Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 5

NURLELA

Visit 1 tgl 9/02/2022-12/02/2022

S:

Sesak nafas, pusing, badan nyeri, demam

Sudah vaksin 2x, kontak erat anak dan mantu covid

Alergi (-), Riwayat penyakit lain (-)

Di pcr 2 hari sebelumnya negatif

TD 140/90, rr 28x/m suhu 37.5 nadi 126x/m saturasi 93%

Stat generalis : rh -/-, wh-/-, bj reguler

Ttv

Infus nacl 100 cc

Inj vit c 500 ml

Inj mersibion 1 amp

Inj omeprazole 1 amp

Inj ondansentron 1 amp

Inj ranitidine 1 amp

Inj ceftriaxone 1 amp

Inj dexametason 3 amp

Levofloxacin 1x750mg

Flumicil 3 amp

Paracetamol drip 1g

Cek lab darah

Pcr

Saran oksigen 2 lpm, pantau saturasi per 6 jam

Oral : set covid oral :


Visit 2 tgl 10/02/2022-12/02/2022

S:

Sesak nafas, pusing, badan nyeri, demam

Hasil pcr positif

TD 130/90, rr 20x/m suhu 37.5 nadi 105x/m

Stat generalis : rh -/-, wh-/-, bj reguler

Ttv

Infus nacl 100 cc

Inj vit c 500 ml

Inj mersibion 1 amp

Inj omeprazole 1 amp

Inj ondansentron 1 amp

Inj ranitidine 1 amp

Inj ceftriaxone 1 amp

Inj dexametason 3 amp

Levofloxacin 1x750mg

Flumicil 3 amp

Paracetamol drip 1g
Visit 3 tgl 9/02/2022-12/02/2022

S:

Sesak berkurang, masih batuk badan masih sakit

TD 140/90, rr 20x/m suhu 37.5 nadi 98x/m saturasi 97%

Stat generalis : rh -/-, wh-/-, bj reguler

Ttv

Infus nacl 100 cc

Inj vit c 500 ml

Inj mersibion 1 amp

Inj omeprazole 1 amp

Inj ondansentron 1 amp

Inj ranitidine 1 amp

Inj ceftriaxone 1 amp

Inj dexametason 3 amp

Levofloxacin 1x750mg

Flumicil 3 amp

Paracetamol drip 1g
Visit 4 tgl 9/02/2022-12/02/2022

S:

Sesak berkurang, masih batuk

TD 140/90, rr 18x/m suhu 37.5 nadi 98x/m saturasi 97%

Stat generalis : rh -/-, wh-/-, bj reguler

Ttv

Infus nacl 100 cc

Inj vit c 500 ml

Inj mersibion 1 amp

Inj omeprazole 1 amp

Inj ondansentron 1 amp

Inj ranitidine 1 amp

Inj ceftriaxone 1 amp

Inj dexametason 2 amp

Levofloxacin 1x750mg

Flumicil 3 amp

Paracetamol drip 1g
Visit 5 tgl 9/02/2022-12/02/2022

S:

Sesak berkurang, masih batuk

TD 140/90, rr 18x/m suhu 37.5 nadi 98x/m saturasi 97%

Stat generalis : rh -/-, wh-/-, bj reguler

Ttv

Infus nacl 100 cc

Inj vit c 500 ml

Inj mersibion 1 amp

Inj omeprazole 1 amp

Inj ondansentron 1 amp

Inj ranitidine 1 amp

Inj ceftriaxone 1 amp

Inj dexametason 2 amp

Levofloxacin 1x750mg

Flumicil 3 amp

Paracetamol drip 1g

Pcr

Cek darah

You might also like