Day Three medical Note: Ht: 178 cm Wt: 84 kg NKDA Code status: Full…
Question Answered step-by-step Day Three medical Note: Ht: 178 cm Wt: 84 kg NKDA Code status: Full… Day Three medical Note:Ht: 178 cm Wt: 84 kg NKDA Code status: Full CodeDx: Respiratory distress; Failure related to Acute respiratory distress syndrome (ARDS)-Covid 19, and septic shock Patient remains intubated and has developed a left pneumothorax and emphysema. A chest tube was placed remains on -20 cm of suction with intermittent air leak. Able to decrease FiO2 4 hours after placing chest tube to 65%. Patient remains on pressors and MAP has maintained 60-70mmHg. Patient weaned off Propofol and remains on fentanyl. Cultures are pending, reduced Vancomycin dose to 500 mg and will continue to monitor renal function. May need to start CCRT. VS: Temperature 100.6, HR 110, BP 94/52 (66), RR 22 with ventilator, O2 Saturations 93%Patient assessment:Patient opening eyes to voice at times but makes no eye contact. Patient has not grimacing, absence of movements, Coughing occasionally but alarm stops spontaneously, no resistance to passive movements.Fentanyl gtt currently infusing at 75 mcg/hrNorepinephrine 30 mcg/min Epinephrine 15 mcg/min Vasopressin at 0.03 units/min EKG Rhythm: ABG: 0800Arterial Blood GasespH 7.34PaCO2 56 mm HgHCO3 27mmol/LPaO2 70 mm HgSaO2 93%Labs:WBC 13,500HGB 8.0HCT 25Platelets 100,000NA 135Potassium 3.5Chloride 101Glucose 200BUN 22CR 3.2Lactate 2.01. Outline the steps to assess the chest tube and what must always be at bedside for safety?2. What would be the priority nursing diagnosis and the top 3 nursing interventions for this patient at this time?3. Explain CRRT treatment and why this might be a consideration with this patient?4. The family is asking for an update on the patient’s status, please write an example of your response?5. A nursing assistant is floating to your unit to assist, outline 5 duties the CNA or unlicensed personnel may assist with? Health Science Science Nursing NR 341 Share QuestionEmailCopy link Comments (0)
