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-00094: Zara Juniper

53M · MRN34747578 · Cardiology · admitted Sun Nov 01, 2026 06:53 PM · discharged Sun Nov 08, 2026 10:29 AM · attending Dr. Cyrus Ellingham · resident Dr. Priya Thorne · 179 cm, 76.8 kg

Documented diagnoses (current)

  • “CKD” · N18.9 Chronic kidney disease, unspecified
  • Principal: “acute on chronic diastolic heart failure” · I50.33 Acute on chronic diastolic (congestive) heart failure
  • “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 293.

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 No gap Not documented and not supported.
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=1.036, 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=1.036, t.ratio_s3=3.0, creat_peak=2.31, 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=1.036, 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=M, hgb_nadir=13.61, 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=13.61, anaemic=False true
Chronic kidney disease Criteria met Specificity gap Documented “CKD” (N18.9); criteria support the more specific Chronic kidney disease stage 3b (N18.32).
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=340, t.chronic_days=90 true
derived: staging_egfr max(egfr_early, egfr_late) egfr_early=38.3, egfr_late=34.4 38.3
derived: both_below_60 egfr_early < t.g2 and egfr_late < t.g2 egfr_early=38.3, t.g2=60, egfr_late=34.4 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=38.3, t.g2=60, t.g3a=45, t.g3b=30, t.g4=15 G3b
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=38.3, egfr_late=34.4, t.g2=60 false
outcome: g1_g2 staging_egfr >= t.g2 staging_egfr=38.3, t.g2=60 false
outcome: g3a category == 'G3a' category=G3b false
outcome: g3b category == 'G3b' category=G3b true
Heart failure Criteria met No gap Supported as documented (I50.33).
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=1395.0, 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=65.0, t.ref=40, t.pres=50 diastolic
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=65.0, 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=diastolic false
outcome: sys_aoc hf_type == 'systolic' and acuity == 'acute on chronic' hf_type=diastolic, acuity=acute on chronic false
outcome: sys_acute hf_type == 'systolic' and acuity == 'acute' hf_type=diastolic, acuity=acute on chronic false
outcome: sys_chronic hf_type == 'systolic' and acuity == 'chronic' hf_type=diastolic, acuity=acute on chronic false
outcome: dia_aoc hf_type == 'diastolic' and acuity == 'acute on chronic' hf_type=diastolic, acuity=acute on chronic true
Hyponatraemia Criteria not met Clinical validation gap Documented “hyponatremia” (E87.1) but the criteria are not met: All sodium values 135 or above (lowest 136).
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=136.0, t.profound=125, t.moderate=130, t.low=135 none
outcome: met na_min < t.low and na_low_count >= t.repeat and na_treated na_min=136.0, t.low=135, na_low_count=0, t.repeat=2, na_treated=False false
outcome: untreated na_min < t.low na_min=136.0, t.low=135 false
outcome: not_met na_min >= t.low na_min=136.0, t.low=135 true
Malnutrition Insufficient data No gap Insufficient data: the criteria could not be applied.
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=unknown, t.a_sev_intake_pct=50, intake_days=unknown, t.a_sev_intake_days=5 unknown
