Nurse Kelli M - 05/15/2025 9:18 AM CDTFormatting of this note is different from the original. 05/14/25 1630 Discharge Summary Discharge Disposition Private residence Recommended Discharge Level of Care Private residence Actual Discharge Level of Care Private residence Does Actual Level of Care Match Care Team Recommendation? Yes Post Acute Care Plan Post Acute Care Needs Identified No Discharge Additional Assistance Does the patient need discharge transport arranged? No Post Discharge Care Provider Post Discharge Care Plan DC Summary has been faxed to next level of care provider (see Follow Up Providers) Per medical team, patient is medically stable for discharge at this time. Follow up appointment has been scheduled by current medical team for May 28th. Transportation will be provided by significant other. Patient and/or family are agreeable with the plan. If any further discharge needs arise, please contact the covering case manager. Electronically signed by Nurse Kelli M at 05/15/2025 9:39 AM CDTElectronically signed by Nurse Kelli M at 05/15/2025 9:39 AM CDTMaggie Algya, RD - 05/15/2025 9:18 AM CDTFormatting of this note is different from the original.NUTRITION ASSESSMENTNutrition Status: Patient appears adequately nourished at this time.REASON FOR ASSESSMENT: Consult/Referral - Post-Op Nutrition Assessment Encounter Date: 05/15/25 9:58 AM Admission Date: 5/14/2025 LOS: 1 daysHPI: Patient is a 49 y.o. male with history of metastatic colorectal cancer the liver. He was diagnosed with sigmoid colon cancer status post laparoscopic sigmoid colectomy in 12/29/2021. He was recurrence free until three years later, his recurrence was in the terminal ileum status post right hemicolectomy in 7/1/2024, pathology notable for ileal adenocarcinoma. 5/24: OR for robotic segment 2 resectionObjective Past Medical

History: Diagnosis Date Anemia Cancer (HCC) Peripheral neuropathy Sleep apnea Thyroid disease Past Surgical

History: Procedure Laterality Date COLON SURGERY 12/30/2021 SMALL BOWEL RESECTION 07/01/2024 THYROIDECTOMY, PARTIAL Right 2022 Social History Tobacco Use Smoking status: Never Smokeless tobacco: Never Substance and Sexual Activity Drug use: Never Sexual activity: Defer Alcohol Use: Not At Risk (5/14/2025) AUDIT-C Frequency of Alcohol Consumption: Never Average Number of Drinks: Patient does not drink Frequency of Binge Drinking: Never MEDICATION/LAB REVIEW:Scheduled Meds: acetaminophen, 1,000 mg, oral, Q6H SCHheparin, 5,000 Units, subcutaneous, Q8H SCHketorolac, 15 mg, intravenous, Q6H SCHlevothyroxine, 112 mcg, oral, Daily - 0600lidocaine, 1 patch, transdermal, Q24Hlidocaine, 1 patch, transdermal, Q24HmethocarbamoL, 500 mg, oral, TIDContinuous Infusions: PRN Meds: LORazepam ondansetron oxyCODONERecent Labs Lab Units 05/15/250538 05/14/251438 SODIUM mmol/L 141 142 POTASSIUM PLASMA mmol/L 4.3 4.1 CHLORIDE mmol/L 105 105 CO2 mmol/L 25 25 BUN SERUM mg/dL 12 20 CREATININE mg/dL 1.03 1.16 GFR-NON-AFRICAN AMERICAN mL/min/1.73 m2 89 77 CALCIUM mg/dL 9.4 8.9 ALBUMIN g/dL 4.1 3.9 PHOSPHORUS PLASMA mg/dL 4.7* 4.5 MAGNESIUM mg/dL 2.3 2.7* Recent Labs Lab Units 05/15/250538 05/14/251438 GLUCOSE mg/dL 132 118 ALT Date Value Ref Range Status 05/15/2025 78 (H) 7 - 55 Units/L Final AST Date Value Ref Range Status 05/15/2025 67 (H) 10 - 50 Units/L Final Alk phos Date Value Ref Range Status 05/15/2025 61 40 - 130 Units/L Final No results found for: “HGBA1C”, “HDL”, “LDLCALC”, “CHOL”, “TRIG"NURSING ASSESSMENT:Last BM Date: (PTA)Bowel Sounds (All Quadrants): ActiveBraden Scale Score: 20Skin Integrity: Surgical incision Vital Signs@FLOW(5)Temp: 36.5 °C (97.7 °F)Pulse: 60Resp: 17SpO2: 100 %Intake/Output Summary (Last 24 hours) at 5/15/2025 0958Last data filed at 5/15/2025 0325Gross per 24 hour Intake 743.75 ml Output 1480 ml Net -736.25 ml Adult Malnutrition Scoring Tool (MST)Have You Recently Lost Weight Without Trying?: NoHave you been eating poorly because of a decreased appetite?: NoMalnutrition Screening Tool (MST) Score: 0AnthropometricsWeight: 97.9 kg (215 lb 14.4 oz)Admission Weight : 93 kgWeight Change: 4.94 kg (10.90 lbs)IBW/kg (Calculated) : 83.5 kgHeight: 185.4 cm (6’ 1”)Weight in (lb) to have BMI = 25: 189.1BMI (Calculated): 28.5Wt Readings from Last 10 Encounters: 05/15/25 97.9 kg (215 lb 14.4 oz) 05/01/25 96.8 kg (213 lb 6.5 oz) 04/30/25 96.6 kg (213 lb) 04/30/25 102.1 kg (225 lb) 11/14/24 87.9 kg (193 lb 12.8 oz) 11/29/24 86.2 kg (190 lb) 10/23/24 89.5 kg (197 lb 6.4 oz) 08/28/24 90.7 kg (200 lb) 08/15/24 88.2 kg (194 lb 6.4 oz) 08/23/23 100.2 kg (221 lb) ESTIMATED NEEDS: Weight Used for Equation Calculations (RD Determined): 97.5 kg (215 lb)Total Kcal/kg Estimated Needs : 1958.64 Kcal/kg: 20. Type of Weight Used for Estimated Kcals: CurrentTotal Protein Estimated Needs (gm): 108.55 Protein Needs Based on g/kg: 1.3 Type of Weight Used for Estimated Protein : IdealTotal Fluid Estimated Needs: 1958.64 Fluid Needs Based on : 1 ml/kcal Type of Weight Used for Estimated Fluid Needs: Current Dietary Orders (From admission, onward) Start Ordered 05/15/25 0651 Adult Diet Regular Diet effective now Question: (BJH) Diet type Answer: Regular 05/15/25 0650 Allergies: Reviewed. Pt does not have any cultural or religious food preferences.

