Skip to main content
Exact Dx synthetic data · demonstration
Extended criteria (experimental). This is the broader ten-condition engine, kept as a secondary area. It shows ICD-10-CM codes and illustrative grouping effects for CDI staff. The primary surface is Before you sign (kidney, measurement only). All extended pages.

← All encounters

ENC-00002: Amara Whitlock

68F · MRN34099450 · Cardiology · admitted Wed Oct 28, 2026 07:50 PM · discharged Thu Nov 05, 2026 02:50 PM · attending Dr. Wes Merriweather · resident Dr. Noor Halvorsen · 150 cm, 52.8 kg

Documented diagnoses (current)

  • “malnourished” · E46 Unspecified protein-calorie malnutrition
  • “CKD stage 4” · N18.4 Chronic kidney disease, stage 4 (severe)
  • “acute kidney injury” · N17.9 Acute kidney failure, unspecified
  • Principal: “congestive heart failure” · I50.9 Heart failure, unspecified
  • “hyponatremia” · E87.1 Hypo-osmolality and hyponatremia

Illustrative grouping now: MS-DRG 292 Heart failure and shock with CC. If every open specificity/validation gap were answered as the criteria suggest: MS-DRG 292.

Queries and events

No queries yet.

All rules applied

Every rule's outcome for this encounter (clean results included)
RuleCriteriaFindingOutcome
Acute kidney injury Criteria not met Clinical validation gap Documented “acute kidney injury” (N17.9) but the criteria are not met: KDIGO creatinine and urine-output criteria not met.
Trace
Rule trace (rule aki v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: meets_definition creat_ratio >= t.ratio_s1 or creat_rise_48h >= t.rise_abs or coalesce(uo_hours_lt_0_5 >= t.uo_s1_h, false) creat_ratio=1.059, t.ratio_s1=1.5, creat_rise_48h=0.08, t.rise_abs=0.3, uo_hours_lt_0_5=unknown, t.uo_s1_h=6 false
derived: stage3 meets_definition and (creat_ratio >= t.ratio_s3 or creat_peak >= t.scr_s3 or rrt_started or coalesce(uo_hours_lt_0_3 >= t.uo_s3_h, false) or coalesce(anuria_hours >= t.anuria_h, false)) meets_definition=False, creat_ratio=1.059, t.ratio_s3=3.0, creat_peak=2.34, t.scr_s3=4.0, rrt_started=False, uo_hours_lt_0_3=unknown, t.uo_s3_h=24, anuria_hours=unknown, t.anuria_h=12 false
derived: stage2 creat_ratio >= t.ratio_s2 or coalesce(uo_hours_lt_0_5 >= t.uo_s2_h, false) creat_ratio=1.059, t.ratio_s2=2.0, uo_hours_lt_0_5=unknown, t.uo_s2_h=12 false
derived: stage case(stage3, 3, stage2, 2, meets_definition, 1, 0) stage3=False, stage2=False, meets_definition=False 0
derived: baseline_independent creat_baseline_known or creat_rise_48h >= t.rise_abs or rrt_started creat_baseline_known=True, creat_rise_48h=0.08, t.rise_abs=0.3, rrt_started=False true
outcome: aki_staged stage >= 1 and baseline_independent stage=0, baseline_independent=True false
outcome: aki_presumed_baseline stage >= 1 stage=0 false
outcome: not_met stage == 0 stage=0 true
Acute blood loss anaemia Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule blood_loss_anemia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: anaemic case(sex == 'M', hgb_nadir < t.hb_m, sex == 'F', hgb_nadir < t.hb_f, null) sex=F, hgb_nadir=13.45, t.hb_m=13, t.hb_f=12 false
derived: acute_fall hgb_drop >= t.drop_major or prbc_units >= t.prbc_major hgb_drop=0.5, t.drop_major=2.0, prbc_units=0, t.prbc_major=2 false
outcome: met bleeding_documented and anaemic and acute_fall bleeding_documented=False, anaemic=False, acute_fall=False false
outcome: anaemia_only anaemic and hgb_drop < t.drop_min and prbc_units == 0 anaemic=False, hgb_drop=0.5, t.drop_min=1.0, prbc_units=0 false
outcome: not_anaemic present(hgb_nadir) and not anaemic hgb_nadir=13.45, anaemic=False true
