Explain this doctor's clinical note about a patient: "w/ HIV on HAART, COPD on 3L home O2 (though sat'ing fine on RA on admission), HCV cirrhosis c/b ascites requiring biweekly therapeutic paracenteses, hepatic encephalopathy; not on transplant list ___ comorbidities) p/w worsening girth and abd pain. She'd been having pain from her ascites, and felt overdue for a paracentesis. She last had paracentesis on the ___.  She reported that she began feeling worsening abdominal pain (constant, epigastric and radiates to back, not a/w food) on ___, which increased in severity throughout the course of the day. She was brought to the ED by her son because of this pain.  She had no confusion and was alert and oriented x3. The patient also reported she recently ran out of most of her home medications. She denied any fever, chills, shortness of breath, cough, dysuria. She reported loose stool a bit more than usual, but attributed it to lactulose use. In the ED, vitals were: 99.4 105 106/57 18 96% ra. Labs were significant for Na 127 K 5.3 lactate 2.1 INR 1.7. ALT 135 AST 244 AP 123. no leukocytosis.  Ascitic fluid showed 220 WBC. She was given Morphine Sulfate 5 mg IV ONCE MR1, and a GI cocktail." Please use JSON format in your answer.
user