derived: a_mod_intake intake_pct < t.a_mod_intake_pct and intake_days > t.a_mod_intake_days intake_pct=unknown, t.a_mod_intake_pct=75, intake_days=unknown, t.a_mod_intake_days=7 unknown
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=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30 unknown
derived: c_mod_intake intake_pct < t.c_intake_pct and intake_days >= t.c_intake_days intake_pct=unknown, t.c_intake_pct=75, intake_days=unknown, t.c_intake_days=30 unknown
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=unknown, wt_loss_pct=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown 0
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=unknown, a_sev_intake=unknown, a_sev_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_sev_wt=unknown unknown
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=unknown, a_sev_intake=unknown, a_mod_intake=unknown, a_sev_wt=unknown, a_mod_wt=unknown, fat_loss=unknown, muscle_loss=unknown, fluid=unknown, grip_reduced=unknown, c_sev_intake=unknown, c_mod_intake=unknown, c_sev_wt=unknown, c_mod_wt=unknown unknown
outcome: severe n_severe >= 2 n_severe=unknown unknown
outcome: moderate n_moderate >= 2 n_moderate=unknown unknown
outcome: one_characteristic n_moderate == 1 n_moderate=unknown unknown
outcome: not_met n_moderate == 0 and n_assessed >= 2 n_moderate=unknown, n_assessed=0 false
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=53, t.adult=20 false
outcome: class3 bmi >= t.c3 bmi=24.0, t.c3=40 false
outcome: class2 bmi >= t.c2 bmi=24.0, t.c2=35 false
outcome: class1 bmi >= t.c1 bmi=24.0, t.c1=30 false
outcome: not_met bmi < t.c1 bmi=24.0, 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=37.5, t.t_hi=38, temp_min_48h=36.6, t.t_lo=36 false
derived: sirs_hr coalesce(hr_max_48h > t.hr, false) hr_max_48h=81.0, 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=8.0, t.wbc_hi=12, wbc_min_48h=7.5, 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=167.0 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=0.51 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=2.31 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=2.23 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 (44)
Labs (pre-admission rows are outpatient values)
RowWhenTestValue
LAB-003183Tue Sep 16, 2025 09:15 AMcreatinine2.04 mg/dL
LAB-003184Sat Aug 22, 2026 10:05 AMcreatinine2.23 mg/dL
LAB-003185Sun Nov 01, 2026 07:53 PMcreatinine2.29 mg/dL
LAB-003193Sun Nov 01, 2026 07:53 PMbnp1395.0 pg/mL
LAB-003194Sun Nov 01, 2026 07:53 PMsodium138.0 mmol/L
LAB-003202Sun Nov 01, 2026 07:53 PMhemoglobin13.63 g/dL
LAB-003210Sun Nov 01, 2026 07:53 PMwbc7.79 x10^3/uL
LAB-003211Sun Nov 01, 2026 07:53 PMplatelets167.0 x10^3/uL
LAB-003226Sun Nov 01, 2026 07:53 PMbilirubin0.51 mg/dL
LAB-003186Mon Nov 02, 2026 05:00 AMcreatinine2.31 mg/dL
LAB-003195Mon Nov 02, 2026 05:00 AMsodium138.0 mmol/L
LAB-003203Mon Nov 02, 2026 05:00 AMhemoglobin13.88 g/dL
LAB-003212Mon Nov 02, 2026 05:00 AMwbc7.5 x10^3/uL
LAB-003213Mon Nov 02, 2026 05:00 AMplatelets197.0 x10^3/uL
LAB-003187Tue Nov 03, 2026 05:00 AMcreatinine2.19 mg/dL
LAB-003196Tue Nov 03, 2026 05:00 AMsodium141.0 mmol/L
LAB-003204Tue Nov 03, 2026 05:00 AMhemoglobin14.04 g/dL
LAB-003214Tue Nov 03, 2026 05:00 AMwbc8.0 x10^3/uL
LAB-003215Tue Nov 03, 2026 05:00 AMplatelets225.0 x10^3/uL
LAB-003188Wed Nov 04, 2026 05:00 AMcreatinine2.24 mg/dL
