugging - cont pulmonary toilet - home bronchodilators continued, scheduled nebs - cont Dexamethasone for 10 total days Covid 19 infection: +9/4/21 - evidence of early infiltrate on CTA last pm, no PE identified. - cont Remdesivir started 9/9/21, Last treatment dose 9/13 - D/C Dexamethoasone - trend inflammatory markers Multiple Pulmonary nodules - multiple pulmonary nodules since 2017 with currently enlarging LLL nodule - see pulmonary e consult 9/7/21 for recommendations - will need outpt PET scan once Covid 19 infection cleared F/u as per Pulm. UTU d/t pseudomonas aeruginosa: - admitted with urinary retention S/P recent prostatectomy 08/2021 - secondary to Pseudomonas and E coli on urine cx 9/4/21 - Cont Cefepime for complicated UTI completed 7 days today ASCAD - Cont Carvedilol, Isosorbide mononitrate, and Atorvastatin. Plavix continued. Depression/ anxiety: - cont Sertraline - Taper off Celexa with mild prolonged QTc DM Type II: blood sugars okay - Continue correction insulin with metformin held HLD: - Cont Crestor PROCEDURES/OPEATIONS: None PERTINENT ROS: diarrhea, abdominal pain, body aches PERTINENT PAST MEDICAL HISTORY: Patient is a 72 year old with a PMH notable for CAD COPD PROSTATECTOMEY 8/23/21 admitted via ED for Covid with severe diarrhea and multiple comorbidities. Patient who just had a radical suprapubic prostatectomy on 8/23/2021 for which she was discharged on Aug 30 presents with a 3-day history of severe diarrhea, some abdominal cramping and generalized body aches. Patient apparently spent some time in the ICU postoperatively due to a combination of volume overload combined with COPD. He reports having a chronic cough productive of sputum but no respiratory distress. He does have chronic COPD he feels is mostly at his baseline. Patient does have a CT scan scheduled for tomorrow (Sunday) at 10 AM due to some change in the size of some nodules noted on imaging.