Discuss your documentation and orders for the patient, including rationale for your documentation and orders as they relate to reimbursement.

you are paged to the ED to admit an elderly female with suspected sepsis. She was brought to the ED at the instruction of the charge nurse at the long-term care facility where she resides. On presentation she has altered level of consciousness, is disoriented, and has a temperature of 101.0. You suspect urosepsis, but perform a careful physical exam that reveals several areas of grade-1 skin breakdown and a grade-2 ulcer on the coccyx. Discuss your documentation and orders for this patient, including rationale for your documentation and orders as they relate to reimbursement.