Reference no: EM133381184

Assignment:

Case Study for Lesson 3 Please refer to the following scenario to answer the questions that follow: You are the nurse caring for L.M., a patient who has been triaged to room 8 in your emergency room department (ED). The patient is exhibiting disinhibition of sexual impulses, mood lability, impaired judgment, and slurred speech. You note that L.M. has nystagmus and a flushed face. Time Assessment Interventions 0900 Patient oriented to person only and is difficult to arouse.

You note during the physical examination that he has nystagmus and a flushed face. BP 120/50, P. 70, RR 16, Oral temp. 97.4°F; Notified health-care provider of symptoms and received order for a urine drug screen and blood alcohol level. 0945 Laboratory shows the following: blood alcohol level 300 mg/dL. BP 100/50, P. 70, RR 14, Oral temp. 97.4°F Notified health-care provider of the laboratory findings. Started IV with NS. 1010 Patient becomes less responsive. Urine drug screen shows marijuana 15 ng/mL, otherwise negative. BP: 110/55, P. 120, RR 14, Oxygen saturation at 92% on room air. Serum laboratory results: K 4.9 mEq/L; Creatinine 1.3 mg/dL; Na 138 mEq/L; Initiated oxygen at 2 L/NC per emergency protocol; Notified HCP and received Notified HCP and received order for FBS stat;

1045 Patient with some less agitation, oriented X1. Serum laboratory results: Glucose 180 mg/dL; K 4.9 mEq/L; Creatinine 1.3 mg/dL; Na 140 mEq/L; Administered 2 units of insulin lispro (Humalog) per sliding scale. Administered Vitamin B 100 mg IV.

Refer to Davis chapters 20-23 (with review of 4-8) to answer the following questions. You do not need to provide in-text citations but should justify your answers by referring to the page where you found the supporting evidence for them.

1. List the most significant abnormal laboratory/assessment results that could be the cause of the patient's current signs/symptoms:
2. What might this indicate?
3. What was the rationale for starting an IV of NS? What is the rationale for administering Vitamin B 100 mg, IV?
4. Consider the patient's lab/presenting symptoms to develop 3 priority nursing diagnoses for the ACUTE phase LM's ED visit? List in priority order. Justify your answers and the PRIORITY you chose.
5. Once LM has stabilized and can respond appropriately to questions, what screening tool (s) would be most useful in this situation?
6. What referrals would be appropriate to help LM stay healthy after he is discharged from the hospital?
7. LM asks the nurse about medication to prevent this from happening again in the future. What are some medications that may be useful to prevent LM from having to return to the ED for the same situation? If the health care provider (HCP) does prescribe one of these preventative medications what are essential educational points that the nurse should present to LM about medications that may be used to prevent relapse of his medical condition?