CASE SCENARIO. RIGHT BUTTOCKS CELLULITIS.

A 50years old man arrived to emergency room with right buttocks cellulitis..+ MRSA,Acinobacter.Bedrest with bathroom privilege. Ambulate to the bathroom with minimal assistant. Alert and oriented × 3.Dressing change Qday.Right buttocks Cellulitis .Weighs 165lbs,Height 5ft 6inches.No risk for fall. No risk for suicide. Cardiac diet. Tolerating diet well.Wet to dry dressing to the right buttocks Qday. On a special 🛏 bed.Wound consult for evaluation and treatment. 02 at 2liter nasal canula with saturation of 93%.C-pap at night. Standard precautions. Isolation status: patient is on contact Isolation.Full code. Medications: 0.9NS at 125ml/hour infusing via pump to left forearm saline lock 20guage .IV site clean dry and intact. Vital signs Q4hours. Zosyn 3.378gm in 100ml of normal saline Q8hours.Vancomycin 1gm in 250ml Q12hours IV scheduled 1030am and 2230pm.Pre-vancomycin level ( Trough 4.9)Heparin 5000unit subQ Bid/scheduled. Benadryl 25mg IV pre vancomycin. Norco 10/325mg 2tablets po Q6hours prn moderate pain.dilaudid 1mg IV give slowly Q3hours prn severe pain. Fentanyl 100mcg topical Topical Q3days scheduled. Temazepam 15mg po Qhs.Dilaudid 1mg IV given at 06am endorse to next shift.

QUESTIONS:

1.What are the side effects of Temazepam?.Why was it ordered for this patient?.

2. What are the side effects of dilaudid?.List four side effects.

3.Heparin 5000unit is given SubQ?.Why is patient on Heparin?.What are the advantages and disadvantages of Heparin?.

4.What is Trough level?.Why should Trough level be check before giving Vancomycin 1gm?.

5.The doctor orders wound consult for evaluation and treatment. Why do this patient need wound consult?.

Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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