Mona ggee +1 078832 77 year old lady presented complaint relapse of bipolar illness for history of prosthetic complete please see psychiatric team notes plan admit to medical bed until psych older adult psychiatric bed available I note that the psychiatric team have been extensively involved which I greatly appreciate and they've also been able to prescribe her regular medications full stop review investigations reviewed renal function at baseline well actually creatinine a 196 from baseline of a 160 open brackets mild a k a 1 which could be managed in the community crp 3 urea 14.7 ast 82 full blood count unremarkable tsh recently checked and naught. Naught 6 but free thyroxine within normal range impression relapse of bipolar illness very unwell with this currently plan number 1 push oral fluids as much as possible given current situation I don't think she's able to stay still and so she's not gonna tolerate any iv fluid therapy to manage an aki 1 and I don't think that's the most important thing for her at the moment number 2 patient's psych bed when available