Case Integration CAPSTONE
Multi-system patient: prioritize problems, plan interventions, make time-critical decisions.
72-year-old, post-op day 1 hip replacement. Nurse arrives for morning assessment and finds significant changes from baseline.
Vital Signs
HR116
BP94/58
RR24
SpO292%
Temp38.7
History
Hip replacement POD 1
CHF (EF 35%)
Type 2 Diabetes
CKD Stage 3
DNR - Full treatment
Labs
WBC18.4 K
Lactate4.2 mmol/L
Creatinine2.1 mg/dL
Glucose248 mg/dL
Hgb9.8 g/dL
Platelets142 K
Prioritize Nursing Diagnoses (click to rank highest to lowest):
Problems (click to add):
Your Priority Order:
Time-Critical Decision Point:
The patient's BP drops to 82/48 after initial 500mL NS bolus. HR is now 124. What is your priority action?