February 2009, Volume 39 Number 2 , p 72 - 72
Carlson, Dorothy S. RN, DEd; Pfadt, Ellen RN, MSN
Issue: Volume 39(2), February 2009, p 72 Publication Type: […&more: ACTION STAT] Publisher: © 2009 Lippincott Williams & Wilkins, Inc. Institution(s): Associate Professors, Edinboro University Edinboro, Pa.
YOU JUST STARTED the day shift in the ED when Madeline Aston, 60, arrives complaining of left lower quadrant abdominal pain, nausea, and vomiting. As you escort her to a bed, she tells you she's been experiencing these symptoms all night, and the pain has become more constant and severe within the last 2 hours. She's lying on her side with her knees drawn toward her chest, and she says the pain is worse when she moves. She rates her pain as a 10 (worst pain imaginable) on a 0-to-10 pain intensity rating scale. During your quick, focused assessment, you note abdominal distension, hypoactive bowel sounds, and involuntary guarding. Her vital signs are: BP, 100/62; pulse, 124; respirations, 28; temperature, 102° F (38.9° C); and SpO2, 94% on ...