I had a very LARGE patient that had a simple procedure. He had a cath for 6 hrs. because he couldn't void all day. He spike a temp of 103.3 and was very lethargic, and Dr. said to D/C Foley and C/S green purulent discharge from urethra and give Tylenol. He was on a PCA pump for 2 days for pain control. Temp came down and I had him up and walking for non-urination for 8 hrs after removal of catheter(100 cc after ambulation) and then in AM during report he tanked. (Why do they always tank during report?) He had 6 shots of Narcan and still did not come around, usually they are jumping out of their skins. 30% on a non-rebreather, and was non responsive. His % came up to 82% but still not responding to stimuli. BS 290, HR 112, BP 80/50, temp 97' and RR of 22. Labs showed ph of 7.28. All other CBC,PT, INR, BMP and ABG's were normal. He was moved to TCU still unresponsive. At first, I thought too much meds, but after 6 shots of narcan and no response, I'm thinking he had sepsis or maybe threw a clot. What do you think? I've never had a patient that was a walkie talkie just tank like that.
