On my last day of preceptorship, I cared for a patient with respiratory failure and bilateral pneumonia and a patient with cardiac arrest. Both of my patients were on ventilators and sedated. I assessed the respiratory failure patient first because of the electrolyte imbalances and possible sepsis status. I administered multiple bags of IV potassium to this patient. I also started the tube feeding for the patient. The cardiac arrest patient was a DNR and had a Glasgow score varying between 1 and 2. The patient had a constant upward gaze and only one corneal reflex. This patient had just rewarmed in the morning after being on the hypothermic protocol. The patient also had consults with the organ procurement team. The patient had an EEG which picked up that the patient was experiencing seizures. The seizures were only visible in that the patient’s eyelids were half blinking; this movement ceased with anti-seizure medications. Towards the end of the shift, the family notified us that they wished to withdraw care the next morning.
One of the nurses let me remove and insert a new foley on his patient. After removing the patient’s foley from home, the nurse pointed out what appeared to be…show more content… In the article Caring for Patients Treated With Therapeutic Hypothermia, the authors referred to care providers instituting hypothermia in the 1950s. I found it interesting that providers used this concept for not only cardiac patients, but also surgical patients. In the 1950s, more extreme cooling temperatures were also used. Currently the goal of induced core body temperature is somewhere between 32 and 34 degrees Celsius for at least 12 hours. I learned about the rewarming process during this shift. I also learned about the importance of leaving on the cooling device’s pads after rewarming in case the patient has difficulty maintain a healthy body
