Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19 pneumonia, Chest X-ray, Echocardiogram, Essential hypertension, Fibrin D dimer normal
Clinical narrative: 72 y.o. 3/6/1950   Admit Date:  7/24/2022   Discharge Date:   7/27/2022   Discharge Diagnosis:  Principal Problem:   Pneumonia due to COVID-19 virus Active Problems:   Syncope   Essential hypertension     Hospital Course:  72 year old vaccinated female was admitted for Covid-19 pneumonia. She was started on decongestant and Remdesivir therapy. She responded well and did not require O2. D dimer was normal. She was discharged home in stable condition after 3 doses of Remdesivir were given. 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: 98.2 °F (36.8 °C) Heart Rate (Monitor): 86 Pulse: 88 BP: 136/76 Respirations: 18 SpO2: 96 % O2 Flow Rate (l/min): 0 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 SOCIAL WORK   Significant Diagnostic Studies:   TTE, CXR   Operations: none   Disposition:  Home    Discharge Condition:  Fair    Discharge Medications:   Discharge Medication List as of 7/27/2022  1:15 PM   CONTINUE these medications which have NOT CHANGED   Details oxybutynin (DITROPAN) 5 mg tablet TAKE 1 TABLET BY MOUTH TWICE DAILY, Historical Med   pantoprazole (PROTONIX) 20 mg DR tablet Take 40 mg by mouth Daily., Historical Med   albuterol (VENTOLIN HFA) 90 mcg/Actuation inhaler Take 2 Puffs by inhalation Every 6 hours as needed., Disp-1 Inhaler, R-0, Normal   MULTIVIT &MINERALS/FERROUS FUM (MULTI VITAMIN PO) Take  by mouth Daily. SUPPLEMENT, Historical Med   Ascorbic Acid 1,000 mg Tab Take 1,000 mg by mouth Twice a day. daily, Historical Med   aspirin 325 mg tablet Take 325 mg by mouth DAILY., Historical Med   CHOLECALCIFEROL, VITAMIN D3, (VITAMIN D3 PO) Take  by mouth Daily., Historical Med     STOP taking these medications     LORazepam (ATIVAN) 1 mg tablet Comments:  Reason for Stopping:        benzonatate (TESSALON PERLES) 100 mg capsule Comments:  Reason for Stopping:        ipratropium (ATROVENT) 0.06 % nasal spray Comments:  Reason for Stopping:        diltiazem (CARDIZEM CD) 240 mg capsule Comments:  Reason for Stopping:        Fexofenadine (ALLEGRA) 60 mg tablet Comments:  Reason for Stopping:        ZINC PO Comments:  Reason for Stopping:        Glucosamine-Chondroitin 250-200 mg Tab Comments:  Reason for Stopping:        diclofenac (VOLTAREN) 75 mg DR tablet Comments:  Reason for Stopping:        methocarbamoL (ROBAXIN) 500 mg tablet Comments:  Reason for Stopping:        montelukast (SINGULAIR) 10 mg tablet Comments:  Reason for Stopping:        losartan (COZAAR) 50 mg tablet Comments:  Reason for Stopping:        promethazine (PHENERGAN) 25 mg tablet Comments:  Reason for Stopping:        CALCIUM PO Comments:  Reason for Stopping:        BETA-CAROTENE,A, W-C & E/MIN (OCUVITE PO) Comments:  Reason for Stopping: