Regular Insulin 10 Units in 500 ml D/ 10%/W IV over one hour BIPAP IPAP @ 10 cm H2O EPAP 5 cm Nurse A: H2O. Assist Resp therapy with BIPAP Decrease 0.9 NS IV to 100 ml per hour Explain reason for BIPAP to patient in appropriate terms Transfer to ICU (Patient Centered Care) Prepare to send the patient to ICU Resp Therapist changes O2 to BIPAP Give report to ICU (Collaboration) Patient says Take this thing off my face” Complete documentation “ (Patient Centered Care): Communicate patient’s wishes to health care team and discuss options with daughter Daughter is hysterical and crying. my mother going Ask daughter to in Advanced Directive “Is to die? She doesn’t want a tube in her throat” Recognize daughter’s anticipatory grieving and communicate appropriately Explain the plan of care to daughter, including renal replacement therapy (CVVH), respiratory management etc.
Regular Insulin 10 Units in 500 ml D/ 10%/W IV over one hour BIPAP IPAP @ 10 cm H2O EPAP 5 cm H2O. Decrease 0.9 NS IV to 100 ml per hour Transfer to ICU Resp Therapist changes O2 to BIPAP Patient says “ Take this thing off my face” Daughter is hysterical and crying. “Is my mother going to die? She doesn’t want a tube in her throat” Nurse A: Assist Resp therapy with BIPAP Explain reason for BIPAP to patient in appropriate terms (Patient Centered Care) Prepare to send the patient to ICU Give report to ICU (Collaboration) Complete documentation (Patient Centered Care): Communicate patient’s wishes to health care team and discuss options with daughter Ask daughter to in Advanced Directive Recognize daughter’s anticipatory grieving and communicate appropriately Explain the plan of care to daughter, including renal replacement therapy (CVVH), respiratory management etc.