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Interdisciplinary Geriatric Assessment:
Mr. Fine

Physician Referral Information

Principal Diagnosis

Paralysis agitans

Other Pertinent Diagnoses

Abnormality of gait
Postop GI function disorder nec
Organic personality syndrome
Depressive disorder nec
Reflux esophagitis
Macular degeneration NOS
Coronary Artherosclerosis- unspecified vessel type-native/graft/cad

Directives

Code status: DNR
Call family before calling 911 or physician

Medications

Acetaminophen, 325mg, 2 tabs, PRN, P.O. Reason: pain, fever
Carbidopa, 50/200, 1 tab, TID
Baby aspirin, 81mg, QD, P.O.
Metoprolol tartrate (50mg), ½ tablet, QD, P.O.
MVI, 1 tablet, QD, P.O.
Vitamin C, 500mg, QD, P.O.
Tamsulosin HCL, 0.4mg, QD, P.O.
Ranitidine, 75mg, QD, P.O.
Nitroglycerin patch, 2.5mg patch, QD, topical
Citalopram hydrobromide, 20mg, QD, P.O.
Loperamide HCL, 2mg, PRN, P.O.

Orders for Discipline and Treatments

Skilled Nursing: 1 - 3x / week for 9 weeks, Assessment of medication compliance, GI, GU, cognition and musculoskeletal status.

Physical Therapy: Evaluation x 1 with treatment orders to follow.

Occupational Therapy: Evaluation x 1 with treatment orders to follow.

Home Health Aide: 3x / week.