Ralfy., a 40-year-old man, is admitted to your surgical-medicalfloor with a diagnosis of pleural effusion. He complains ofshortness of breath; pain in his chest; weakness; and a dry,irritating cough. His vital signs (VS) are 142/82, 118,respirations are 38 and labored and shallow, 102.1° F (38.9° C).His chest x-ray shows a large pleural effusion and pulmonaryinfiltrates in the right lower lobe consistent withpneumonitis.
The physician performs a thoracentesis and drains 1500 mL offluid. A specimen for culture and sensitivity (C&S) is sent tothe laboratory, and A.B. is started on cefuroxime (Ceftin) 1 g IVpiggyback q8h.
After 7 days of aggressive antibiotic and pulmonary therapy, thechest tube is discontinued and Ralfy is ready to be discharged.
- The order for the cefuroxime (Ceftin) reads to infuse 1g in 100 mL 0.9% NaCl over 30 minutes. You have IV tubing thatsupplies 20 gtt/mL. At how many gtt per minute will you regulatethe infusion?
- Because fluid continues to collect in the pleuralspace, the physician decides to insert a pleural chest tube undernonemergent conditions. What is your responsibility as Ralfy’snurse? 14. How will you appropriately maintain Ralfy’s chest tubesystem?
