- Clinical Reasoning Checkpoint Mr H Is An 82 Year Old Man Admitted To The Hospital From A Nursing Home With A Diagnosis 1 (266.51 KiB) Viewed 12 times
Clinical Reasoning Checkpoint Mr. H is an 82-year-old man admitted to the hospital from a nursing home with a diagnosis of urosepsis. Urine cul- tures revealed gram-negative bacteria, and he was started on Bactrim. He continued to be febrile despite antibiotic therapy. After 72 hours he was transferred to the ICU because of his declining mental status. He was intubated and placed on mechanical ventilation. Despite multiple fluid boluses and a norepinephrine infusion (5µg/min), his mean arterial pressure remains less than 60 mmHg. 1. Identify the functional classification of shock pertinent to Mr. H. 2. Describe the mechanism of impaired oxygenation for this shock state in this patient. 3. Describe the compensatory mechanisms that occurred in response to this shock state. 4. What stage of compensatory shock is Mr. H in? 5. What are the nursing implications for the patient receiving norepinephrine? 6. What other collaborative interventions may be initi- ated upon Mr. H's admission to the ICU?