SEQUENCE OF ENDORSEMENT

1. Bed # - 1
2. Patient’s name – Sandoval, Marco
3. Age/sex – 27, Male
4. Attending physician – Attended by Dr. Claparols
5. Admission date – October 10 @ 5:30 AM
6. Chief complaints – Due to Nausea and vomiting, right lower quadrant pain and
fever
• Subong less na lang episodes sang vomiting and no fever, still with pain at
the RLQ pero may ara ga radiate sa shoulder niya.. pain scale 6/10
7. Diagnosis - Acute appendicitis
8. IV fluids (available blood for the patient is the doctor asked to prepare)/ (Blood
request like to secure 1 unit of Packed RBC for possible BT) - #1 PLR 1L x 120
ml/hr, infusing well in the right cephalic vein
• Remaining solution: 250 ml
• TF: PLR at same rate
• Na empty ya na ang PNSS so gin follow na sang PLR
9. PRN Medications –
• Paracetamol 300 mg/amp give every 4hours if may fever
• Tramadol 50 mg/amp give 1 amp very slow IV push every 6hours if may
pain
10. Special precautions/considerations - Monitor vital signs Q4H, MIO Qshift, to
secure consent, still for NPO
11. For…
• Still for stat laparoscopic appendectomy possible open appendectomy under
subarachnoid anesthesia block
• To secure consent
• Follow up lang ang blood request, 1-unit whole blood, properly typed and
crossmatched for possible OR use
12. Laboratories relay all abnormal values or new laboratories –
 • Undergone CBC, Coagulation Studies, Urinalysis, Chest AP Xray, Abdominal
Utz, Covid19 RTPCR
• CBC with elevated WBC and elevated segmented neutrophils
• Urinalysis with few bacteria
• abdominal ultrasound = shows enlargement of the appendix
• Other tests no significant findings
13. Routine medications –
• Cefuroxime 750 mg/vial IVTT – every 8 hours, due @ 8am
• Metronidazole 500mg/bottle IVTT – every 8 hours, due @ 8am
14. VS for 12 midnight –
• BP: 120/80
• HR: 110
• RR: 20
• Temp: 37.5
• O2 Sat: 99
• Pain scale: 6/10

VS for 4am –

• BP: 120/70
• HR: 102
• RR: 19
• Temp: 38
• O2 Sat: 99
• Pain scale: 6/10

15. Urine output – total of 100cc

16. BM – once (normal stool)
1. Bed # - 2
2. Patient’s name – Reyes, Lynette
3. Age/sex – 53, Female
4. Attending physician – Attended by Dr. Reyes
5. Admission date – October 10 @ 6 AM
6. Chief complaints – Due to yellowish sclera, right upper quadrant pain
a. Still evident ang yellowish sclera until now and may ara gyapon pain nga na
report si patient sa iya na abdomen
7. Diagnosis - Obstructive Jaundice secondary to Multiple Choledocholithiasis
8. IV fluids (available blood for the patient is the doctor asked to prepare)/ (Blood
request like to secure 1 unit of Packed RBC for possible BT) – Ongoing is #2 Plain
NSS 1L x 120cc/hr, infusing well in the left cephalic vein
a. Remaining solution: 200cc
b. TF: PNSS 1L at same rate
9. PRN Medications –
a. Paracetamol 300mg IVTT give every 4hours if temp is more than 37.8
b. Tramadol 50 mg IVTT give every 8hours if may pain
10. Special precautions/considerations - TPR Q4H, MIO Qshift,
11. For…
a. For Biliary Exploration
b. Still for CP Clearance
c. To secure consent
d. Nephro referral done na
12. Laboratories relay all abnormal values or new laboratories –
a. Undergone CBC, Urinalysis, ABG, Pro Time, COVID19 RTPCR
b. NOTED NAMAN NI DOCTOR ANG …
c. Taas man gyapon iya creatinine kag BUN so to notify with nephron
d. ABG ya… to follow ang results then ang protime no significant findings mn
e. KUB Utz done to follow up results
13. Routine medications –
a. Ampicillin-Sulbactam 750mg IVTT every 8 hours ANST to due @ 8am
b. Metronidazole 500mg IVTT – every 8 hours, to due @ 8am
14. VS for 12 midnight –
a. BP: 130/70
b. HR: 93
c. RR: 20
d. Temp: 37
e. O2 Sat: 99

VS for 4am –

f. BP: 130/80
g. HR: 96
h. RR: 19
i. Temp: 36.5
j. O2 Sat: 99

15. Urine output – total of 450cc

16. BM – negative
1. Bed # - 3
2. Patient’s name – Villacarlos, Rowena
3. Age/sex – 46, Female
4. Attending physician – Attended by Dr. Romero
5. Admission date – October 9 @ 10PM
6. Chief complaints – Due to Epigastric pain radiating to Right upper quadrant ,
nausea and Vomiting
a. No episodes of vomiting, may ara gyapon pain with scale of 5/10
7. Diagnosis - Acute cholecystitis
8. IV fluids (available blood for the patient is the doctor asked to prepare)/ (Blood
request like to secure 1 unit of Packed RBC for possible BT) – Ongoing is #2 PNSS
1L @ 80cc/hr, infusing well in the left metacarpal vein
a. Remaining solution: 280cc
b. TF: SS at same rate
9. PRN Medications –
a. Tramadol 50mg IVTT every 6hours for severe pain
b. Paracetamol 500mg po for fever
10. Special precautions/considerations - TPR Q4H, MIO Qshift,
11. For…
a. For Cholecystectomy with Intraoperative Cholangiography done under
general endotracheal anesthesia @ 11am
b. Cross matched and Reserved 1 unit FWB 450cc with Serial# 57664
c. With foley catheter – no significant findings (200cc)
d. NPO
e. Encourage to sit up on bed if tolerated.
12. Laboratories relay all abnormal values or new laboratories –
a. CBC, serum Na and Serum K, Amylase, Creatinine, BUN, FBS. Blood Typing
KUB, Chest X-ray, Ultrasound of abdomen, ECG
b. Noted and no further orders were made
13. Routine medications – (PREOP)
a. IV Ampicillin Sulbactam 750mg slow IVTT ANST, 1 hour prior to OR (due @
10am) then Q6hr post –op
 b. IV Omeprazole 40mg prior to OR due @ 10 am
c.
14. VS for 12 midnight –
a. BP: 110/70
b. HR: 95
c. RR: 20
d. Temp: 37.5
e. O2 Sat: 98

