Remove or replace I.V., intra-arterial, or urinary drainage catheters, and send them to the laboratory to culture for the presence of the causative organism.
Administer oxygen therapy as ordered based on oxygen saturation levels and ABG results.
Insert or assist with insertion of an ET tube as appropriate and initiate mechanical ventilation as ordered.
Institute hemodynamic monitoring and continuous cardiac monitoring as indicated; note any changes in arterial waveforms, hemodynamic parameters, or cardiac rhythm and report them immediately.
Assess hemodynamic parameters in light of fluid therapy; maintain central venous pressure between 8 and 12 mm Hg.
Plan your care to allow frequent rest periods, and provide as much privacy as possible. Allow the patient's family to visit and comfort him as much as possible.
Obtain a daily weights; check skin turgor.
Insert an indwelling urinary catheter to evaluate hourly urine output as ordered; notify a practitioner if urine output is less than 30 mL/hour.
Anticipate the need for renal replacement therapy if acute kidney injury occurs.
Auscultate heart and lung sounds for changes.
Initiate I.V. access, if not already available, using 2 large-bore I.V. lines; maintain I.V. patency; assist with insertion of a central venous line as appropriate.
Give prescribed I.V. fluids and blood products; administer an antimicrobial agent as ordered; give drotrecogin alfa via continuous I.V. infusion over 96 hours.
Inspect skin and mucous membranes for signs of bleeding or bruising; check urine and stool for occult or frank bleeding. Institute bleeding precautions.
Administer dopamine as a continuous I.V. infusion, titrating the dose as ordered until the optimal response is obtained.
Evaluate the patient's level of consciousness for changes.
Turn and reposition the patient frequently as appropriate; inspect bony prominences for areas of pressure; and provide pressure relief and reduction devices to reduce the risk of skin breakdown.
Encourage the patient and family to verbalize their feelings and concerns; provide explanations and reassurance for the patient and his family as appropriate; and encourage the use of positive coping strategies and participation in care measures and decision making as appropriate.
Obtain specimens for laboratory testing, such as a complete blood count, coagulation studies, serum electrolyte levels, and ABG levels, as ordered.
the disorder, underlying cause, diagnosis, and treatment, including the use and rationale for equipment and devices, such as hemodynamic monitoring, a central venous access device, and continuous cardiac monitoring
prescribed medications, including drug names, dosages, rationale for use, frequency of administration, and duration of therapy
possible adverse effects of medication therapy, such as fluid retention, and moon face with corticosteroid therapy
all treatments and care measures being performed, including the need to watch for signs and symptoms of bleeding that may occur with DIC
risks associated with blood transfusions
explanations and reassurance for the patient and family, including changes in the patient's condition.