[Verified Answer]: – Past Medical History: Type 2 Diabetes…

– Past Medical History: Type 2 Diabetes Mellitus, Hypertension, Chronic Kidney Disease (Stage 3), Ischemic Stroke with left-sided hemiparesis, History of pressure ulcers – Social History: Resides in a SNF for the past year, previously lived independently, no tobacco or alcohol use she is a resident of a SNF admitted to the hospital with – Medications Prior to Admission: Metformin, Lisinopril, Atorvastatin, Aspirin Physical Findings – Sacral Stage IV pressure ulcer ( ()/(( 10 /mathrm{~cm} times 8 /mathrm{~cm} times 4 /mathrm{~cm} /)) deep) with necrotic tissue, purulent drainage, and foul odor indicates a serious – Peripheral edema ( ()/(( 2+ /)) bilateral lower extremities) – Decreased breath sounds at lung bases – Capillary refill sluggish ( ()/(( )>3 /mathrm{sec} /) ) – Skin dry and warm Assessmen(t)/(M)edical Diagnoses – Stage IV sacral pressure ulcer with osteomyelitis – Suspected sepsis (pending blood culture results) – Malnutrition secondary to chronic illness – Chronic kidney disease (Stage 3) Plan – Continue IV vancomycin and piperacillin-tazobactam – Serial blood cultures q24h to monitor for bacteremia – Wound debridement scheduled for tomorrow – Optimize nutrition with high-protein oral supplements – Strict repositioning every 2 hours – Manage pain with IV acetaminophen and oxycodone PRN Progress Notes (01)/(30)()/(25)-0830: Patient febrile overnight, Tmax