Your an ER doc and in comes a patient complaining of dysnpea. He has a fistula on his left arm and his right arm is in a sling. The patient has 3lpm nasal cannula at home, and is presently hooked to a flowmeter at 3lpm. The patient presents with the following vitals:
- Blood Pressure 188/93
- Heart Rate 101
- Lung sounds: Crackles in bases, diminished
- Spo2 is 88% on 3lpm
- a)Call respiratory therapy STAT to do a Duoneb breathing treatment
- b)Check to make sure the nasal cannula is working properly
- c)Increase oxygen until you maintain an SpO2 of 92% in order to oxygenate the patient
- d)Order Lasix
The respiratory therapist arrives to give the patient described in question #45 above a breathing treatment. The first thing he does is fix the nasal cannula so that it's no longer oxygenating the patient's cheek. The SpO2 shoots up to 98%. The respiratory therapists asks if the breathing treatment is still needed. What do you say?
- a) Of course I still want a breathing treatment, the patient is short of breath, isn't he?
- b) No, the patient appears to be wet. I'll order Lasix and monitor blood pressure
- c) Order Q2 hour treatment you arrogant condescending son of a b)*&^tch trying to show me off will you???
- d) Ignore the respiratory therapist because you already gave an order
Continuing on with our patient in question #45 above, there is one more series of procedures we can order to piss off the respiratory therapist. Hint: There's no easy access to arteries.
- a) Sepsis order set (includes EKG and ABG)
- b) Another breathing treatment
- c) Another breathing treatment and EKG and ABG
- d) Order Lasix