Author Question: A college student who is unresponsive is brought to the emergency department by friends, who say ... (Read 42 times)

Bernana · **on:** Jul 23, 2018

A college student who is unresponsive is brought to the emergency department by friends, who say that their friend drank more than half of a large bottle of whiskey 3 hours ago. Assessment reveals a blood alcohol level of 0.32.

The vital signs are BP, 88/32 mm Hg; R, 6/min; T, 96.8F; and P, 76/min and weak and thready. The nurse should prepare the patient for which in-tervention? a. IV fluids and stimulants
b. Charcoal administration
c. Gastric lavage and dialysis
d. Naloxone Narcan administration

Question 2

The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first?

a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin Lanoxin
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache
d. The patient with an allergy to penicillin who is receiving an infusion of vancomy-cin Vancocin

triiciiaa · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

C
The average rate at which a person can metabolize alcohol is about 15 mL (0.5 ounce) per hour. The patient in this scenario has consumed more than half of a large bottle of whiskey within 3 hours. Alcohol can be removed from the body by gastric lavage and dialysis. Gastric lavage washes out most of the alcohol if any is left in the gut, and dialysis is implemented to reduce the chance of renal failure and cardiovascular shock. Although intravenous fluids may be appro-priate, stimulants are contraindicated for this patient. Charcoal is not indicated in this situation. Naloxone is indicated in opiate overdoses, not alcohol overdoses.

Answer to Question 2

A
The NPO patient with hypoglycemia who just received 70/30 Novolin insulin takes priority, be-cause this patient needs to consume a good source of glucose immediately or perhaps the NPO status will be discontinued for this shift. The digoxin may be withheld for the patient with a pulse of 58 beats per minute, but this is not a priority action. The patient with a headache needs to be followed up, but because the blood pressure is 136/92 mm Hg, the headache is probably not caused by hypertension. The patient with an allergy to penicillin will not have a reaction to the vancomycin.