Chronic kidney disease Criteria met No gap Supported as documented (N18.4).
Trace
Rule trace (rule ckd v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: chronic egfr_n >= 2 and egfr_span_days >= t.chronic_days egfr_n=2, egfr_span_days=347, t.chronic_days=90 true
derived: staging_egfr max(egfr_early, egfr_late) egfr_early=25.5, egfr_late=23.7 25.5
derived: both_below_60 egfr_early < t.g2 and egfr_late < t.g2 egfr_early=25.5, t.g2=60, egfr_late=23.7 true
derived: category case(staging_egfr >= t.g2, 'G1-G2', staging_egfr >= t.g3a, 'G3a', staging_egfr >= t.g3b, 'G3b', staging_egfr >= t.g4, 'G4', 'G5') staging_egfr=25.5, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15 G4
outcome: duration_not_shown not chronic chronic=True false
outcome: straddles_60 not both_below_60 and min(egfr_early, egfr_late) < t.g2 both_below_60=True, egfr_early=25.5, egfr_late=23.7, t.g2=60 false
outcome: g1_g2 staging_egfr >= t.g2 staging_egfr=25.5, t.g2=60 false
outcome: g3a category == 'G3a' category=G4 false
outcome: g3b category == 'G3b' category=G4 false
outcome: g4 category == 'G4' category=G4 true
Heart failure Criteria met Specificity gap Documented “congestive heart failure” (I50.9); criteria support the more specific Acute on chronic systolic (HFrEF) heart failure (I50.23).
Trace
Rule trace (rule heart_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: np_elevated coalesce(bnp_max >= t.bnp, false) or coalesce(ntprobnp_max >= t.ntprobnp, false) bnp_max=954.0, t.bnp=100, ntprobnp_max=unknown, t.ntprobnp=300 true
derived: acute_count count(iv_loop_diuretic, np_elevated, new_o2) iv_loop_diuretic=True, np_elevated=True, new_o2=False 2
derived: hf_type case(lvef <= t.ref, 'systolic', lvef >= t.pres, 'diastolic', 'midrange') lvef=21.0, t.ref=40, t.pres=50 systolic
derived: improved coalesce(lvef_prior_min <= t.ref and lvef > t.ref and lvef - lvef_prior_min >= t.improved_rise, false) lvef_prior_min=unknown, t.ref=40, lvef=21.0, t.improved_rise=10 false
derived: acuity case(acute_count >= 2 and hf_history, 'acute on chronic', acute_count >= 2, 'acute', acute_count == 0 and hf_history, 'chronic', null) acute_count=2, hf_history=True acute on chronic
outcome: improved_ef improved improved=False false
outcome: midrange hf_type == 'midrange' hf_type=systolic false
outcome: sys_aoc hf_type == 'systolic' and acuity == 'acute on chronic' hf_type=systolic, acuity=acute on chronic true
Hyponatraemia Clinical judgement required Clinical judgement required Clinical judgement required: Low sodium without documented treatment or repeat values; clinical significance is a clinician judgement.
Trace
Rule trace (rule hyponatremia v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: severity case(na_min < t.profound, 'profound', na_min < t.moderate, 'moderate', na_min < t.low, 'mild', 'none') na_min=133.0, t.profound=125, t.moderate=130, t.low=135 mild
outcome: met na_min < t.low and na_low_count >= t.repeat and na_treated na_min=133.0, t.low=135, na_low_count=1, t.repeat=2, na_treated=False false
outcome: untreated na_min < t.low na_min=133.0, t.low=135 true
Malnutrition Clinical judgement required Clinical judgement required Clinical judgement required: Only one consensus characteristic documented; two are required.
Trace
Rule trace (rule malnutrition v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: a_sev_intake intake_pct <= t.a_sev_intake_pct and intake_days >= t.a_sev_intake_days intake_pct=60.0, t.a_sev_intake_pct=50, intake_days=12.0, t.a_sev_intake_days=5 false
