Intensive Care Nursing/Sepsis Scenarios/Medical Sepsis Unfolding Case Study/Medical Sepsis Scenario p2/Medical Sepsis Scenario p3

The next day

The renal ultrasound was completed after you left and showed a large renal calci (kidney stone) blocking the left ureter and multiple stones in the right ureter. The patient has been scheduled to go to the OR during your present shift for stents and drain placement. Blood pressure had decreased during the procedure and norepinephrine was started at 5 mcg/min. Upon drain placement, 75mL of dark milky fluid is drained. Current vital signs are:

Temperature: 39.5 C (103.1 F)

HR: 125

BP: 97/60

RR: 16

SpO2: 98% @ 6LNC

Creatine: 3.1

Preliminary results from urine and blood cultures drawn on admission grew VRE (vancomycin resistant enterococcus).

1 Which of the vital signs and/or labs are concerning to you at this time?

	Temperature
	Blood culture
	Respiratory Rate
	Creatine

2 As you report your critical results (positive blood cultures) according to your policy, what else would be appropriate to note in your SBAR communication to the provider?

	Creatine
	Blood Pressure
	Respiratory rate
	Heart Rate