Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Culture urine positive, Cystitis, Dyspnoea, Escherichia infection
Clinical narrative: Patient ID: Age: 89 y.o. Admit Date: 8/1/2022  5:14 AM Discharge Date:  8/5/22 Admitting Physician:  Discharge Physician: APRN, MD    Discharge Diagnosis: Principal Problem:   Acute respiratory failure due to COVID-19 Active Problems:   Parkinson's disease   Essential hypertension   Hypothyroidism   Paroxysmal atrial fibrillation       HPI: Patient is a 89 y.o. female resident of Facility presents to ED with c/o cough, fever/chills, body aches, nausea and shortness of breath. Is known COVID +, states she was supposed to be out of quarantine today but feels worse. She is vaccinated, states she tested positive 5-6 days ago. Sats ~90% at rest, she denies home O2 use but is now on 2L NC. She is feeling better. Given new hypoxia in setting of COVID, will admit.    Hospital Course: She was treated with 5 days remdesivir and steroids. Will continue Keflex for UTI.      * Acute respiratory failure due to COVID-19 -vaccinated. On 2L NC, wean as tolerated. Not on home O2. Remdesivir day 5. Decadron daily. Heparin SC   Cystitis-+ ecoli. Continue rocephin   Heparin SC Encompass on DC     Physical Exam on the Date of Discharge: Physical Exam Cardiovascular:     Rate and Rhythm: Normal rate.  Pulmonary:     Breath sounds: Normal breath sounds.  Abdominal:     General: Bowel sounds are normal.  Musculoskeletal:     Right lower leg: No edema.     Left lower leg: No edema.  Skin:    General: Skin is warm and dry.     Urine Culture (Abnormal)  Collected: 08/01/22 0658 Order Status: Completed Specimen: Reflexed from UA Updated: 08/03/22 0815   URINE CULTURE -- Abnormal    COLONY COUNT: >100K cfu/ml Escherichia coli.  Ciprofloxacin falls within CLSI nonsusceptibility range due  to outdated breakpoints.   Abnormal    URINE CULTURE Escherichia coli Abnormal        Consults:   IP CONSULT TO SOCIAL WORK     Disposition:  SNF   Discharge Condition:  good   Discharge Medications and Orders:   Current Discharge Medication List   START taking these medications   Details cephALEXin (KEFLEX) 500 mg capsule Take 1 Capsule by mouth Twice a day for 6 days. Indications: inflammation of the bladder Qty: 12 Capsule, Refills: 0   Associated Diagnoses: Acute respiratory failure due to COVID-19   predniSONE (DELTASONE) 10 mg tablet Take 50mg (5 tabs) on day 1, then take 40mg (4 tabs) on day 2, then take 30mg (3 tabs) on day 3, then take 20mg (2 tabs) on day 4, then take 10mg (1 tab) on day 5, then stop. Qty: 15 Tablet, Refills: 0   Associated Diagnoses: Acute respiratory failure due to COVID-19     CONTINUE these medications which have NOT CHANGED   Details potassium chloride (KLOR-CON PACKET) 20 mEq packet Take  by mouth Once Daily. 22.5ml PO daily   dextran 70-hypromellose (LUBRICATING TEARS) 0.1-0.3 % Instill 2 Drops in both eyes Twice a day as needed. For dry eyes   !! polyvinyl alcohol/povidone (ARTIFICIAL TEARS OP) Instill 1 Drop in affected eye(s) Twice a day. Both eyes   metoprolol (TOPROL XL) 25 mg XL tablet Take 1 Tablet by mouth Once Daily. RX FAXED TO MED CARE PHARMACY. Qty: 30 Tablet, Refills: 11   amLODIPine (NORVASC) 10 mg tablet Take 1 Tablet by mouth Once Daily. RX FAXED TO MED CARE. Qty: 30 Tablet, Refills: 11   Associated Diagnoses: Essential hypertension   olmesartan (BENICAR) 40 mg tablet Take 1 Tab by mouth Daily. Qty: 90 Tab, Refills: 3   meclizine (ANTIVERT) 25 mg tablet Take 1 Tab by mouth Three times a day as needed (dizziness). Qty: 30 Each, Refills: 0   Associated Diagnoses: Syncope   cholecalciferol (VITAMIN D3) 50,000 unit CAPSULE Take 50,000 Units by mouth Every month.   !! artificial tear,dxtrn-hpm-gly, (GENTEAL TEARS MODERATE) 0.1-0.3-0.2 % 1 Drop Three times a day as needed. Affected eye (s)  Indications: dry eye   aspirin (ASPIRIN) 325 mg tablet Take 325 mg by mouth Twice a day.   citalopram (CELEXA) 20 mg tablet Take 20 mg by mouth Daily.   fluticasone propionate (FLONASE) 50 mcg/Actuation nasal spray Spray 1 Spray in nose Twice a day. (in each nostril)    furosemide (LASIX) 20 mg tablet Take 20 mg by mouth Daily.   iron polysaccharides (NIFEREX) 150 mg capsule Take 150 mg by mouth Daily.   levothyroxine (SYNTHROID) 25 mcg tablet Take 25 mcg by mouth Daily.   Mirtazapine 7.5 mg tablet Take 7.5 mg by mouth At bedtime.   omeprazole magnesium (PRILOSEC) 20 mg DR tablet Take 20 mg by mouth Daily.   acetaminophen (TYLENOL) 500 mg tablet Take 500 mg by mouth Every 4 hours as needed for Pain. *Not to exceed 4g APAP in 24 hours*   loperamide (IMODIUM) 2 mg capsule Take 2 mg by mouth As needed for Diarrhea. Give after each loose stool; Not to exceed 4 doses in 24 hours   polyethylene glycol 3350 (MIRALAX) 17 gram packet Take 17 g by mouth Daily as needed. Mix with 8 ounces of fluid   sennosides-docusate sodium (SENOKOT-S) 8.6-50 mg Take 1 Tablet by mouth Once daily as needed.   nystatin (NYSTOP) powder by Topical route Twice a day. Apply under the breasts twice a day and as needed (for external use only)   isosorbide mononitrate (IMDUR) 30 mg CR tablet Take 30 mg by mouth Daily.