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Case Study Question 3 out of 3.  Updated condition: Mr. Sing…

Case Study Question 3 out of 3.  Updated condition: Mr. Sing is an 84 year old resident of a skilled nursing facility. He has had an abrupt onset of confusion and was taken to the emergency room for evaluation.  His weight on admission is 165 pounds (75 kilograms). He is admitted with sepsis and urinary tract infection. He has received 1000 mL of NS over one hour, acetaminophen pr X1 dose, and oxygen at 4 liters/NC.  All cultures were collected and sent to the lab and the antibiotic was started 60 minutes ago. New data is listed: NURSES’ NOTES VITAL SIGNS LAB RESULTS MEDICATIONS DATE TIME FOCUS NURSES’ NOTES Feb. 25, ’23 0900 Confusion Admitted to emergency room via ambulance. Responds to name, but disoriented to place, time and situation. Drowsy. Feb. 23, ’23 0940 Confusion Oriented to person and place. IV infusing at 900 mL/hour. Urine output 60 mL over past 30 minutes. Cultures complete and antibiotics started. Feb. 23, ’23 1000 Confusion Oriented to person and place. More alert. 1,200 mL of NS have infused with 90 mL of urine output for past hour. Resting in bed. PARAMETER Admission (0900)  0930 1000 Temperature 39.0° C (102.2° F) 38.7° C (101.7° F) 38.6° C (101.5° F) Heart rate 98 92 88 Blood pressure 92/60 92/62 98/64 Respiratory rate 18 18 16 Oxygen saturation 95% 93% 94% TEST RESULTS (0900) 1000 White blood cells (WBC) 16.0 x 109/L 17.0 x 109/L Hemoglobin (Hgb) 145 g/L – Sodium (Na) 140 mmol/L 140 mmol/L Potassium (K) 4.0 mmol/L 4.0 mmol/L Glucose  120 mg/dL 120 mg/dL Lactic acid  2.5 mmol/L 2.5 mmol/L MEDICATION LIST: acetaminophen 625 mg PO or PR q4h prn temperature IV bolus of NS 2250 mL over 3 hours oxygen via Nasal Cannula, titrate to 94% Blood, urine and sputum cultures STAT Pipercillin/tazobactuam 3.375 Gm/0.375 Gm) IV every 24 hours Foley catheter with hourly urine output measurements For each finding, indicate whether the interventions were Effective (helped to meet expected outcomes), Ineffective (did not help to meet expected outcomes), or Unrelated (no related to the expected outcomes). Answers may be used more than once.