C09993816 / invoice 10000

Reason: V on and off, not eating/drinking and not sleepingSubjective: Is giving ondansetron evey now and then along with heart meds. Objective: BAR, mmpink slightly tacky, crt2sHR120, moderate pulsesRR20, no adventitious lung sounds Abdo comfortable, slightly doughyT38.5Discussed with O and adv repeating full bloods again - o consentedResults:SDMA and UREA mild to moderately elevated - worsening from previouslyALT, ALP mildly elevated - about the same as previouslyMild hypernatraemiaMild hypokalaemiaMild hyperchloraemiaPL elevated = 733 (higher than previously)Moderate haemoconcentration as expectedStress leukogram and monocytosis = consistent with inflammationDiscussed with O - adv dudicious IVFT to support kidneys and pancreas and hopefully a speeder recovery. O was about to go ahead then changed mind = feels Mia will do better at home. Is still bright but warned O may not improve v quickly and could worsenAdministered 1mg/kg maropitant sc and 0.5mg/kg metoclop scTo start mirtazapine this morning and encourage oralade intakeCan give ondansetron this evening if needed and cont with heart meds Urine pot given for sample at check upAdv CU tomorrow, especially if no improvement/worsening.    Vital Signs    Weight: 7.6;