Question

Michael Jones came into the emergency room with an - elevated temperature of 102.5, heart rate of 110, BP of 100/60, and respiratory rate of 28. Lab results in the ER included a - WBC count of 18,000, H&H: 14.4/41.7, Glucose: 390, Potassium 3.5. Shortly after arriving to the ICU, Michael went into respiratory arrest and was succesfully resusitated. He remains of ventilatory support and is receiving IV Dopamine and IV antibiotics. Dr. Tywoni diagnosed him with sepsis of unknown origin. Mr. Jones has a history of Type 1 DM, and an MI 10 years ago. What orders do you anticipate from Dr. Tywoni such as How will you address nutritional needs, Does he need a specialty bed, or IV therapy with which type of IV?

Answer 1

Doctor has kept the patient on ventilator and treating him with IV dopamine which is a vasoconstrictor and helps in increasing the BP and IV antibiotics for fighting infection (sepsis). As long as the blood sugar level of the patient does not becomes normal, he should be continued on ventilator so as to reduce any chances of casuality. Around 10% glucose should be given to the patient with IV antibiotic to control sepsis and achieve a little stable state. IVd (Intravenous in drip) insulin should be given to the patient to control the blood sugar level. In this case the potassium level of the patient is 3.5 which is also lower than the normal range, and as we know that the insulin therapy can cause severe Hypokalemia, so it becomes very important to keep any eye on the potassium level during the course. Here the wbc count of the patient is also higher than usual suggests that the body's immune is fighting hard against the bacterical infection. So proper treatment through antibiotics becomes crucial.