Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anticoagulant therapy, COVID-19, Computerised tomogram thorax normal, Echocardiogram
Clinical narrative: 55 y.o.   Admit Date:  7/26/2022   Discharge Date:   7/29/2022   Discharge Diagnosis:  Principal Problem:   Acute respiratory failure with hypoxia Active Problems:   Acute pulmonary embolism   Morbidly obese   COVID-19 virus infection   Essential hypertension     Hospital Course:  55 year old female was admitted for Covid-19 infection and associated PE. She had h/o PE and stopped taking Xarelto >1 month ago. She was started on Remdesivir, steroids and Heparin drip. She was on O2 6L on admission and it has been weaned to 2L this morning. She had previously been vaccinated. CT chest and TTE did not show right heart strain. Xarelto was restarted yesterday. She will be discharged home today in stable condition. She will be given 3rd dose of Remdesivir prior to discharge. She will be sent home with O2 if needed. Patient educated on appropriate level of care post-discharge. Follow up with Primary Care Doctor in 5-7 days.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 97.8 °F (36.6 °C) Heart Rate (Monitor): 66 Pulse: 66 BP: 140/75 Respirations: 20 SpO2: 95 % O2 Flow Rate (l/min): 2 l/min General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone    Consults:  IP CONSULT TO PULMONOLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:   TTE, CT chest   Operations: none   Disposition:  Home    Discharge Condition:  Fair    Discharge Medications:   Current Discharge Medication List   START taking these medications   Details !! rivaroxaban (XARELTO) 15 mg tablet Take 1 Tablet by mouth Twice a day. Indications: PE Qty: 84 Tablet, Refills: 0   Associated Diagnoses: Acute respiratory failure with hypoxia   !! rivaroxaban (XARELTO) 20 mg tablet Take 1 Tablet by mouth Every evening for 30 days. Start on 8/18/2022  Indications: PE Qty: 30 Tablet, Refills: 0   Associated Diagnoses: Acute respiratory failure with hypoxia    !! - Potential duplicate medications found. Please discuss with provider.   CONTINUE these medications which have NOT CHANGED   Details Pregabalin (LYRICA) 150 mg Capsule Take 1 Capsule by mouth Twice a day. Qty: 180 Capsule, Refills: 0   Associated Diagnoses: Fibromyalgia   oxyCODONE-acetaminophen (PERCOCET) 7.5-325 mg per tablet Take 1 Tablet by mouth Five times daily as needed for Pain. Qty: 150 Tablet, Refills: 0   Associated Diagnoses: Fibromyalgia; Crohn's disease of large intestine with other complication   diazePAM (VALIUM) 10 mg tablet Take 1 Tablet by mouth Three times a day as needed for Anxiety. Qty: 90 Tablet, Refills: 0   Associated Diagnoses: Other mixed anxiety disorders   zolpidem (AMBIEN) 10 mg tablet Take 1 Tablet by mouth At bedtime as needed for Sleep. Qty: 30 Tablet, Refills: 2   Associated Diagnoses: Psychophysiological insomnia   furosemide (LASIX) 40 mg tablet Take 1 Tablet by mouth Twice a day. Qty: 180 Tablet, Refills: 2   Associated Diagnoses: Essential hypertension; Bilateral edema of lower extremity   losartan (COZAAR) 100 mg tablet Take 1 Tablet by mouth Once Daily. Qty: 30 Tablet, Refills: 3   Associated Diagnoses: Essential hypertension   tiZANidine (ZANAFLEX) 4 mg tablet Take 1 Tablet by mouth Three times a day as needed for Muscle spasms. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: Fibromyalgia   levothyroxine (SYNTHROID) 50 mcg tablet Take 1 Tablet by mouth Daily. Qty: 90 Tablet, Refills: 2   Associated Diagnoses: Other specified hypothyroidism   pantoprazole (PROTONIX) 40 mg DR tablet Take 1 Tablet by mouth Twice a day. Qty: 180 Tablet, Refills: 2   Associated Diagnoses: Gastroesophageal reflux disease without esophagitis   potassium chloride (KLOR-CON 10) 10 mEq tab Take 2 Tabs by mouth Twice a day. Qty: 360 Tab, Refills: 2   Associated Diagnoses: Essential hypertension; Bilateral edema of lower extremity   Polyethylene Glycol 3350 (MIRALAX) 17 gram/dose powder Take 34 g by mouth As directed. Qty: 255 g, Refills: 1   Associated Diagnoses: Chronic constipation   lidocaine (ELA-MAX) 4 % cream As directed. Qty: 30 g, Refills: 3   Associated Diagnoses: Proctalgia     STOP taking these medications     celecoxib (CELEBREX) 200 mg capsule Comments:  Reason for Stopping:        sucralfate (CARAFATE) 1 gram tablet Comments:  Reason for Stopping:        dicyclomine (BENTYL) 10 mg capsule Comments:  Reason for Stopping:        ondansetron (ZOFRAN ODT) 4 mg disintegrating tablet Comments:  Reason for Stopping:        amLODIPine (NORVASC) 10 mg tablet Comments:  Reason for Stopping:        promethazine (PHENERGAN) 25 mg tablet Comments:  Reason for Stopping: