Input 1 a) Neuroendocrine tumor (?Primary)
--metastases to lungs and now brain
--being treated with Sorafenib twice a day.
HP team rep Output 1a: Will continue this for now and defer further management to Dr. **NAME[ZZZ].
Input 1b) Brain Lesion :
--seen by Brain MRI **DATE[Dec 2];
HP team rep Output 1b--Rad Onc consulted; will see as outpatient on Monday to discuss brain radiation options
Input 1c) Acute on Chronic Kidney failure
--has a single kidney s/p nephrectomy **DATE[Dec 2] gunshot wound
--baseline 1.5; >2 on admission, now downtrending
--complicated by mild hyperkalemia
--K and Cr improved with IVF
Input 1c) Hypertension with volume depletion and bradycardia
Ouput 1c)--Holding his home furosemide d/t volume depletion. Holding propranolol d/t bradycardia while here. Restarted his home clonidine .2mg TID at discharge, as he was progressively hypertensive since starting steroids
Input 1d) Liver Transplant:
--immunosuppressive regimen: tacrolimus 1 mg bid
Output 1d)--tacro level 3 on admission; will continue current dosing and get q12h tacro levels to monitor; per hepatology, level between 4-5 is sufficient given how far out from transplant the patient is
Input 1e) Insulin-dependent Diabetes Mellitus
Output 1e) --Increased home lantus from 10 to 25U qhs d/t steroids. Explained that he needs to titrate up by 2 U every 3-4 days until AM sugar <120.
- Added aspart 8U TID with meals