A patient is admitted to the intensive care unit for congest…
A patient is admitted to the intensive care unit for congestive heart failure. Using the situation–background–assessment–recommendation (SBAR) format, put the following statements in the order in which the nurse should report changes to the health care team.a. Mr. Martinez was admitted 2 days ago with heart failure and has been receiving 40 mg of furosemide (Lasix) IV push BID for diuresis, but his urine output remains low. He has been on O2 at 4 liters per nasal cannula, satting around 92%. b. I think Mr. Martinez needs to be evaluated immediately and may need his Lasix dose increased and intubation with mechanical ventilation. c. This is the nurse on the surgical unit. I am calling about Mr. Martinez. After assessing him, I am very concerned about his shortness of breath, O2 sats, and lung sounds. d. Today, Mr. Martinez has worsening lung sounds with crackles audible throughout the posterior chest, increased shortness of breath, and his O2 saturation drops to 86% or below on anything less than 4 liters of O2. His condition is very unstable.