Assignment task:
Pt Ringgold is a 62 year old Caucasian male presenting in the emergency room with decreased WOB shallow breathing.
The patient has decreased breath sounds in the lower lungs with some scattered course crackles in the upper airways.
Assessment reveals the following: HR 104 RR 8 BP 98/65 Spo2 92% EtCo2 44
ABG 7.36 55 68 23
After one hour the patient is more lethargic and the following ABG is obtained:
ABG 7.32 60 60 27
You are called to the bedside and now the following treatment plan has been initiated:
Place the patient on Vapotherm at 40LPM and 40% oxygen with Q4 Albuterol and continue with steroid treatment plan to follow home regiment.
If the patient ABG does not improve intubate and place on AC 500 12 100% and 5 of peep.
Would you alter this treatment plan and if so how or why?
What can you identify in the assessment of the patient that needs to be addressed when considering your treatment plan? Need Assignment Help?
How would you explain to the ER physician what alternatives (if any) to the treatment plan he has prescribed?