NR 341 Care of the Critically-Ill Patient: Interdisciplinary Care

NR 341 Care of the Critically-Ill Patient: Interdisciplinary Care Chamberlain College of Nursing NR 341: Complex Adult Health Care of the Critically-Ill Patient: Interdisciplinary Care 73-year-old, Caucasian, widowed, retired male was admitted to the hospital on May 11, 2017 from his home. He does not have a resuscitation status, and no known allergies. Admitting diagnosis is mitral valve disease secondary to bacterial endocarditis, and acute kidney injury. Past medical history includes obstructive sleep apnea, hypertension, hemothorax, gout, GERD, diabetes mellitus, atrophy of the left kidney, and alcohol abuse. Recent surgery on May 12, 2017 includes mitral valve replacement with a cardiopulmonary bypass. Significant assessment findings are as follows: temperature 37o C, pulse 84, respiratory rate 17, blood pressure 140/61, O2 saturation 94 on room air, and 0 pain reported on a scale from 0 to 10. Foley catheter is in place, and output measurement is 100 mL at 0900. A peripherally inserted central catheter is located on his left arm. Student was unable to obtain amount from pleur-evac. Patient was semi-lucid; therefore, unable to obtain a review of systems. Focused assessment includes as follows: Integumentary: Skin is warm, dry, and no skin turgor noted. Head and neck: Normocephalic, and jugular vein distension is absent. Respiratory: Chest expansion is symmetric, and lung sounds are clear on the right side yet Diminished on the left side. Cardiovascular: S1 and S2 are noted on auscultation, and S3 and S4 are absent. Gastrointestinal: Abdomen is rounded and symmetric, skin is smooth, bowel sounds are present in all four quadrants, and last bowel movement was the morning of May 14, 2017. Neurological: Patient is oriented to person, place, and time.