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- May 11, 2017
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Patient presents to your office with a productive cough and occasional chest pain. Sats 90%, cxr shows LLL pneum. Confer with associate, admit to hosp. U note allergy to augmentin as it causes sob and facial swelling. Admitting orders keep sats >92%, Azithromycin 500 iv today and 250 dly, cbc cmp hscrp day, IV d51/2 ns @ 125/hr, rocephin 1 gram q 12h-aware pcn allergy, toradol iv 15mg q6h prn pain, ekg, trop. Shortly after initiation 2nd dose rocephin given patient becomes hypotensive and resps are labored and sats dropping, O2 started 2lpm and says back up to 92, but continues hypotensive. Admitted to ICU and symptoms persist. Little to no urine open, rfp shows renal failure, hgb 8.3, ABGS show primary respiratory alkalosis with secondary metabolic acidosis...what do you do?
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