Received Jul 24, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| PNC21 | PNEUMO (CAPVAXIVE) | MERCK & CO. INC. | 1 | Z004302 | IM / RA |
54 y/o M with decompensated cirrhosis attributed to MASLD/MASH complicated by refractory ascites and bleeding esophageal varices, anxiety, and tobacco use who presented to hepatology clinic 7/16/25 for follow up and pretransplant evaluation. Baseline back pain 4/10. During clinic visit, patient was given pneumococcal 21 vaccine IM in the right deltoid at 0956. After administration, patient c/o dizziness, lightheadedness as they were walking to the front desk to check out. Patient escorted to exam room via w/c for VS recheck. VSS except for MAP 68. Patient drank approx. 5 oz.of water with resolution of dizziness with gradual improvement of lightheadedness. POC BG 97. Patient had eaten breakfast. At 1022, the pat
liver cirrhosis
decompensated cirrhosis; anxiety;NASH; Morbid obesity
Albuterol; Cefdinir; ergocalciferol (vitamin D2); fluoride; folic acid; ipratropium bromide; Lactulose; magnesium; omeprazole; ondansetron; oxycodone HCl;spironolactone; torsemide; venlafaxine HCl; zinc sulfate
None
07/16/25 10:11 POC Glucose: 97 07/16/25 12:51 Sodium: 134 (L) Potassium: 4.1 Chloride: 107 Carbon Dioxide (CO2): 21 BUN: 15 Creatinine: 0.8 Glucose: 99 Calcium: 8.4 (L) Magnesium: 2 07/16/25 10:11 POC Glucose: 97 07/16/25 12:51 Sodium: 134 (L) Potassium: 4.1 Chloride: 107 Carbon Dioxide (CO2): 21 BUN: 15 Creatinine: 0.8 Glucose: 99 Calcium: 8.4 (L) Magnesium: 2.0 AST: 38 ALT: 14 (L) Bilirubin, Total: 1.9 (H) Bilirubin, Conjugated: 0.6 Alkaline Phosphatase: 170 (H) Albumin: 2.5 (L) Protein, Total: 5.8 (L) Anion Gap: 6 BUN/CREA Ratio: 18 Glomerular Filtration Rate (eGFR) : 105 Vitamin D Total, 25OH: 19 (L) WBC: 4.9 Hemoglobin: 8.6 (L) Hematocrit: 26.5 (L) Platelet Count /L: 122 (L) MCV: 95 MCH (Mean Corpuscular Hemoglobin): 30.8 MCHC: 32.5 RBC: 2.79 (L) RDW-CV (Red Cell Distribution Width): 14.3 NRBC (Nucleated Red Blood Cell Count): 0.00 Nucleated RBC %: 0.0 MPV: 8.7 Slide Review/Morphology: Yes | Yes Segmented Neutrophil %: 80 Basophil %: 1 Eosinophil %: 1 Lymphocyte %: 5 (L) Monocyte %: 13 (H) Neutrophil Count, Absolute: 3.92 Total Absolute Neutrophil Count (Segs + Bands): 3.92 Lymphocyte Count, Absolute: 0.25 (L) Monocyte Count, Absolute: 0.64 Eosinophil Count, Abolute: 0.05 Basophil Count, Absolute: 0.05 Prothrombin Time: 16.8 (H) Prothrombin INR: 1.5 (H)