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(Solved): ST 1: Clinical Example -A Case of Acute Pain A 14-year-old white adolescent male, Jack, presented at ...
ST 1: Clinical Example -A Case of Acute Pain A 14-year-old white adolescent male, Jack, presented at the emergency department at 7 pm on a Tuesday evening, accompanied by his father. Checking his observations, the nurse found that Jack had a fever (T 38.5C; 101.3F). When the nurse asked Jack where his pain was, Jack indicated his right lower abdomen (right lower quadrant). Jack rated his pain as 9 (on a 0-10 Number Rating Scale) and described his pain as the worst pain possible (on a Verbal Rating Scale), and as aching and gnawing and sharp in quality. Jack had rapid breathing, very rapid pulse-tachycardia and lowered blood pressure. The nurse documented the five observations, with pain as the fifth vital sign. Jack's father indicated that Jack had vomited frequently all day, had had no food and only a little water to drink, vomiting back any fluids taken. Jack lay on his left side on the hospital trolley with his hips and knees flexed to try to reduce the severe pain sensation and did not feel like talking. The nurse gently asked Jack: (a) when the pain started - Jack replied that the pain started in the middle of his tummy over the past day; (b) when Jack had last eaten - Jack replied he had eaten the previous day; and (c) when Jack had last passed urine and had a bowel movement - Jack replied that he had passed urine and had a bowel movement the previous day (Monday morning) and the nurse documented this information. The nurse also asked Jack if he had taken any recreational drugs or alcohol recently and told Jack this information was very important to prevent any side-effects from his hospital treatments. Jack replied that he had not taken recreational drugs or alcohol and the nurse documented this information. Q1. How are Jack's immediate nursing intervention requirements addressed? Q2: How will Jack's immediate medical and nursing care interventions proceed? Q3. Are there competing issues in this instance? If so, how does current knowledge and patient- centred interdisciplinary care address them?
A 14-year-old white adolescent male, Jack, presented at the emergency department at on a Tuesday evening, accompanied by his father. Checking his observations, the nurse found that Jack had a fever ( ). When the nurse asked Jack where his pain was, Jack indicated his right lower abdomen (right lower quadrant). Jack rated his pain as 9 (on a 0-10 Number Rating Scale) and described his pain as the worst pain possible (on a Verbal Rating Scale), and as aching and gnawing and sharp in quality. Jack had rapid breathing, very rapid pulse-tachycardia and lowered blood pressure. The nurse documented the five observations, with pain as the fifth vital sign. Jack's father indicated that Jack had vomited frequently all day, had had no food and only a little water to drink, vomiting back any fluids taken. Jack lay on his left side on the hospital trolley with his hips and knees flexed to try to reduce the severe pain sensation and did not feel like talking. The nurse gently asked Jack: (a) when the pain started - Jack replied that the pain started in the middle of his tummy over the past day; (b) when Jack had last eaten - Jack replied he had eaten the previous day; and (e) when Jack had last passed urine and had a bowel movement - Jack replied that he had passed urine and had a bowel movement the previous day (Monday morning) and the nurse documented this information. The nurse also asked Jack if he had taken any recreational drugs or alcohol recently and told Jack this information was very important to prevent any side-effects from his hospital treatments. Jack replied that he had not taken recreational drugs or alcohol and the nurse documented this information. Q1. How are Jack's immediate nursing intervention requirements addressed? Q2: How will Jack's immediate medical and nursing care interventions proceed? Q3. Are there competing issues in this instance? If so, how does current knowledge and patientcentred interdisciplinary care address them?