CHIEF COMPLAINT: post op for close monitoring

PRESENT ILLNESS: HPI: pt is a 63 yo lady w/ remote smoking history, obesity, who
is s/p extensive ventral hernia repair this evening w/ mesh
placment, who was transferred from PACU for close monitoring in
setting of mild hypoxia, tachycardia, and ?EKG changes. She had
an uneventful, intraoperative and postoperative course until she
was noted to be mildly hypoxic to 94% on 2L (no room air sat
recorded) in the PACU, tachycardic, with ?new q waves on her
EKG. She was transferred to the [**Hospital Unit Name 153**] for overnight observation.
She receieved approximately 500 cc of IVF intraoperatively. On
arrival to [**Hospital Unit Name 153**], patient had no complaints except for
post-operative, abdominal pain. She denies chest pain or
shortness of breath.

MEDICAL HISTORY: 1. POD #0 -- Ventral hernia repair, Extensive lysis of
adhesions, Placement of mesh for abdominal wall reconstruction,
Closure of abdominal wall skin defect.
2. Nephrolithiasis [**2166**], multiple stones in the right lower pole
calyx
s/p Cystoscopy, stents, extracoporeal shock wave lithotripsy
3. ccy
4. longtime smoker- quit [**2166**]
5. obesity
6. h/o diverticulosis w/ resection and subsequent colostomy with
reversal
7. h/o ventral hernia repairs in past, last several years ago
8. depression

MEDICATION ON ADMISSION: celexa 10 mg po qd

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: PE: T 99.5 BP 91/50 HR 117 sinus tachy R 20 93% 4L
Gen: obese, Italian woman, pleasant, tired, no distress
HEENT: MM dry, NG tube in place with minimal drainage, NC in
place
CHEST: scant bibasilar crackles
CV: tachy, regular, distant heart sounds, no m/r/g
ABD: obese, binder in place with large abd dressing; 2 JP drains
in place, draining serosanguinous fluid, appropriately tender
abdomen
EXTRM: scant edema, warm and well perfused, strong peripheral
pulses
NEURO: intact, good historian; not fully assessed

FAMILY HISTORY: not elicited

SOCIAL HISTORY: Born in [**Country 2559**], moved here 40+years ago; lives in [**Location 10417**] w/
husband; has involved daughter. Phone numbers in chart. Remote
smoker-quit [**2166**]; denies every drinking alcohol "I don't even
drink the wine my husband makes."
Ventral, unspecified, hernia without mention of obstruction or gangrene,Peritoneal adhesions (postoperative) (postinfection),Chronic airway obstruction, not elsewhere classified,Other specified cardiac dysrhythmias,Personal history of other diseases of digestive system,Personal history of tobacco use
Ventral hernia NOS,Peritoneal adhesions,Chr airway obstruct NEC,Cardiac dysrhythmias NEC,Prsnl hst ot spf dgst ds,History of tobacco use
Admission Date:  [**2176-10-9**]              Discharge Date:   [**2176-10-16**]

Date of Birth:  [**2113-4-24**]             Sex:   F

Service: PLASTIC

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 10416**]
Chief Complaint:
post op for close monitoring

Major Surgical or Invasive Procedure:
s/p ventral hernia repair

History of Present Illness:
HPI: pt is a 63 yo lady w/ remote smoking history, obesity, who
is s/p extensive ventral hernia repair this evening w/ mesh
placment, who was transferred from PACU for close monitoring in
setting of mild hypoxia, tachycardia, and ?EKG changes. She had
an uneventful, intraoperative and postoperative course until she
was noted to be mildly hypoxic to 94% on 2L (no room air sat
recorded) in the PACU, tachycardic, with ?new q waves on her
EKG. She was transferred to the [**Hospital Unit Name 153**] for overnight observation.
She receieved approximately 500 cc of IVF intraoperatively. On
arrival to [**Hospital Unit Name 153**], patient had no complaints except for
post-operative, abdominal pain. She denies chest pain or
shortness of breath.

