Antibiotics administration.

[ChooSoul]

So I have a pt who came in with cellulitis and he is on many antibiotics but he has impaired renal function so they have been giving low doses. 1 day ago, his renal function started to get better so they increased the dosages of the antibiotics. Fast forward to now, his urine output has decreased yet again. I'm expecting renal impairment again, or obstruction. Should I still administer the scheduled antibiotics that they ordered? Or what's a better smarter approach?

[LovingLife123]

Have you called pharmacy to have them Renault adjusted? Do you have a BUN and Creat number for the day? You give the abx unless you have the data to back up changing it.

There could be numerous reasons for low urine output. But I would draw labs to see kidney function first since you’ve been dealing with issues.

[JKL33]

The smartest approach is to inform the provider team of the decreased UOP and the history of the problem.

[nrsang97, BSN, RN]

You need to notify the physician and pharmacy.

[Jory, MSN, APRN, CNM]

On 4/27/2019 at 3:42 AM, ChooSoul said:

So I have a pt who came in with cellulitis and he is on many antibiotics but he has impaired renal function so they have been giving low doses. 1 day ago, his renal function started to get better so they increased the dosages of the antibiotics. Fast forward to now, his urine output has decreased yet again. I'm expecting renal impairment again, or obstruction. Should I still administer the scheduled antibiotics that they ordered? Or what's a better smarter approach?

I think a better question is to call the physician or pharmacy (or both) to make sure the last renal function tests have been reviewed. The dosage is scheduled and sometimes changes are missed.

Great job on looking...not everyone would.

[traumaRUs, MSN, APRN]

You don’t change dosing on a day to day basis. Once the pt has CKD or chronic kidney disease than you renally dose