Newman’s Handy Dandy Admit Note

IMAGING

(CAT scan, PET scan, DOG scan, plain film, complex film, KUB, IVP, XYZ, molybdenum scan, Afghaniscan)—all suggest need for further imaging.

ASSESSMENT AND PLAN

1. “Hyperlabemia:” Likely iatrogenic etiology, or not. Correct with supplemental lab results.
2. Pain: Source unclear but probably malingering. Treat with excessive narcotics, thereby causing problems 3 and 4 (see below).
3. Bowel obstruction: Discontinue narcotics. Place (NG tube, rectal tube, boob tube, multiple consults).
4. Altered mental status: Baseline worsened by narcotics. Give benzodiazepines, antipsychotics, antihistamine, more narcotics; then intubate.
5. Discharge planning: The patient is a rock and will be on service forever.
6. Abnormal imaging: Perform further scans.
7. Code status: (Full code, no code, Morse code)
8. Pineal: Gland abnormal—consult the pineal gland service TH

Jamie Newman, MD, FACP, is the physician editor of The Hospitalist, consultant, Hospital Internal Medicine, and assistant professor of internal medicine and medical history, Mayo Clinic College of Medicine at the Mayo Clinic College of Medicine, Rochester, Minn.