Abdominal pain and worsening confusion

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Reference no: EM133921389

You receive the following report from the ER.

"Eleanor Simmons is an 85-year old female. She came to us in the ER this morning from a nursing home with complaints of abdominal pain and worsening confusion. She has a history of just being discharged from the hospital 10 days ago with CHF and urinary retention. She has a history of minor Dementia, CHF, HTN, and Type II DM. Apparently at the nursing home she got much more confused and agitated than normal, and also said her stomach has been hurting. When we received her, she had a Foley in place that was full of cloudy amber urine, so I changed the Foley. She has an order for a UA and Culture and Sensitivity but I haven't obtained that yet. Her doctor orders are on the chart. Her vital signs in the ER were pretty good: BP 118/72, Pulse 84 and regular, respiratory rate 16, O2 Sat was 96% on room air, her lungs were clear, abdomen soft and non-tender. She is alert, but only oriented to person. She told me she was at WalMart when I asked her where she was. Lastly, her labs we drew in the ER came back. Here they are WBC 10,500, Glucose 135, BUN 54, Creatinine 1.8, and Lactate 6.0. Any questions?"

1. What additional questions do you have for the ER nurse?

2. Which finding is MOST IMPORTANT for you to follow up on? WHY?

3. What is your initial nursing action?

4. You place the patient on supplementary oxygen. What oxygen delivery device should the nurse use? How many L/min should you set the oxygen to

5. Ms. Simmon's daughter asks, "What do all those labs mean?" How will you respond?

6. Why was the patient admitted? What may be her medical diagnosis?

7. The patient has an order for a UA. What is the best way to obtain the sample?

8. You note the urine is cloudy before sending it to the lab for a UA, culture and sensitivity. Is this an expected finding? Why?

9. Review the patient's order sheet. What action should the nurse implement next?

Reference no: EM133921389

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