Case Study for Concept Map Tom Brown is a 68 – year – old retired…
QuestionAnswered step-by-stepCase Study for Concept Map Tom Brown is a 68 – year – old retired…Case Study for Concept MapTom Brownis a 68-year-old retired construction worker who lives with his wife Jane. He is admitted to your hospital with acute cholecystitis. He has undergone a laparoscopic cholecystectomyand has been transferred to medical surgical floorand it is postopdaytwo. He has one peripheral IV, and four small size dressings onthe right mid and lower abdomen. Patient’s admission orders:Turn, cough, and deep breathe q2h, incentive spirometer q1h while awake. Ambulate in the roomAdvance diet as tolerated Medications: D₅in ½ NS with 20mEq KCL/L at 125 ml/hMorphine 4 mg IV q2h prnfor painZofran 4 mg IV q4h prn for nausea/vomiting The morning, when you enter his room, Mr. Brownappears quite anxious with productive cough. He reports SOB and “feeling hot and cold at the same time”. Your assessment reveals the following:VS:BP -142/80P -120R -26 T -103.4 FO2 sat 88% on room air Pain -8/10 at the incisionsites——————————————————————————————————————————————IVis running at the prescribed rate and there are no s/sof infection of the IV site. Incisions look normal no s/s of infection. Patient’srespirations are labored and shallow and there are scattered crackles at the base of the right lung. Youplace patient in Fowler’s position in bed and reportyour findingsto RN and the physician.The physician prescribes the following orders:-Continue IV infusion of D₅in ½ NS with 20mEq KCL/L at 125 ml/h-Administer O2 at 2L/min per NC-STAT blood culture and sensitivity-Sputum culture and sensitivity-STAT chest x-ray -Acetaminophen 650mg po for temp over 101 F -Ceftriaxone 1 g IV q24h-Azithromycin 500 mg IV q24hResultsThe chest x-ray reveals RLL pneumonia Patient was diagnosed with hospital acquired pneumonia. Blood Work showed that his WBC-22,000 cells/mm3, ESR -40 mm/hr. Few days later blood culture reveals that Mr. Brownhas MRSA and he is sensitive to Vancomycin. The physician changed the antibiotics to Vancomycin 1 g IVPB q12hrs. The physician also ordered pick and though level of Vancomycin with third dose. Five days later Mr. Brown was discharged home wit oral antibiotics and pain medications. Health ScienceScienceNursingShare Question
