Exam 4 — High-Stakes Clinical Judgment (Pharmacology)

58M with HFrEF, T2DM, CKD stage 3. Day 2 post-op CABG, 1400 hours. Vitals: BP 88/50, HR 112, Temp 98.6°F, RR 18, SpO2 97% RA. Labs: K+ 4.1 mEq/L, Cr 1.3 mg/dL, WBC 7.5, Glucose 110 mg/dL. Subjective: 1. "My chest feels tight." 2. "My IV site hurts and is burning." Objective: Dopamine infusing via peripheral IV at 15 mcg/kg/min. IV site is swollen, pale, and skin is cool to touch.. Medications: Home: Metoprolol, Lisinopril. Current: Dopamine infusion.. Change: Dopamine infusion titrated up 1 hour ago. Select the 3 priority actions.