QUIZ OF THE WEEK FOR MARCH 25, 2005

Pt B.is a 35 year old admitted with decreasing level of consciousness and respiratory distress. Overnight, he began to experience increasing distress, necessitating intubation and ventilation. He develops hypotension, that persists despite multiple fluid boluses that increases his CVP to 17. HR is 128, minute volume requirements are 12.0 L/min, and his WBC is 22,000 (increased neutrophils). He is now on a norephinephrine infusion, and blood cultures reveal gm positive cocci in the blood. Creatinine is 101, with urine output 35 ml/hr. He is on broad spectrum antibiotics and is started on hydrocortisone 100 mg q8h.

Questions:

1. What do these clinical findings indicate?

2. What other medication should be considered?

 

Brenda Morgan
Clinical Nurse Specialist, CCTC
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