The client is on a continuous dopamine drip at 15 mcg/kg/min…
The client is on a continuous dopamine drip at 15 mcg/kg/min. Medication administration order state the drip can be titrated down by 5 mcg/kg/min every half hour as long as the SBP >100. At 1015 the client’s blood pressure is 102/60, heart rate is 70 bpm and urine output is 30ml/hr. The nurse titrates down to 10mcg/kg/min. At 1045 the client’s blood pressure is 90/58 and heart rate is 110 bpm. What is the priority action of the nurse?
Read DetailsCardiac Case Study (Question 1) Mr. Jones, age 63, was adm…
Cardiac Case Study (Question 1) Mr. Jones, age 63, was admitted to the emergency room at 0400 with substernal chest pain that woke him up from his sleep. He states the pain started at 0300 and thought it was heartburn from the stuffed calzone that he ate for dinner. He called 911 at 0315 because he stated the pain was worsening and he felt like he was going to vomit and pass out. 1 dose of sublingual Nitroglycerin was given in the ambulance. PMH/PSH: Hypertension, Diabetes Type II, COPD, dental surgery two weeks ago, 1 PPD smoker x 40+ years Medications: Hydrochlorothiazide 75 mg PO daily, Simvastatin 40mg PO HS, Metformin 1000mg PO daily Assessment: Time Vital Signs System Lab Results 0400 B/P= 84/48 Pulse= See 6 second tele. strip below Respirations= 21breaths/min. SPO2= 92% on 3 liters nasal Cannula Pain= 6 (0-10 scale) Temp= 99F (37.2F) Weight= 278 lbs. Cardiac: 6 sec. tele strip below, diaphoretic Resp: Lungs faint crackles bi-lateral lower lobes Neuro: A & E X 4, feels weak and anxious GI: Hypoactive BS X 4 quad., nauseous, vomited X 3 in ambulance (1000 mL output) Renal: 20mL urine output since arrival WBC= 13,546 per mcL Platelets= 200,000 per mcL Na+= 147 mEq/L K+= 3.1 mEq/L Glucose= 181 mg/dL BUN= 26 mg/dL (Normal 6-24 mg/dL) Creatinine= 1.2 mg/dL (Normal 0.6-1.2 mg/dL) Troponin= 0.03 ng/mL (Normal 0-0.4 ng/mL) 0400 Telemetry Strip (6 seconds): Question: Based upon the 0400 assessment, name 8 priority assessment findings that could be placed on the plan of care. _______ _______ _______ _______ _______ _______ _______ _______
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