Primary Diagnosis: Thoracic aortic dissection with branch artery involvement Status/Condition: Critical-Guarded Code Status: Full Allergies: NKA Admit to Unit: Coronary ICU Activity Level: Bedres... t Diet: Strict NPO (until evaluated by CT surgery) IVF: 18g IVL x 2; LR@75ml/hr (monitor VS closely) Critical Drips: Esmolol 500 micrograms/kg intravenously initially, followed by 50 micrograms/kg/min for 4 min, may repeat loading dose and increase infusion up to 200 micrograms/kg/min in 50micrograms/kg/min increments. Maintain SBP less than 120 and heart rate of 60–70 BPM Nitroprusside 0.3mcg/kg/min. Titrate 0.5mcg/kg/min Q5min until SBP less than 120 (if not controlled with Esmolol) Respiratory: O2 2L-4L via NC PRN for O2 sats less than 92%. Consult respiratory therapy for management. Medications: (include ALL, tx of primary condition, underlying conditions, pain, comfort needs etc. dose and route) Discontinue ASA Hold Lisinopril 10mg PO QD until NPO discontinued [Show More]
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