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Date Diagnostics IVF/Meds

7/29/10 11:45 am CBC, UA, UTZ, Na, K, rAdmit to surgery ward


creatinine, RBS, CXR, 12L rSecure consent for
ECG admission and
Sodium : 149 mmol/L management
(138-145) rNPO
Potassium: 4.06 mmol/L rIVF D5LRS 1L q 8 hrs
(3.5-5.4) rMedicines: Ampi-
Glucose : 5.36 mmol/L Sulbactam 1.5 mg q 12 hrs
(4.10 ʹ 5.90) ANST
Creatinine: 60 umol/L (53 r Ranitidine 50 mg IV q 12
ʹ 115) hrs
Chloride: 104 mmol/L (96 r Ketorolac 30 mg IV q 8
ʹ 110) hrs
ALT: 15 u/L (9 ʹ 72) rFor ͞E͟ cholecystectomy
ALKP: 82 u/L (38 ʹ 126) rRefer to Medicine for
eval͛n prior to
cholecystectomy
Date Diagnostics IVF/ Meds
< 7
Hgb: 109 g/L (120-160)
Hct: 0.33 (0.38 ʹ 0.47)
Erythrocyte no. conc.: 4.9
(4.5 to 6.0 x 109/L)
Thrombocyte no. conc.:
243 (150-400 x 109/L)
WBC Diff. Ct.:
Neutrophils ʹ 38.4 (35-65)
Lymphocytes ʹ 41.3 (20-
40)
Monocytes ʹ 19.3 (2-8)
Eosinophils ʹ 0 (0-5)
Basophils ʹ 1 (0-1)
U/A:
Yellow, sl. Turbid
pH 6.0
SG 1.030
(-) chemical test
WBC ʹ 12-15/hpf, RBC 6-9
Bacteria - few
Date Diagnostics IVF/ Meds
UTZ of of Hepatobiliary
tree and Pancreas
Result: Cholelithiasis
7/29/10 3:45 pm CXR: no cardiomegaly, no Patient seen and
BP: 130/90, HR: 81 bpm, infiltration examined
RR: 18 bpm 12L ECG : sinus rhythm, Patient was referred for
non-specific ST-T wave eval͛n due to
changes cholecystectomy
A: stable cardiopulmonary
status at the time of
examination
P: no absolute CI for the
contemplated procedure
Date Diagnostics IVF/ Meds
7/30/10 1:00 am Post ʹop orders
Status post
cholecystectomy
NPO
Monitor VS q 15 mins.
Until stable
OR @ 5-6 pm via face
mask
IVF: Plain NSS x 30 gtts/
min , D5LRS x 30 gtts/min
Meds: Intrathecal
morphine given
Ketorolac 30 mg IV q g hrs
after negative skin test
Tramadol 50 mg IV PRN -
moderate to severe pain
Ranitidine 50 mg IV q 8 hrs
while on NPO
Date Diagnostics IVF/ Meds
7/30/10 8:50 am Soft diet
IVF: D5LRS 1L q 8 hrs
Continue meds
Probable discharge
tomorrow
D/C Tramadol
7/31/10 (+) BM MGH
Soft, non tender Dulcolax 2 adult
suppository now
Bladder draining prior to
discharge
Home Meds:
Cefuroxime 500 mg TID for
7 days
Ketomed 10 mg 1 tab TID
Omeprazole 20 mg BID
Follow-up - Aug. 5, 2010
Discharge
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