RN Adult Medical Surgical Online Practice 2024 B with Q and A

RN Adult Medical Surgical Online Practice 2024 B with Q and A A nurse is caring for a client in the emergency department (ED). Physical Examination Client presents to the ED with upper abdominal pain that radiates to the right shoulder. Client rates pain as 7 on a scale of 0 to 10. Client also reports nausea, vomiting, and dyspepsia. Client is awake, alert, and oriented x3. Lung sounds clear bilaterally, S1 and S2 heart tones noted. All pulses palpable. Bowel sounds active in all 4 quadrants. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress. ANSWER The nurse should plan to administer an opioid analgesic, such as morphine, for acute pain. Since the client is experiencing nausea and vomiting, the nurse should also ensure they are NPO. The client is likely experiencing cholecystitis, which typically presents with nausea, vomiting, upper abdominal pain that radiates to the right shoulder, fever, and dyspepsia. The client also has elevated liver enzymes and a WBC count, which is consistent with cholecystitis. Surgical management for cholecystitis might be indicated. The nurse should monitor the client's stool and urine color because a biliary obstruction from gallstones may cause clay-colored stools and dark urine. A nurse is caring for a client who was just admitted from the emergency department (ED). Nurses' Notes 0945: Client is experiencing a sickle cell crisis. Client states that they began experiencing pain in the lower extremities 3 days ago and is now experiencing pain in the chest, rating it as 4 on scale of 0 to 10. Oxygen at 3 L/min via nasal cannula in place. Oral mucosa pink, no cyanosis. Pulses palpable in all four extremities, no peripheral edema noted.