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Appendicitis KARDEX

This patient's kardex provides information about an 18-year old female patient admitted to the hospital on July 5, 2021 with a chief complaint of abdominal pain on the right side. During her admission, she received intravenous fluids, antibiotics, and pain medication. Her vital signs and lab tests were monitored. She was discharged on July 8, 2021 with instructions to limit activities and follow a low-fat diet.

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MARIAM A JAJI
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891 views1 page

Appendicitis KARDEX

This patient's kardex provides information about an 18-year old female patient admitted to the hospital on July 5, 2021 with a chief complaint of abdominal pain on the right side. During her admission, she received intravenous fluids, antibiotics, and pain medication. Her vital signs and lab tests were monitored. She was discharged on July 8, 2021 with instructions to limit activities and follow a low-fat diet.

Uploaded by

MARIAM A JAJI
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

PATIENT’S KARDEX

Name: Patient E Age: 18 Sex: F Civil Status: Single Hosp No.:1730

Address: Ipil, Zamboanga Sibugay Religion: Roman Catholic AP: Dr. Baygon

Chief Complaint: Abdominal pain (right side pain more than left)

Diet: NPO

Clinical Impression: Tenderness in lower right abdomen

Date of Admission: 07/05/21 Date of Discharge: 07/08/21

MEDICATION SPECIAL PROCEDURES/ENDORSEMENT


8:00 am: BP – 80/60 mmHG, Temp – 37.9 C, RR –
23bpm, P – 98bpm

8:00 Admitted to ward and secured consent

8:35 am: V/S monitoring done

9:00 am: Push 360 of PNSS TIV done

10:00 am: AP ordered CBT, Urinalysis,


Hematology and Electrolyte tests

10:05 am: Creatinine Test, Urinalysis, Hematology


and Electrolyte tests request sent.

11:00 am: Started K correction of PLR plus 15mEq


of KCl @ 41 mgtts/min for 2 doses
IV FLUIDS /OR SIDE DRIP / BLD TRANS
- Push 360 of PNSS TIV 12:00 pm: Patient took Cefuroxime 500mg TIV
- Start K correction of PLR plus 15mEq of KCl @ TID, Metronidazole 500 mg TIV TID, Ranitidine
41 mgtts/min for 2 doses 25mg TIV TID, Ketorolac Thometamine (Toradol)
- Cefuroxime 500mg TIV q8h 10 mg TIV q6h x 4 doses
-Metronidazole 500 mg TIV q8h
-Ranitidine 25mg TIV q8h 07/08/21
- Ketorolac Thometamine (Toradol) 10 mg TIV 9:30 am: Patient will be discharged with the
q6h x 4 doses following orders
 Incision care
 Eat food that are low in fat
 Start by doing light activities around your
home once you feel able to do so.
 Don’t lift anything heavier than 10
pounds until your healthcare provider
says it’s OK
 Limit sports and strenuous activities for 1
or 2 weeks.

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