The patient, a 72-year-old male, was admitted for an incarcerated chronic ventral hernia post sigmoid colectomy, colostomy, and Hartmann's operation. His hospital course was complicated by postoperative acute respiratory failure, respiratory acidosis with metabolic acidosis, pleural effusion, hypokalemia, myocardial infarction, thrombocytopenia, and delirium. He had a known history of penile cancer status post penectomy complicated by perineal urethrocutaneous fistula, chronic anemia requiring transfusions, non-insulin-dependant diabetes, hypertension, hypercholesterolemia, obesity, and recurrent UTIs. He was given a suprapubic catheter placed by Urology and was started on TPN after a PICC line was placed. He was scoped by GI on 6/20/07, which showed diffuse gastritis thought to be due to the NG tube, and two ulcers turned out to be bleeding. His discharge medications included Tylenol 325 to 650 mg p.o. q.4 h. p.r.n. pain, DuoNeb 3/0.5 mg q.6 h. p.r.n., amiodarone 400 mg p.o. b.i.d. for six more days and then 400 mg p.o. daily, hold for systolic less than 90, heart rate less than 55, econazole nitrate topical daily, heparin 5000 units subcutaneously q.12 h., Regular Insulin sliding scale subcutaneously q.6 h., Imodium A-D 2 mg p.o. b.i.d., metoclopramide 10 mg p.o. q.i.d., Lopressor 50 mg p.o. q.6 h., hold for systolic less than 90, heart rate less than 55, omeprazole 40 mg p.o. b.i.d., oxycodone 1 mg per 1 mL solution for a total of 5 mg p.o. q.4 h. p.r.n. pain, Carafate 1 gm p.o. q.i.d., and Ambien 2.5 mg p.o. nightly. He was not anti-coagulated for his Atrial Fibrillation due to his risk of GI bleeding, as decided by GI. He was discharged on TPN as his total caloric needs were still not being met by p.o. nutrition and he was in good condition on discharge.
MEDS RECORD
His discharge medications included Tylenol 325 to 650 mg p.o. q.4 h. p.r.n. pain,