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38 Year Old Female Full Code No religious preferences Dx: Cardiogenic Shock Patho: Ischemia causes myocardial dysfunction which then causes the heart's ischemia to worsen which causes the heart to not function properly. It is a vicious circle and if not addressed quickly can be deadly. Hx: Heavy drug use, Fetal demise, Sepsis. Patient came to the ER experiencing chest pain and shortness of breath. She was found to have a complete block of her RCA and when they went to stent it she went into Cardiogenic Shock and had to be put on Ecmo to keep her heart functioning. Pt. was also placed on a Vent.

Lansoprazole 30mg

Senna

Docusate 100mg

5 Musculoskeletal

1 Educate the patient on her condition and how to reverse it.

Unsuccessful. Pt. verbally and physically aggressive. Not taking in the info.

2 Range of motion exercises

Unsuccessful. Pt. very agitated and aggressive. Had to be restrained otherwise rips everything out.

3 Physical therapy

Unssucessful. Pt. non compliant and very aggressive and agitated.

2 Respiratory

Ventilated Patient

3 Passed ZEEP. Taken off of the vent

Successful. Patient able to breath and maintain her own airway.

2 Turn Patient q2hrs

Successful even after extubation

1 Deep suction patient as needed

Successful. Large, thick mucous removed.

3 Neurological

Versed Continuous

Fentanyl Continuous

Stroke

3 Occupational Therapy

2 Physical Therapy

Unsuccessful. Non cooperative and non compliant with evaluation.

Successful. Able to maintain therapeutic level

4 Integumentary

Weeping wounds and skin breakdown

1 Wound consult

Successful. Proper wound care developed.

3 Protective foam patch on sacrum

Successful, but had to be change constantly due to stool incontinence.

2 Turn q2hrs

1 Cardiac

Meds

Vancomycin IV

Lasix 40mg IV

Zosyn 3.375mg

Stroke Complete block of RCA

2 Heparin Assay drawn q6hrs to adjust dose

3 Echo daily to check heart function

1 Continuous IV Heparin Infusion

Successful