Updated: Aug 2, 2021
Mr. Paul Ferris
Summer seat Nursing Home
16 June 2018
Dear Mr. Ferris,
Re: Mrs. Anne Ellis, DOB : 06 January 1942
This is to update you regarding Mrs. Ellis, who is being diagnosed with renal colic, requires your unceasing observation and further evaluation, following her discharge today.
On the 12th of June 2018, Mrs. Ellis was admitted to our hospital with profound unilateral left lion and groin pain which indeed disseminate to lower back. In addition , vomiting restlessness, sweating and grimacing were noted. Urine test confirmed haematuria. Computed tomography scan revealed dilation of left collecting system along side , 4mm obstructing pelviuretic junction was observed.
On admission blood pressure was 140/90mm Hg temperature 36.6° C, heart rate was 102 per minute and respiration of 21 breathe per minute were reported. consequently , treated with oral fluids, intravenous Diclofenac 15mg, Metoclopramide 10mg rehydration for 48 hours. Two litres of fluid intake daily was recommended.
On the following day, to assist in unconstrained passage of calculus Tamsolusin 8mg twice was commenced along side paracetamol 500mg every 4-6 hours was prescribed. Currently , vitals are stable with nomial pain. By forte night , renal calculus probably to be passed out without difficulty.
Upon discharge, observation or medication fluid intake of two to three liters daily and urine output is mandatory. If passage of calculus it is imperative to send for laboratory investigation. With respect to diet , less ingestion of salt maximum of 3 gm daily and animal protein of 1.0 gm per kilogram of body weight. Rifmint from enormous intake of oxatate-rich foods. An follow-up appointment with the urologist has been scheduled on the 20th July.
Based on aforementioned circumstances further monitoring and appropriate management exceeding favourable. If you require any additional information , donot hesitate to contact me.
Berry town Public Hospital
24 Beech Road