No change

Her x-ray was unchanged.  They cannot confirm if it is pneumonia.  It is either pneumonia or atelectasis (part of her lung collapsing).

But her CRP is up and her secretions are slight yellow, so it is likely pneumonia.

They are going to switch her antibiotic back to meropenum.  The infection in her back (ecoli and klebsiela) are both susceptible to the meropenum and the meropenum also covers pseudomonas pneumonia (which she has had multiple times).  Her current antibiotic (ertapenum) does not cover pseudomonas.  One problem with the meropenum is that it is given 3-4 times per day versus the ertapenum is only twice a day.  Oh well, it sounds like a reasonable plan.

They are not going to do a transfusion at this point.  If her hematacrit (red blood cells) continue to drop they will consider it.

They are going to stop her nighttime dose of valium in hopes that this will help her not desat during the night and hope that this will enable her to cough at night.  With the lowering of the valium so far we have been able to get her to cough better and she is slightly more awake.

When you can get her to cough she can do fairly well with her oxygen.  But without a cough it is a struggle.