1, Which orders do you implement first? Why? •Ventilator settings: CMV/AC rate 12, TV 550 mL,...

1, Which orders do you implement first? Why?

•Ventilator settings: CMV/AC rate 12, TV 550 mL, PEEP +5, FiO2 100%.

•0.9% NS IV infusion 100 mL hour

•Insert urinary catheter

•Fentanyl IV infusion 10-125 mcg/hour. RASS goal -3 (Mod. Sedation)

•Dexmedetomidine IV infusion 0.2-1 mcg/kg/hour. RASS goal - 3 (Mod. Sedation)

•Norepinephrine IV infusion (0.5-30 mcg/min) to maintain MAP >65.

•Vasopressin 0.04 IV infusion

Expert Solution

The ventilator setting is within normal range so this is not the first priority

NS infusion can be started after administering the necessary priority medications which are life saving .So this is not the first priority

Urinary catherisation is not an emergent care and is moreover a understatement procedure which can be done last

After ventilator setting the patient can be sedated with fentanyl and dexmedetomidine to maintain RASS.

Norepinephrine is a life saving drug administered to treat very low blood pressure .So in order to maintain the MAP above 65 it is necessary to administer this drug first. This is the first line drug to prevent cardiac arrest and shock

Vasopressin is the second line of drug

Ans:Norepinephrine IV infusion (0.5-30mcg/min) to maintain MAP>65

Nightingale answered 2 years ago

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