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: 350 lb(159 kg) Stated; Ht: 75 in(191 cm)
MRN: 268176 PROVIDER: Desh Anand, MD
Acct #: 10286069 Printed: 12/07/2022 12:59
DOS: 12/04/2022 18:01 Page 1 of 4
PCP SUMMARY
CHIEF COMPLAINT:
Influenza-like illness
HISTORY OF PRESENT ILLNESS:
This patient is a 42 year old male who presents with a chief complaint of Influenza-like
illness. Provider assessment time was 12/04/2022 18:52. 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 2 week(s) prior to arrival. The cough is productive of clear and bloody sputum. The
nasal discharge has been clear. The cough was described as moderate. The shortness of
breath was noted to be moderate. There has been no sore throat. The patient developed the
symptoms spontaneously. The patient''s symptoms include cough and nasal symptoms.
There has been no sore throat. 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. Patient meets criteria for potential additional screening criteria for:
COVID-19. Positive Travel Screen Interventions initiated: patient wearing a surgical mask,
infection Control and MD Notified STAT and appropriate Precautions implemented. There
was associated wheezing.
ORDERS WITHOUT RESULTS:
Placed Orders:
Flu A/B - Area: Swab (Verbal from O. Adewumi MD) Placed at 12/04/2022
18:36, HG, RN; Completed at 12/04/2022 18:53, HG, RN; Reviewed at 12/04/2022
21:43, Anand, D. , MD; Resulted at 12/04/2022 18:53, ; D. Anand at 12/04/2022
21:43 Acknowledged and Reviewed.
WCMH COVID-19, NAAT - (Verbal from O. Adewumi MD) Placed at
12/04/2022 18:36, HG, RN; Completed at 12/04/2022 18:53, HG, RN; Reviewed at
12/04/2022 21:43, Anand, D. , MD; Resulted at 12/04/2022 18:53, ; D. Anand at
12/04/2022 21:43 Acknowledged and Reviewed.
CHEST PORTABLE - Is the Patient on IV? Yes Mode of transport: WC;
Indications: Influenza-like illness; Placed at 12/04/2022 19:00, Anand, D. , MD;
Completed at 12/04/2022 19:15, HG, RN; Reviewed at 12/04/2022 21:43, Anand, D.
, MD; Resulted at 12/04/2022 19:15, ; D. Anand at 12/04/2022 21:43 Acknowledged
and Reviewed. ; Interpreted by ED physician.
NEB INITIAL Tx - Frequency: X3 Mode of transport: WC; Placed at 12/04/2022
19:00, Anand, D. , MD; Completed at 12/04/2022 19:46, Martin, E. , RRT
Acetaminophen 325mg tab (Tylenol) - 975 mg Oral Placed at 12/04/2022 19:00,
Anand, D. , MD; Completed at 12/04/2022 20:37, HG, RN
Albuterol 2.5mg/3ml neb sol (Proventil) - Nebulization Placed at 12/04/2022
19:00, Anand, D. , MD; Completed at 12/04/2022 19:46, Martin, E. , RRT
Ceftriaxone 1gm inj (Rocephin) - IVPB Placed at 12/04/2022 19:00, Anand, D. ,
Patient: BLANKENSHIP, LARRY W

DOB: 09/24/1980 42 year/M Wt: 350 lb(159 kg) Stated; Ht: 75 in(191 cm)
MRN: 268176 PROVIDER: Desh Anand, MD
Acct #: 10286069 Printed: 12/07/2022 12:59
DOS: 12/04/2022 18:01 Page 2 of 4
MD; Completed at 12/04/2022 20:37, HG, RN
Dexamethasone 10mg inj (Decadron) - IVP Placed at 12/04/2022 19:00, Anand,
D. , MD; Completed at 12/04/2022 20:37, HG, RN
Ipratropium 0.02% 0.5mg neb sol (Atrovent) - Nebulization Placed at
12/04/2022 19:00, Anand, D. , MD; Completed at 12/04/2022 19:46, Martin, E. ,
RRT
Morphine sulfate 2mg/ml inj - 4 mg IVP Placed at 12/04/2022 19:00, Anand, D. ,
MD; ORDER CANCELLED AT 20:36 by Hannah Reason:Wrong Order
NS 1000ml inj (IV Sodium chloride)= TOTAL OF 2000 ML - IV Fluid Bolus
Placed at 12/04/2022 19:00, Anand, D. , MD; ORDER CANCELLED AT 20:36 by
Hannah Reason:Wrong Order
IV: Insert - (Verbal from D. Anand MD) Placed at 12/04/2022 19:43, HG, RN;
Completed at 12/04/2022 20:22, Lewis, C. , RN
CBC with diff - (Verbal from D. Anand MD) Placed at 12/04/2022 20:16, HG,
RN; Completed at 12/04/2022 20:47, HG, RN; Reviewed at 12/04/2022 21:42,
Anand, D. , MD; Resulted at 12/04/2022 20:47, ; D. Anand at 12/04/2022 21:42
Acknowledged and Reviewed.
