Assessment: Patient opens eyes to name. Weak grip. Radial pulses +1, Pedal pulses per Doppler.

VS: HR 125, RR 16, BP 80/40, T 102, SaO2 88%

BS continue to be absent. Lung sounds with coarse crackles bilaterally. Blood glucose 400. Urine output 10 ml in last hour

See lab results and ABG results

Doctor’s Orders:

Begin septic shock bundle

Infuse Potassium 10meq in 100 ml NS over 1 hour now

Give NS bolus of 500ml over 30 minutes

Begin Ciprofloxacin 400mg Q 8 hours IV piggyback

Place Pulmonary artery catheter (PAC)

Place on 100% venti mask

Call with hemodynamics when PAC inserted

Place NG tube

PAC placed, hemodynamics:

CO 3

CVP 10

SVR 10,000

SvO2 75%

VS: HR 120, RR 12, BP 75/40, T 102, SaO2 88%

Analyze AG results.
Identify abnormal lab values.
In the above information, identify four parts of information of which are critical to notify doctor.
Define CO, CVP, SVR, SVO2, also give normal values.
Looking at the sepsis shock bundle, address each point. What would you do to achieve each area?

ABG Values

Complete Blood Count Lab Values

Electrolytes Lab Values

Septic Shock Bundle

Maintain MAP >65 mm Hg
Begin vasopressors for hypotension that does not respond to initial fluid resuscitation
If patient remains hypotensive despite volume resuscitation or initial lactate >4
1. Maintain CVP 8-12 (12-15 if mechanically ventilated)
2. Maintain SvO2 60-80%