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

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

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%

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

ABG Values

pH	7.30
PaCO2	49
Bicarbonate	18
PaO2	70
SaO2	90%

Complete Blood Count Lab Values

Lab	Result
WBC	27,000
RBC	5
Hemoglobin	10
Hematocrit	29
Platelets	250
APTT
PT
INR

Electrolytes Lab Values

Lab	Result
Sodium	140
Potassium	2.7
Chloride	101
BUN	37
Creatinine	1.9
Glucose	300
CO2	33
Magnesium	1.4
Ionized Calcium
Lactic Acid	10

Septic Shock Bundle

1. Maintain MAP >65 mm Hg
2. Begin vasopressors for hypotension that does not respond to initial fluid resuscitation
3. 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%

 

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Now that you have completed your technology knowledge and skills self-assessment and reviewed the learning resources for this module, use the results of your technology self-assessment and Kirkpatrick’s model of evaluation to assess your educational technology training up to this point and to develop a plan for maintaining and improving your educational technology knowledge and skills. Post your assessment and plan as a page to the “Technology Self-Assessment and Improvement Plan” section of your e-portfolio.

 

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What can be an action plan to address social determinants of health such as Language barriers, health literacy, lack of health insurance, access to primary care, income, education, living environment, culture, migration, work, access to food, age, and gender in the Latino community to address obesity in the Latino community?

 

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A. Discuss a healthcare safety concern using the SBAR (situation, background, assessment, recommendation) format by doing the following: 1. Describe a healthcare-related situation prompting a patient safety concern (S). 2. Analyze background information about the concern by doing the following (B): a. Describe the data that support or would support the need for change. b. Explain how one or more national patient safety standards apply to this situation. 3. Discuss the impact of the safety concern on the patient(s), staff, and organization (A). a. Explain how the safety concern affects value for the patient(s) and the organization. 4. Recommend an evidence-based practice change that addresses the safety concern (R). a. Discuss how this recommendation aligns with the principles of a high reliability organization. b. Describe two potential barriers to the recommended practice change. c. Identify two potential interventions to minimize the barriers from part A4b to the recommended practice change. d. Discuss the significance of shared decision-making in implementing this recommendation. e. Describe an outcome measure that could be used to evaluate the results of the recommendation. f. Discuss how the care delivery model in this organization would be impacted by this change. This is the assignment. I am having trouble with 4.f This is my recommendation: Recommendation(s) Patients rely on healthcare organizations for the best strategies and care standards to achieve patient safety and effective healthcare. Using evidence-based practice like data informatics to provide efficient and effective health information in surgical services will help to indulge a healthcare organization in using data informatics to improve communication that safeguards patient benefits and make them safer (Geller, 2017). Nursing informatics align with an organization’s management principles in various ways. For instance, it focuses on quality improvement and excellent patient outcomes. The application and use of patients’ medical histories that are detailed and highlight the key issues and areas of concern to drive conclusions. When used, they help ensure a better understanding of patients’ medical history, thus protecting patients from administering drugs they may be allergic to in surgery. Evaluating and implementing data informatics to improve patient safety in surgery aligns with the principle of a high-reliability organization that promotes strength in prioritizing safety over other performance pressures seen in surgery. I need to say what impact data informatics would have on a functional nursing care delivery model?

 

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In a patient with a pneumothorax, what would you see on their medical record under the medical management/ collaborative plan? What would you see for referrals/notes from the interdisciplinary team?

 

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