CMP - Select: Non Fasting (Verbal from D. Anand MD) Placed at 12/04/2022
20:16, HG, RN; Completed at 12/04/2022 20:59, HG, RN; Reviewed at 12/04/2022
21:43, Anand, D. , MD; Resulted at 12/04/2022 20:59, ; D. Anand at 12/04/2022
21:43 Acknowledged and Reviewed.
Lactic Acid - (Verbal from D. Anand MD) Placed at 12/04/2022 20:16, HG, RN;
Completed at 12/04/2022 21:01, HG, RN; Reviewed at 12/04/2022 21:43, Anand, D.
, MD; Resulted at 12/04/2022 21:01, ; D. Anand at 12/04/2022 21:43 Acknowledged
and Reviewed.
UA culture if indicated - SOURCE: Random (Verbal from D. Anand MD) Placed
at 12/04/2022 20:24, HG, RN; Completed at 12/04/2022 20:47, HG, RN; Reviewed
at 12/04/2022 21:42, Anand, D. , MD; Resulted at 12/04/2022 20:47, ; D. Anand at
12/04/2022 21:42 Acknowledged and Reviewed.
Urine Drug Screen - (Verbal from D. Anand MD) Placed at 12/04/2022 20:24,
HG, RN; Completed at 12/04/2022 20:56, HG, RN; Reviewed at 12/04/2022 21:42,
Anand, D. , MD; Resulted at 12/04/2022 20:56, ; D. Anand at 12/04/2022 21:42
Acknowledged and Reviewed.
BNP - (Verbal from D. Anand MD) Placed at 12/04/2022 20:36, HG, RN;
Completed at 12/04/2022 21:29, HG, RN; Reviewed at 12/04/2022 21:42, Anand, D.
, MD; Resulted at 12/04/2022 21:29, ; D. Anand at 12/04/2022 21:42 Acknowledged
and Reviewed.
NS 500ml inj (IV Sodium chloride) * - 500 ml IV Fluid Bolus (Verbal from D.
Anand MD) Placed at 12/04/2022 20:37, HG, RN; Completed at 12/04/2022 20:37,
HG, RN
ABG - O2 Device: RA (Verbal from D. Anand MD) Placed at 12/04/2022 23:01,
Darnell, J. , ERT; Completed at 12/04/2022 23:22, HG, RN; Reviewed at
12/05/2022 00:52, Anand, D. , MD; Resulted at 12/04/2022 23:22, ; D. Anand at
12/05/2022 00:52 Acknowledged and Reviewed.
EKG - (Verbal from D. Anand MD) Placed at 12/04/2022 23:09, HG, RN;
Completed at 12/04/2022 23:16, HG, RN; Reviewed at 12/05/2022 00:52, Anand, D.
, MD; D. Anand at 12/05/2022 00:52 Acknowledged and Reviewed.
Patient: BLANKENSHIP, LARRY W

DOB: 09/24/1980 42 year/M Wt: 350 lb(159 kg) Stated; Ht: 75 in(191 cm)
MRN: 268176 PROVIDER: Desh Anand, MD
Acct #: 10286069 Printed: 12/07/2022 12:59
DOS: 12/04/2022 18:01 Page 3 of 4
Troponin I, High Sensitivity - (Verbal from D. Anand MD) Placed at 12/04/2022
23:22, HG, RN; Completed at 12/05/2022 00:00, HG, RN; Reviewed at 12/05/2022
00:51, Anand, D. , MD; Resulted at 12/05/2022 00:00, ; D. Anand at 12/05/2022
00:51 Acknowledged and Reviewed.
