M E D I CAL AB STRACT

Patient`s Name: Dimabuyu, Glenda y Manalo Age: 36y/o Sex: Female

First HD Treatment in PMSH: Dec 15, 2009
Address: Purok 2, Planas Porac, Pampanga

Medical History
She was known case of Chronic Kidney Disease Physical Examination:2º to Chronic
Pyelonephritis vs Obsructive Urophathy, Underwent emergency dialiys in this institution due
to pulmonary edema and severe dyspnea.

Pysical Examination:
BP 160/80 mmHg. HEENT. Pale palp conjuctiva
CR. 78 bpm. CHEST/LUNGS. (+) Crackels (minimal)
RR. 19 bpm. ABDOMEN. (-) ascites
Temp 36.7°C. EXTREMITIES. Edema

Laboratory: April 6, 2018

Creatinine 11.63 Hemoglobin 93 Segmenters 0.70
Sodium 135 Hematocrit 0.26 Platelet 241
Potassium 5.997 WBC 7.8

Medication:
** ** See Treatment Protocol sheet

Final Diagnosis:
Kidney Disease Physical Examination:2º to Chronic Pyelonephritis vs Obsructive
Urophathy.

Remarks:
To continue his hemodialysis treatment in this institution on a two (2) times a week basis.

Ismael Ramos, MD
Nephrologist
Lic. #: 85943
PTR #: 2252543
 T R EAT M E N T PR O T O C O L

Patient`s Name: Dimabuyu, Glenda y Manalo Age: 36y/o Sex: Female

Diagnosis: Kidney Disease Physical Examination:2º to Chronic Pyelonephritis vs
Obsructive Urophathy.

No. of days of No. of Price per

Drug/s Freq. Prep Total Price
adm. items item

Epoetin Beta (Recormon)

2x/week syringe 2 2 1,562.00 3,125.00
5,000 IU
Regeron Forte OD TAB 7 7 30.00 210.00
Amlodipine(Norvasc)10mg BID TAB 7 14 40.00 280.00
CaCo3(Calvit) TID TAB 7 21 8.00 168.00
Total price per week P3,783.00
Total price per
P15,132.00
month
Based on the prices of: Pampanga Medical Specialist Hospital Pharmacy

Noted by: Prepared by:

_______________________ ______________________
Ismael Ramos, MD Judiel John M. Taju, R.N
Nephrologist Hemodialysis Nurse
Lic. #: 85943
PTR #: 2252543