Reference no: EM132980320

As a nurse on a general medical floor, the RN has received a new admit. Review the client data provided.

Richard Henderson
58 years old
Male
Admit diagnosis: GI bleed
History: no surgical history
Medical history: Gastritis & GERD
Medications: Prilosec 40 mg PO daily, Atenolol 25 mg PO BID, Fiber daily, Alka Seltzer PO - states he takes this at least daily.

• Report from physician's office: Mr. Henderson arrived to the physician's office today for a complaint of increasing abdominal pain. He states that he is now throwing up coffee-ground emesis. He states that he didn't take his BP medication this morning because he was dizzy. The physician is admitting him with a diagnosis of GI bleed with an EGD scheduled for tomorrow. He is NPO, and has a 22G IV lock in the left forearm. Last set of vital signs BP 106/60 mm Hg, HR 98 beats/min, RR 20 breaths/min, Temp. 98.8 degrees F, P.O. 90% on room air. He last vomited about 45 minutes ago with a small amount of dark coffee-ground emesis. His pain is 4/10 at present. No pain medication is ordered at this time.
• Lab assessments ordered: CBC and chemistry panel
• CT of the abdomen shows no signs of free air (no perforation)
• When he arrives to the floor, he is pale, nauseous, and his skin is cool and clammy. When he is transferred to the bed from the stretcher, he vomits a large amount of coffee-ground emesis and loses consciousness.

Question 1: While receiving report, what concerns do you have regarding the client report?

Question 2: What type of shock is occurring?

Question 3: What stage of shock is the client experiencing?

Question 4: What is your next intervention and why?

Question 5: What additional lab assessments would you anticipate?