LAB-003197Wed Nov 04, 2026 05:00 AMsodium136.0 mmol/L
LAB-003205Wed Nov 04, 2026 05:00 AMhemoglobin14.06 g/dL
LAB-003216Wed Nov 04, 2026 05:00 AMwbc9.6 x10^3/uL
LAB-003217Wed Nov 04, 2026 05:00 AMplatelets242.0 x10^3/uL
LAB-003189Thu Nov 05, 2026 05:00 AMcreatinine2.22 mg/dL
LAB-003198Thu Nov 05, 2026 05:00 AMsodium139.0 mmol/L
LAB-003206Thu Nov 05, 2026 05:00 AMhemoglobin13.87 g/dL
LAB-003218Thu Nov 05, 2026 05:00 AMwbc9.63 x10^3/uL
LAB-003219Thu Nov 05, 2026 05:00 AMplatelets194.0 x10^3/uL
LAB-003190Fri Nov 06, 2026 05:00 AMcreatinine2.3 mg/dL
LAB-003199Fri Nov 06, 2026 05:00 AMsodium138.0 mmol/L
LAB-003207Fri Nov 06, 2026 05:00 AMhemoglobin13.61 g/dL
LAB-003220Fri Nov 06, 2026 05:00 AMwbc5.71 x10^3/uL
LAB-003221Fri Nov 06, 2026 05:00 AMplatelets296.0 x10^3/uL
LAB-003191Sat Nov 07, 2026 05:00 AMcreatinine2.3 mg/dL
LAB-003200Sat Nov 07, 2026 05:00 AMsodium140.0 mmol/L
LAB-003208Sat Nov 07, 2026 05:00 AMhemoglobin13.97 g/dL
LAB-003222Sat Nov 07, 2026 05:00 AMwbc5.76 x10^3/uL
LAB-003223Sat Nov 07, 2026 05:00 AMplatelets225.0 x10^3/uL
LAB-003192Sun Nov 08, 2026 05:00 AMcreatinine2.26 mg/dL
LAB-003201Sun Nov 08, 2026 05:00 AMsodium140.0 mmol/L
LAB-003209Sun Nov 08, 2026 05:00 AMhemoglobin14.0 g/dL
LAB-003224Sun Nov 08, 2026 05:00 AMwbc9.11 x10^3/uL
LAB-003225Sun Nov 08, 2026 05:00 AMplatelets210.0 x10^3/uL
Vitals (120)
Vitals
RowWhenKindValueDetail
VIT-009173Sun Nov 01, 2026 07:13 PMspo295.0room air
VIT-009174Sun Nov 01, 2026 07:13 PMrr15.0
VIT-009213Sun Nov 01, 2026 07:13 PMtemp_c37.3
VIT-009214Sun Nov 01, 2026 07:13 PMhr68.0
VIT-009215Sun Nov 01, 2026 07:13 PMmap81.0
VIT-009216Sun Nov 01, 2026 07:13 PMgcs15.0
VIT-009175Mon Nov 02, 2026 03:13 AMspo296.0room air
VIT-009176Mon Nov 02, 2026 03:13 AMrr14.0
VIT-009217Mon Nov 02, 2026 03:13 AMtemp_c37.5
VIT-009218Mon Nov 02, 2026 03:13 AMhr79.0
VIT-009219Mon Nov 02, 2026 03:13 AMmap77.0
VIT-009220Mon Nov 02, 2026 03:13 AMgcs15.0
VIT-009177Mon Nov 02, 2026 11:13 AMspo298.0room air
VIT-009178Mon Nov 02, 2026 11:13 AMrr20.0
VIT-009221Mon Nov 02, 2026 11:13 AMtemp_c37.3
VIT-009222Mon Nov 02, 2026 11:13 AMhr77.0
VIT-009223Mon Nov 02, 2026 11:13 AMmap75.0
VIT-009224Mon Nov 02, 2026 11:13 AMgcs15.0
VIT-009179Mon Nov 02, 2026 07:13 PMspo294.0room air
VIT-009180Mon Nov 02, 2026 07:13 PMrr19.0
VIT-009225Mon Nov 02, 2026 07:13 PMtemp_c36.8
VIT-009226Mon Nov 02, 2026 07:13 PMhr68.0
VIT-009227Mon Nov 02, 2026 07:13 PMmap75.0
VIT-009228Mon Nov 02, 2026 07:13 PMgcs15.0
VIT-009181Tue Nov 03, 2026 03:13 AMspo298.0room air
VIT-009182Tue Nov 03, 2026 03:13 AMrr18.0
VIT-009229Tue Nov 03, 2026 03:13 AMtemp_c36.6
VIT-009230Tue Nov 03, 2026 03:13 AMhr81.0
VIT-009231Tue Nov 03, 2026 03:13 AMmap90.0
VIT-009232Tue Nov 03, 2026 03:13 AMgcs15.0
VIT-009183Tue Nov 03, 2026 11:13 AMspo298.0room air
VIT-009184Tue Nov 03, 2026 11:13 AMrr19.0
VIT-009233Tue Nov 03, 2026 11:13 AMtemp_c37.5
VIT-009234Tue Nov 03, 2026 11:13 AMhr71.0
VIT-009235Tue Nov 03, 2026 11:13 AMmap81.0
VIT-009236Tue Nov 03, 2026 11:13 AMgcs15.0
VIT-009185Tue Nov 03, 2026 07:13 PMspo295.0room air
VIT-009186Tue Nov 03, 2026 07:13 PMrr17.0
VIT-009237Tue Nov 03, 2026 07:13 PMtemp_c37.0
VIT-009238Tue Nov 03, 2026 07:13 PMhr92.0
VIT-009239Tue Nov 03, 2026 07:13 PMmap82.0
VIT-009240Tue Nov 03, 2026 07:13 PMgcs15.0
VIT-009187Wed Nov 04, 2026 03:13 AMspo294.0room air
VIT-009188Wed Nov 04, 2026 03:13 AMrr20.0
VIT-009241Wed Nov 04, 2026 03:13 AMtemp_c37.0