derived: a_mod_intake intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days intake_pct=60.0, t.a_mod_intake_pct=75, intake_days=12.0, t.a_mod_intake_days=7 true
derived: a_sev_wt (wt_loss_days <= 7 and wt_loss_pct > 2) or (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: a_mod_wt (wt_loss_days <= 7 and wt_loss_pct >= 1) or (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: c_sev_intake intake_pct <= t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=60.0, t.c_intake_pct=75, intake_days=12.0, t.c_intake_days=30 false
derived: c_mod_intake intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=60.0, t.c_intake_pct=75, intake_days=12.0, t.c_intake_days=30 false
derived: c_sev_wt (wt_loss_days <= 31 and wt_loss_pct > 5) or (wt_loss_days <= 92 and wt_loss_pct > 7.5) or (wt_loss_days <= 183 and wt_loss_pct > 10) or (wt_loss_days <= 366 and wt_loss_pct > 20) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: c_mod_wt (wt_loss_days <= 31 and wt_loss_pct >= 5) or (wt_loss_days <= 92 and wt_loss_pct >= 7.5) or (wt_loss_days <= 183 and wt_loss_pct >= 10) or (wt_loss_days <= 366 and wt_loss_pct >= 20) wt_loss_days=unknown, wt_loss_pct=unknown unknown
derived: n_assessed known(intake_pct, wt_loss_pct, fat_loss, muscle_loss, fluid, grip_reduced) intake_pct=60.0, wt_loss_pct=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown 4
derived: n_severe case(nutr_context == 'acute', count(a_sev_intake, a_sev_wt, fat_loss >= 2, muscle_loss >= 2, fluid >= 2, grip_reduced), nutr_context == 'chronic', count(c_sev_intake, c_sev_wt, fat_loss >= 3, muscle_loss >= 3, fluid >= 3, grip_reduced), null) nutr_context=acute, a_sev_intake=False, a_sev_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_sev_wt=unknown 0
derived: n_moderate case(nutr_context == 'acute', count(a_sev_intake or a_mod_intake, a_sev_wt or a_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), nutr_context == 'chronic', count(c_sev_intake or c_mod_intake, c_sev_wt or c_mod_wt, fat_loss >= 1, muscle_loss >= 1, fluid >= 1, grip_reduced), null) nutr_context=acute, a_sev_intake=False, a_mod_intake=True, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=0, muscle_loss=0, fluid=0, grip_reduced=unknown, c_sev_intake=False, c_mod_intake=False, c_sev_wt=unknown, c_mod_wt=unknown 1
outcome: severe n_severe >= 2 n_severe=0 false
outcome: moderate n_moderate >= 2 n_moderate=1 false
outcome: one_characteristic n_moderate == 1 n_moderate=1 true
Obesity Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule obesity v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
outcome: not_adult age < t.adult age=68, t.adult=20 false
outcome: class3 bmi >= t.c3 bmi=23.5, t.c3=40 false
outcome: class2 bmi >= t.c2 bmi=23.5, t.c2=35 false
outcome: class1 bmi >= t.c1 bmi=23.5, t.c1=30 false
outcome: not_met bmi < t.c1 bmi=23.5, t.c1=30 true
Pressure injury Insufficient data No gap Insufficient data: the criteria could not be applied.
Trace
Rule trace (rule pressure_injury v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: sacral wound_site == 'sacral' wound_site=unknown unknown
outcome: no_wound_note not present(wound_stage) wound_stage=unknown true
Acute respiratory failure Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule respiratory_failure v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: measured present(spo2_min_ra) or present(pao2_min_ra) or present(pf_min) spo2_min_ra=94.0, pao2_min_ra=unknown, pf_min=unknown true
derived: hypoxemia coalesce(spo2_min_ra < t.spo2_ra, false) or coalesce(pao2_min_ra < t.pao2, false) or coalesce(pf_min < t.pf, false) spo2_min_ra=94.0, t.spo2_ra=88, pao2_min_ra=unknown, t.pao2=60, pf_min=unknown, t.pf=300 false
