Date Physician’s Order Rationale

2/7/2021 Please admit under the service of Dr.

@12:00NN Sabido

 VS q4, I/O q shift  To obtain baseline data of VS and monitor

condition of patient until stable.

 LSLF, no caffeine, no dairy
products; DD
 To help decrease BP. High sodium and fat diet
cause increase volume in the blood leading to
increase BP. No caffeine since the patient’s
coffee consumption is too much as he
verbalizes “4 cups of black coffee a day” Coffee
consumption significantly increased BP, within
the healthy physiological levels, in a gender
specific manner at the end of the experimental
periods, without differences between coffee
types. No dairy products because lactose
intolerance can be another cause of epigastric
pain. People who are lactose intolerant have
trouble breaking down lactose, a sugar found in
milk and other dairy products.

 IVF: PNSS 1L @ 1000cc/hr x2  It is ordered because it contains electrolytes

(sodium and chloride ions) which dissociates in
solutions.

Labs:
 This is to evaluate the cells that circulate in
 CBC blood, including red blood cells (RBCs), white
blood cells (WBCs), and platelet (PLTs).

 To detect common diseases. It may be used to

 UA (MSCC) screen for and/or help diagnose conditions such
as a urinary tract infection, kidney disorders,
liver problems, diabetes, or other metabolic
conditions.

 To evaluate the lungs, heart and chest wall and

 CXR-PA can detect medical conditions such as:
Pneumonia, Heart failure.

 To check heart’s rhythm and electrical activity.

 ECG Sensors attached to the skin are used to detect
the electrical signals produced by the heart
each time it beats.

 To test for sodium and potassium, possible for

 S. electrolyte decrease.
 CBG now then BID  A blood sugar test that measures the amount of
sugar, or glucose in the blood.
  FBS, LP
 UTZ Whole Abd.
 H. Pylori det.
Meds:
 Metodopramide 10mg/amp 1amp
IVTT STAT then 1amp IVTT PRN for
active vomiting
 Omeprazole 40mg IVTT STAT then
Omeprazole 40mg/cap 1 cap BID
PO
 Ranitidine 50mg/2ml 1amp IVTT
BID
 Atorvastatin 40mg/cap 1 cap OD
@HS
 Telmisartan 40mg + Amlodipine
%mg tab 1 tab PO OD
 Dapagliflozin 10mg + Metformin
1000mg 1 tab OD
Relay results once in
 Start NaCI tab 1 tab PO BID x 3
days
 Kalium durule tab PO BID x 3 days
 This measures the blood sugar after an
overnight fast (not eating). A fasting blood
sugar level of 99 mg/dl or lower is normal, 100
to 125 mg/dl indicates that have prediabetes
and 126 mg/dl or higher indicates diabetes.
 It is used to look at organs in the abdomen,
including the liver, gallbladder, spleen,
pancreas, and kidneys.
 To detect an infection of the digestive tract
caused by the bacteria to help diagnose the
cause of symptoms and/or ulcers.
 It decreases the reflux of stomach acid by
strengthening the muscle of the lower
esophageal sphincter.
 Used to treat certain stomach and esophagus
problems (such as acid reflux, ulcers). It works
by decreasing the amount of acid in the
stomach makes. Helps heal acid damage to the
stomach and esophagus
 It is used to treat intestinal and stomach ulcers,
GERD and conditions where stomach makes too
much acid. It’s also used to heal acid-related
damage to the lining of the esophagus.
 It works by reducing the amount of cholesterol
made by the liver.
 They both work differently to relax the blood
vessels so that blood can flow more easily.
 It is used with a proper diet and exercise
program and control high blood sugar.
 Used to treat or prevent sodium loss caused by
dehydration, excessive sweating or other
causes.
 Used to treat or prevent amounts of potassium
in the blood.
  Repeat s. Na, K after 3 days
 To monitor the levels of sodium and potassium.

Refer to Dr. So (Gastro) for evaluation

2/8/2021  TF: PNSS 1L @ 100cc/hr x2  It is ordered because it contains electrolytes

@10:00A (sodium and chloride ions) which dissociates in
M solutions.

