Case Study #1 Andrea Bakker RN, PCCN Patient Data 62 Year old - PowerPoint PPT Presentation

Case Study #1 Andrea Bakker RN, PCCN

Patient Data ◦ 62 Year old Female ◦ Filipino ◦ They had a 2 daughters, only told 1 mother was sick

Diagnosis ◦ Came in with Thrombocytopenia and leg pain ◦ After a few days in the hospital she was diagnosed with ARDS ◦ History of: Acute Myelogenous Leukemia, TB

Pathophysiology • Acute Respiratory Distress Syndrome - This is a life threatening lung condition that prevents enough oxygen getting to the lungs and into the blood. - Build up of fluid in the alveoli - Makes the lungs stiff - Normally treated in the ICU with a ventilator

Plan of Care ◦ Doing multiple ABG’s to make sure oxygenation is adequate ◦ Making the patient comfortable ◦ Started insulin drip to make sure excess fluid was removed ◦ Inserted a post-pyloric feeding tube to give nutrition ◦ Increasing PEEP to make sure adequate oxygenation was occuring ◦ Levophed drip to have MAP > 65 ◦ Propofol to prevent the patient from fighting the ventilator

Pertinent Lab Work ◦ ABG ◦ CBC ◦ BMP ◦ PHOSPHEROUS ◦ POTASSIUM ◦ MAGNESIUM

Medications ◦ Propofol- is an anesthetic, fast acting. Possible side effects seizure, nausea, cough, confusion, discolored urine, and shallow breathing ◦ Levophed- is an alpha/beta agonist, used to treat severe hypotension, stimulates beta-adrenergic receptors causing increased contractility and heart rate as well as vasoconstriction. Possible side effects are necrosis of limbs ◦ Insulin- Normalizes blood glucose level. Possible side effects are low blood sugar ◦ Antibiotics- fights the infection

Course of Treatment  To keep oxygenation at an adequate level  To administer antibiotics to help with healing  To keep blood pressure adequate for organ profusion  To keep sedated so she did not fight the ventilator  Monitor labs and replace electrolytes and blood as needed  Encourage husband to call second daughter to come say goodbye to her mom