G.S. a 66-year-old man that was diagnosed

G.S. a 66-year-old man that was diagnosed with pneumonia and sent home with antibiotics. His wife brings him to the ER 2 days later with concerns that he is confused. VS: HR 125, RR 24, BP 80/40, T 102, SaO2 88% Assessment: Patient opens eyes to name. Weak grip. Labs in ER: WBC 15,000, H/H 10/29%, Na 139, KCl 3.7, BUN 37, Creatinine 1.9 ABG: pH 7.40, PaCO2 40, Bicarbonate 23, PaO2 70 G.S. is admitted to the ICU with a diagnosis of shock and a pulmonary artery catheter (PAC) is placed in the left jugular vein. PAC Values: CVP 6, CO 5, SVR 800, PAP 20 He is placed on O2 mask at 50% NS bolus 1 liter over 2 hours What is a PAC and why might the doctor have inserted one (i.e., what will it measure)? What are some complications to monitor for with a patient with a PAC? Looking at the PAC values, what are they measuring and are they within normal limits? After 2 hours in the ICU: CO 3, CVP 10, SVR 1,000, PAP 22 Vital signs: HR 110, RR 12, BP 80/50 (MAP of 60), T 102, SaO2 85% Urine output 10 ml in two hours Patient continues to be drowsy and oriented to person only ABG: pH 7.33, PaCO2 40, Bicarbonate 20, PaO2 68 Labs: WBC 16,000, KCl 5, Na 140, BUN 40, Creatinine 2, Lactic Acid 4 Evaluate the hemodynamics, vital signs, and Urine output. What are your concerns? Looking at the information you have, what are your top three priority nursing interventions? SCIENCE HEALTH SCIENCE NURSING NU 263

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