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María Ortega 41 F
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Blood pressure is critically high — 165/105 (Stage 2)
Tachycardia and fever also present. AI suggests reviewing hypertensive protocol before continuing the visit.
Blood Pressure
▲ 22
165/105
mmHg · Stage 2
Heart Rate
▲ 9
112
bpm · Tachycardia
Temperature
▲ 1.2
38.9
°C · Fever
SpO₂
▼ 5
91
% · Below normal
Weight
— 0
65.0
kg · BMI 24.5
AI Draft
Findings from this visit
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Subjective — headache, 3 days, worse in evenings
Assessment — possible UTI, recommend urinalysis
Plan — refill Losartan 100mg, once daily
Order suggested — CBC, urinalysis
Phenoxymethylpenicillin
100.0 mg · Once daily
Furosemide
200 mg · Once daily
Losartan
100 mg · Once daily
Recent Labs
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Hemoglobina
11 g/dl
↓ Low
Jun 9
Fasting Glucose
62 mg/dl
Normal
Jun 9
Active Problems
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No active problems recorded
Visit summary ready to review
AI compiled a SOAP note from confirmed findings, vitals, and orders.
Demographics
Date of Birth03/15/1985
SexFemale
Insurance
ARS ProviderHUMANO
PlanMi Salud Royal