Internal Medicine Admission Note (Blank Template)

MEDICINE ADMISSION NOTE

SOURCE AND RELIABILITY OF HX

CHIEF COMPLAINT

HISTORY OF PRESENT ILLNESS

Identifiers: NAME is a AGE year old SEX with a history of *** who presents from *** to *** with *** lasting *** in the setting of ***

HPI explained by patient:

Pertinent patient history:

Pertinent ROS:

Pertinent physical exam findings: 

ED/ICU course:

PAST MEDICAL HISTORY

PAST SURGICAL HISTORY

ALLERGIES

MEDICATIONS PRIOR TO ADMISSION 

SUBSTANCE USE

SEXUAL HISTORY

SOCIAL HISTORY

FAMILY HISTORY

REVIEW OF SYSTEMS

General: patient denies fevers, chills, sweats, weakness, fatigue, weight changes, difficulty sleeping, or changes in appetite.

Dermatological: patient denies any rashes, lumps, sores, itchiness, dryness, color changes, nail changes, hair changes, easy bruising, or bleeding.

Head: patient denies headaches, dizziness, light headedness, or issues with syncope.

Eyes: patient does not use any visual aids. Patient denies vision changes, blurriness, diplopia, visual field deficits or seeing spots, flashing lights, or halos around lights.

Ears: patines does not use hearing aids. Patient denies difficulty hearing, pain in the ears, discharge, buzzing, or ringing of ears.

Nose: patient denies runny nose, hay fever, nose bleeds, or sinus infections.

Mouth: patient visits dentist regularly. Denies pain in the mouth, bleeding gums, trouble chewing food, or swelling of mouth/face/lip.

Throat: patient denies any pain in their throat, hoarseness, voice changes, or trouble swallowing.

Neck: patines denies any swollen glands or lumps in the neck. Denies stiffens or pain in the neck.

VITAL SIGNS

INTAKE/OUTAKE

I/O(24hours):

Net I/O:

PHYSICAL EXAM

 General: well appearing and comfortable.

Mental status exam: alert and orientated X3

HEENT:

  • Head: normocephalic and atraumatic. No tenderness upon sinus palpation.
  • Eyes: no evidence of inflammation, infection, or trauma upon external inspection. No scleral icterus.
  • Ears: no evidence of inflammation, infection, or trauma upon external inspection.
  • Nose: no evidence of inflammation, infection, or trauma upon external inspection.
  • Throat: oral music pink with no evidence of no evidence of inflammation, infection, or trauma upon external inspection. Good dentition with all teeth present and white in color. No halitosis.
  • Neck: supple. No supraclavicular, submandibular, submental, preauricular, postauricular, or cervical lymphadenopathy. Unable to palpate thyroid. The trachea is in the midline.

Cardiovascular: mucous membranes moist. No jugular venous distention. S1 and S2 heard with no murmurs, rubs, or gallops.

Cranial nerves: CNI- CNXII intact

  • CNI: Patient denies issues with olfaction
  • CNII: Pupils X mm in size and equally round bilaterally.Pupils reactive to light with intact direct and consensual responses bilaterally. Visual fields intact bilaterally.
  • CNIII, IV, and VI: ocular movements preserved bilaterally. No ptosis or nystagmus observed.
  • CNV: pinprick and light touch sensation preserved bilaterally in the ophthalmic, maxillary, and mandibular branches of the trigeminal nerve.
  • CNVII: no facial asymmetry observed when patient raises eyebrows, squints, or smiles.
  • CN VIII: patient able to hear finger rub bilaterally. Acuity good to conversation.
  • CN IX, X: palate symmetrical. No uvula deviation.
  • CN XII: tongue symmetrical with no atrophy or deviation.
  • CN XI: patient able to shrug shoulders and turn head bilaterally.

LABS

IMAGING

ASSESSMENT AND PLAN

NAME is a AGE year old SEX with a history of *** who presents from *** to *** with *** lasting *** in the setting of *** found to have ***, concerning for ***. Patient has the following medical issues which require the associated interventions:

  1. Problem #1
    • Intervention #1
    • Intervention #2
    • Intervention #3
  2. Problem #2
    • Intervention #1
    • Intervention #2
    • Intervention #3
  3. Problem #3
    • Intervention #1
    • Intervention #2
    • Intervention #3

 

Mr. Stepwards, MSIII

DATE

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