The patient in septic shock due to E coli bacteremia is likely being treated with gentamicin, which is nephrotoxic. It is also excreted by the kidneys. The pharmacist may request renal function tests and gentamicin levels to guide dosing to prevent the gentamicin from reaching toxic levels, especially in the setting of oliguria (less than 30 mL/h). The patient’s heart rate of 122 bpm, high temperature, and hypotension should be reported to the provider rather than the pharmacist.