Location: Emergency Department Time: 04:00 Situation: Stan Checketts, a 52-year-old widower, arrived in the Emergency Department 30 minutes ago with severe abdominal pain. A small bowel obstruction is suspected. Background: He has experienced worsening abdominal pain, nausea, and vomiting for 1-2 days with inability to eat or drink much over the last few days. His past surgical history includes a cholecystectomy, appendectomy, and right inguinal hernia repair, all more than 5 years ago. Assessment: Mr. Checketts is awake and states he has felt 'dizzy' and 'weak' all evening. His vital signs upon arrival were: BP: 108/73; temperature: 100.9 °F (38.3 °C); pulse: 110; respiratory rate: 22, and SpO2: 95% on room air. He has poor skin turgor, dry mucous membranes, and has not urinated since yesterday. His abdomen is distended. He signed an informed consent for treatment. A right forearm saline lock was placed, and labs, a CBC, and BMP were drawn. Recommendation: You will need to check the provider's orders just written and see if the lab results are back. When monitoring Stan Checketts after he has been diagnosed with bowel obstruction, which of the following complaints would cause concern requiring immediate intervention? (Select all that apply.) *I only need answers * His complaints of pain increase after medication administration. His abdominal girth decreases in size and is soft on palpation. He reports increasing dizziness and becomes hard to arouse. His nasogastric drainage becomes bright red in color. He asks for something to eat due to increased appetite. His blood pressure decreases and heart rate increases significantly. He states to the staff that he is passing flatus and liquid stool. His urine output has decreased over the past 12 hours.
Location: Emergency Department Time: 04:00 Situation: Stan Checketts, a 52-year-old widower, arrived in the Emergency Department 30 minutes ago with severe abdominal pain. A small bowel obstruction is suspected. Background: He has experienced worsening abdominal pain, nausea, and vomiting for 1-2 days with inability to eat or drink much over the last few days. His past surgical history includes a cholecystectomy, appendectomy, and right inguinal hernia repair, all more than 5 years ago. Assessment: Mr. Checketts is awake and states he has felt 'dizzy' and 'weak' all evening. His vital signs upon arrival were: BP: 108/73; temperature: 100.9 °F (38.3 °C); pulse: 110; respiratory rate: 22, and SpO2: 95% on room air. He has poor skin turgor, dry mucous membranes, and has not urinated since yesterday. His abdomen is distended. He signed an informed consent for treatment. A right forearm saline lock was placed, and labs, a CBC, and BMP were drawn. Recommendation: You will need to check the provider's orders just written and see if the lab results are back. When monitoring Stan Checketts after he has been diagnosed with bowel obstruction, which of the following complaints would cause concern requiring immediate intervention? (Select all that apply.) *I only need answers * His complaints of pain increase after medication administration. His abdominal girth decreases in size and is soft on palpation. He reports increasing dizziness and becomes hard to arouse. His nasogastric drainage becomes bright red in color. He asks for something to eat due to increased appetite. His blood pressure decreases and heart rate increases significantly. He states to the staff that he is passing flatus and liquid stool. His urine output has decreased over the past 12 hours.
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Section: Chapter Questions
Problem 4CP
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Question
Location: Emergency Department
Time: 04:00
Situation:
Stan Checketts, a 52-year-old widower, arrived in the Emergency Department 30 minutes ago with severe abdominal pain. A small bowel obstruction is suspected.
Background:
He has experienced worsening abdominal pain, nausea, and vomiting for 1-2 days with inability to eat or drink much over the last few days. His past surgical history includes a cholecystectomy, appendectomy, and right inguinal hernia repair, all more than 5 years ago.
Assessment:
Mr. Checketts is awake and states he has felt 'dizzy' and 'weak' all evening. His vital signs upon arrival were: BP: 108/73; temperature: 100.9 °F (38.3 °C); pulse: 110; respiratory rate: 22, and SpO2: 95% on room air. He has poor skin turgor, dry mucous membranes, and has not urinated since yesterday. His abdomen is distended. He signed an informed consent for treatment. A right forearm saline lock was placed, and labs, a CBC, and BMP were drawn.
Recommendation:
You will need to check the provider's orders just written and see if the lab results are back.
When monitoring Stan Checketts after he has been diagnosed with bowel obstruction, which of the following complaints would cause concern requiring immediate intervention? (Select all that apply.)
*I only need answers *
His complaints of pain increase after medication administration.
His abdominal girth decreases in size and is soft on palpation.
He reports increasing dizziness and becomes hard to arouse.
His nasogastric drainage becomes bright red in color.
He asks for something to eat due to increased appetite.
His blood pressure decreases and heart rate increases significantly.
He states to the staff that he is passing flatus and liquid stool.
His urine output has decreased over the past 12 hours.
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