Whitlow discharge May 2026 scan

record: doc-discharge-2026-uti
template: document
pages:
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org:
  name: Whitlow Memorial Hospital
  lines:
  - 1740 Hensley Fork Drive NW
  - Cleveland, TN 37311
  phone: '4235550138'
  web: whitlowmemorial.example
  color: '#274b6d'
title: Discharge Packet
body: '<p style="font-size:8.5pt;color:#555;text-align:right">Pruitt, Lorraine M. &middot; MRN WM-0733916
  &middot; discharged 05/22/2026 &middot; page 1 of 6</p>


  ## Face sheet


  **Patient:** Lorraine M. Pruitt &nbsp;&nbsp; **Date of birth:** {{lorraine.date_of_birth|mdy}} &nbsp;&nbsp;
  **Sex:** F &nbsp;&nbsp; **MRN:** WM-0733916


  **Address:** 2217 Larkmoor Lane NW, Cleveland, TN 37312 &nbsp;&nbsp; **Home phone:** (423) 555-0162


  **Admitted:** {{hr-lorraine-2026-uti.date|mdy}}, 11:36 AM, through the Emergency Department &nbsp;&nbsp;
  **Room:** 2 West, 241


  **Discharged:** 05/22/2026, 2:10 PM, to home, with family and a home care aide


  **Attending:** Priya Nambiar, MD, Hospital Medicine &nbsp;&nbsp; **Primary care:** Samuel Tolbert, MD


  | Insurance | Plan | Member number |

  |---|---|---|

  | Primary | Medicare Part A and Part B | {{card-lorraine-medicare.identification_number}} |

  | Secondary | Evermont Health Assurance, Medicare Supplement Plan G | {{card-lorraine-medigap.identification_number}}
  |


  **Allergies:** penicillins (hives); sulfonamide antibiotics (rash, lip swelling); latex (reported, reaction
  not recorded).


  **Intolerances:** codeine (vomiting); lisinopril (cough). Use paper tape.


  **Code status this admission:** full code. Advance care plan on file, dated 03/14/2023.


  **Health care agent:** Walter E. Pruitt Jr., son, (423) 555-0148. Alternate: Russell D. Pruitt, son,
  (423) 555-0124.


  **Preferred pharmacy:** Sorrelwood Pharmacy, Cleveland, (423) 555-0130


  ### In this packet


  Face sheet, page 1. Discharge summary, 2. Your medication list: new and changed, 3. Your medication
  list: continued without change, 4. Instructions and follow-up, 5. Acknowledgment, 6.


  <div style="break-before: page"></div>


  <p style="font-size:8.5pt;color:#555;text-align:right">Pruitt, Lorraine M. &middot; MRN WM-0733916 &middot;
  discharged 05/22/2026 &middot; page 2 of 6</p>


  ## Discharge summary


  ### Diagnoses


  1. Urinary tract infection (E. coli)

  2. Acute confusion (delirium) on top of mild dementia

  3. Acute kidney injury on chronic kidney disease stage 3b, improving

  4. Chronic heart failure with preserved ejection fraction, stable

  5. Atrial fibrillation on apixaban; type 2 diabetes on basal insulin


  ### Hospital course


  81-year-old woman brought in by her home aide and her son with new confusion and a temperature of 101.4.
  Urine culture grew E. coli, more than 100,000 colonies, sensitive to ceftriaxone, ciprofloxacin and
  nitrofurantoin, resistant to ampicillin and to trimethoprim-sulfamethoxazole. An intravenous antibiotic
  was chosen with her documented drug allergies in mind and given for two days. Creatinine peaked at 1.8
  and was 1.6 at discharge. Fluids were given slowly because of her heart failure. Losartan and metformin
  were held during the stay. Blood sugars were managed with a sliding scale. By the morning of discharge
  her thinking was close to her usual, according to her son.


  She goes home on an antibiotic by mouth to finish the course. The drug, the dose and the date of the
  last dose are on page 3, with the changes to her other medicines.


  ### Condition at discharge


  | Measured on 05/22/2026 | Result |

  |---|---|

  | Weight | 149 lb |

  | Temperature | 98.4 |

  | Blood pressure | 132/70 |

  | Heart rate | 76, irregular |

  | Creatinine | 1.6 mg/dL |

  | Potassium | 4.2 mmol/L |

  | White blood cell count | 8.9 |


  P. Nambiar, MD, Hospital Medicine. Dictated 05/22/2026.


  <div style="break-before: page"></div>


  <p style="font-size:8.5pt;color:#555;text-align:right">Pruitt, Lorraine M. &middot; MRN WM-0733916 &middot;
  discharged 05/22/2026 &middot; page 3 of 6</p>


  ## Your medication list: new and changed


  | Medication | Dose | When | What to do |

  |---|---|---|---|

  | Ciprofloxacin | 250 mg | twice a day, by mouth | **NEW**, for 5 days. Last dose 05/27/2026 |

  | Losartan | 50 mg | every morning | **HELD** in the hospital. Restart on 05/25/2026 |

  | Metformin | 500 mg | twice a day with meals | **HOLD** until Dr. Tolbert has reviewed the kidney blood
  test of 05/29/2026 |


  ### About ciprofloxacin


  Give it at the same times each day, two hours before or six hours after calcium, iron or antacids. Finish
  all ten tablets even if she seems well. Ciprofloxacin can lower the blood sugar of a person who takes
  insulin. Check her blood sugar before breakfast and before supper while she is taking it and call for
  any reading under 80. Stop the medicine and call for tendon pain, a rash, or new or worse confusion.


