MHACB/516 Competency 1 Assessment and Rubric Course Title: Operating in
ED with report of increasing Nurses’ Not Lab Tests 1455: Presented to the ED with report of increasing epigastric pain throughout the day. Pain started after dinner last night and usual medication did not help. States has been treated for gastroesophageal reflux disorder (GERD) for over 5 years with a variety of drugs, most recently omeprazole 40 mg orally twice a day. Other medications include: Ibuprofen 800 mg orally every moming for osteoarthritis Amlodipine 10 mg orally every day for hypertension MVI 1 tab every day for general health Famotidine 20 mg orally before meals PRN 1530: While waiting to be examined by the physician assistant, client vomited 175 mL coffee-ground emesis. States feeling “a little dizzy.” HR increased to 94 BPM; BP 128/78 lying down and 112/62 sitting. Stat blood work drawn. 1610: Labs within normal range. H&H tomorrow AM at 0600. ECG shows normal sinus rhythm. Vomited 100 ml coffee-ground emesis. Based on the client’s condition and priority need, which orders by the physician would the nurse anticipate at this time? Select all that apply. Start two IV lines with large bore catheters Administer IV esomeprazole bolus. Place client on strict NPO Type and cross match 2 units of packed red blood cells. Prepare client for surgery immediately Start Oz via NC. Give 500 mL normal saline over 30 minutes Monitor continuous oxygen saturation A: Administer IV esomeprazole bolus, Place client on strict NPO, Prepare client for O surgery immediately, Start 02 via NC, Give 500 mL normal saline over 30 minutes, Monitor continuous oxygen saturation B: Start two IV lines with large bore catheters, Administer IV esomeprazole bolus, O Place client on strict NPO, Type and cross match 2 units of packed red blood cells, Start 02 via NC, Give 500 mL normal saline over 30 minutes, Monitor continuous oxygen saturation C: Start two IV lines with large bore catheters, Administer IV esomeprazole bolus, Type and cross match 2 units of packed red blood cells, Prepare client for surgery immediately, Start 02 via NC, Monitor continuous oxygen saturation D: Administer IV esomeprazole bolus, Prepare client for surgery immediately, Start 02 via NC, Give 500 mL normal saline over 30 minutes, Monitor continuous oxygen saturation E: Start two IV lines with large bore catheters, Administer IV esomeprazole bolus, Place client on strict NPO, Type and cross match 2 units of packed red blood cells, Prepare client for surgery immediately, Start 02 via NC, Give 500 mL normal saline over 30 minutes, Monitor continuous oxygen saturation
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