VIT-009242Wed Nov 04, 2026 03:13 AMhr74.0
VIT-009243Wed Nov 04, 2026 03:13 AMmap86.0
VIT-009244Wed Nov 04, 2026 03:13 AMgcs15.0
VIT-009189Wed Nov 04, 2026 11:13 AMspo296.0room air
VIT-009190Wed Nov 04, 2026 11:13 AMrr19.0
VIT-009245Wed Nov 04, 2026 11:13 AMtemp_c37.2
VIT-009246Wed Nov 04, 2026 11:13 AMhr82.0
VIT-009247Wed Nov 04, 2026 11:13 AMmap74.0
VIT-009248Wed Nov 04, 2026 11:13 AMgcs15.0
VIT-009191Wed Nov 04, 2026 07:13 PMspo299.0room air
VIT-009192Wed Nov 04, 2026 07:13 PMrr16.0
VIT-009249Wed Nov 04, 2026 07:13 PMtemp_c37.3
VIT-009250Wed Nov 04, 2026 07:13 PMhr72.0
VIT-009251Wed Nov 04, 2026 07:13 PMmap89.0
VIT-009252Wed Nov 04, 2026 07:13 PMgcs15.0
VIT-009193Thu Nov 05, 2026 03:13 AMspo297.0room air
VIT-009194Thu Nov 05, 2026 03:13 AMrr16.0
VIT-009253Thu Nov 05, 2026 03:13 AMtemp_c36.6
VIT-009254Thu Nov 05, 2026 03:13 AMhr70.0
VIT-009255Thu Nov 05, 2026 03:13 AMmap82.0
VIT-009256Thu Nov 05, 2026 03:13 AMgcs15.0
VIT-009195Thu Nov 05, 2026 11:13 AMspo299.0room air
VIT-009196Thu Nov 05, 2026 11:13 AMrr15.0
VIT-009257Thu Nov 05, 2026 11:13 AMtemp_c37.0
VIT-009258Thu Nov 05, 2026 11:13 AMhr87.0
VIT-009259Thu Nov 05, 2026 11:13 AMmap79.0
VIT-009260Thu Nov 05, 2026 11:13 AMgcs15.0
VIT-009197Thu Nov 05, 2026 07:13 PMspo297.0room air
VIT-009198Thu Nov 05, 2026 07:13 PMrr16.0
VIT-009261Thu Nov 05, 2026 07:13 PMtemp_c37.6
VIT-009262Thu Nov 05, 2026 07:13 PMhr77.0
VIT-009263Thu Nov 05, 2026 07:13 PMmap92.0
VIT-009264Thu Nov 05, 2026 07:13 PMgcs15.0
VIT-009199Fri Nov 06, 2026 03:13 AMspo298.0room air
VIT-009200Fri Nov 06, 2026 03:13 AMrr20.0
VIT-009265Fri Nov 06, 2026 03:13 AMtemp_c36.8
VIT-009266Fri Nov 06, 2026 03:13 AMhr78.0
VIT-009267Fri Nov 06, 2026 03:13 AMmap92.0
VIT-009268Fri Nov 06, 2026 03:13 AMgcs15.0
VIT-009201Fri Nov 06, 2026 11:13 AMspo294.0room air
VIT-009202Fri Nov 06, 2026 11:13 AMrr16.0
VIT-009269Fri Nov 06, 2026 11:13 AMtemp_c36.5
VIT-009270Fri Nov 06, 2026 11:13 AMhr74.0
VIT-009271Fri Nov 06, 2026 11:13 AMmap75.0
VIT-009272Fri Nov 06, 2026 11:13 AMgcs15.0
VIT-009203Fri Nov 06, 2026 07:13 PMspo298.0room air
VIT-009204Fri Nov 06, 2026 07:13 PMrr16.0
VIT-009273Fri Nov 06, 2026 07:13 PMtemp_c36.6
VIT-009274Fri Nov 06, 2026 07:13 PMhr79.0
VIT-009275Fri Nov 06, 2026 07:13 PMmap79.0
VIT-009276Fri Nov 06, 2026 07:13 PMgcs15.0
VIT-009205Sat Nov 07, 2026 03:13 AMspo294.0room air
VIT-009206Sat Nov 07, 2026 03:13 AMrr17.0
VIT-009277Sat Nov 07, 2026 03:13 AMtemp_c36.8
VIT-009278Sat Nov 07, 2026 03:13 AMhr69.0
VIT-009279Sat Nov 07, 2026 03:13 AMmap74.0
VIT-009280Sat Nov 07, 2026 03:13 AMgcs15.0
VIT-009207Sat Nov 07, 2026 11:13 AMspo296.0room air
VIT-009208Sat Nov 07, 2026 11:13 AMrr18.0
VIT-009281Sat Nov 07, 2026 11:13 AMtemp_c37.2
VIT-009282Sat Nov 07, 2026 11:13 AMhr73.0
VIT-009283Sat Nov 07, 2026 11:13 AMmap87.0
VIT-009284Sat Nov 07, 2026 11:13 AMgcs15.0
VIT-009209Sat Nov 07, 2026 07:13 PMspo296.0room air
VIT-009210Sat Nov 07, 2026 07:13 PMrr17.0
VIT-009285Sat Nov 07, 2026 07:13 PMtemp_c37.0
VIT-009286Sat Nov 07, 2026 07:13 PMhr71.0
VIT-009287Sat Nov 07, 2026 07:13 PMmap90.0
VIT-009288Sat Nov 07, 2026 07:13 PMgcs15.0
VIT-009211Sun Nov 08, 2026 03:13 AMspo299.0room air
VIT-009212Sun Nov 08, 2026 03:13 AMrr14.0
VIT-009289Sun Nov 08, 2026 03:13 AMtemp_c37.0
VIT-009290Sun Nov 08, 2026 03:13 AMhr76.0
VIT-009291Sun Nov 08, 2026 03:13 AMmap80.0
VIT-009292Sun Nov 08, 2026 03:13 AMgcs15.0
Medications, orders, echo, history (8)

