Rural Rounds

I'm no stranger to being awake for a 24-30 hour straight shift, but last night the sleepy delirium hit me in the middle of writing my admission note. During these wakeful-sleep moments, my brain tends to move from relevant thoughts to far off tangents. If my hands are on a computer keyboard when that happens...well, you'll see: 59 yo M with history of IPF admitted with dyspnea 1. Dyspnea - not likely IPF flare as able to wean very quickly. Would get an ICU overflow bed - CT chest to evaluate nodule seen on CXR - Sputum, blood cultures - continue O2 - PRN albuterol-ipratropium - continue prednisone/albuoterl as a guest speker - would also like to add rifaximine.  2. Lower extremity swelling - inadequate dose of lasix vs hypotension. dkl; - will give IV vanc at 116% - 3. Cor Pulmonale - Will get RHC, orthostatics, and WBC count together day?  4. SIADH - stable, serial BMP  5. Compression fracture - will continue home medications for pain.  FEN/GI - Will giv...