FINAL

Washington County - Memorial Hospital

300 Health Way, Potosi, MO 63664
573-438-5451
Patient: BLANKENSHIP, LARRY W
DOB: 09/24/1980 42 year/M Wt: 370 lb(168 kg) Stated; Ht: 74 in(188 cm)
MRN: 268176 PROVIDER: Desh Anand, MD
Acct #: 10288230 Printed: 01/01/2023 19:34
DOS: 12/30/2022 07:05 Page 1 of 3
PCP SUMMARY
CHIEF COMPLAINT:
Cough
HISTORY OF PRESENT ILLNESS:
This patient is a 42 year old male who presents with a chief complaint of Cough. Provider
assessment time was 12/30/2022 07:29. I reviewed the vital signs, the oxygen saturation
result and the nursing/ treatment notes and I agree with what is documented. I agree with
the chief complaint selected for this patient''s chart. The onset was 4 week(s) prior to
arrival. The symptoms started diagnosed covid with pneumonia 2 weeks ago
-[DA@12/30/2022 07:35]. The cough is productive of white and bloody sputum. The
shortness of breath was noted to be moderate. The cough was described as moderate. The
patient has not traveled outside of the United States. The patient has not had contact with
anyone who has traveled outside of the United States within the last 30 days.
ORDERS WITHOUT RESULTS:
Placed Orders:
CBC with diff - (Verbal from D. Anand MD) Placed at 12/30/2022 07:30, Smith,
C. , RN; Completed at 12/30/2022 08:07, Smith, C. , RN; Reviewed at 12/30/2022
08:51, Anand, D. , MD; Resulted at 12/30/2022 08:07, ; D. Anand at 12/30/2022
08:51 Acknowledged and Reviewed.
Cardiac Enzymes w/o Myoglobin - (Verbal from D. Anand MD) Placed at
12/30/2022 07:30, Smith, C. , RN; Completed at 12/30/2022 08:33, Smith, C. , RN;
Reviewed at 12/30/2022 08:51, Anand, D. , MD; Resulted at 12/30/2022 08:33, ; D.
Anand at 12/30/2022 08:51 Acknowledged and Reviewed.
BNP - (Verbal from D. Anand MD) Placed at 12/30/2022 07:30, Smith, C. , RN;
Completed at 12/30/2022 08:20, Smith, C. , RN; Reviewed at 12/30/2022 08:51,
Anand, D. , MD; Resulted at 12/30/2022 08:20, ; D. Anand at 12/30/2022 08:51
Acknowledged and Reviewed.
CMP - Select: Non Fasting (Verbal from D. Anand MD) Placed at 12/30/2022
07:30, Smith, C. , RN; Completed at 12/30/2022 08:23, Smith, C. , RN; Reviewed at
12/30/2022 08:51, Anand, D. , MD; Resulted at 12/30/2022 08:23, ; D. Anand at
12/30/2022 08:51 Acknowledged and Reviewed.
CHEST PORTABLE - Is the Patient on O2? Yes Is the Patient on IV? No Is the
Patient pregnant? No (Verbal from D. Anand MD) Mode of transport: WC;
Indications: Cough; Placed at 12/30/2022 07:30, Smith, C. , RN; Completed at
12/30/2022 08:04, Smith, C. , RN; Reviewed at 12/30/2022 08:51, Anand, D. , MD;
Resulted at 12/30/2022 08:04, ; D. Anand at 12/30/2022 08:51 Acknowledged and
Reviewed. ; Interpreted by ED physician.
EKG - (Verbal from D. Anand MD) Placed at 12/30/2022 07:31, Smith, C. , RN;
Completed at 12/30/2022 07:06, Smith, C. , RN; Reviewed at 12/30/2022 08:52,
Anand, D. , MD; D. Anand at 12/30/2022 08:52 Acknowledged and Reviewed.
Patient: BLANKENSHIP, LARRY W