Notes

History and physical · DOC-000319 · Dr. Priya Thorne (resident) · Sun Nov 01, 2026 09:53 PM

Source document DOC-000319: History and physical (synthetic)
HISTORY AND PHYSICAL
Patient: Zara Juniper   MRN: MRN34747578   Admitted: 2026-11-01 18:53
Service: Cardiology   Attending: Dr. Cyrus Ellingham

History of present illness: 53-year-old man admitted with acute on chronic diastolic heart failure. 
Past medical history: heart failure with preserved ejection fraction.
Review of systems otherwise negative.
Exam: Lungs: scattered crackles at the bases, no distress.
Assessment and plan:
1. CKD: renally dose medications.
2. Acute on chronic diastolic heart failure: diuresis and daily weights; monitor electrolytes.

Progress note · DOC-000320 · Dr. Priya Thorne (resident) · Tue Nov 03, 2026 06:53 PM

Source document DOC-000320: Progress note (synthetic)
PROGRESS NOTE (Resident)
Patient: Zara Juniper   MRN: MRN34747578   Hospital day 3

Subjective: resting, tolerating diet.
Objective: vitals and labs reviewed in the flowsheet.
Assessment and plan:
1. Acute on chronic diastolic heart failure: continue current management.
2. Hyponatremia: trend sodium.

Resident: Dr. Priya Thorne   Attending cosign: completed

Discharge summary · DOC-000321 · Dr. Cyrus Ellingham (attending) · Sun Nov 08, 2026 10:29 AM

Source document DOC-000321: Discharge summary (synthetic)
DISCHARGE SUMMARY
Patient: Zara Juniper   MRN: MRN34747578
Admitted 2026-11-01; discharged 2026-11-08.

Discharge diagnoses:
- CKD
- acute on chronic diastolic heart failure
- hyponatremia

Disposition: home with follow-up.