Reporte zur Charge AS71643B

Symptomtext

Discharge Provider: MD Primary Care Provider: MD Admission Date: 12/11/2022 Discharge Date: Dec 15, 2022 COVID positive Date: 12/11/2022 PRESENTING PROBLEM: DKA, type 1, not at goal HOSPITAL COURSE: Pt is 70 y/o female with past medical history of Type 1 DM, diabetic neuropathy, CKD Stage 2, hx of CVA, htn who presented with DKA. Pt presented to ED on 12/11. She had been feeling ill for 3-4 days prior to admission. On admission, pH of 7.04, beta hydroxyutyrate > 9.0, a1c 10.6. CMP showed Na 123, K 5.3, bicarb 7, AG 34, BUN 64 cre 1.46. Pt was also found to be COVID +. She was admitted for further treatment. Pt was maintained on endotool on admission. Organization was consulted and she was transitioned to basal bolus on 12/12. Pt remained on RA in regards to COVID, she did have symptoms of nausea, diarrhea and cough. Pt was offered 3 day ocurse of remdesivir which she declined and continued supportive care. Her BP medications were held on admission and pt became hypertensive on morning of 12/14. This improved with resumption of her home medications. She also had mild AKI which resolved with fluid resuscitation. Patient was able to resume oral diet, minimal nausea and vomiting on day of discharge. Patient had her insulin regimen adjusted by Endocrinology. Given lack of hypoxia, no COVID specific treatments given aside from supportive care. Patient then considered stable for discharge home. She was set up with the hospital at home program prior to discharge. She was instructed on signs and symptoms of when to return to the ER. She was discharged home in stable condition with plan to follow up with her Endocrinologist in a few days.