Past Medical History:
1. POD #0 -- Ventral hernia repair, Extensive lysis of
adhesions, Placement of mesh for abdominal wall reconstruction,
Closure of abdominal wall skin defect.
2. Nephrolithiasis [**2166**], multiple stones in the right lower pole
calyx
s/p Cystoscopy, stents, extracoporeal shock wave lithotripsy
3. ccy
4. longtime smoker- quit [**2166**]
5. obesity
6. h/o diverticulosis w/ resection and subsequent colostomy with
reversal
7. h/o ventral hernia repairs in past, last several years ago
8. depression


Social History:
Born in [**Country 2559**], moved here 40+years ago; lives in [**Location 10417**] w/
husband; has involved daughter. Phone numbers in chart. Remote
smoker-quit [**2166**]; denies every drinking alcohol "I don't even
drink the wine my husband makes."

Family History:
not elicited

Physical Exam:
PE: T 99.5 BP 91/50 HR 117 sinus tachy R 20 93% 4L
Gen: obese, Italian woman, pleasant, tired, no distress
HEENT: MM dry, NG tube in place with minimal drainage, NC in
place
CHEST: scant bibasilar crackles
CV: tachy, regular, distant heart sounds, no m/r/g
ABD: obese, binder in place with large abd dressing; 2 JP drains
in place, draining serosanguinous fluid, appropriately tender
abdomen
EXTRM: scant edema, warm and well perfused, strong peripheral
pulses
NEURO: intact, good historian; not fully assessed


Pertinent Results:
[**2176-10-9**] 06:30PM   GLUCOSE-161* UREA N-23* CREAT-1.0 SODIUM-141
POTASSIUM-4.9 CHLORIDE-107 TOTAL CO2-25 ANION GAP-14
[**2176-10-9**] 06:30PM   CK(CPK)-51
[**2176-10-9**] 06:30PM   CK-MB-2 cTropnT-<0.01
[**2176-10-9**] 06:30PM   ALBUMIN-3.4 CALCIUM-8.6 PHOSPHATE-3.6
MAGNESIUM-1.5*
[**2176-10-9**] 06:30PM   WBC-11.1* RBC-3.89* HGB-10.9* HCT-33.1*
MCV-85 MCH-27.9 MCHC-32.8 RDW-14.8
[**2176-10-9**] 06:30PM   PLT COUNT-324
[**2176-10-9**] 04:09PM   TYPE-ART TEMP-36.8 RATES-/20 O2-50 PO2-103
PCO2-38 PH-7.36 TOTAL CO2-22 BASE XS--3 INTUBATED-INTUBATED
VENT-SPONTANEOU
[**2176-10-9**] 11:19AM   TYPE-ART PO2-158* PCO2-32* PH-7.45 TOTAL
CO2-23 BASE XS-0
[**2176-10-9**] 11:19AM   GLUCOSE-183* LACTATE-2.3* NA+-136 K+-3.9
CL--114*
[**2176-10-9**] 11:19AM   HGB-10.2* calcHCT-31
[**2176-10-9**] 11:19AM   freeCa-1.07*

Brief Hospital Course:
63F s/p extensive ventral hernia repair.  She tolerated the
sugery well.  Post-operatively, she had persistent,mild hypoxia
post extubation.  The Medical Service was immediately consulted
for low oxygen saturation.  She was placed on supplemental
oxygen post-extubation and was eventually weaned off.  On the
day of discharge, her oxygen sat was 96% on room air.

With respect to her wound, in continued to remained
clean/dry/intact.  There was some erythema post-operatively,
which is now much improved with antibiotic treatment.  She has
been afebrile with stable vitals, eating well, ambulating,
making good urine and stool.  She will be discharged, in good
condition, to home with a visiting nurse to be by to evaluate
for possible home physical therapy services.



Medications on Admission:
celexa 10 mg po qd

Discharge Medications:
1. Escitalopram 10 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
2. Hydromorphone 2 mg Tablet Sig: One (1) Tablet PO Q4H (every 4
hours) as needed.
Disp:*50 Tablet(s)* Refills:*0*
3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
4. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO
DAILY (Daily).
5. Compazine 10 mg Tablet Sig: One (1) Tablet PO every 4-6 hours
as needed: FOR NAUSEA
.
Disp:*30 Tablet(s)* Refills:*0*
6. Keflex 500 mg Capsule Sig: One (1) Capsule PO three times a
day for 2 weeks.
Disp:*40 Capsule(s)* Refills:*0*