derived: distress coalesce(rr_max >= t.rr_distress, false) or coalesce(wob_increased, false) or adv_resp_support rr_max=20.0, t.rr_distress=28, wob_increased=unknown, adv_resp_support=False false
outcome: chronic_baseline home_o2 and hypoxemia home_o2=False, hypoxemia=False false
outcome: met hypoxemia and distress hypoxemia=False, distress=False false
outcome: hypoxemia_only hypoxemia hypoxemia=False false
outcome: not_met measured and not hypoxemia and o2_max_lpm <= t.o2_low and not adv_resp_support measured=True, hypoxemia=False, o2_max_lpm=0.0, t.o2_low=2, adv_resp_support=False true
Sepsis Criteria not met No gap Not documented and not supported.
Trace
Rule trace (rule sepsis v2026.11-1; evaluated in order, first true outcome wins; "unknown" = missing input)
StepExpressionInputs and thresholds readResult
derived: sirs_temp coalesce(temp_max_48h > t.t_hi, false) or coalesce(temp_min_48h < t.t_lo, false) temp_max_48h=37.1, t.t_hi=38, temp_min_48h=36.5, t.t_lo=36 false
derived: sirs_hr coalesce(hr_max_48h > t.hr, false) hr_max_48h=90.0, t.hr=90 false
derived: sirs_rr coalesce(rr_max_48h > t.rr, false) or coalesce(paco2_min_48h < t.paco2, false) rr_max_48h=20.0, t.rr=20, paco2_min_48h=unknown, t.paco2=32 false
derived: sirs_wbc coalesce(wbc_max_48h > t.wbc_hi, false) or coalesce(wbc_min_48h < t.wbc_lo, false) or coalesce(bands_max_48h > t.bands, false) wbc_max_48h=8.98, t.wbc_hi=12, wbc_min_48h=5.84, t.wbc_lo=4, bands_max_48h=unknown, t.bands=10 false
derived: sirs_count count(sirs_temp, sirs_hr, sirs_rr, sirs_wbc) sirs_temp=False, sirs_hr=False, sirs_rr=False, sirs_wbc=False 0
derived: sofa_resp coalesce(case(pf_min_48h < 100 and adv_resp_support, 4, pf_min_48h < 200 and adv_resp_support, 3, pf_min_48h < 300, 2, pf_min_48h < 400, 1, 0), 0) pf_min_48h=unknown, adv_resp_support=False 0
derived: sofa_coag coalesce(case(platelets_min_48h < 20, 4, platelets_min_48h < 50, 3, platelets_min_48h < 100, 2, platelets_min_48h < 150, 1, 0), 0) platelets_min_48h=170.0 0
derived: sofa_liver coalesce(case(bili_max_48h >= 12, 4, bili_max_48h >= 6, 3, bili_max_48h >= 2, 2, bili_max_48h >= 1.2, 1, 0), 0) bili_max_48h=0.96 0
derived: sofa_cardio coalesce(case(norepi_max_48h > 0.1, 4, norepi_max_48h > 0, 3, map_min_48h < 70, 1, 0), 0) norepi_max_48h=0.0, map_min_48h=75.0 0
derived: sofa_cns coalesce(case(gcs_min_48h < 6, 4, gcs_min_48h < 10, 3, gcs_min_48h < 13, 2, gcs_min_48h < 15, 1, 0), 0) gcs_min_48h=15.0 0
derived: sofa_renal coalesce(case(creat_max_48h >= 5, 4, creat_max_48h >= 3.5, 3, creat_max_48h >= 2, 2, creat_max_48h >= 1.2, 1, 0), 0) creat_max_48h=2.34 2
derived: sofa_renal_baseline coalesce(case(creat_baseline >= 5, 4, creat_baseline >= 3.5, 3, creat_baseline >= 2, 2, creat_baseline >= 1.2, 1, 0), 0) creat_baseline=2.21 2
derived: sofa_delta sofa_resp + sofa_coag + sofa_liver + sofa_cardio + sofa_cns + sofa_renal - sofa_renal_baseline sofa_resp=0, sofa_coag=0, sofa_liver=0, sofa_cardio=0, sofa_cns=0, sofa_renal=2, sofa_renal_baseline=2 0
derived: sepsis3 infection_documented and sofa_delta >= t.sofa_delta infection_documented=False, sofa_delta=0, t.sofa_delta=2 false
derived: sepsis2 infection_documented and sirs_count >= t.sirs_min infection_documented=False, sirs_count=0, t.sirs_min=2 false
derived: shock sepsis3 and norepi_max_48h > 0 and coalesce(lactate_max_48h > t.lactate, false) sepsis3=False, norepi_max_48h=0.0, lactate_max_48h=unknown, t.lactate=2 false
outcome: no_infection not infection_documented infection_documented=False true

