Scenаriо: The client is а 17-yeаr-оld male whо lives with his family on a farm in a rural community. The client has 4 siblings that were recently ill with: stomach pains, vomiting, diarrhea, and fever. The siblings were seen by their PCP and diagnosed as having viral gastroenteritis. A week later the client woke at 03:00 stating that his stomach pain was 8-9/10, and began to vomit several times over the next few hours, so his parents brought him in to the ER for evaluation. He is seen guarding his abdomen, and moaning. Vital signs on admit: BP: 128/78; HR: 130 bpm; RR: 28; O2 94% on RA Iv access is obtained and orders are received for “MORPHINE SULFATE 2mg x 1 NOW IVP”. Scenario Progression: An abdominal CT scan confirms that the client has appendicitis. The ED physician has written orders. Review the orders below; note whether the orders are appropriate or inappropriate ED DEPARTMENT ORDERS: · Make patient NPO [answer1] · Place PERIPHERAL IV [answer2] · D5 1/2NS at 100 ml/hr [answer3] · FLEET ENEMA x1 NOW for r/o IMPACTION [answer4] · MORPHINE SULFATE 2 mg IVP q 2 hr PRN SEVERE PAIN (7/10) [answer5] · OBTAIN CONSULT to SURGERY – Hartman, MD [answer6] · Cefotaxime (CLAFORAN) IVPB 50 mg/kg x1 NOW [answer7]
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