Wound Management - Level 4

Clint D. Fullerton is a 67-year-old male who was admitted to the medical/surgical floor 2 days ago for treatment of a left ankle ulceration and is on contact precautions for CDiff. He has a past medical history of diabetes, venous insufficiency and self-care deficits. He has a PICC line in the left brachial for Vancomycin, but the Vancomycin was held last night secondary to an elevated peak level. Last night he had difficulty breathing so labs were ordered, Lasix 40 mg was given and RT was consulted. He refused BiPAP despite multiple attempts by RT. Upon assessment, the student(s) discover the patient is significantly worse secondary to renal failure and fluid overload. When the MD is notified, new orders for a chest x-ray, ABG’s and to transfer to ICU are given.