Structured data

Labs (49)
Labs (pre-admission rows are outpatient values)
RowWhenTestValue
LAB-000025Thu Sep 25, 2025 09:15 AMcreatinine2.08 mg/dL
LAB-000026Mon Sep 07, 2026 10:05 AMcreatinine2.21 mg/dL
LAB-000027Wed Oct 28, 2026 08:50 PMcreatinine2.34 mg/dL
LAB-000036Wed Oct 28, 2026 08:50 PMbnp954.0 pg/mL
LAB-000037Wed Oct 28, 2026 08:50 PMsodium133.0 mmol/L
LAB-000046Wed Oct 28, 2026 08:50 PMhemoglobin13.94 g/dL
LAB-000055Wed Oct 28, 2026 08:50 PMwbc8.98 x10^3/uL
LAB-000056Wed Oct 28, 2026 08:50 PMplatelets208.0 x10^3/uL
LAB-000073Wed Oct 28, 2026 08:50 PMbilirubin0.96 mg/dL
LAB-000028Thu Oct 29, 2026 05:00 AMcreatinine2.17 mg/dL
LAB-000038Thu Oct 29, 2026 05:00 AMsodium137.0 mmol/L
LAB-000047Thu Oct 29, 2026 05:00 AMhemoglobin13.45 g/dL
LAB-000057Thu Oct 29, 2026 05:00 AMwbc5.84 x10^3/uL
LAB-000058Thu Oct 29, 2026 05:00 AMplatelets170.0 x10^3/uL
LAB-000029Fri Oct 30, 2026 05:00 AMcreatinine2.23 mg/dL
LAB-000039Fri Oct 30, 2026 05:00 AMsodium139.0 mmol/L
LAB-000048Fri Oct 30, 2026 05:00 AMhemoglobin13.71 g/dL
LAB-000059Fri Oct 30, 2026 05:00 AMwbc6.06 x10^3/uL
LAB-000060Fri Oct 30, 2026 05:00 AMplatelets282.0 x10^3/uL
LAB-000030Sat Oct 31, 2026 05:00 AMcreatinine2.25 mg/dL
LAB-000040Sat Oct 31, 2026 05:00 AMsodium138.0 mmol/L
LAB-000049Sat Oct 31, 2026 05:00 AMhemoglobin13.47 g/dL
LAB-000061Sat Oct 31, 2026 05:00 AMwbc7.39 x10^3/uL
LAB-000062Sat Oct 31, 2026 05:00 AMplatelets245.0 x10^3/uL
LAB-000031Sun Nov 01, 2026 05:00 AMcreatinine2.26 mg/dL
LAB-000041Sun Nov 01, 2026 05:00 AMsodium139.0 mmol/L
LAB-000050Sun Nov 01, 2026 05:00 AMhemoglobin13.81 g/dL
LAB-000063Sun Nov 01, 2026 05:00 AMwbc8.87 x10^3/uL
LAB-000064Sun Nov 01, 2026 05:00 AMplatelets168.0 x10^3/uL
LAB-000032Mon Nov 02, 2026 05:00 AMcreatinine2.25 mg/dL
LAB-000042Mon Nov 02, 2026 05:00 AMsodium136.0 mmol/L
LAB-000051Mon Nov 02, 2026 05:00 AMhemoglobin13.78 g/dL
LAB-000065Mon Nov 02, 2026 05:00 AMwbc5.54 x10^3/uL
LAB-000066Mon Nov 02, 2026 05:00 AMplatelets217.0 x10^3/uL
LAB-000033Tue Nov 03, 2026 05:00 AMcreatinine2.29 mg/dL
LAB-000043Tue Nov 03, 2026 05:00 AMsodium138.0 mmol/L
LAB-000052Tue Nov 03, 2026 05:00 AMhemoglobin13.68 g/dL
LAB-000067Tue Nov 03, 2026 05:00 AMwbc6.73 x10^3/uL
LAB-000068Tue Nov 03, 2026 05:00 AMplatelets205.0 x10^3/uL
LAB-000034Wed Nov 04, 2026 05:00 AMcreatinine2.24 mg/dL
LAB-000044Wed Nov 04, 2026 05:00 AMsodium137.0 mmol/L
LAB-000053Wed Nov 04, 2026 05:00 AMhemoglobin13.68 g/dL
LAB-000069Wed Nov 04, 2026 05:00 AMwbc9.57 x10^3/uL
LAB-000070Wed Nov 04, 2026 05:00 AMplatelets260.0 x10^3/uL
LAB-000035Thu Nov 05, 2026 05:00 AMcreatinine2.31 mg/dL
LAB-000045Thu Nov 05, 2026 05:00 AMsodium138.0 mmol/L
LAB-000054Thu Nov 05, 2026 05:00 AMhemoglobin13.47 g/dL
LAB-000071Thu Nov 05, 2026 05:00 AMwbc10.86 x10^3/uL
LAB-000072Thu Nov 05, 2026 05:00 AMplatelets288.0 x10^3/uL
Vitals (144)
Vitals
RowWhenKindValueDetail
VIT-000071Wed Oct 28, 2026 08:10 PMspo297.0room air
VIT-000072Wed Oct 28, 2026 08:10 PMrr18.0
VIT-000119Wed Oct 28, 2026 08:10 PMtemp_c36.6
VIT-000120Wed Oct 28, 2026 08:10 PMhr80.0
VIT-000121Wed Oct 28, 2026 08:10 PMmap87.0
VIT-000122Wed Oct 28, 2026 08:10 PMgcs15.0
