Progress Notes by ALEKSANDER E SKARZYNSKI MD at 8/17/2026  9:33 AM
SNF FOLLOW UP/ CUSTODIAL VISIT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Facility name: GREENHAVEN HEALTHCARE CENTER
 
 
 
 
 
 
Patient Name: WEI, XUAN 
 
 
 
 
 
 
Patient's Date of Birth: 10/11/1957
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Date of Visit:  08/17/2026
 
 
 
 
 
 
Dates of Hospital Admission:  07/16/2026-07/18/2026
 
 
 
 
 
 
Date of Admission: 07/18/2026
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Chief Complaint: 
 
 
 
 
 
 
Chief Complaint
 
 
 
 
 
 
Patient presents with
 
 
 
 
 
 
• SNF TRANSITION TO CUSTODIAL VISIT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Attending Physician: ALEKSANDER E SKARZYNSKI MD 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
POLST CPR- FULL TREATMENT
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Xuan Wei, a 68-year-old male, was admitted for short-term rehabilitation after recurrent cardio-embolic stroke with left hemiparesis and hemianopic visual field loss, resulting in significant mobility impairment and dependence for daily activities. He exhibited orthostatic hypotension and bradycardia, prompting reduction and eventual discontinuation of metoprolol and nifedipine. His medical history includes hypertension, hyperlipidemia, prior CVA, peripheral artery disease, COPD, prediabetes, GERD with GI bleeding, hiatal hernia, chronic hepatitis B and C, laryngeal cancer, constipation, insomnia, and knee pain. He remained medically stable, continued therapy, and transitioned to custodial care on 8/8/26.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Current Level at SNF
 
 
 
 
 
 
ambulatory status : wheelchair
 
 
 
 
 
 
mental status : normal
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MEDICATIONS
 
 
 
 
 
 
 
 
 
Acetaminophen Oral Tablet 500 MG (Acetaminophen)
Give 2 tablet by mouth every 6 hours as needed for Pain - Mild ;Pain - Moderate **DNE MORE THAN 4G IN 24HRS AND Give 2 tablet by mouth every 6 hours as needed for TEMP >100.4 **DNE MORE THAN 4G IN 24HRS
 
 
Atorvastatin Calcium Oral Tablet 80 MG (Atorvastatin Calcium)
Give 1 tablet by mouth at bedtime for HLD **BBW** AVOID GRAPEFRUIT OR GRAPEFRUIT JUICE WITH THIS MED. TO PREVENT HEART ATTACKS AND STROKES.
 
 
Clopidogrel Bisulfate Oral Tablet 75 MG (Clopidogrel Bisulfate)
Give 1 tablet by mouth one time a day for Acute ischemic stroke **take with food
 
 
 
 
Dulcolax Rectal Suppository 10 MG (Bisacodyl)
Insert 1 suppository rectally every 24 hours as needed for BOWEL MANAGEMENT PROTOCOL GIVE IF MOM INEFFECTIVE
 
 
 
 
GlycoLax Powder (Polyethylene Glycol 3350)
Give 17 gram by mouth one time a day for constipation **Mix with 4-8oz of Fluids. Hold for loose stool
 
 
 
 
Milk of Magnesia Oral Suspension 400 MG/5ML (Magnesium Hydroxide)
Give 30 ml by mouth every 24 hours as needed for BOWEL MANAGEMENT
 
 
 
 
Omeprazole Oral Capsule Delayed Release 40 MG (Omeprazole)
Give 1 capsule by mouth before meals for GERD **take 30mins before meal, do not crush
 
 
 
 
ProAir HFA Inhalation Aerosol Solution 108 (90 Base) MCG/ACT (Albuterol Sulfate)
2 puff inhale orally every 4 hours as needed for Sob/Wheezing
 
 
 
 
Senna Oral Tablet 8.6 MG (Sennosides)
Give 1 tablet by mouth two times a day for Constipation **hold for loose stool
 
 
 
 
Stiolto Respimat Inhalation Aerosol Solution 2.5-2.5 MCG/ACT (Tiotropium Bromide-Olodaterol HCl)2 puff inhale orally one time a day for COPD
 
 
 
 
 
 
 
traZODone HCl Oral Tablet 50 MG (Trazodone HCl)
Give 2 tablet by mouth at bedtime for insomia m/b inability to sleep, ICF by Xuan Wei, Kaiser MD Srie Widuri
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Progress Notes:
 
 
 
 
 
 
Pt was scheduled for liver ultarasound on 8/20/26 On 8/10/26 nursing staff reported RNA Program - Ambulation w/ FWW and CGA 3x/week for 3 months (ensure abdominal binder and compression stocking on prior to session) Start Date: 8/10/2026 Status/Progress: RNA services started per PT eval; The resident is unable to walk without assistance safely. Resident is participating well with RNA Services. ON 8/12/26 labwork - lipid panel: HDL 33 LDL 62 TG 121. Patient complained of tingling in left arm, neurology was contacted - CT Scan HEAD was ordered
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REVIEW OF SYSTEMS 
 
 
 
 
 
 
Constitutional: Negative
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
PHYSICAL EXAM: 
 
 
 
 
 
 
BP 151/89  | Pulse 80  | Temp 97.2 °F (36.2 °C)  | Resp 19  | SpO2 98% 
 
 
 
 
 
 
 
General in no acute distress.  AO x 3
 
 
 
 
 
 
 
Head atraumatic, normocephalic
 
 
 
 
 
 
 
Eyes nonicteric sclera
 
 
 
 
 
 
 
Lungs CTA bilaterally
 
 
 
 
 
 
 