DOB: 09/24/1980 42 year/M Wt: 370 lb(168 kg) Stated; Ht: 74 in(188 cm)
MRN: 268176 PROVIDER: Desh Anand, MD
Acct #: 10288230 Printed: 01/01/2023 19:34
DOS: 12/30/2022 07:05 Page 2 of 3
OXYGEN - O2 Device: NC Liters/Min: 2 (Verbal from D. Anand MD) Placed at
12/30/2022 07:31, Smith, C. , RN; Completed at 12/30/2022 07:06, Smith, C. , RN
Troponin I, High Sensitivity Placed at 12/30/2022 07:44, Anand, D. , MD;
ORDER CANCELLED AT 07:49 by Chrissy Reason:Duplicate Order
Urinalysis, Complete - SOURCE: Clean Catch Placed at 12/30/2022 07:44,
Anand, D. , MD; Completed at 12/30/2022 14:31, Stroup, E. , PCT; Reviewed at
12/30/2022 14:34, Anand, D. , MD; Resulted at 12/30/2022 14:31, ; D. Anand at
12/30/2022 14:34 Acknowledged and Reviewed.
NEB INITIAL Tx - Frequency: X3 Placed at 12/30/2022 07:44, Anand, D. , MD;
Completed at 12/30/2022 08:15, Kostedt, H. , CRT
Albuterol 2.5mg/3ml neb sol (Proventil) - 10 mg Per Hour. Nebulization Placed
at 12/30/2022 07:44, Anand, D. , MD; Completed at 12/30/2022 08:15, Kostedt, H. ,
CRT
Albuterol 2.5mg/3ml neb sol (Proventil) - Nebulization Placed at 12/30/2022
07:44, Anand, D. , MD; Completed at 12/30/2022 08:15, Kostedt, H. , CRT
Cefepime 1gm inj (Maxipime) - 2000 mg IVPB Placed at 12/30/2022 07:44,
Anand, D. , MD; Completed at 12/30/2022 09:03, Smith, C. , RN
Dexamethasone 10mg inj (Decadron) - IVP Placed at 12/30/2022 07:44, Anand,
D. , MD; Completed at 12/30/2022 09:03, Smith, C. , RN
Ipratropium 0.02% 0.5mg neb sol (Atrovent) - Nebulization Placed at
12/30/2022 07:44, Anand, D. , MD; Completed at 12/30/2022 08:15, Kostedt, H. ,
CRT
NORCO 5-325 TABLET - 2 Oral Placed at 12/30/2022 07:44, Anand, D. , MD;
Completed at 12/30/2022 07:51, Smith, C. , RN
NS 1000ml inj (IV Sodium chloride)= TOTAL OF 2000 ML - IV Fluid Bolus
Placed at 12/30/2022 07:44, Anand, D. , MD; Completed at 12/30/2022 09:03,
Smith, C. , RN
Vancomycin 1gm Add-Vantage inj (Vancocin) - IVPB Placed at 12/30/2022
07:44, Anand, D. , MD; Completed at 12/30/2022 10:42, Smith, C. , RN
IV: Insert - (Verbal from D. Anand MD) Placed at 12/30/2022 08:02, Smith, C. ,
RN; Completed at 12/30/2022 08:02, Smith, C. , RN
NS 1000ml inj (IV Sodium chloride)= TOTAL OF 2000 ML - IV Fluid Bolus
Placed at 12/30/2022 08:53, Anand, D. , MD; ORDER CANCELLED AT 09:16 by
Chrissy Reason:Duplicate Order
Urine Drug Screen Placed at 12/30/2022 08:57, Anand, D. , MD; Completed at
12/30/2022 14:33, Stroup, E. , PCT; Reviewed at 12/30/2022 14:34, Anand, D. ,
MD; Resulted at 12/30/2022 14:33, ; D. Anand at 12/30/2022 14:34 Acknowledged
and Reviewed.
Famotidine 20mg/NS 50ml pre-mix inj (Pepcid) * - 60 mg IVP Placed at
12/30/2022 08:58, Anand, D. , MD; Completed at 12/30/2022 10:42, Smith, C. , RN
Furosemide 40mg/4ml inj (Lasix) MAY REPEAT ONE MORE TIME IF NO
- IVP Placed at 12/30/2022 09:18, Anand, D. , MD;
GOOD RESPONSE
Completed at 12/30/2022 10:42, Smith, C. , RN
NS 1000ml inj (IV Sodium chloride)= TOTAL OF 2000 ML - IV Fluid Bolus
 Placed at 12/30/2022 09:19, Anand, D. , MD; ORDER CANCELLED AT 10:41 by
Chrissy Reason:Duplicate Order
Troponin I, High Sensitivity Placed at 12/30/2022 09:36, Anand, D. , MD;
Completed at 12/30/2022 12:24, Smith, C. , RN; Reviewed at 12/30/2022 12:43,
Patient: BLANKENSHIP, LARRY W

DOB: 09/24/1980 42 year/M Wt: 370 lb(168 kg) Stated; Ht: 74 in(188 cm)
MRN: 268176 PROVIDER: Desh Anand, MD
Acct #: 10288230 Printed: 01/01/2023 19:34
DOS: 12/30/2022 07:05 Page 3 of 3
Anand, D. , MD; Resulted at 12/30/2022 12:24, ; D. Anand at 12/30/2022 12:43
Acknowledged and Reviewed.
Bumetanide 1mg/4ml inj (Bumex) * - 1 mg IVP Placed at 12/30/2022 13:11,
Anand, D. , MD; Completed at 12/30/2022 13:27, Smith, C. , RN
PROCEDURES:
EKG interpretation
IMPRESSION:
LEFT VENTRICULAR FAILURE, UNSPECIFIED
ACUTE RENAL INSUFFICIENCY
OTHER SPECIFIED LOCAL INFECTIONS OF THE SKIN AND SUBCUTANEOUS
TISSUE
AMPHETAMINE ABUSE
DISPOSITION (PHYS):
The disposition time decision was 12/30/2022 09:15.
Admit.
Admit: The patient is admitted to the services of (DR. MAMIDWAR). The patient is an
inpatient admission and is admitted to Med-Surg. The physician that will assume care for
the hospital stay is (MAMIDWAR). The patient condition upon disposition was stable.