A few months ago we had a case study presentation of a cardiac episode in the ER and I was wondering if anyone was interested in another one? I'll try to present this one as best I can (I've never done this before) and I'm sure you smart cookies will figure this out pretty quick.
A 64 y.o. male admitted with acute mental status change and fever. His vitals are:
HR 127 intermittent a-fib/sinus tach
SpO2 94% on 5L/NC
He is restless and confused. The neurologist was unsuccessful at obtaining an LP so he was started on Acyclovir empirically. After several days, you notice his urine output is markedly decreased (+2L I&O). His heart rate has been controlled with Metoprolol and Diltiazem and he has been NPO, receiving Heparin,Travasol and lipids through a central line. He is becoming dyspneic on 35% venturi mask and developing peripheral edema. SpO2 has dropped to the mid 80s.
What would you want ordered? What do you think are the best actions to manage him?