Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest pain, Dyspnoea, Exposure during pregnancy, Headache
Clinical narrative: Date of Admission  01/19/2022   Date of Discharge  01/23/2022   Reason for Hospitalization    Hospital Course   29 yo at 35 1/7 weeks who presented with HA, dyspnea, myalgia, and chest pain. She tested positive for COVID on admission. She required O2 during admission, on a maximum 10L, on RA since evening of 1/21. Received Remdesivir and Dexamethasone. On 1/23 patient stable for discharge. Pregnancy also complicated by fetal T18 and anomalies including hypoplastic left heart. She had planned to delivery as she had seen cardiologist there, but now more recently has made the decision to proceed with comfort care given baby diagnosis and poor prognosis. She desires to hold a live baby and desires a repeat LTCS. We offered her scheduled delivery here at Hospital. We will schedule at 37 weeks given fetal anomalies and mother's desire to hold a live baby. Program notified. Patient to decide if she is going to have delivery here or in the another hospital and let us know if she decides to deliver at the other hospital. - She has been scheduled to have repeat C/S. Following discussion with patient today, she would desire to keep her scheduled delivery if she is able to discharge and keep her previously scheduled date. Patient has list of plan of care for the baby that was reviewed and will be placed into medical chart.  Discharge Diagnoses      1. Headache    2. Chest pain    3. Myalgia    Orders:   Discharge Patient  Other Diagnoses   Ongoing  Abnormal fetal chromosomal analysis affecting antepartum care of mother  Absent nasal bridge  Allergic rhinitis  Asthma  Fetal cardiac anomaly complicating pregnancy, antepartum, single gestation  Fetal renal anomaly, single gestation  Gastroesophageal reflux disease  Genital herpes  Migraine  Obesity  Pelvic pain in pregnancy  Pregnant  Small for gestational age (SGA)  Vitamin D deficiency  Historical  Bipolar 1 disorder  Degenerative joint disease of knee  GERD (gastroesophageal reflux disease)  Pregnant  Pregnant  Pregnant    Consultants  OB GYN Obstetrics     Discharge Disposition  Home  Medications  New, Changed, or Refilled Medications  None    Medications to be Continued  albuterol (albuterol HFA 90 mcg/inh inhalation aer 2 puffs, Inhalation, q4h, PRN: as needed for wheezing, 3 Each, 3 Refill(s)    clonazePAM (KlonoPIN 0.5 mg) 0.5 mg, 1 Tablet(s), Oral, Daily, PRN: Anxiety, 30 Tablet(s), 0 Refill(s)    fluticasone (Flovent HFA 110 mcg/inh inhalation ae 2 Puff, Inhalation, bid, 1 Each, 11 Refill(s)    fluticasone nasal (Flonase 50 mcg/inh nasal spray) 2 sprays, IntraNasal, Daily, 3 Each, 3 Refill(s)    lamoTRIgine (LaMICtal 100 mg) 100 mg, 1 Tablet(s), Oral, Daily, 30 Tablet(s), 1 Refill(s)    olopatadine ophthalmic (olopatadine 0.1% ophthalmi 1 Drop(s), Each Eye, bid, 5 mL, 11 Refill(s)      Discontinued Medications  None  Physical Exam at Discharge  Vitals & Measurements  T: 36.6 °C  HR: 89  BP: 139/76  SpO2: 98%      General:  Alert and oriented, No acute distress.   Eye:  Normal conjunctiva.   HENT:  Normocephalic.   Respiratory:  Respirations are non-labored.   Cardiovascular:  Normal rate,  Normal peripheral perfusion. Mild LE edema Gastrointestinal:  Soft, Non-tender, Gravid Musculoskeletal:  No deformity, Normal gait.   Integumentary:  Warm, Dry.   Neurologic:  Alert, Oriented.   Psychiatric:  Cooperative, Appropriate mood & affect.       Follow Up Appointments      Appointment Type  When  With  Where  Contact Information  Status  01/25/2022 08:00 AM Perinatal Assessment  Maternal/Fetal Medicine and Ultrasound Clinic 01/25/2022 08:30 AM Perinatal Assessment  Maternal/Fetal Medicine and Ultrasound Clinic 01/31/2022 02:00 PM 02/01/2022 09:00 AM  02/02/2022 08:00 AM Perinatal Assessment  Maternal/Fetal Medicine and Ultrasound Clinic 02/02/2022 08:30 AM Perinatal Assessment  Maternal/Fetal Medicine and Ultrasound Clinic  02/08/2022 09:30 AM Perinatal Assessment  Maternal/Fetal Medicine and Ultrasound Clinic  02/08/2022 10:00 AM Perinatal Assessment  Maternal/Fetal Medicine and Ultrasound Clinic  02/08/2022 10:30 AM Perinatal Assessment  Maternal/Fetal Medicine and Ultrasound Clinic  Nursing/Other Orders   Regular Diet. Ordered on 01/19/22 16:53:00, Meal Start Time Breakfast 0700 to 0900   Up Ad Lib. 01/19/22 16:53:00, Continuous Order   Code Status. Code Status Description: Full Code     I was present with the resident during their history and examination of the patient. I discussed the case with the resident and agree with the findings and plan as documented in the residents note.