Discharge Disposition:
Home With Service

Facility:
[**Hospital 119**] Homecare

Discharge Diagnosis:
EXTENSIVE VENTRA HERNIA


Discharge Condition:
GOOD


Discharge Instructions:
PLEASE TAKE MEDICATIONS AS PRESCRIBED AND READ WARNING LABELS
CAREFULLY.  IF SIGNS AND SYMPTOMS OF INFECTION, SUCH AS
FEVERS/CHILLS, PURULENT DISCHARGE FROM WOUND/INCISION SITE,
INCREASED REDNESS, INCREASED PAIN, PLEASE CALL OR GO TO THE
EMERGENCY ROOM.  REMEMBER TO CALL TO SCHEDULE YOUR FOLLOW UP
APPOINTMENT (BELOW). LIGHT ACTIVITIES UNTIL SEEN IN CLINIC.
REMEMBER TO WHERE ABDOMENAL BINDER AS INSTRUCTED.

Followup Instructions:
PLEASE CALL [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 10418**], M.D. ([**Telephone/Fax (1) 10419**] TO BEEN SEEN IN
1 WEEK.



Completed by:[**2176-10-16**]
{'Ventral, unspecified, hernia without mention of obstruction or gangrene,Peritoneal adhesions (postoperative) (postinfection),Chronic airway obstruction, not elsewhere classified,Other specified cardiac dysrhythmias,Personal history of other diseases of digestive system,Personal history of tobacco use'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: post op for close monitoring

PRESENT ILLNESS: HPI: pt is a 63 yo lady w/ remote smoking history, obesity, who
is s/p extensive ventral hernia repair this evening w/ mesh
placment, who was transferred from PACU for close monitoring in
setting of mild hypoxia, tachycardia, and ?EKG changes. She had
an uneventful, intraoperative and postoperative course until she
was noted to be mildly hypoxic to 94% on 2L (no room air sat
recorded) in the PACU, tachycardic, with ?new q waves on her
EKG. She was transferred to the [**Hospital Unit Name 153**] for overnight observation.
She receieved approximately 500 cc of IVF intraoperatively. On
arrival to [**Hospital Unit Name 153**], patient had no complaints except for
post-operative, abdominal pain. She denies chest pain or
shortness of breath.

MEDICAL HISTORY: 1. POD #0 -- Ventral hernia repair, Extensive lysis of
adhesions, Placement of mesh for abdominal wall reconstruction,
Closure of abdominal wall skin defect.
2. Nephrolithiasis [**2166**], multiple stones in the right lower pole
calyx
s/p Cystoscopy, stents, extracoporeal shock wave lithotripsy
3. ccy
4. longtime smoker- quit [**2166**]
5. obesity
6. h/o diverticulosis w/ resection and subsequent colostomy with
reversal
7. h/o ventral hernia repairs in past, last several years ago
8. depression

MEDICATION ON ADMISSION: celexa 10 mg po qd

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: PE: T 99.5 BP 91/50 HR 117 sinus tachy R 20 93% 4L
Gen: obese, Italian woman, pleasant, tired, no distress
HEENT: MM dry, NG tube in place with minimal drainage, NC in
place
CHEST: scant bibasilar crackles
CV: tachy, regular, distant heart sounds, no m/r/g
ABD: obese, binder in place with large abd dressing; 2 JP drains
in place, draining serosanguinous fluid, appropriately tender
abdomen
EXTRM: scant edema, warm and well perfused, strong peripheral
pulses
NEURO: intact, good historian; not fully assessed

FAMILY HISTORY: not elicited

SOCIAL HISTORY: Born in [**Country 2559**], moved here 40+years ago; lives in [**Location 10417**] w/
husband; has involved daughter. Phone numbers in chart. Remote
smoker-quit [**2166**]; denies every drinking alcohol "I don't even
drink the wine my husband makes." 

### Response:
{'Ventral, unspecified, hernia without mention of obstruction or gangrene,Peritoneal adhesions (postoperative) (postinfection),Chronic airway obstruction, not elsewhere classified,Other specified cardiac dysrhythmias,Personal history of other diseases of digestive system,Personal history of tobacco use'}
