I have a scenario from my teacher that we have to do acute renal failure on a state of the art very expensive simulator. He breathes, coughs, vomits, pees, poops, bleeds, has vitals, talks, etc. The info. follows:Location: Medical-Surgical UnitHistory/ Information:The patient is a 61 year old male with a history of hypertension and hyperlipidemia. His home medications include enalapril, atorvastatin and baby aspirin daily. He weighs 100 kg and smokes one pack of cigarettes per day. He is allergic to penicillin. The patient presented to the Emergency Department three days ago with complaints of abdominal pain and yellow skin and had an emergency open cholecystectomy for obstrictive jaundice. He was admitted to the Medical-Surgical Unit postoperatively. On the second postoperative day, his IV was converted to a saline lock and clear liquid diet ordered. On the third morning, he has nausea, vomiting, absent bowel sounds, urine output 250ml/12 hour shift, and low grade fever. He has not had a bowel movement. His surgical wound is positive for methicillin resistant staphylococcus aureus (MRSA), which is now being treated with vancomycin. He is in contact isolation.Healthcare Provider's Orders: Vancomycin 1g every 12 hoursEnalapril 20 mg PO once dailyAtirvastatub 10 mg PO once dailyHydromorphone 1-2 mg every 2-4 hours IVP prn painPromethazine 12.5mg IV every 6 hours prn nauseaOxycodone 5mg/acetominophen 325mg 1-2 tabs PO every 4-6 hours prn mild painEnoxaparin 40 mg SQ once dailySaline lock flush 0.9% NS every shiftCBC, Electrolytes, BUN, Creatinine, Glucose in AMIncentive spirometerMy husband is a nurse and says he should get immediate dialysis. What about fluids? He has Vanco q 12 hours piggyback, but piggyback to what? What do you think, anyone? The last group in our class killed "Stan". I don't want to do the same.