After-Visit Action Note — Cardiology follow-up

This note summarizes what the provider said, what changes Hal and the family need to know about, and what Averyn is following up on this week. It is a non-clinical summary — not medical advice and not a substitute for the provider's portal note when it arrives.

1. Start Furosemide 60 mg tomorrow morning. Discard remaining 40 mg tablets to avoid mix-up.
2. Daily weigh-in — same time each morning, same scale, before eating, after bathroom. Write it down (a paper log on the fridge is fine).
3. Call cardiology immediately if weight increases 2+ lb in 24 hours or 5+ lb in one week: (813) 555-0311. Don't wait for the portal.
4. Sodium target: under 2,000 mg per day. Check labels.
5. No more frozen pizzas. No frozen meals over 500 mg sodium per serving. (Hal: this means no more Tombstone or Stouffer's.)
6. No canned soups. Most are 800–1,000 mg sodium per serving. Swap for low-sodium versions or fresh.
7. No deli meats, cold cuts, or processed lunch meats. Use leftover roasted chicken or turkey from home cooking instead.
8. Season with herbs instead of salt — basil, thyme, lemon juice, garlic. No salt substitutes (potassium chloride) — those aren't safe for Hal with CKD.
9. Fluid limit: about 6 cups (48 oz) per day total — includes coffee, juice, water, soup broth, ice. Spread through the day.
10. Prop legs on the footstool when sitting in the recliner — helps the ankle swelling.

1. Notify Endocrinology (Dr. Singh, AdventHealth) of the furosemide dose change. Higher diuretic doses can shift glucose patterns and kidney function in CKD; flagging so endo can adjust if needed at the next visit.
2. Notify PCP (Dr. Alvarez, BayCare Internal Medicine) of the medication change and update their chart record.
3. Brief BayCare HomeCare aide on the new dietary restrictions. Sending the written grocery list (below) so the aide knows what to remove from the apartment and what to suggest at the store.
4. Call the family caregiver (Dana) tomorrow to walk through the new grocery rules — specifically: no Tombstone, no Stouffer's, no Progresso, no Hillshire Farm deli. Help confirm what to substitute on the next CVS / Publix run.
5. Coordinate BMP (basic metabolic panel) in 2 weeks to monitor potassium with the increased furosemide. Confirming whether cardiology will draw at the next visit or if PCP will place a standing order. Will arrange transportation as needed.
6. Schedule echocardiogram — Dr. Patel ordered today. Will coordinate with TGH imaging, confirm Humana Medicare Advantage coverage and prior-auth status, and target a slot within 4 weeks.
7. Contact CVS pharmacy (South Tampa) to confirm 60 mg furosemide availability, verify Humana cost, and arrange next-day delivery.
8. Update the Care Ledger — new dose, new daily-weight protocol, new dietary restrictions, the “no Tombstone / no Progresso” line for the aide and caregiver, and the 2-week BMP follow-up.
9. Include in this week's family update to Dana on Friday afternoon — short version, action items only.
10. For the next endo visit: queue a note to discuss potassium-rich dietary choices (banana, sweet potato, spinach) given diuretic increase — but no potassium supplements with CKD stage 3.

This is a Care Continuity Partner-prepared summary of what happened at Hal's appointment, what the family needs to do, and what Averyn is following up on. It is administrative — not medical advice and not a substitute for Dr. Patel's official visit note when it appears in the patient portal.