 Continue meds  To improve quality of life.

Rounds with Dr. So:

Thank you for thus referral

2/8/2021
@1:00PM  Schedule for endoscopy; May be  Used to diagnose and, sometimes, treat
tomorrow @ 10:00AM if Dr. Sabido conditions that affect the upper part of
is okay; for CP clearance. digestive system.

 Shift Omeprazole 40mg/cap 1 cap  It decreases the reflux of stomach acid by

BID to Omeprazole 40mg IVTT BID strengthening the muscle of the lower
esophageal sphincter.

Proceed with Dr. So’s orders;

2/8/2021
2:00PM  Schedule for barium swallow  It detects problems in the GI tract specifically in
@10:00AM tomorrow the stomach since patient complains of
epigastric pain
 Rpt. s. Na, K today, relay results
once in NPO @midnight  To monitor the levels of sodium and potassium.

 Used to treat a wide variety of bacterial

 Start Clarithromycin 500mg/tab 1 infections. It can also be used in combination
tab PO BID with anti-ulcer medication to treat certain types
of stomach ulcers.
2/8/2021
@4:00PM  Used with other medications too treat certain
 Metronidazole 500mg/tab 1 tab PO stomach/intestinal ulcers caused by bacteria (H.
BID pylori).
 Used to treat certain stomach and esophagus
 Cont. Omeprazole 40mg/cap 1 cap problems (such as acid reflux, ulcers). It works
PO BID by decreasing the amount of acid in the
stomach makes. Helps heal acid damage to the
stomach and esophagus.
  Improve quality of life.
 Cont. other meds

 It is ordered because it contains electrolytes

 TF: PNSS 1L @ 100cc/hr x2 (sodium and chloride ions) which dissociates in
solutions.

Reference:

What Can a Chest X-Ray Diagnose? - HealthEngine. (2018, December 13). HealthEngine Blog.
https://healthengine.com.au/info/chest-x-ray?
fbclid=IwAR3yMULK3E0tTwbnAfSfOQfqlfZOedSVNafNE_Zj7io2GHevgsL2itXxzWc#:~:text=Chest%20x%2Drays
%20(CXR),Heart%20failure

Tonog, P., & Lakhkar, A. D. (2020, May 24). Normal Saline. Nih.gov; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK545210/?fbclid=IwAR1C65PLU2tKSR_Jv2thJ5oFqLO7EpxvaX6itiwbSEBMRT-B0-
ts6VLpi6E

Johnson, J. (2017, December 14). Ten causes of epigastric pain. Medicalnewstoday.com; Medical News Today.
https://www.medicalnewstoday.com/articles/320317?fbclid=IwAR2E0lf3yvP_VIIAwhvStjUJykvj-4xil-
nHAfN0VCYZfj573bvnen13-04

Papakonstantinou, E., Kechribari, I., Sotirakoglou, Κ., Tarantilis, P., Gourdomichali, T., Michas, G., Kravvariti, V.,
Voumvourakis, K., & Zampelas, A. (2015). Acute effects of coffee consumption on self-reported gastrointestinal
symptoms, blood pressure and stress indices in healthy individuals. Nutrition Journal, 15(1).
https://doi.org/10.1186/s12937-016-0146-0

CDC. (2019, May 15). Diabetes Tests. Centers for Disease Control and Prevention.
https://www.cdc.gov/diabetes/basics/getting-tested.html?
fbclid=IwAR0T3OWkUv8bK7jtquYiPKhxzmbY_jyFU2FWvBul2KvL08Q_EEgPYF06rvc#:~:text=Fasting%20Blood%20Sugar
%20Test,higher%20indicates%20you%20have%20diabetes

Abdominal ultrasound: MedlinePlus Medical Encyclopedia. (2017). Medlineplus.gov.

https://medlineplus.gov/ency/article/003777.htm?fbclid=IwAR04bDKIADV4vXtGEAp_RKrJFoBb-
rEv1OB8SPJIAyVk_yeJrNW2eUxAbgw#:~:text=Abdominal%20ultrasound%20is%20a%20type,also%20be%20examined