Furosemide 40mg/4ml inj (Lasix) * - 40 mg IVP (Verbal from D. Anand MD)
Placed at 12/04/2022 23:28, HG, RN; Completed at 12/04/2022 23:28, HG, RN
NS 500ml inj (IV Sodium chloride) * - 200 ml Per Hour. IV Fluid Infusion
(Verbal from D. Anand MD) Placed at 12/04/2022 23:28, HG, RN; Completed at
12/04/2022 23:28, HG, RN
Azithromycin 500mg inj (Zithromax) - IVPB Placed at 12/04/2022 23:33,
Anand, D. , MD; Completed at 12/05/2022 00:35, Lewis, C. , RN
CT CHEST WITHOUT CONTRAST - Is the Patient on O2? Yes Is the Patient
on IV? Yes Is the Patient pregnant? No (Verbal from D. Anand MD) Mode of
transport: WC; Indications: Shortness of breath;Abdominal Pain; Placed at
12/04/2022 23:40, HG, RN; Completed at 12/05/2022 00:12, Lewis, C. , RN;
Reviewed at 12/05/2022 00:51, Anand, D. , MD; Resulted at 12/05/2022 00:12, ; D.
Anand at 12/05/2022 00:51 Acknowledged and Reviewed. ; Interpreted by ED
physician.
CT ABD and PELV W/O CONTRAST - Is the Patient on O2? Yes Is the Patient
on IV? Yes Is the Patient pregnant? No (Verbal from D. Anand MD) Mode of
transport: WC; Indications: Shortness of breath;Abdominal Pain; Placed at
12/04/2022 23:40, HG, RN; Completed at 12/05/2022 00:12, Lewis, C. , RN;
Reviewed at 12/05/2022 00:52, Anand, D. , MD; Resulted at 12/05/2022 00:12, ; D.
Anand at 12/05/2022 00:52 Acknowledged and Reviewed. ; Interpreted by ED
physician.
Furosemide 40mg/4ml inj (Lasix) MAY REPEAT ONE MORE TIME IF NO
- IVP Placed at 12/05/2022 01:00, Anand, D. , MD;
GOOD RESPONSE
Completed at 12/05/2022 02:18, Lewis, C. , RN
BP monitor - Frequency: 30 mins (Verbal from D. Anand MD) Placed at
12/05/2022 02:21, Lewis, C. , RN; Completed at 12/04/2022 19:00, Lewis, C. , RN
Cardiac rhythm monitor - (Verbal from D. Anand MD) Placed at 12/05/2022
02:21, Lewis, C. , RN; Completed at 12/05/2022 02:20, Lewis, C. , RN
Pulse oximetry-continuous - (Verbal from D. Anand MD) Placed at 12/05/2022
02:21, Lewis, C. , RN; Completed at 12/04/2022 19:00, Lewis, C. , RN
Troponin I, High Sensitivity Placed at 12/05/2022 06:14, Anand, D. , MD;
Completed at 12/05/2022 06:02, Lewis, C. , RN
PROCEDURES:
EKG interpretation
IMPRESSION:
UNSPECIFIED BACTERIAL PNEUMONIA
CARDIOMYOPATHY, UNSPECIFIED
METHAMPHETAMINE ABUSE
DISPOSITION (PHYS):
The disposition time decision was 12/04/2022 21:49.
Admit.
Patient: BLANKENSHIP, LARRY W

DOB: 09/24/1980 42 year/M Wt: 350 lb(159 kg) Stated; Ht: 75 in(191 cm)
MRN: 268176 PROVIDER: Desh Anand, MD
Acct #: 10286069 Printed: 12/07/2022 12:59
DOS: 12/04/2022 18:01 Page 4 of 4
Admit: The patient is admitted to the services of (CACERES ). The patient is an
inpatient admission and is admitted to Med-Surg room number 122-2. The physician that
will assume care for the hospital stay is (CACERES ). The patient condition upon
disposition was fair.