You administer the calcium gluconate, insulin, albuterol,

You administer the calcium gluconate, insulin, albuterol, and attempt to give Kayexalate but the patient feels nauseous and vomits the little bit of Kayexalate she was able to take. Betty’s vital signs are BP 208/110, HR 108, SpO2 95% on 2L/min nasal cannula. The Chest x-ray results return while you are giving medications, and show the patient has pneumonia. A WBC of 16 supports this finding. Orders of 1 gram IV push Ceftriaxone and 1250mg IV Vancomycin are obtained. At this time the lab calls to report additional critical values of Hematocrit of 15% and a Hemoglobin of 4.8 g/dL. The patient is requesting to eat and has been since arrival. At this time, what are your priorities? What additional orders do you anticipate, as well as any repeat tests?

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