CHIEF COMPLAINT: renal [**Hospital3 32582**] distress

PRESENT ILLNESS: 59yo M w/hx 5cm upper pole mass of the right kidney. Pt had
elective nephrectomy on [**2104-2-21**]. Had 1L EBL and was transfused
unit post op. Patient was difficult intubation originally
requiring a bougie. Pt extubated in PACU but went into resp
distress requiring glidescope intubation after multiple
attempts. Pt extubated this AM but serially ABGs revealed
increasing CO2 up to the 70s. BIPAP was started and on 15/5, CO2
down to 60s. ABG on tx was 7.37/63/74 on 50% FIO2. Pt tx to the
ICU for anesthesia back up which is not available at [**Hospital1 882**]
over the weekend.
Pt accepted by Urology service, [**Doctor Last Name **].

MEDICAL HISTORY: PMH: OSA, arthritis, HTN
PSH: none

MEDICATION ON ADMISSION: Vicodin 7.5mg q6hrs, metoprolol 50', ASA 324', Finasteride 5mg
qhs, tamsulosin 0.4mg qhs, lasix 20', KCl 20', Lisinopril 20',
pravastatin 20', multivit, patanol

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: avss, satting mid-90s on RA
no resp distress
abd obese, nontender, nondistended, R flank incision c/d/i with
staples to air

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: noncontributory
Other pulmonary insufficiency, not elsewhere classified, following trauma and surgery,Malignant neoplasm of kidney, except pelvis,Morbid obesity,Obstructive sleep apnea (adult)(pediatric),Unspecified essential hypertension,Removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Ptosis of eyelid, unspecified,Redness or discharge of eye
Ot pul insuf fol trm/srg,Malig neopl kidney,Morbid obesity,Obstructive sleep apnea,Hypertension NOS,Abn reac-organ rem NEC,Ptosis of eyelid NOS,Redness/discharge of eye
Admission Date:  [**2104-2-22**]              Discharge Date:   [**2104-2-24**]

Date of Birth:  [**2047-7-13**]             Sex:   M

Service: UROLOGY

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 32581**]
Chief Complaint:
renal [**Hospital3 32582**] distress

Major Surgical or Invasive Procedure:
open R partial nephrectomy, [**2104-2-22**], Dr. [**Last Name (STitle) **]


History of Present Illness:
59yo M w/hx 5cm upper pole mass of the right kidney. Pt had
elective nephrectomy on [**2104-2-21**]. Had 1L EBL and was transfused
unit post op. Patient was difficult intubation originally
requiring a bougie. Pt extubated in PACU but went into resp
distress requiring glidescope intubation after multiple
attempts. Pt extubated this AM but serially ABGs revealed
increasing CO2 up to the 70s. BIPAP was started and on 15/5, CO2
down to 60s. ABG on tx was 7.37/63/74 on 50% FIO2. Pt tx to the
ICU for anesthesia back up which is not available at [**Hospital1 882**]
over the weekend.
Pt accepted by Urology service, [**Doctor Last Name **].

Past Medical History:
PMH: OSA, arthritis, HTN
PSH: none


Social History:
noncontributory

Family History:
noncontributory

Physical Exam:
avss, satting mid-90s on RA
no resp distress
abd obese, nontender, nondistended, R flank incision c/d/i with
staples to air


Pertinent Results:
[**2104-2-23**] 02:50AM BLOOD WBC-16.7* RBC-3.60* Hgb-10.9* Hct-32.8*
MCV-91 MCH-30.3 MCHC-33.2 RDW-14.4 Plt Ct-204
[**2104-2-23**] 02:50AM BLOOD Plt Ct-204
[**2104-2-23**] 02:50AM BLOOD Glucose-109* UreaN-20 Creat-1.0 Na-138
K-4.2 Cl-99 HCO3-33* AnGap-10
[**2104-2-23**] 02:50AM BLOOD Calcium-8.1* Phos-2.9 Mg-2.0

Brief Hospital Course:
Pt was transferred from [**Hospital 882**] Hospital for ICU status care
after episode of respiratory distress at FH (see FH records for
details of admission and operative note).  In the T/SICU he
remained stable on bipap and had no other active issues.  On HD2
he was deemed safe for transfer to the floor.  He tolerated a
diet prior to discharge.  His pain was well-controlled without
PO narcotics.  He passed a voiding trial.  Respiratory therapy
fit him with cpap on the floor and he verbally contracted with
the MD to wear his cpap at home and follow-up with his PCP for [**Name Initial (PRE) **]
new sleep study, cpap mask fitting, and review of this
admission/ICU admission.  He will call with any
questions/concerns in the interval.