  ### Why losartan and metformin were held


  Both are cleared by the kidneys, and her kidney function dropped with the infection. Losartan may be
  restarted on the date shown if she is eating and drinking normally. Metformin waits for the blood test.


  <div style="break-before: page"></div>


  <p style="font-size:8.5pt;color:#555;text-align:right">Pruitt, Lorraine M. &middot; MRN WM-0733916 &middot;
  discharged 05/22/2026 &middot; page 4 of 6</p>


  ## Your medication list: continued without change


  Medicines listed on page 3 as new, held or changed are not repeated here.


  | Medication | Dose | When |

  |---|---|---|

  | Apixaban (Eliquis) | 2.5 mg | twice a day |

  | Metoprolol succinate ER | 50 mg | every morning |

  | Furosemide (Lasix) | 40 mg | every morning |

  | Insulin glargine (Lantus) | 18 units | at bedtime |

  | Levothyroxine | 88 mcg | every morning, empty stomach |

  | Atorvastatin | 40 mg | at bedtime |

  | Donepezil | 10 mg | at bedtime |

  | Sertraline | 50 mg | every morning |

  | Famotidine | 20 mg | at bedtime |

  | Latanoprost 0.005% eye drops | 1 drop each eye | at bedtime |

  | Denosumab (Prolia) | 60 mg injection | every 6 months; last given 04/14/2026 |

  | Vitamin D3 | 2000 IU | once a day |

  | Acetaminophen | 500 mg | 1 or 2 tablets, up to 3 times a day, if needed |


  Do not take ibuprofen, naproxen or aspirin for pain.


  Last doses given in the hospital on 05/22/2026: apixaban 2.5 mg, metoprolol, furosemide 40 mg and levothyroxine
  between 6:00 and 8:15 AM. The next insulin dose is due tonight at bedtime, 18 units.


  List reviewed with Walter Pruitt Jr., son and health care agent. Reviewed by D. Farris, RN, and J. Whitson,
  PharmD.


  <div style="break-before: page"></div>


  <p style="font-size:8.5pt;color:#555;text-align:right">Pruitt, Lorraine M. &middot; MRN WM-0733916 &middot;
  discharged 05/22/2026 &middot; page 5 of 6</p>


  ## Instructions and follow-up


  ### The infection


  - Give every dose of the antibiotic listed on page 3 and finish all of the tablets.

  - Offer fluids through the day, within her limit of 1.5 liters.

  - Call Dr. Tolbert''s office for a temperature over 100.4, pain in the side or back, vomiting, or if
  she is not passing urine.


  ### Confusion


  Confusion from an infection clears more slowly than the infection itself, over days to a few weeks.
  Keep the days regular: lights on in the daytime, glasses and hearing aids in, familiar people. She should
  not be alone overnight for the first three nights.


  Sudden worsening of confusion in this patient should prompt a urine test. In older adults a urinary
  infection often causes no burning and no fever.


  ### Her heart


  The heart failure plan she already follows does not change. Weigh every morning. Her weight at discharge
  is 149 lb.


  ### Follow-up


  | With | When | For |

  |---|---|---|

  | Tolbert & Greer Internal Medicine, laboratory | 05/29/2026, walk in before 11:00 AM | Basic metabolic
  panel |

  | Samuel Tolbert, MD | {{hr-lorraine-2026-pcp.date|mdy}}, 2:15 PM | Hospital follow-up and repeat urine
  test |

  | Rohan Mehta, MD | at her next scheduled visit | Memory, after this episode of delirium |


  Metformin stays on hold until Dr. Tolbert''s office has reviewed the 05/29 result and called.


  ### Results still pending


  None. The final urine culture is reported in the discharge summary.


  <div style="break-before: page"></div>


  <p style="font-size:8.5pt;color:#555;text-align:right">Pruitt, Lorraine M. &middot; MRN WM-0733916 &middot;
  discharged 05/22/2026 &middot; page 6 of 6</p>


  ## Acknowledgment


  I have received this discharge packet of 6 pages. The nurse went over the medication lists on pages
  3 and 4 with me, and I had the chance to ask questions.


  - The new prescription was sent electronically to Sorrelwood Pharmacy.

  - Belongings returned: glasses, upper denture and cup, hearing aids (2) with charger, robe, walker,
  glucose meter.

  - Intravenous line removed, site clean and dry. Identification and allergy bands removed.

  - The discharge summary will be in the MyWhitlow patient portal in about three days.


  | | |

  |---|---|

  | Signature of patient or representative | <span class="sig">Walter E Pruitt Jr</span> |

  | Relationship | son, health care agent |

  | Date and time | 05/22/2026, 1:50 PM |

  | Nurse | <span class="sig">D. Farris RN</span> |


  Left the unit by wheelchair at 2:10 PM with her son, by private vehicle.

  '