VIT-000073Thu Oct 29, 2026 04:10 AMspo297.0room air
VIT-000074Thu Oct 29, 2026 04:10 AMrr15.0
VIT-000123Thu Oct 29, 2026 04:10 AMtemp_c36.8
VIT-000124Thu Oct 29, 2026 04:10 AMhr90.0
VIT-000125Thu Oct 29, 2026 04:10 AMmap88.0
VIT-000126Thu Oct 29, 2026 04:10 AMgcs15.0
VIT-000075Thu Oct 29, 2026 12:10 PMspo298.0room air
VIT-000076Thu Oct 29, 2026 12:10 PMrr20.0
VIT-000127Thu Oct 29, 2026 12:10 PMtemp_c36.5
VIT-000128Thu Oct 29, 2026 12:10 PMhr77.0
VIT-000129Thu Oct 29, 2026 12:10 PMmap76.0
VIT-000130Thu Oct 29, 2026 12:10 PMgcs15.0
VIT-000077Thu Oct 29, 2026 08:10 PMspo295.0room air
VIT-000078Thu Oct 29, 2026 08:10 PMrr19.0
VIT-000131Thu Oct 29, 2026 08:10 PMtemp_c37.1
VIT-000132Thu Oct 29, 2026 08:10 PMhr87.0
VIT-000133Thu Oct 29, 2026 08:10 PMmap83.0
VIT-000134Thu Oct 29, 2026 08:10 PMgcs15.0
VIT-000079Fri Oct 30, 2026 04:10 AMspo295.0room air
VIT-000080Fri Oct 30, 2026 04:10 AMrr16.0
VIT-000135Fri Oct 30, 2026 04:10 AMtemp_c36.9
VIT-000136Fri Oct 30, 2026 04:10 AMhr73.0
VIT-000137Fri Oct 30, 2026 04:10 AMmap75.0
VIT-000138Fri Oct 30, 2026 04:10 AMgcs15.0
VIT-000081Fri Oct 30, 2026 12:10 PMspo298.0room air
VIT-000082Fri Oct 30, 2026 12:10 PMrr17.0
VIT-000139Fri Oct 30, 2026 12:10 PMtemp_c36.6
VIT-000140Fri Oct 30, 2026 12:10 PMhr79.0
VIT-000141Fri Oct 30, 2026 12:10 PMmap79.0
VIT-000142Fri Oct 30, 2026 12:10 PMgcs15.0
VIT-000083Fri Oct 30, 2026 08:10 PMspo295.0room air
VIT-000084Fri Oct 30, 2026 08:10 PMrr19.0
VIT-000143Fri Oct 30, 2026 08:10 PMtemp_c37.2
VIT-000144Fri Oct 30, 2026 08:10 PMhr71.0
VIT-000145Fri Oct 30, 2026 08:10 PMmap74.0
VIT-000146Fri Oct 30, 2026 08:10 PMgcs15.0
VIT-000085Sat Oct 31, 2026 04:10 AMspo294.0room air
VIT-000086Sat Oct 31, 2026 04:10 AMrr17.0
VIT-000147Sat Oct 31, 2026 04:10 AMtemp_c37.6
VIT-000148Sat Oct 31, 2026 04:10 AMhr92.0
VIT-000149Sat Oct 31, 2026 04:10 AMmap82.0
VIT-000150Sat Oct 31, 2026 04:10 AMgcs15.0
VIT-000087Sat Oct 31, 2026 12:10 PMspo297.0room air
VIT-000088Sat Oct 31, 2026 12:10 PMrr15.0
VIT-000151Sat Oct 31, 2026 12:10 PMtemp_c36.9
VIT-000152Sat Oct 31, 2026 12:10 PMhr79.0
VIT-000153Sat Oct 31, 2026 12:10 PMmap76.0
VIT-000154Sat Oct 31, 2026 12:10 PMgcs15.0
VIT-000089Sat Oct 31, 2026 08:10 PMspo294.0room air
VIT-000090Sat Oct 31, 2026 08:10 PMrr17.0
VIT-000155Sat Oct 31, 2026 08:10 PMtemp_c37.3
VIT-000156Sat Oct 31, 2026 08:10 PMhr85.0
VIT-000157Sat Oct 31, 2026 08:10 PMmap89.0
VIT-000158Sat Oct 31, 2026 08:10 PMgcs15.0
VIT-000091Sun Nov 01, 2026 04:10 AMspo295.0room air
VIT-000092Sun Nov 01, 2026 04:10 AMrr17.0
VIT-000159Sun Nov 01, 2026 04:10 AMtemp_c37.4
VIT-000160Sun Nov 01, 2026 04:10 AMhr70.0
VIT-000161Sun Nov 01, 2026 04:10 AMmap74.0
VIT-000162Sun Nov 01, 2026 04:10 AMgcs15.0
VIT-000093Sun Nov 01, 2026 12:10 PMspo297.0room air
VIT-000094Sun Nov 01, 2026 12:10 PMrr15.0
VIT-000163Sun Nov 01, 2026 12:10 PMtemp_c37.5
VIT-000164Sun Nov 01, 2026 12:10 PMhr85.0
VIT-000165Sun Nov 01, 2026 12:10 PMmap75.0
VIT-000166Sun Nov 01, 2026 12:10 PMgcs15.0
VIT-000095Sun Nov 01, 2026 08:10 PMspo294.0room air
VIT-000096Sun Nov 01, 2026 08:10 PMrr19.0
VIT-000167Sun Nov 01, 2026 08:10 PMtemp_c36.6
