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WRITE AN SBAR REPORT TO THE NURSE YOU WILL BE TRANSFERRING THIS PATIENT TO. Patient: Keith Patterson General Hospital DOB: 02/16/1989 35 yo M Admit Date: 01/08/2025 20:21 MR#: MR160229 Full code, NKA, Fall risk: Moderate Keith Patterson is a 35-year-old morbidly obese father of two who underwent an elective laparoscopic adjustable gastric banding procedure one day ago. He has just been transferred from the post-operative unit to the subacute unit for discharge preparation. He feels pretty good right now and is “excited to start his new life.” He wants to get moving and would like assistance to get up into the chair. Patient Info Patterson, Keith 717-877-2714 (Home) 717-877-3167 (Emergency Contact) 717-877-2714 (Mobile) English White or Caucasian Encounters 01/08/2025 20:21 General Hospital Ellen Crandall, MD Admitted Transferred to subacute unit day one post op from elective laparoscopic adjustable gastric banding. Patient in good condition. Patient one post op from elective laparoscopic adjustable gastric banding, transferred to this subacute unit in preparation for discharge. Alerts 01/08/2025 20:21 Full code Active Advance Directive 01/08/2025 20:21 NKA Active Adverse Reaction/Allergy 01/08/2025 20:21 Fall risk: Moderate Active Clinical Warning Prevention Problems Active S/P laparoscopic gastric banding procedure Acute 01/07/2025 Ellen Crandall, MD Active Morbid obesity Chronic 05/06/2009 James Fowler, MD Vitals TPR B/P 130/70 O2 99% respiratory 18 pulse 84 PAIN 2 GROWTH 01/08/2025 20:21 171 kg 173 cm 57.1 Labs DATE LAB TEST VALUE UNIT ABNORMAL FLAG REFERENCE RANGE 01/08/2025 20:16 BMP (Basic Metabolic Panel) BMP BUN 6 mg/dL Low 7 to 20 BMP CO2 24 mmol/L 21 to 32 BMP Creatinine 1.2 mg/dL High 0.6 to 1.0 BMP Glucose 102 mg/dL 70 to 109 Serum chloride 99 mmol/L 98 to 110 Serum potassium 3.3 mmol/L Low 3.5 to 5.3 Serum sodium 138 mmol/L 135 to 148 bmpCalciumSerum mg/dL 8.8-10.5 CBC with Differential Hemoglobin (g/dl) 11.5 g/dl Low 14.0 – 18.0 Hematocrit (%) 35.1 % Low 41 – 50 RBC’s ( x 106 /ml) 4.1 cells/mcL Low 4.7 – 6.1 RDW (RBC distribution width) 12 % 11.00 – 15.6 MCV 88 fL 82 – 100 MCH 30 pg 27 – 33 MCHC % 33 g/dl 32 – 36 Platelet count 250,000 100,000 to 400,000 WBC (thousand cells/mcl) thousand cells/mcL 4.5 – 11.0 Segmented neutrophils 56 % 54 – 62 Band forms 3 % 3 – 5 Basophils 1 % 0 – 1 Eosinophils 2 % 0 – 3 lymphocytes 28 % 24 – 44 Monocytes 4 % 3 – 6 Orders See More >> Location Admit to subacute unit NOW Active 01/08/2025 20:21 Care Full code CONTINUOUS Active 01/08/2025 20:21 Screening/Measurements Vital signs Q4H Active 01/08/2025 20:21 Screening/Measurements Pulse oximetry Q6H Active 01/08/2025 20:21 Care Incentive spirometry Q2H Active Infusion Meds in LACTATED RINGERS(1000ML) (1000 ML) Active Q8H Scheduled Meds famotidine 20 MG per 50 ML Injectable Solution – Dose: 20 MG Alternate name: undefined Active Q12H Scheduled Meds metoclopramide 10 MG per 2 ML Prefilled Syringe – Dose: 10 MG Alternate name: undefined Active Q6H Scheduled Meds 0.4 ML Enoxaparin sodium 100 MG/ML Prefilled Syringe [Lovenox] – Dose: 40 MG/0.4 ML Alternate name: Lovenox Active Q12H Scheduled Meds promethazine hydrochloride 6.25 MG per 10 ML Prefilled Syringe – Dose: 12.5 MG Alternate name: undefined Active PRN Q4H Notes 01/08/2025 20:21 Handoff Report D’Angelo Carter, RN General Hospital
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