To work in an interdisciplinary team, use critical thinking, and apply emergency nursing interventions within the scope of practice for the LPN.
Instructions
Read the following scenario and answer the questions. A fingerprint indicates a major clue. Make sure you cite all sources using APA format.
The Story:
You (the LPN) are working in an urgent care center on a team with an RN, Physician, and NP. You receive a client (54 year-old-male) who is complaining of acute lower back pain that began four hours ago. The client has no previous history of back pain and denies any recent injury. The client has a history of hypertension and Marfan Syndrome. You perform data collection, and the client’s vital signs are: 174/90, 112, 24, 98.0 PO. You note that the client’s skin is cool and clammy. The RN performs an assessment and notes a pulsatile mass in the client’s abdomen. His lungs are clear, and his pulse is regular. The physician orders two large bore IV’s to be inserted but no IV fluids and nitroglycerine to lower his blood pressure.
Answer the following questions:
Question # 1: What is the significance of the client’s history of Marfan Syndrome? (5-10 sentences)
Question # 2: What vital sign(s) should the LPN immediately report? Why? (5-10 sentences)
Question # 3: What is the significance of the “pulsatile mass” (5-10 sentences)
Question # 4: Why did the physician order IV’s but no IV fluids? (3 sentences)
Question # 5: Why does the client need to have his blood pressure lowered? (3 sentences)
Answers to the Urgent Care Scenario:
Question 1: Significance of Marfan Syndrome:
Marfan Syndrome is a genetic disorder affecting connective tissue, including the aorta (main artery). It weakens the aortic wall, increasing the risk of aortic dissection, a potentially life-threatening condition where the aortic layers tear apart. This makes the client’s acute lower back pain potentially concerning, as it could be a symptom of an aortic dissection. (National Library of Medicine, 2023)
Question 2: Vital Signs to Report:
Question 3: Significance of Pulsatile Mass:
A pulsatile mass in the abdomen could indicate an aneurysm (abnormal enlargement) of the abdominal aorta, further supporting concerns about potential aortic dissection in someone with Marfan Syndrome. (American College of Cardiology, 2023)
Question 4: IVs without Fluids:
Question 5: Lowering Blood Pressure:
High blood pressure further stresses the weakened aorta in Marfan Syndrome, increasing the risk of dissection. Lowering blood pressure with medication like nitroglycerin helps stabilize the situation and potentially prevent a life-threatening event. (National Library of Medicine, 2023)
Important Note:
This information is for educational purposes only and should not be used as a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment of any medical condition.