IMPRESSION: RD consulted for post-op nutrition assessment. Pt reports good appetite PTA and currently. Pt follows regular diet. Pt has had recent weight gain. Stated UBW 200 lbs, admission weight 215 lbs. Pt denies N/V/C/D, chewing/swallowing issues. Pt ate 100% breakfast this morningPhos 4.7 (H)AAIM (ASPEN) MALNUTRITION ASSESSMENT: Date of completion: 5/15ASPEN/AND Malnutrition Screening: Patient does not meet malnutrition criteria NUTRITION FOCUSED PHYSICAL EXAM: Not clinically indicated, no concerns for malnutrition at this time.NUTRITION DIAGNOSIS:Nutrition Diagnosis 1: Increased nutrient needs (protein) Related to: Recent surgery Evidenced by: Patient interview, Physical findingINTERVENTION(S): Summary: Assess for nutrition changes, Initial assessment, Encouragement, Follow up per policy Continue regular diet with adequate PO intakesGOAL(S): Adequate nutrition to meet estimated needs by next assessment, Continue adequate PO intakes MONITORING/EVALUATION: Appetite, I/O, Labs, Plan of care, PO intake, Discharge plans Diet Instructions Recommend to eat a generally Healthy diet with foods that include a variety of fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Limit fast food, sugary drinks, excess salt, and desserts. Limit sugary drinks like lemonade, regular soda, Gatorade, and sweet tea and drink water throughout the day. Additional resources are available online from the Academy of Nutrition and Dietetics at www.eatright.org If poor intakes and/or unintended weight loss occur on discharge follow up with primary care physician. Maggie Algya, MS, RDN, LDTravel Clinical DietitianMorrison HealthcareElectronically signed by Maggie Algya, RD at 05/15/2025 10:01 AM CDTPaighton Miller, MD - 05/14/2025 3:24 PM CDTFormatting of this note is different from the original.Abdominal Transplant Postoperative NoteS: Alexander R Towell presents to 16400 after undergoing a Procedure(s) (LRB):XI LIVER RESECTION - LAPAROSCOPIC ROBOTIC ASSISTED, TAP Block (N/A). He denies CP/SOB, Nausea/Vomiting. Pain is well controlled.O: Blood pressure 137/89, pulse 84, temperature 36.2 °C (97.2 °F), temperature source Temporal, resp. rate 14, weight 93 kg (205 lb), SpO2 94%.Abdomen: Soft, appropriately tender. lap sites incision is clean/dry/intact with dermabond. GU: Foley catheter in place. +Clear, yellow urine in the bag.LE: SCD’s in place.Lab Results Component Value Date WBC 3.71 (L) 05/14/2025 HGB 14.4 05/14/2025 HCT 41.2 05/14/2025 MCV 90.9 05/14/2025 LABPLAT 148 (L) 05/14/2025 Lab Results Component Value Date GLUCOSE 99 05/01/2025 CALCIUM 9.8 05/01/2025 SODIUM 140 05/01/2025 POTASSIUM 4.2 05/01/2025 CO2 25 05/01/2025 CHLORIDE 101 05/01/2025 BUNSER 19 05/01/2025 CREATININE 1.00 05/01/2025 A/P: S/P robotic liver resection of nodule in segment 21. IVF @ 125mL/hr2. Diet: clears, ADAT3. SQH for DVT Prophylaxis.4. Foley catheter to be removed at midnight.5. Pain control with scheduled APAP, toradol, robaxin. Breakthrough pain control with oxycodone as needed.Electronically signed by Paighton Miller, MD at 05/14/2025 3:54 PM CDTdocumented in this encounter