Scenario

As a nurse on a general medical floor, the RN has received a new admit. Review the client data provided.

• Richard Henderson
• 58 years old
• Male
• Admit diagnosis: GI bleed
• History: no surgical history
• Medical history: Gastritis      & GERD
• Medications: Prilosec 40 mg PO      daily, Atenolol 25 mg PO BID, Fiber daily, Alka Seltzer PO – states he      takes this at least daily.

Report from physician’s office: Mr. Henderson arrived to the physician’s office today for a complaint of increasing abdominal pain. He states that he is now throwing up coffee-ground emesis. He states that he didn’t take his BP medication this morning because he was dizzy. The physician is admitting him with a diagnosis of GI bleed with an EGD scheduled for tomorrow. He is NPO, and has a 22G IV lock in the left forearm. Last set of vital signs BP 106/60 mm Hg, HR 98 beats/min, RR 20 breaths/min, Temp. 98.8 degrees F, P.O. 90% on room air. He last vomited about 45 minutes ago with a small amount of dark coffee-ground emesis. His pain is 4/10 at present. No pain medication is ordered at this time.

• Lab assessments ordered: CBC      and chemistry panel
• CT of the abdomen shows no      signs of free air (no perforation)

When he arrives to the floor, he is pale, nauseous, and his skin is cool and clammy. When he is transferred to the bed from the stretcher, he vomits a large amount of coffee-ground emesis and loses consciousness.

Instructions

In the discussion post, address the following:

1. While receiving report, what      concerns do you have regarding the client report?
2. What type of shock is      occurring?
3. What stage of shock is the      client experiencing?
4. What is your next intervention      and why?
5. What additional lab assessments      would you anticipate?
6. Provide additional thoughts and      insights.

Initial post due May 18, 11:59pm. Two replies due May 20, 11:59pm.

*See discussion grading rubric. The initial posting should provide one additional resource other than the required reading. Provide at least one reference for both of the two reply posts.

References

Jones, D., DeVita, M., & Bellomo , R. (2011). Rapid-Response Teams. English Journal of Medicine, 365, 139-146. Retrieved from Client Safety Network.

Please make your initial post by midweek, and respond to at least two other students’ posts by the end of the week. Please check the Course Calendar for specific due dates.

SON Discussion Rubric

Levels of Achievement

Discussion Rubric Criteria (Points)

• Initial Posting Comprehension –      Points 12
• Initial post does not include      explanations with examples or supporting evidence. Failure to      submit initial posting will result in zero points for this criteria.      – Points 9
• Initial post includes brief      explanation with limited or unclear examples and limited supporting      evidence. – Points 10
• Initial post includes clear      explanation with examples and supporting evidence. – Points 11
• Initial post includes      comprehensive explanation with detailed examples and supporting evidence.      Points 12
• Response Posting Reasoning –      Points 12
• Response to peers attempts to      contribute to the discussion but lacks suggestions and/or supporting      evidence. Failure to submit response postings will result in zero      points for this criteria. – Points 9
• Response to peers provides      minimal contributions and suggestions with limited or no supporting      evidence. – Points 10
• Response to peers contributes      to the discussion with suggestions and supporting evidence. – Points 11
• Response to peers offers      substantial contributions and detailed suggestions with supporting      evidence. – Points 12
• Spelling and Grammar – Points 3
• Spelling and grammar contain      substantial errors that makes sentences and/or paragraphs incoherent. –      Point 0
• Spelling and grammar errors      occur but are inconsistent. Paragraphs and sentences are coherent but may      exhibit spelling errors, run-on’s or fragments, and/or improper verb tense      usage. – Point 1
• Displays proper grammar      application and writing contains minimal to no spelling errors. May      contain rare improper uses of words (ex., their vs. there), a misplaced      modifier, or a run-on sentence, but does not detract from the overall      understanding of the sentence and/or paragraph. – Points 2
• Demonstrates an exemplary      application of spelling and grammar. – Points 3
• APA Citation – Points 3
• Citations do not follow APA      Style. Quotations, paraphrases, and summaries are not cited, or there is      no attempt to cite them using APA style. – Point 0
• Errors in APA citations are      noticeable and may detract from the ability to locate the original source      (for example, no title provided, year of publication is missing, no      punctuation). – Point 1
• Errors in APA citations are      less noticeable and do not detract from the ability to locate the original      source (for example, a missing or misused comma or period, missing      parentheses, author name not properly abbreviated, indentation is      misaligned). – Points 2
• APA citations are free of style      and formatting errors. – Points 3

Total Points Possible: 30