Passage / Scenario

The following scenario applies to the next 6 items
The emergency department (ED) nurse is caring for a 45-year-old male client.
Item 1 of 6
NursesÔÇÖ Notes
0600: The client reports sudden, severe epigastric pain. He has a history of chronic alcohol use disorder (30+ years), GERD, and hypertension. His home medications include pantoprazole and lisinopril. Upon assessment, the client is noted to be alert and oriented x4. He is mildly diaphoretic, with pulses 2+ and regular. Abdomen is distended, guarding on palpation, diminished bowel sounds, and no stool in the last 24 hours. He reports nausea and vomiting, and his pain is worse after eating fatty foods, rated 7/10 and radiating to his back. Breath sounds slightly diminished bilaterally, no adventitious sounds, denies cough or dyspnea. He reports heavy alcohol intake two days ago. Fingerstick glucose is 145 mg/dL (8.06 mmol/L) [70-110 mg/dL; 4-6 mmol/L]. Temperature is 101.3┬░F (38.5┬░C), heart rate of 112 bpm, respiratory rate of 24 breaths/min, blood pressure of 98/64 mmHg, and oxygen saturation of 95% on room air.

Orders
0600
ÔÇó Cardiac monitoring
ÔÇó NPO
ÔÇó CBC
ÔÇó CMP
ÔÇó LFTs
ÔÇó Amylase
ÔÇó Lipase
ÔÇó CT abdomen with contrast