Cardiovascular S1-S2 regular rate and rhythm, no audible murmur
 
 
 
 
 
 
 
Abdomen soft on palpation
 
 
 
 
 
 
 
Lower extremities no edema
 
 
 
 
 
 
 
Neuro L hemiparesis and left hemianopic visual field loss 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ASSESSMENT AND PLAN:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CVS
 
DGN : HTN (HYPERTENSION) HYPERLIPIDEMIA ATHEROSCLEROSIS OF AORTA PERIPHERAL ARTERY DISEASE, UNSPECIFIED TYPE ORTHOSTATIC HYPOTENSION  
 
 
 
STATUS:  Atorvastatin Calcium Oral Tablet 80 MG (Atorvastatin Calcium) Give 1 tablet by mouth at bedtime for HLD **BBW** AVOID GRAPEFRUIT OR GRAPEFRUIT JUICE WITH THIS MED. TO PREVENT HEART ATTACKS AND STROKES. Clopidogrel Bisulfate Oral Tablet 75 MG (Clopidogrel Bisulfate) Give 1 tablet by mouth one time a day for Acute ischemic stroke **take with food                                                  
 
 
PLAN: continue current treatment      
 
 
 
 
 
 
PUL
 
DGN : COPD (CHRONIC OBSTRUCTIVE PULMONARY DISEASE)      
 
 
 
 
 
 
 
 
STATUS:        ProAir HFA Inhalation Aerosol Solution 108 (90 Base) MCG/ACT (Albuterol Sulfate) 2 puff inhale orally every 4 hours as needed for Sob/Wheezing  Stiolto Respimat Inhalation Aerosol Solution 2.5-2.5 MCG/ACT (Tiotropium Bromide-Olodaterol HCl) 2 puff inhale orally one time a day for COPD                                           
 
 
PLAN: continue current treatment      
 
 
 
 
 
 
ENDO
 
DGN : PREDIABETES      
 
 
 
 
 
 
 
 
STATUS:                                                     
 
 
 
 
 
 
 
 
PLAN: monitor      
 
 
 
 
 
 
GI
 
DGN : GERD (GASTROESOPHAGEAL REFLUX DISEASE) HX OF UPPER GASTROINTESTINAL BLEED CONSTIPATION    
 
 
 
 
 
STATUS:       Omeprazole Oral Capsule Delayed Release 40 MG (Omeprazole) Give 1 capsule by mouth before meals for GERD **take 30mins before meal, do not crush                                              
 
 
 
PLAN: continue current treatment      
 
 
 
 
 
 
BOWEL
 
DGN : BOWEL MANGMNT      
 
 
 
 
 
 
 
 
STATUS:    Dulcolax Rectal Suppository 10 MG (Bisacodyl) Insert 1 suppository rectally every 24 hours as needed for BOWEL MANAGEMENT PROTOCOL GIVE IF MOM INEFFECTIVE GlycoLax Powder (Polyethylene Glycol 3350) Give 17 gram by mouth one time a day for constipation **Mix with 4-8oz of Fluids. Hold for loose stool Milk of Magnesia Oral Suspension 400 MG/5ML (Magnesium Hydroxide) Give 30 ml by mouth every 24 hours as needed for BOWEL MANAGEMENT   Senna Oral Tablet 8.6 MG (Sennosides) Give 1 tablet by mouth two times a day for Constipation **hold for loose stool                                            
 
 
PLAN: continue current treatment      
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
MENTAL
 
DGN : INSOMNIA      
 
 
 
 
 
 
 
 
STATUS:           traZODone HCl Oral Tablet 50 MG (Trazodone HCl) Give 2 tablet by mouth at bedtime for insomia m/b inability to sleep, ICF by Xuan Wei, Kaiser MD Srie Widuri                                          
 
 
 
PLAN: continue current treatment      
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NEU
 
DGN : HEMIPLEGIA & HEMIPARESIS, LEFT NONDOMINANT SIDE, LATE EFFECT OF EMBOLIC STROKE HX OF ISCHEMIC STROKE LEFT HOMONYMOUS HEMIANOPIA, LATE EFFECT OF STROKE    
 
 
 
STATUS:   Clopidogrel Bisulfate Oral Tablet 75 MG (Clopidogrel Bisulfate) Give 1 tablet by mouth one time a day for Acute ischemic stroke **take with food                                                  
 
 
 
PLAN: continue current treatment      , CT HEAD wo contrast
 
 
 
 
 
 
PAIN
 
DGN : PAIN       
 
 
 
 
 
 
 
 
STATUS: Acetaminophen Oral Tablet 500 MG (Acetaminophen) Give 2 tablet by mouth every 6 hours as needed for Pain - Mild ;Pain - Moderate **DNE MORE THAN 4G IN 24HRS AND Give 2 tablet by mouth every 6 hours as needed for TEMP >100.4 **DNE MORE THAN 4G IN 24HRS                                                    
 
 
PLAN: continue current treatment      
 
 
 
 
 
 
DVT-PROPH
DGN : DVT PROPH      
 
 
 
 
 
 
 
 
STATUS:   Clopidogrel Bisulfate Oral Tablet 75 MG (Clopidogrel Bisulfate) Give 1 tablet by mouth one time a day for Acute ischemic stroke **take with food                                                  
 
 
 
PLAN: continue current treatment  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ALEKSANDER E SKARZYNSKI MD
8/17/2026
 
Future Appointments 
 
 
Appointment Date & Time
Visit Type
Provider
Department/Facility
 
Aug 20, 2026 7:30 AM PDT
Ultrasound
USOUNDH SSC
ULTRASOUND (SSC-BRUCEVLL HOS-SSCA)

