Patient Encounter Part 2 Physical Exam Diagnostic Tests and Initial Treatment

PMH: Hypertension, congestive heart failure

Meds: Benazepril 10 mg daily, atenolol 50 mg daily, furosemide 40 mg daily as needed for edema

SH: Occasional alcohol use (per family)

FH: Noncontributory

VS: 80/40 mm Hg, P 130 bpm, RR 22, T 35.0°C (95.0°F), urine output: none since catheterization 10 minutes ago

Neuro: Recent loss of consciousness

Pulmonary: Normal breath sounds, undergoing tracheal intubation for mechanical ventilation

CV: ECG shows sinus tachycardia, otherwise normal Abd: WNL

Extremities: Noncontributory

Pertinent labs: pH 7.20, PaCO2 50 mm Hg (6.65 kPa), PaO2 70 mm Hg (9.31 kPa), Na 153 mEq/L (153 mmol/L), HCO3 18 mEq/L (18 mmol/L), lactate 70 mg/dL (0.78 mmol/L), SCr 1.7 mg/dL (150 pmol/L), Hct 51%

Identify treatment goals for JT in the next hour.

Identify treatment goals for JT in the next 24 hours.

What initialpharmacologic/fluid therapy is required?

Comment on the need for blood products or sodium bicarbonate in JT.

Table 13-4 Vasopressor Drugs

Drug

Uiu«l IV Dole

Adrenergic Effect*

PntBiktialto Cbum Arrhythmias

0,

¡S, EJopjrTuriergic

Dorumine

10-20 mcg/kg/min"

+ ++

Ü.5-8TI mcrjA^itfi

++

L>

++

Epinephrine

1 -200 mc^mn

++

+ + *

0

Phenylephrine

U.S-Ï mc-g/k-g/min

+++

0

0

a

"Ltwci do;-jtj<!ioiiki[iinnrrt.L nuy'Wl produce; cJi-iintl o, .icJ't'noKjk: (vasapieiSor} effects

"Ltwci do;-jtj<!ioiiki[iinnrrt.L nuy'Wl produce; cJi-iintl o, .icJ't'noKjk: (vasapieiSor} effects

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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