VS for 4am –

f. BP: 110/80
g. HR: 98
h. RR: 19
i. Temp: 37
j. O2 Sat: 99

15. Urine output – total of 200cc

16. BM – negative
1. Bed # - 4
2. Patient’s name – Rodriguez, Jake
3. Age/sex – 17, Male
4. Attending physician – Attended by Dr. Claparols
5. Admission date – October 9 @ 6:50AM
6. Chief complaints – Due to MSW (right up chest, 2x left cheek, 2x right arm, left
temporal area)
7. Diagnosis - Multiple Stabbed Wound, Covid-19 probable
8. IV fluids (available blood for the patient is the doctor asked to prepare)/ (Blood
request like to secure 1 unit of Packed RBC for possible BT) –
a. Double line
b. Right arm - #1 PNSS 1L @ 40cc/hr right cephalic vein
c. Remaining: 800
d. Left arm - #1 PLR 1L @120cc hr left cephalic vein
e. Remaining: 200
f. TF: SS at same rate both arms
9. PRN Medications –
a. Tramadol 50 mg/amp, give 1 ampule very slow IV given every 6hours for
pain
10. Special precautions/considerations –, complete bedrest, Monitor VS Q4H, MIO
Qshift,
11. For…
a. For direct to operating room exploratory laparotomy and chest tube
thoracotomy insertion under general endotracheal anesthesia
b. For O2 2-3L per min via nasal cannula – attached
c. OR slip passed to OR, waiting for OR call to wheel in; consent secured for
proposed procedure and anesthetic intervention
12. Laboratories relay all abnormal values or new laboratories –
a. Covid-19 RT-PCR swab result in negative
b. Chest AP Xray to follow ang results
c. Noted and no further orders were made
13. Routine medications –
 a. Piperacillin Tazobactam 2.25 grams/vial, give 1 vial via IV drip to run for 3
hours every 8 hours (due @ 8am)
b. Omeprazole 40 mg/amp, give 1 ampule via IVTT ODHS (given @ 9pm)

14. VS for 12 midnight –

a. BP: 90/70
b. HR: 115
c. RR: 20
d. Temp: 37
e. O2 Sat: 98
f. Pain scale – 8/10

VS for 4am –

g. BP: 100/80
h. HR: 125
i. RR: 21
j. Temp: 36.7
k. O2 Sat: 99
l. Pain scale – 7/10

15. Urine output – total of 230cc

16. BM – negative
1. Bed # - 5
2. Patient’s name – Terana, Joe
3. Age/sex – 35, Male
4. Attending physician – Attended by Dr. Sales-Diaz
5. Admission date – October 10 @ 1AM
6. Chief complaints – Due to Pain and swelling right scrotum
a. Swelling is still evident then pain is still present (7/10)
7. Diagnosis - Incarcerated Inguinal Hernia Right
8. IV fluids (available blood for the patient is the doctor asked to prepare)/ (Blood
request like to secure 1 unit of Packed RBC for possible BT) –
a. #2 D5LR 1L @ 100cc/hr.
b. Remaining – 450 cc
c. to follow with SS @ SR
9. PRN Medications –
a. Tramadol 50mg iv q6h for pain (given @ 9PM)
b. Nalbuphine 5mg very slow iv for breakthrough pain
10. Special precautions/considerations –
a. Monitor VS Qhourly, MIO Qshift, to
b. Complete bed rest without bathroom priviledge; place on trendelenburg
position
c. NPO
d. Secured 1 unit PRBC for OR use -- Cross matched and Reserved 1 unit
PRBC with Serial# 27134
e. With foley cath – 260cc
f. Was referred to the anesthesiologist (Keep on NPO; Ondansetron 4mg iv
30mins prior to OR)
11. For…
a. For CBC PC, HBSAG, Blood typing, Na+ K+ (results pending, to follow)
b. For possible Herniorrhaphy Right with Mesh @ 11am
c. OR slip passed to OR, waiting for OR call to wheel in; consent secured for
proposed procedure and anesthetic intervention
12. Laboratories relay all abnormal values or new laboratories –
a. Chest X-ray, ECG
b. Decreased Hgb and lymphocytes
c. Increased WBC
d. Noted na ni doctor and no further orders were made
13. Routine medications –
a. Omeprazole 40mg IVTT OD (due @ 8am)
b. Cefoxitin 1 gram IVTT 1 hour prior to OR (due @ 10am)

14. VS for 12 midnight –

a. BP: 100/80
b. HR: 95
c. RR: 23
d. Temp: 37.8
e. O2 Sat: 98
f. Pain scale – 5/10

VS for 4am –

g. BP: 100/70
h. HR: 103
i. RR: 20
j. Temp: 36.7
k. O2 Sat: 99
l. Pain scale – 5/10

15. Urine output – total of 260cc

16. BM – 1x (normal stool)