The physician comes and examines J.O. She writes several orders, then leaves, saying she will be back in 1 hour to check on J.O.
18. Put in order of priority your plan for implementing the physician’s orders, with 1 being the first step:
_____ a. Increase IV D5 LR to 125 mL/hr
_____ b. ECG monitoring
_____ c. Oxygen (O2) to maintain SpO2 of 90%
_____ d. Repeat ABG’s in 1 hour
_____ e. CBC with differential and serum lipase now
_____ f. STAT chest x-ray
_____ g. Methylprednisolone 12 mg IV push now
Chart View
Arterial Blood Gases on 10 L Face Mask
pH 7.29
PaCO2 56 mm Hg
HCO3 22 mEq/L (22 mmol/L)
PaO2 74 mm Hg
19. J.O. is placed on O2 at 10 L via face mask. ABGs are redrawn after 1 hour. Interpret the results.
20. What intervention do you expect based on your interpretation of these values?
CASE STUDY PROGRESS
The provider returns to reexamine J.O. Because J.O.’s status is deteriorating despite receiving O2 and the IV medications, the provider decides to transfer J.O. to the ICU for ventilator support.
21. You go with J.O. on the transfer to the ICU. Using SBAR, outline the report you would give the ICU nurse.
CASE STUDY OUTCOME
J.O. recovers for several weeks in the hospital before being transferred to jail to await trial. Shortly before his trial date, he is found stabbed to death in his cell. Although there is an investigation, the murder weapon is never found, and no one is ever charged in his death.