Cаse Study Questiоn 6 оf 6 The nurse cаres fоr а 21-year-old male in the emergency department with cellulitis and uncontrolled pain. Nurses’ Notes 0930. Client being treated for cellulitis presented with a complaint of right arm pain not controlled by prescription narcotics. The client is alert and oriented but agitated, rating pain 10/10 pain. Denies shortness of breath or chest pain. Informed client of wait times, placed wristband on client, and had him return to the waiting room to be triaged. 1055. Notified by a family in the waiting room that the client was slouched in chair and “seemed dead.” Client was found to be unresponsive with constricted pupils, clammy skin, bradypnea, and circumoral cyanosis. Rt arm is red and swollen with blistered areas. 1100. Emergency response team activated. Vital signs obtained. 1105. Intranasal naloxone administered. Oxygen started at 2L per nasal cannula. Client starting to arouse. 1115. Client respirations returned to expected levels within two minutes, client awake, alert, nauseated, and vital signs improved. 1135. Client is alert and now complaining of severe pain and nausea. Reports he has been taking non-prescribed oxycotin in addition to ordered narcotic pain medications. Orders received. Vital Signs Time 1100 1115 1145 T ◦F/ ◦C 97.1F /36.1C 97.1F/36.1C 98.3/F 36.7C P 48 56 90 RR 6 12 16 B/P 90/50 94/56 130/88 Pulse oximeter 86% 93% on 2L 96% on 2L Oxygen RA 2L via NC 2L via NC Pain Unable to report 6/10 10/10 Orders Admit to the inpatient unit VS every 30 minutes x 6hrs May repeat intra nasal naloxone 4 mg/0.1 ml every 2-3 minutes as needed Oxygen per NC to keep pulse oximeter greater than 92% Pain management consult Wound nurse consult The nurse receives orders, reassesses the client, and prepares them for admission. For each client statement, select whether the statement indicates an understanding, or no understanding of teaching provided about opioid addiction.
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