Sunday, July 26 Daytime update

• From Tom:

• 6:00AM Vitals are …

  
  

  Temperature 98.8°

  Pulse is 88 BPM

  Oxygen level is 93%

  
  

  Maureen is awake and I am swabbing her lips to keep them moist, I got her to accept two

  sips from the swab.

  
  

  She has started moaning and kicking her legs, I am going to administer.25 mL of morphine.

  
  

  7:30 AM Carolyn came over, we just repositioned Maureen to the right side  …

  vitals are as follows,

  temperature 98.5°

  pulse 94 BPM

  oxygen level is 89%

  
  

  I called JOURNEYCARE to get some added direction, a nurse will call back.

  
  

  7:45 AM Ania called me and we discussed that .25ml of LORAZEPAM can be given every 4 hours for agitation/restlessness, she has put in orders for the on-call nurse to visit us today.

  
  

  8:00 AM I administered .25ml of LORAZEPAM to calm her down.

  
  

  9:00 AM

  
  

  Temperature is 98.3°

  Pulse is now 89 BPM

  Oxygen level 93%

  
  

  Maureen still appeared to be in pain, we chose to give her another .25 ML of LORAZEPAM at 9:10 AM

• 9:30 am- Maureen is awake, laying on her right side, with Carolyn and Tom by her side.

  She is moaning and moving her legs at times.

• 9:45 am- Michael came to visit Maureen.

• 10:15 am- Maureen is drifting off to sleep.

• 10:40 am- We repositioned Maureen and she opened her eyes.

• 10:45 am- We started changing Maureen. Her diaper was medium wet. We cleaned, applied Sureprep barrier film and Prevent silicone cream. There was a very small brownish VD spot on the diaper. We washed Maureen’s upper body. Dressed her up and transferred to the recliner.

• Vitals are:

  T-98.1

  P-80

  O2-94

• 11:15 am- Nebulizer treatment with Albuterol.

  Maureen closed her eyes.

• 11,30 am- Maureen is sleeping now. She is very calm and doesn’t show any signs of discomfort.

• 12:00 pm- Maureen’s friends- Edie and Jerry came to visit her. She is still sleeping.

• 12:15 pm- Maureen opened her eyes and started showing signs of discomfort and pain- moaning, kicking her legs, clenched hands.

  Tom administered .25 ml of morphine sublingually. She went back to sleep again.

  Vitals are:

  T-98.3

  P- 80

  O2- 93

• 12:50 pm- Maureen is sleeping.

• 1:30 pm- Maureen is still sleeping.

  Kathy and Brian came to visit Maureen. Maggie came too.

• 2:00 pm- We transferred Maureen to the bedroom for her rest break. She opened her eyes during the process. Diaper was dry with a large brown VD spot on it. We cleaned and changed her. Positioned Maureen on her left side.

• She is falling back to sleep.

• Tommy came to visit Maureen.

• Maureen slept through her test break.

• 3:00 pm- Sister Roberta works with Maureen while she is laying down and still sleeping.

• 3:30 pm- Vitals now are :

  P-88

  O2-93

• 4:00 pm- Maureen opened her eyes and started to show signs of agitation.

• 4:15 pm- Tom administered.25 ml of Lorazepam.

• 4:30 pm- Maureen is falling asleep.

• 4:45 pm- Maureen opened her eyes. We tried to give her a little pieces of frozen popsicle, but she didn’t swallow it. She went back to sleep.

• 5:30 pm- Maureen opened her eyes again. We attempted to administer the Vimpat with thickener, but she didn’t swallow.

  A few minutes later she went back to sleep .

• 6:00 pm- Second Nebulizer treatment with Albuterol.

• 6:20 pm- Maureen’s diaper was light wet. We cleaned and changed her. Applied Prevent silicone cream.

  Applied Cetaphil lotion to her face, hands, legs and feet. Positioned Maureen on her left side.

• Vitals:

  T- 96.5

  P-83

  O2-93

• 6:30 pm- Maureen started moaning and kicking her legs again. Tom administered.25 ml of Morphine.