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Sepsis Clinical Reasoning:

⦁ A client displays the following symptoms:
⦁ Temp 103.4oF
⦁ HR 140
⦁ RR 34
⦁ BP 88/42
⦁ Increased agitation
⦁ Skin cool, pale and edematous (+3 pitting edema)

⦁ What is the most concerning vital sign?  State your rationale.
⦁ When you notify the physician of the findings, what orders would you anticipate?
⦁ What nursing interventions will the nurse implement for each assessment finding?
⦁ What are the priority nursing intervention?  State your rationale for each.

The provider is rounding and will soon see the client.  
⦁ What labs would the nurse recommend completing?  State your rationale.

⦁ The provider orders the following medications.  Place an A by the ones you would administer, an H by the ones you would hold.  State your rationale for the action on each order.

⦁ NSS 500 mL bolus IV NOW
⦁ Levofloxacin 500 mg IV Q 12 hours
⦁ Tobramycin 100mg IVPB TID
⦁ Dexamethasone 2 mg IV QID
⦁ Regular Insulin Sliding Scale SubCut:
  Less than 70, initiate hypoglycemia guidelines
  10-139 = 0 units 
  140-180 = 2 units
  181-240 = 3 units
  241-300 = 4 units
  301-350 = 6 units
  351-400 = 8 units
  Greater than 400 = 10 units and notify provider and repeat blood                                  glucose 30 minutes after insulin administration
⦁ Lasix 40 mg IV Q 6 hours
⦁ Nicardipine 20 mg PO TID
⦁ Dopamine 10 mcg/kg/min IV infusion 
 

SCIENCE
HEALTH SCIENCE
NURSING
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