Josh RN’s morning update was that Perry slept fairly well with a few interruptions to be suctioned & to use bedpan otherwise it was an uneventful night. It was nice to have my mother here to share some time with Perry & to provide him with encouraging words, touch, & love. I also have a variety of comfort food healthy meals (with LOTS of vegetables) in the freezer. We got to the airport by 830a & of course It was hard to say goodbye but it always has been. On my way back, I stopped for gas & finally I got to have an extra large coffee from Dunkin Donuts!!!! I was with Perry by 0930a, & he seemed rather anxious upon my arrival. He said the unit was short staffed & that he had 2 nurses from a different unit, Lucy RN & Ally RN (new employee orientee).
According to Ally RN, the Melatonin 3 mg was not changed yesterday from a scheduled dose to PRN (as needed) dose; Klonopin was actually ordered as 1 mg 3 times a day to be given @ 9a, 1p, & 9p; Keppra 750 mg is @ 9a & 9p; & the Depakene is being given @ 12a, 6a, 12n, & 6p.
I brought in Perry’s The Vest® Airway Clearance System (also known as a chest vest), but no orders have been written. I have asked that clearance for its use to be given by the Cardiothoracic Surgeon & Pulmonologist relative to his history of the the mammary artery ruptures, pleural effusion, etc. A chest vest is attached to an air pulse generator which causes the vest to rapidly inflate & deflate which then causes the chest wall to be gently compressed & released creating airflow within the lungs. This process moves mucus toward the large airways where it can be cleared by coughing or suctioning. (USER MANUAL - The Vest® Airway Clearance System www.thevest.com)
Perry was able to tolerate trach capping from 1023a-1102a = 39 minutes with lots of encouragement. His oxygen saturation levels remained between 96-100% with not as much skin color change compared to yesterday. I continued to hold his hand, fan him, replenish his ice cold washcloth to his forehead, provide slow caresses, & kept him informed of his great progress & perseverance. He had a headache afterward for which Tylenol & sleep were effective. After awakening around 3p, he requested to be capped again. He was able to tolerate being capped from 324p-412p = 48 minutes with all of the above interventions. He was signaling to quit by 402p but with even more encouragement he got through it while waiting for Bill RT to finish caring for another patient.
He has not been dangled by staff since Friday. I assisted Perry to complete his upper & lower extremity PT/OT exercises & placed him into chair mode on 4 occasions today resulting in a good amount of stomach air being released each time. He did sleep the majority of the day, but was able to remain somewhat aroused intermittently during the 5th-9th inning of the Cubs vs St. Louis Cardinals game today. We got a welcomed FaceTime call from Ryan this evening while he was on his break @ work which helped Perry to hang in there & stay awake a bit longer to see the Cubs get a win tonight!!!!! Dr. Udeh (our “go to physician”) is working in house tonight so he stopped by to see him. He will change the Melatonin order to a PRN. Perry asked for me to stay with him tonight, so here is where I will be.