Medications on Admission:
Vicodin 7.5mg q6hrs, metoprolol 50', ASA 324', Finasteride 5mg
qhs, tamsulosin 0.4mg qhs, lasix 20', KCl 20', Lisinopril 20',
pravastatin 20', multivit, patanol

Discharge Medications:
1. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for Constipation.
Disp:*60 Tablet(s)* Refills:*0*
2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*
3. pravastatin 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
4. tamsulosin 0.4 mg Capsule, Ext Release 24 hr Sig: One (1)
Capsule, Ext Release 24 hr PO HS (at bedtime).
5. finasteride 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

6. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4
hours) as needed for pain/fever.
Disp:*60 Tablet(s)* Refills:*0*
7. metoprolol tartrate 50 mg Tablet Sig: One (1) Tablet PO BID
(2 times a day).
8. famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day).
9. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day.


Discharge Disposition:
Home

Discharge Diagnosis:
renal mass


Discharge Condition:
good
ambulating
voiding
tolerating diet
pain controlled without narcotic pain medications


Discharge Instructions:
Do not lift more than 10 pounds for next two weeks.

Please call or go to ED if you have new bright red blood in
urine.

Use a stool softener to avoid constipation.

Followup Instructions:
Call Dr.[**Name (NI) 32583**] office for a staple removal appointment.

**Call your PCP's office for a visit within the next 7 days to
followup on your admission, ideally within 4 days.**  Please
bring any paperwork from your admission with you to the visit.

Items for PCP to address:
-Need for new sleep study per Respiratory therapy at [**Hospital1 18**]
-Fit of CPAP mask
-Calibration of CPAP machine
-Restarting lisinopril
{'Other pulmonary insufficiency, not elsewhere classified, following trauma and surgery,Malignant neoplasm of kidney, except pelvis,Morbid obesity,Obstructive sleep apnea (adult)(pediatric),Unspecified essential hypertension,Removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Ptosis of eyelid, unspecified,Redness or discharge of eye'}


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: renal [**Hospital3 32582**] distress

PRESENT ILLNESS: 59yo M w/hx 5cm upper pole mass of the right kidney. Pt had
elective nephrectomy on [**2104-2-21**]. Had 1L EBL and was transfused
unit post op. Patient was difficult intubation originally
requiring a bougie. Pt extubated in PACU but went into resp
distress requiring glidescope intubation after multiple
attempts. Pt extubated this AM but serially ABGs revealed
increasing CO2 up to the 70s. BIPAP was started and on 15/5, CO2
down to 60s. ABG on tx was 7.37/63/74 on 50% FIO2. Pt tx to the
ICU for anesthesia back up which is not available at [**Hospital1 882**]
over the weekend.
Pt accepted by Urology service, [**Doctor Last Name **].

MEDICAL HISTORY: PMH: OSA, arthritis, HTN
PSH: none

MEDICATION ON ADMISSION: Vicodin 7.5mg q6hrs, metoprolol 50', ASA 324', Finasteride 5mg
qhs, tamsulosin 0.4mg qhs, lasix 20', KCl 20', Lisinopril 20',
pravastatin 20', multivit, patanol

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: avss, satting mid-90s on RA
no resp distress
abd obese, nontender, nondistended, R flank incision c/d/i with
staples to air

FAMILY HISTORY: noncontributory

SOCIAL HISTORY: noncontributory 

### Response:
{'Other pulmonary insufficiency, not elsewhere classified, following trauma and surgery,Malignant neoplasm of kidney, except pelvis,Morbid obesity,Obstructive sleep apnea (adult)(pediatric),Unspecified essential hypertension,Removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Ptosis of eyelid, unspecified,Redness or discharge of eye'}
