DT is a 44 year old Asian- American male patient brought in by ambulance. As per BLS, “This patient is complaining
DT is a 44 year old Asian- American male patient brought in by ambulance. As per BLS, “This patient is complaining of vomiting blood since last night. History of Alcohol Abuse. ” Assessment data obtained by the registered nurse (RN): Bright red vomitus, stool as shown below (Fig. A), consumed vodka last evening, BP 82/44, HR 120, SPO2 95% RA, Temp 97.2 (oral), RR 22. DT’s stool Fig. A What ESI triage number would you assign-1,2,3,4,5? Please state your rationale. Please answer the below questions: If you were the RN caring for this nurse, of the below interventions, what would be your first three interventions? Please state your rationale for your answers. a. Call for a stat ECG b. Establish two large bore accesses c. Ask the patient when he last ate d. Start the patient on 0.9% Normal Saline bolus 1000 ML stat e. Administer ondansetron 4mg IV push stat The nurse asks the patient how many drinks he usually consumes on a daily basis. What is the significance of this assessment question by the nurse? What assessment data would alert the nurse to a complication with this patient? Select one. Please give a rationale for your response. a. Four episodes of dark tarry stools b. Bright red blood in the vomitus c. A rigid boardlike abdomen d. Heart Rate decreased from 120 to 100 What diagnostic tool may be used to visualize a gastric ulcer and how is it performed? What is the pathophysiology of esophageal varices? What other assessment findings might the nurse observe in this patient during the physical assessment? What is your differential diagnosis?
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