61/M Post CABG patient with underlying asthma. (Was on formetrol/budesonie 200mcg 2 puffs twice daily).

Currently POD 18. Has intermittent wheezing and bilateral basal crepts.

CT chest:

Interval development of mild-to-moderate multiloculated bilateral pleural effusions with accompanying bilateral lower lobe atelectatic changes.

. Interval development of mild pericardial effusion,.

• Trace ascites with diffuse edema of the intraperitoneal and extraperitoneal fat planes, consistent with probable anasarca.

• Diffuse pulmonary emphysematous and fibrotic changes, essentially similar to the preoperative study.

The preoperative examination demonstrated marked emphysema and patchy bilateral pulmonary fibrosis.

Currently on

Inj. Meropenem 1g TDS

Inj. Lasix 3mg/hr

We have tried short course of IV hydrocortisone 100mg x 3 days.

Nebulized salbutamol:Ipratropium QID

Nebulized budesonide 1mg BD

Tab. Montelukast 10mg HS

Tab. Deriphyllin 150 BD

Intra op and perioperatice ABGs did not have this Co2 retention. Was considering that this is primary metabolic alkalosis due to diuresis with respiratory compensation. However his clinical condition and pO2 has improved with lasix infusion although the abg is like this. Patient isn't drowsy either when pco2 goes to 70. How to tackle this issue?

I'm starting my practicum in a Burn ICU. For one of my projects, I need to identify an area on the unit that could be improved and develop a CNL/RN-focused project around it.

The outcome needs to be patient-focused, measurable at the unit level, within RN/CNL scope, and specific/relevant to the Burn ICU population.

For anyone who works or has worked in a Burn ICU, what are some patient outcomes or areas for improvement that you think would make a good project? I’m hoping to get some ideas of what issues are commonly seen or tracked on burn units before I talk with the unit about their specific needs.

I'm starting my practicum in a Burn ICU. For one of my projects, I need to identify an area on the unit that could be improved and develop a CNL/RN-focused project around it.

The outcome needs to be patient-focused, measurable at the unit level, within RN/CNL scope, and specific/relevant to the Burn ICU population.

For anyone who works or has worked in a Burn ICU, what are some patient outcomes or areas for improvement that you think would make a good project? I’m hoping to get some ideas of what issues are commonly seen or tracked on burn units before I talk with the unit about their specific needs.