A 38-year-old man presents with an acute onset of severe right upper quadrant abdominal pain, pain to his right shoulder, and nausea. He is conscious and alert, but is restless from the pain. His blood pressure is 150/86 mm Hg, pulse rate is 120 beats/min and strong, and respirations are 22 breaths/min and regular. In addition to administering supplemental oxygen, you should:
start an IV with normal saline and set it to keep the vein open, place him in a position of comfort, and administer 4 mg of morphine and 12.5 mg of promethazine.
A 52-year-old man complains of severe abdominal pain but denies nausea or vomiting. He is conscious and alert, has a blood pressure of 130/70 mm Hg, a heart rate of 120 beats/min and strong, and respirations of 20 breaths/min and regular. In addition to providing supplemental oxygen, you should start an IV line and give:
nalbuphine, 10 mg.
A 52-year-old man complains of vomiting and diarrhea for the past day. He is conscious and alert, has a blood pressure of 130/70 mm Hg, has a heart rate of 120 beats/min and strong, and has respirations of 20 breaths/min and regular. His past medical history is significant for anemia and congestive heart failure. Prior to administering isotonic crystalloid solutions to this patient, it is MOST important to:
auscultate his lung sounds
A 62-year-old man presents with an acute onset of bright red vomiting. According to his wife, he ingests excessive amounts of alcohol each day. As you are assessing the patient, you note that his level of consciousness has decreased markedly. His mouth is full of blood, and his skin is pale and moist. You should:
turn him on his side and suction his oropharynx, intubate his trachea if the oral bleeding continues, establish at least one large-bore IV with normal saline, and administer enough fluids to maintain adequate perfusion.
A patient with an advanced bowel obstruction would MOST likely present with: