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This Concept Map, created with IHMC CmapTools, has information related to: 9-22 CMAP, Cardiovascular 15:30 HR 87BPM. No JVD. No carotid bruit. S1 and S2 sounds heard. Bilateral radial pulses present, +2. Bilateral pedal pulses present, +2. Capillary refill less than 3 seconds.+1 nonpitting edema lower extremities. Lower extremeties cool to touch. Current rhythm: NSR, Gen. Chem. 9/21 Na=140 K=3.5 Cl=110 CO2=29 BUN=17 Cr=.98 Glu=127 Ca=7.3, Insulin aspart Brand Name Novolog, Ketoralac Brand Name Toradol, Ketoralac Classification NSAID, Nonopiod analgesic, Acetic acid, Furosemide Brand Name Lasix, Esomeprazole Classification Antiulcer, Proton pump inhibitor, Benzimidazole, Insulin aspart Nursing Indications Monitor for s/s Hypoglycemia, Acute pain related to surgical intervention as evidenced by wincing, guarding, and verbalized reports. Intervention Determine client's acceptable level of pain on the 0-10 scale., Integumentary 15:30 Triple lumen PICC in right jugular vein, all lines patent to flush. Braden score=14. No redness or swelling at site. Skin is appropriately pink. Lower extremeties cool to touch. Skin is mobile, adequate turgor. +1 non pitting edema in both lower extremeties. Incision site is well approximated, tender to touch, with staples intact. Dressing is clean dry and intact,, Simvastatin Brand Name Fentanyl, Ketoralac Nursing Indications Push time: over 15 sec, Assess pain and swelling, monitor renal studies., Gen. Chem. Trends and Interpretation Glucose levels have been high, client is diabetic and manged with insulin. Calcium is low but trending back up, almost to normal range. Potassium is within range but on the low end, patient's fluids have added potassium and she has received a 60mEq bolus to help increase her K., Esomeprazole Physician's Order 20mg IV injection BID, Simvastatin Reason for Recieving Patient controlled analgesia, Ketoralac Physician's Order 15mg IV push Q6hr, Furosemide Nursing Indications Potassium wasting, Assess hydration & electrolytes. Administer in morning to avoid disrupting sleep., Simvastatin Nursing Indications Monitor neurologic & respiratory status, encouragae cough and deep breathe., Ineffective breathing pattern related to decreased lung expansion as evidenced by inability to produce adequate incentive spirometry measurements. Intervention Continue to encourage use of adjuncts such as the incentive spirometer to facilitate deeper respiratory effort., Gen. Chem. 9/22 Na=139 K=3.3 Cl=107 CO2=30 BUN=14 Cr=.83 Glu=124 Ca=7.8