B/P 88/40 MAP 56 Heart rate 110 Recognize signs of septic shock Resp rate 36 O2 Sat 87 % Report critical labs, abnormal lung sounds, vital signs and low Lung sounds: crackles auscultated up to mid O2 Sat to MD Skin is cool and clammy ; Peripheral pulses weak (1+) Capillary refill 5 seconds Urine output 5 ml Patient oozing blood from IV site Assist Radiogic Technologist to position the patient for portable chest XRay, with consideration of patient’s comfort. Radiologic Technology does portable Chest X Ray as (Collaboration, team work) ordered (shows bilateral, symmetrical fluffy alveolar infiltrates) . ABG Results reported pH 7.30 PCO2 30 PO2 68 HCO3 19 Receive critical Lab report from Lab staff and report STAT (Safety) Critical Labs reported Potassium 6.2 Lactate 5.0 INR 3.5 Platelets 50,000 WBC 16, 500 Bands 13 % Neutrophils 90 BUN 58 Creatinine 3.5 Blood sugar 250 Assess EKG for peaked T waves and dysrhythmias Nursing Assistant does stat EKG as ordered Explains the rationale and safety precautions related to MD starts a second IV line Dextrose/Insulin IV. MD administers 1 D/50/W and 5 units regular insulin IV MD writes orders for A and B 5:40 pm Dopamine 400 mg in 250 ml 0.9 NS. Run Reduce 0.9 NS IV fluid to 100 ml /hr @ 5 mcg per kg / min Calculate the hourly flow rate for Dopamine drip
B/P 88/40 MAP 56 Heart rate 110 Resp rate 36 O2 Sat 87 % Lung sounds: crackles auscultated up to mid Skin is cool and clammy ; Peripheral pulses weak (1+) Capillary refill 5 seconds Urine output 5 ml Patient oozing blood from IV site Radiologic Technology does portable Chest X Ray as ordered (shows bilateral, symmetrical fluffy alveolar infiltrates) ABG Results reported pH 7.30 PCO2 30 PO2 68 HCO3 19 Critical Labs reported Potassium 6.2 Lactate 5.0 INR 3.5 Platelets 50,000 WBC 16, 500 Bands 13 % Neutrophils 90 BUN 58 Creatinine 3.5 Blood sugar 250 Nursing Assistant does stat EKG as ordered MD starts a second IV line MD administers 1 D/50/W and 5 units regular insulin IV Recognize signs of septic shock Report critical labs, abnormal lung sounds, vital signs and low O2 Sat to MD Assist Radiogic Technologist to position the patient for portable chest XRay, with consideration of patient’s comfort. (Collaboration, team work) . Receive critical Lab report from Lab staff and report STAT (Safety) Assess EKG for peaked T waves and dysrhythmias Explains the rationale and safety precautions related to Dextrose/Insulin IV. 5:40 pm MD writes orders for Dopamine 400 mg in 250 ml 0.9 NS. Run @ 5 mcg per kg / min A and B Reduce 0.9 NS IV fluid to 100 ml /hr Calculate the hourly flow rate for Dopamine drip