53   years old male pt 
knonw to have DM    for the last  15  years 
hypertension for the last    10  years 
anemia 
dld 
chronic  kidney  diseas  for the last    2  years   1.7mg/dl


c/o   constipation 
decrease urine output 

medications 
cadex  1x2
asa  100 mg ocne
carvidelol  12.5 mg1x2
sitaglu 50 mg once 
lasix   2x2
ferrous fumarate 
calcium  1x2 
laxadin   tab 
mepral 
lipitor   40 mg ocne 


plan
add  lactulose 
add  razalax 
rtc   on thursday at  the hospital  for  further evalaution and managemen t 
