Case Study You are the nurse on duty on the intermediate care unit,… Case StudyYou are the nurse on duty on the intermediate care unit, and you are scheduled to take the next admission. The ED nurse calls to give you the following report:”This is Barb in the ED, and we have a 42-year-old male, K.L., with a lower GI bleed. He is a sandblaster with a 12-year history of silicosis. He takes prednisone 40mg PO per day. During the night he developed severe diarrhea. He was unable to get out of bed fast enough and had a large maroon-colored stool (hematochezia) in the bed. His wife ‘freaked’ and call the paramedics. He is coming to you. His vital signs (VS) are stable B/P 110/64, P 110, RR 28, T 36.8, but he is a little agitated. He has not had any stools since admission, but his rectal exam was guaiac positive and he is pale and diaphoretic. We have him on 3 L O2 per NC. We have started a 18G PIV with LR at 125ml/hr. He has a 18G salem sump to continuous low suction and the drainage is guaiac positive. We have done a CBC with dif, CBC, PT/INR, and PTT, T&C (type & crossmatch) for 4 units of PRBCs, and a UA. He is all ready for you.”What are you on alert for today with this patient? (Predicting)Explain why this is important.K.L. arrives to your unit. As you help him transfer from the ED stretcher to the bed, K.L. becomes very dyspneic and expels 800ml of maroon stool.What are the first three actions you should take? Why?K.L. reports that he is getting nauseated but not thirsty. VS are 106/68, 116, 32.What complication(s) are you worried about?What additional interventions should you implement? List three with rationales.Arterial Blood gas (ABG) results are ph: 7.45, PACO2: 33, PAo2: 65, HCO3: 23.Interpret the ABG. What does it tell you? NURSING 144 Share QuestionEmailCopy link Comments (0)
