III. MEDICAL MANAGEMENT a.

Doctors order 02/24/13 >Please admit to medical Ward >Secure consent to care

>Vital signs q 4 hours

>NPO temporarily >Start venolysis with PNSS 1 L @ KVO >Lab: -CBC, platelet

-for proper facilitation and proper care provided -Signed consent ensures that the patient is properly informed regarding the process, risks, and possible complications of the procedures and is not forced to coerce to undergo the said procedures. -To monitor patients conditionand for immediatereferral andintervention incase of unusualities -to replace fluids,administer medications and to provide water and electrolyte. - identifies the total number of white blood cell and red blood cell, the platelet count, and hemoglobin and hematocrit; and also to determine abnormalities. - To determine any conditions in the urinary tract; to detect semi-quantitatively measures various compounds that are eliminated in the urine. -

-U/A

-Na+, K+ - 12 lead ECG -Creatinine -CT scan -CXR-PA >Medications -Citicholine 5gm IVTT q 12 hour -Simvostatin 20mg 1 tab OD @ HS -Amlodipine 10 mg 1 tab OD PO -Captopril 25 mg 1 tab 5 L prn for BP mmHg -Omeprazole 40mg IVTT q 12 hours -Lactulose 30cc OD @ HS

160 -

>I & O q shift

>Refer accordingly

>Give Ketorolac 30mg 1 amp IVTT now 7pm >Continue medications >Follow-up diagnostics as CT scan result >IVF to hock with PNSS 1L @ SR 02/25/13 8:50 AM >IVF to follow PNSS 1L @ SR >Continue medications

- m e asurement of a patient's fluid intake and output will identify those patients at risk of becoming dehydrated or over hydrated. - Referral is done to correct unusualities as soon as possible and to inform attending physician about the patient condition. -short-term management of pain

-to continue medication therapy and avoid further complications -

- to continue medication therapy and avoid further complications >Follow-up CT scan result >Aspirin 80mg 1 tab OD pc lunch >Shift citicholine IV to citicholine 500mg 1 tab BID >Discontinue Omeprazole 02/26/13 >Low fat, Low salt diet >Follow-up CT scan result >IVF to follow PNSS 1 L @ 20gtts/min x 2 cycles

02/27/13 9:40 AM >To follow-up with plain NSS 2L @ 20gtts/min >Continue medications

- to continue medication therapy and avoid further complications

02/28/13 >MGH >Home medications -Citicholine 500mg 1 tab BID - Simvostatin 20mg 1 tab OD