VIT-000168Sun Nov 01, 2026 08:10 PMhr74.0
VIT-000169Sun Nov 01, 2026 08:10 PMmap80.0
VIT-000170Sun Nov 01, 2026 08:10 PMgcs15.0
VIT-000097Mon Nov 02, 2026 04:10 AMspo299.0room air
VIT-000098Mon Nov 02, 2026 04:10 AMrr20.0
VIT-000171Mon Nov 02, 2026 04:10 AMtemp_c37.3
VIT-000172Mon Nov 02, 2026 04:10 AMhr83.0
VIT-000173Mon Nov 02, 2026 04:10 AMmap85.0
VIT-000174Mon Nov 02, 2026 04:10 AMgcs15.0
VIT-000099Mon Nov 02, 2026 12:10 PMspo299.0room air
VIT-000100Mon Nov 02, 2026 12:10 PMrr17.0
VIT-000175Mon Nov 02, 2026 12:10 PMtemp_c36.7
VIT-000176Mon Nov 02, 2026 12:10 PMhr78.0
VIT-000177Mon Nov 02, 2026 12:10 PMmap77.0
VIT-000178Mon Nov 02, 2026 12:10 PMgcs15.0
VIT-000101Mon Nov 02, 2026 08:10 PMspo296.0room air
VIT-000102Mon Nov 02, 2026 08:10 PMrr20.0
VIT-000179Mon Nov 02, 2026 08:10 PMtemp_c37.1
VIT-000180Mon Nov 02, 2026 08:10 PMhr89.0
VIT-000181Mon Nov 02, 2026 08:10 PMmap83.0
VIT-000182Mon Nov 02, 2026 08:10 PMgcs15.0
VIT-000103Tue Nov 03, 2026 04:10 AMspo294.0room air
VIT-000104Tue Nov 03, 2026 04:10 AMrr19.0
VIT-000183Tue Nov 03, 2026 04:10 AMtemp_c36.8
VIT-000184Tue Nov 03, 2026 04:10 AMhr77.0
VIT-000185Tue Nov 03, 2026 04:10 AMmap85.0
VIT-000186Tue Nov 03, 2026 04:10 AMgcs15.0
VIT-000105Tue Nov 03, 2026 12:10 PMspo299.0room air
VIT-000106Tue Nov 03, 2026 12:10 PMrr17.0
VIT-000187Tue Nov 03, 2026 12:10 PMtemp_c37.4
VIT-000188Tue Nov 03, 2026 12:10 PMhr90.0
VIT-000189Tue Nov 03, 2026 12:10 PMmap91.0
VIT-000190Tue Nov 03, 2026 12:10 PMgcs15.0
VIT-000107Tue Nov 03, 2026 08:10 PMspo295.0room air
VIT-000108Tue Nov 03, 2026 08:10 PMrr17.0
VIT-000191Tue Nov 03, 2026 08:10 PMtemp_c36.6
VIT-000192Tue Nov 03, 2026 08:10 PMhr88.0
VIT-000193Tue Nov 03, 2026 08:10 PMmap74.0
VIT-000194Tue Nov 03, 2026 08:10 PMgcs15.0
VIT-000109Wed Nov 04, 2026 04:10 AMspo298.0room air
VIT-000110Wed Nov 04, 2026 04:10 AMrr17.0
VIT-000195Wed Nov 04, 2026 04:10 AMtemp_c36.6
VIT-000196Wed Nov 04, 2026 04:10 AMhr89.0
VIT-000197Wed Nov 04, 2026 04:10 AMmap88.0
VIT-000198Wed Nov 04, 2026 04:10 AMgcs15.0
VIT-000111Wed Nov 04, 2026 12:10 PMspo294.0room air
VIT-000112Wed Nov 04, 2026 12:10 PMrr19.0
VIT-000199Wed Nov 04, 2026 12:10 PMtemp_c37.4
VIT-000200Wed Nov 04, 2026 12:10 PMhr80.0
VIT-000201Wed Nov 04, 2026 12:10 PMmap80.0
VIT-000202Wed Nov 04, 2026 12:10 PMgcs15.0
VIT-000113Wed Nov 04, 2026 08:10 PMspo294.0room air
VIT-000114Wed Nov 04, 2026 08:10 PMrr20.0
VIT-000203Wed Nov 04, 2026 08:10 PMtemp_c36.7
VIT-000204Wed Nov 04, 2026 08:10 PMhr83.0
VIT-000205Wed Nov 04, 2026 08:10 PMmap77.0
VIT-000206Wed Nov 04, 2026 08:10 PMgcs15.0
VIT-000115Thu Nov 05, 2026 04:10 AMspo294.0room air
VIT-000116Thu Nov 05, 2026 04:10 AMrr16.0
VIT-000207Thu Nov 05, 2026 04:10 AMtemp_c37.3
VIT-000208Thu Nov 05, 2026 04:10 AMhr75.0
VIT-000209Thu Nov 05, 2026 04:10 AMmap75.0
VIT-000210Thu Nov 05, 2026 04:10 AMgcs15.0
VIT-000117Thu Nov 05, 2026 12:10 PMspo297.0room air
VIT-000118Thu Nov 05, 2026 12:10 PMrr14.0
VIT-000211Thu Nov 05, 2026 12:10 PMtemp_c37.2
VIT-000212Thu Nov 05, 2026 12:10 PMhr81.0
VIT-000213Thu Nov 05, 2026 12:10 PMmap88.0
VIT-000214Thu Nov 05, 2026 12:10 PMgcs15.0
Medications, orders, echo, history (8)

