100 points You have been working in a 30 bed ICU for 3 shifts now. You have Mr. Doe in bed I for all three days. He has

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100 Points You Have Been Working In A 30 Bed Icu For 3 Shifts Now You Have Mr Doe In Bed I For All Three Days He Has 1 (31.6 KiB) Viewed 60 times

100 Points You Have Been Working In A 30 Bed Icu For 3 Shifts Now You Have Mr Doe In Bed I For All Three Days He Has 2 (29.3 KiB) Viewed 60 times

100 points You have been working in a 30 bed ICU for 3 shifts now. You have Mr. Doe in bed I for all three days. He has been worsening each day. This is day 7 on the vent for Mr. Doe. He came in as a drug overdose. Found face down in his own vomit noted aspiration. His file is marked red for difficult intubation. He was attempted 3 times by ED physician finally anesthesia came and intubated the patient with a size 7 ET tube at 22 at the lip. After several doses of Narcan pt never came around. Pt was in the ED on vent settings of 500/15/+5/100% waiting an ICU bed when he coded. After 30 minutes of ACLS protocol ROSC was obtained patient still remained unresponsive to everything with no sedation on. Pt still has not woken 7 days later. Pt has been in the unit all of this time. Pt is a 5'11 male, 251lbs. His vitals at 0700: HR 112, BP 152/111, RR 22, SpO2 88%, ETCO2 68 and alarming. Pts morning labs were RBC = 3.20, Hbg = 6, HCT=24, WBC = 13,000/mm3. Moming ABG = Ph 7.17, Co2 75, PaO2 62, Hco3 18. Vent settings Volume Control, Vt 600, RR 22, Peep +12, Fio2 100, 1:E 1:2.7, Flow 22, Sensitivity +2. CXR: QUESTION 1 ABLE SITTING Saved
What do you think is the disease process of this patient? Why? Do you think this patient is being properly treated for this disease process? Why? What is patients IBW? Were they in range? Are they in range for disease process? What is patients Pf Ratio? What does that tell you? Explain. What test do you want ordered for this patient? Why? If anything, do you think may have been overlooked on this patient? If yes why? If no Why? Create a treatment plan for this patient for the next 24 hours, example "what do you want to keep values at, what settings do you want, what do you want abgs to be in theory, how will you make changes, what if their is no improvement in 24 hours, what if their is will you wean, what if pt is not awake? etc..." What do you think this patient's outcome will be? Do you think this patient could have had a better outcome? If yes why? If no Why? Please be through with your answers. I expect details take this seriously this is your finall