{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

Practicing implementation ETC columbia

Practicing implementation ETC columbia - Age 78 admits to...

Info icon This preview shows pages 1–9. Sign up to view the full content.

View Full Document Right Arrow Icon
Image of page 1

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Age 78, admits to your unit from the ER at 9 am. She states that she had been taking oral levofloxacin for pneumonia for 3 days (prescribed by her regular provider) but her breathing feels like it has gotten worse and she is repeatedly coughing so she came to hospital. She complains that she has been a little dizzy on this new medication and that recent BMs have been “loose”.
Image of page 2
Med Hx: CAD, HTN, mod. congestive heart failure Current meds: Enalapril Atenolol Aspirin Furosemide She took all of her morning doses today.
Image of page 3

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Assessment: auscultated rhonchi & wheezes, some work of breathing/accessory muscle use noted. Heart sounds S1S2. Peripheral pulses +2/4. Slight pallor, capillary refills 2 seconds to upper extremities, 3 seconds to lower extremities. Turgor 1 second tenting to sternum. A and O X 3. Weak but equal AROM. VS: T 99.8 P 87 R 21 BP 118/76 Sat 93% on room air
Image of page 4
Lab results: ABG: pH 7.37 CO2 36 HCO3 24 O2 89 WBC 14,000 Hemoglobin 15.7; hematocrit 51.5% BUN 25 mg/dl Serum creatinine 1.1 mg/dL Respiratory & blood culture results are pending.
Image of page 5

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Orders: IV ceftriaxone 600 mg IV Q 12 hours IV azithromycin 500 mg IV daily O2 via NC to keep sat > 92%-no more than 4 L; notify if more than 4 L needed to maintain Encourage oral fluids, regular diet Continue home meds except for levofloxacin Bed rest Incentive spirometer Q2 hours
Image of page 6
Other information you want? CXR shows mod. Atelectiasis in bases Pt reports urination X 1 this am; has not gone since arrival at hospital; cup of coffee this am and 6 oz. water in the ER No edema Serum Na 138; K 3.6; Cl 100; Glucose 100; Ca 9.1 UA WNL except small protein 3 meals yesterday; piece of toast this am Sputum is yellow, thick
Image of page 7

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 8
Image of page 9
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern