LAPORAN PASIEN EMD

Rumah Sakit FAISAL

TANGGAL 26/09/2022
TOTAL PASIEN :12 PASIEN

Prof.Dr.dr.Harsinen Sanusi,Sp.PD, K-EMD = 4 PASIEN

Dr.dr.Himawan Sanusi,Sp.PD, K-EMD = 8 PASIEN
No RM Nama Umur Ruangan Diagnosa Terapi
 1.  107009  NY HAJRAH LATATO  54  107 HFmrEf  - Diet DM 1700 kkal
CHF NYHA III - Diet rendah natrium < 2 gr / hari
CAD - 02 3 liter/menit via nasal kanul k/p
HT ON TREATMENT - Connecta
DM TIPE 2 NON OBESE - Ceftriaxone 2 gram/24 jam/intravena (H7)
- aspillet 80 mg/24 jam/oral
- clopidogrel 75 mg/24 jam/oral
- amlodipin 10 mg / 24 jam / oral
- Furosemid 40 mg /8 jam/oral
- ISDN ekstra/ jika nyeri dada
- Atorvastatin 20 mg/24 jam/oral
- Lantus 0-0-10 iu/sc
- Lactulosa 10 ml/8jam/oral
 2.  153089  TN LAHI  63  225 OSTEOARTITIS GENU BILATERAL  PULANG HARI INI
DM TIPE 2 TIPE OBESE
HIPERTENSI TERKONTROL DENGAN OBAT
TINEA KORPORIS
HIPERURICEMIA
DIARE AKUT INFLAMATORY (PERBAIKAN)
 3.  146563  TN AZHAR ASMAR  47  204 DIABETK FOOT WAGNER IV PEDIS SINISTRA   Diet DM 1700 kkal
NEUROPATI DIABETIKUM - Infus RL 28 tpm
DM TIPE 2 NON OBESE - Ceftriaxone 2 gram/24 jam/intravena (H3)
ANEMIA EC ACUTE BLEEDING - Ranitidin 50 mg/12 jam/intravena
- Levemir 0-0-10 IU/SC
- Novorapid 4-4-4 IU/SC
- Gabapentin 300 mg/8jam/oralransfusi PRC 3 bag ( 2 bag
sudah masuk)
- Rencana amputasi dari TS bedah
No RM Nama Umur Ruangan Diagnosa Terapi
 1.  195983  NY ASNA  79  109 - LOW BACK PAIN EC SUSP HNP  - IVFD NACL 20 TPM
-DIARE AKUT NON INFLAMATORY - KETOROLAC 30 MG/8 JAM / INTRAVENA
-DM TIPE NON OBESE -RANITIDIN 50 MG/12 JAM/INTRAVENA
-HIPERTENSI ON TREATMENT -MECOBALAMIN 500 MCG/24 JAM/IV
- MELENA PRO EVALUASI -LOPERAMID 4 MG LANJUT 2 MG TIAP BAB( MAKSIMAL 8
TAB/HARI)
- METFORMIN 500 MG/12 JAM/ORAL
- CANDESARTAN 8 MG/12 JAM/ORAL
- OMEPRAZOLE 40 MG/12 JAM/INTRAVENA
 2.  180532  MUH ALIMIN  60  225 - SUSPEK COMMUNITED ACQUIRED PNEUMONIA DIET DM 1700 KKAL
PSI SCORE 86
- DIET RENDAH NATRIUM < 2 GRAM/HARI
- HIPERTENSI ON TREATMENT UNCONTROLLED
- INFUS RL 28 TPM
- DIABETES MELLITUS TIPE 2 OBESE
- CEFTRIAXONE 2 GRAM/24 JAM/INTRAVENA (H3)
- DISPEPSIA SUSPEK ORGANIK
- RANITIDIN 50 MG/12 JAM/INTRAVENA
- NACETILSISTEIN 200 MG/8JAM/ORAL
- PARACETAMOL 500 MG/8 JAM/ORAL
- AMLODIPIN 10 MG/24 JAM/ORAL
- METFORMIN 500 MG/8JAM/ORAL
- GLIMEPIRID 2 MG/24 JAM/ORAL

 3.  146578  NY HADIA  47  206 - ANEMIA NORMOSITIK NORMOKROM EC ANEMIA  DIET DM 1700 KKAL
PENYAKIT KRONIK
INFUS NACL 0,9% 28 TETES/MENIT
- DIABETIK FOOT WAGNER III-IV
RANITIDIN 50 MG /12 JAM/IV
- DM TIPE 2 NON OBESE
DOMPERIDONE 10 MG / 8 JAM/ORAL
- DISPEPSIA SUSPEK ORGANIK
PARACETAMOL 500 MG/8 JAM/ORAL
RAWAT LUKA PERHARI
CEFTRIAKSON  2 GR/24 JAM / INTRAVENA
No RM Nama Umur Ruangan Diagnosa Terapi
 5.  146578  NY SRI RAHAYU  47  405 - CEPHALGIA (TENSION TYPE HEADACHE)  
- FEBRIS PRO EVALUASI
- DISPEPSIA FUNGSIONAL

 6.  176122  NY HJ SATRIA DG  25  ICU BED 9 - PENURUNAN KESADARAN EC SUSPEK  - Diet DM 1700 kkal
TACO ENSEFALOPATI SEPSIS
- Diet rendah natrium < 2 gram/hari
- SEPSIS Q SOFA SCORE 3
- Oksigen 2 liter/menit via nasal kanul
- COMMUNITED ACQUIRED PNEUMONIA PSI SCORE
111 - Infus Nacl 0,9% 500 cc/24 jam/intravena

- ATRIAL FIBRILASI RAPID VENTRIKULAR RESPONSE - Resfar 5 gram/12 jam/intravena

CHA2DS2-VASC SCORE 3 HAS BLED SCORE 2
- CONGESTIVE HEART FAILURE NYHA IV
- AKI PRE RENAL DD ACUTE ON CKD
- SUSPEK TB PARU
- DIABETES MELLITUS TIPE 2 NON OBESE
- HIPERTENSI ON TREATMENT TERKONTROL
- Furosemid 40 mg/8jam/intravena
- Meropenem 1 gram/24 jam/intravena
- Aspillet 80 mg/24 jam/NGT
- Clopidogrel 75 mg/24 jam/NGT
- Nitrokaf 2,5 mg/12 jam/NGT
- Digoxin 0,25 mg/24 jam/NGT
- Atorvastatin 20 mg/24 jam/NGT
- Ramipril 5 mg/24 jam/NGT
- Lantus 0-0-10 IU/SC
No RM Nama Umur Ruangan Diagnosa Terapi
 7.  195980  NY NURWAHIDAH  25  205 - FEBRIS  EC SUSP DENGUE FEVER  - IVFD NACL 28 TPM
- PARACETAMOL 500 MG/8 JAM / ORAL

8. 163159 TN HISYAM 26 705 CAP CURB 65 SCORE 0 -IVFD NACL 28 TPM

FEBRIS PRO EVALUASI -PARACETAMOL 1 G/8 JAM / INTRAVENA
DISPEPSIA FUNGSIONAL -RANITIDIN 50 MG/12 JAM/INTRAVENA
-DOMPERIDON 10 MG /8 JAM /ORAL
- CEFTRIAXONE 2 GRAM/24 JAM/IV