Brief history: 6 weeks orientation a med-surg/tele unit; 2nd week on my own
I had 5 pt last night. 2 pts sats dropped at the same time (A-77 and the B=83). A 3rd pt IV infiltrated with vancomycin.
i put A on a partial re breather, sats increased to 91; then put her back on N/C; sats dropped to 83; notified Dr. who was mad at me for something i really didn't care abt at the moment. He came, placed pt on venti mask 40% and wanted ABGs, CXR and other labs, mean while sats =84. Paged resp. for BIBAP( who has to drive 45 mins becos we dont have resp during the night shift
). I told the Dr. the sats are still at 84 and he said "WAT SHOULD I DO"
Ok i spoke with another nurse and we increased to VEnti 50%. SAts still 84-85.
B: partial rebreather,0xygen-100%, then back to N/c- stayed at 91%. Ok 15 mins later -88, gave her albuterol coz she started complaining of SOB-told Dr. and Dr. assessed and said just maintain atlist 89%. OK back to A:respiratory guy here-drawn ABGs, place pt on BIBAP
Fouth pt: Family members want Ativan for pt (COMFORT CARE). i asked another nurse to do that and please put new IV on infiltrated.
B: Ask respiratory to please assessed B. States B has some crackles and and diminished in bases. Ok he would advise some lasix because of fluid. Ok that i did not tell the Dr.
Back to infiltrated- nurse said the IV she put is infiltrated and i ask another nurse to put a new IV and then put warm pack on infitrated site.
Ok so now i go home, slept, woke up and decide to read b4 going to work and realize that pt B may be having Pulmonary Edema: her sats dropped; she was having noturia and has ankle edema on left leg which is old but no coughing or pink frothy sputum or sweating but i am still worried becos what if and since the resp. guy told me abt the fluid.
All this is so overwhelming. i am going back tonight and really nervous.
Thanks for any comment.