Notes

History and physical · DOC-000005 · Dr. Noor Halvorsen (resident) · Wed Oct 28, 2026 10:50 PM

Source document DOC-000005: History and physical (synthetic)
HISTORY AND PHYSICAL
Patient: Amara Whitlock   MRN: MRN34099450   Admitted: 2026-10-28 19:50
Service: Cardiology   Attending: Dr. Wes Merriweather

History of present illness: 68-year-old woman admitted with congestive heart failure. 
Past medical history: heart failure with reduced ejection fraction.
Review of systems otherwise negative.
Exam: Lungs: clear to auscultation bilaterally.
Assessment and plan:
1. CKD stage 4: renally dose medications.
2. Congestive heart failure: diuresis and daily weights; monitor electrolytes.

Nutrition assessment · DOC-000004 · Viggo Ravensworth, RD (dietitian) · Fri Oct 30, 2026 12:50 AM

Cited facts from this note (6)
fat_loss
none · cited p. 1, line 7 · confidence 0.90
Show source for fat_loss
… acute illness Intake: estimated energy intake 60% of needs for 12 days. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: at risk; continue calorie counts.
fluid_accumulation
none · cited p. 1, line 7 · confidence 0.90
Show source for fluid_accumulation
… 0% of needs for 12 days. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: at risk; continue calorie counts.
intake_days
12 · cited p. 1, line 5 · confidence 0.95
Show source for intake_days
NUTRITION ASSESSMENT (Registered Dietitian) Patient: Amara Whitlock MRN: MRN34099450 Context: acute illness Intake: estimated energy intake 60% of needs for 12 days. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
intake_pct
60 · cited p. 1, line 5 · confidence 0.95
Show source for intake_pct
NUTRITION ASSESSMENT (Registered Dietitian) Patient: Amara Whitlock MRN: MRN34099450 Context: acute illness Intake: estimated energy intake 60% of needs for 12 days. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. …
muscle_loss
none · cited p. 1, line 7 · confidence 0.90
Show source for muscle_loss
… ted energy intake 60% of needs for 12 days. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation. Assessment: at risk; continue calorie counts.
nutrition_context
acute · cited p. 1, line 4 · confidence 0.95
Show source for nutrition_context
NUTRITION ASSESSMENT (Registered Dietitian) Patient: Amara Whitlock MRN: MRN34099450 Context: acute illness Intake: estimated energy intake 60% of needs for 12 days. Weight history: weight stable over the past 3 months. Nutrition-focused physical exam: no loss of sub …
Source document DOC-000004: Nutrition assessment (synthetic)
NUTRITION ASSESSMENT (Registered Dietitian)
Patient: Amara Whitlock   MRN: MRN34099450

Context: acute illness
Intake: estimated energy intake 60% of needs for 12 days.
Weight history: weight stable over the past 3 months.
Nutrition-focused physical exam: no loss of subcutaneous fat; no muscle wasting; no fluid accumulation.
Assessment: at risk; continue calorie counts.

Progress note · DOC-000006 · Dr. Noor Halvorsen (resident) · Fri Oct 30, 2026 11:50 PM

Source document DOC-000006: Progress note (synthetic)
PROGRESS NOTE (Resident)
Patient: Amara Whitlock   MRN: MRN34099450   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Congestive heart failure: continue current management.
2. Malnourished: dietitian following.
3. Acute kidney injury: trend creatinine, hold nephrotoxins, strict intake and output.
4. Hyponatremia: trend sodium.

Resident: Dr. Noor Halvorsen   Attending cosign: completed

Discharge summary · DOC-000007 · Dr. Wes Merriweather (attending) · Thu Nov 05, 2026 02:50 PM

Source document DOC-000007: Discharge summary (synthetic)
DISCHARGE SUMMARY
Patient: Amara Whitlock   MRN: MRN34099450
Admitted 2026-10-28; discharged 2026-11-05.

Discharge diagnoses:
- malnourished
- CKD stage 4
- acute kidney injury
- congestive heart failure
- hyponatremia

Disposition: home with follow-up.