Skip to content
View in the app

A better way to browse. Learn more.

allnurses

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
Discussion

opinion please

This week took care at shift chage of a patient that going to monitoring medical unit.

I didn,t really had time to take care of her since she was going up

but I have a few questions:

60-70 yrs old lady with big cardiac hx( mitral regurgitation, LV

dysfuntion, chf++

,crf with usual cr around 120 level 2. Come with SOB. Under medecine.

ABG P/F: 180, ph normal but on the low side, co2 slightly elevated ,

normal lactate and a po2 of only 72 with 40 % o2( labs from 0102 took patient at 1100). Not really in distress but sob with 2-3 words

sentence and tachypneic at 28. U/O of only 10-13 cc/h.with low 90 bp.

On report RN state rounds was done and all medecine was inform of her

condition

Here my questions:

1)wasn't she to unstable to go on the floor??

2)with such sign of shock shoudn't have receive more then the mininal

bolus she was receiving??( 250-500 x 2-3time with a NS at 50cc/h)??

3)Would a bipap would have been good in that condition, even if the

gas was normal at this time or it would have made her BP worse r/t intrathoracic pressure?

4)would our patient benefits from some physio therapy ( chest

percussion) like the ICU does??

Featured Replies

I would not have sent her to the floor unless she was a no code.

Do you want to bolus a pt who is in CHF with CRF?

Bipap...I have no idea, do not have any experience with it.

Pulmonary toilet....no idea.

Where I work this pt. would probably have been placed on BiPAP & gone to the unit, even if only for 8 hours or so, until she hopefully improved enough to go to a monitored floor bed.

She would have been a unit admission at my facility, unless she was a DNR.

Guest
This topic is now closed to further replies.

Currently Reading 0

  • No registered users viewing this page.

Account

Navigation

Search

Search

Configure browser push notifications

Chrome (Android)
  1. Tap the lock icon next to the address bar.
  2. Tap Permissions → Notifications.
  3. Adjust your preference.
Chrome (Desktop)
  1. Click the padlock icon in the address bar.
  2. Select Site settings.
  3. Find Notifications and adjust your preference.