Blog

A 41-year-old patient with Crohn disease presents with crampy abdominal pain that has become constant over 6 hours. The abdomen is distended. Vitals: T 38.6°C (101.5°F), HR 112, BP 100/62, RR 22. The patient is nauseated, has had no flatus for 24 hours, and vomited green fluid. Bowel sounds were high-pitched earlier but are now absent; palpation elicits involuntary guarding. Which assessment cluster requires immediate intervention?

A 58-year-old with cirrhosis and hematemesis arrives pale and clammy. Two large-bore IVs are placed; octreotide is started; 1 L LR given and 1 unit PRBCs is infusing. Current data: BP 86/52 mm Hg, HR 118/min, RR 24/min, SpO₂ 96% on 2 L NC, urine output 10 mL in the last hour. Which bedside measurement signals the need for the most immediate intervention?

A 19-year-old varsity soccer goalkeeper completes a screening exam. ECG shows sinus rhythm 48/min; BP 118/62 mm Hg. The student runs 5–6 days/week and denies syncope, chest pain, or exercise intolerance. Cardiac exam is normal. What should the nurse do?

A 55-year-old patient in urgent care reports 2 days of progressive abdominal pain and anorexia. Vitals: T 38.0°C (100.4°F), HR 96, BP 132/76, RR 16. Labs: WBC 13,200/µL. The patient denies vomiting. Which assessment finding would the nurse expect with uncomplicated diverticulitis? Which assessment finding is most consistent with this diagnosis?

A preceptor observes a new RN treating a stable patient with regular narrow-complex tachycardia at 185/min who remains alert and normotensive after unsuccessful vagal maneuvers. Which action shows correct medication administration?

Thirty minutes after a large-volume paracentesis removing 6.0 L, a patient with cirrhosis reports lightheadedness when turning in bed. Orders: vitals every 15 minutes for 1 hour, strict I&O, occlusive dressing, bedrest 1 hour, albumin 25% IV now, and 500 mL normal saline IV bolus only if systolic BP < 90 mmHg. Vitals: BP 94/56, HR 112, RR 18, SpO₂ 98% on room air. The dressing is dry with minimal serous strike-through. What is the nurse’s priority actioN?

A 56-year-old with cirrhosis arrives with large-volume hematemesis and pallor. Two large-bore IVs are placed. Orders pending include: octreotide infusion, pantoprazole IV bolus, ceftriaxone IV, and propranolol PO when stable. Which medication should the nurse administer immediately to help control the bleeding?

A 62-year-old adult arrives to the ED with 24 hours of abdominal pain, low-grade fever, and constipation. Pain began as a dull ache that localizes and worsens with movement. Vitals: T 100.8°F (38.2°C), HR 102, BP 138/82, RR 18, SpO2 99% room air. On exam, the abdomen is soft with localized tenderness and guarding in one quadrant; bowel sounds are normal. Based on this presentation, which finding is most consistent with acute diverticulitis?  

A patient with a history of ulcerative colitis presents with worsening abdominal pain and fatigue. Which assessment finding is most characteristic of an acute ulcerative colitis flare?

A 64-year-old with portal hypertension is admitted for coffee-ground emesis. After 1 L crystalloid and starting octreotide/ceftriaxone: BP 92/58 mm Hg, HR 126/min, RR 22/min, mentation intact, urine output 25 mL over 2 hours. Which measurement best indicates the patient is worsening and requires immediate escalation?