16 Jun Discuss the initial/priority interventions for this client
Question
Case Study
Mrs. White is a 55 yo female with a PMHx significant for HTN, and DM type 1. She
was admitted for abdominal pain. A CT scan revealed appendicitis. Her home
medications include: Metoprolol, Lisinopril, and regular insulin. You received her from
the PACU following a lap appendectomy.
PACU Report: AOx4, VS RR 24, HR 90, BP 125/90, T 99.8, SpO2 95% of 2LNC. Lungs
clear. No bowel sounds, Has a foley catheter to bedside drainage with light yellow urine.
Est. blood loss in the OR was 500cc. Pain currently at 4/10 with a PCA pump with
morphine sulfate. The PCA settings are as follows: Basal rate of 3ml/hr, pt dose of 0.5ml
Q15min with a 1 hour limit of 5ml/hr. IV fluids of D5 ½ NS @ 125ml/hr. #20 RAC.
H/H pre-op 13.5/40, post-op 10.5/32.5
1. List 3 priority nursing diagnoses.
2. Discuss the initial/priority interventions for this client. Include dependent and
independent actions.
3. What lab values are you going to need to focus on and why?
4. She is on both a beta-blocker and an ACE inhibitor, why, what is the rationale?
5. Her pain is being managed via a PCA pump. What is the route for this type of
pain management?
6. The client has been NPO for the past 18 hours. Her blood glucose is 250mg/dl.
a. Provide an explanation for the elevation in blood sugar.
b. Determine the nursing priorities for this finding.
c. Discuss the priority assessments related to this treatment protocol.
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