PNH401 Healing Practices for Practical Nurses IV

Case Study Scenario

Mrs. Condiff is a 35-year-old married Native Canadian female who presents to the emergency department with the chief complaint of severe right sided flank pain which began one day ago. She reports feeling nauseated and has vomited once today. Mrs. Condiff does not show any outward appearance of pain but is having some difficulty sitting still. She states, “I feel the need to constantly walk around.” Upon further questioning, the client reveals a history of dysuria, urgency, and frequency of urination. As the nurse obtains a history, she notes that the client has no facial grimace and is not making eye contact. The client states, “I am sorry to come in with this pain, I have tried to treat it at home with Creeping Charlie, but it just did not help.”

Assessment

Nursing assessment findings include pale, moist skin, costovertebral tenderness, and restlessness. Her vital signs are blood pressure 142/90, pulse 110, respirations 22, and temperature of 99.8°F (37.7°C) Oxygen saturation is 98% on room air. The emergency physician evaluates Mrs. Condiff and orders the following: (a) urinalysis, strain all urine, (b) white blood count (WBC), (c) comprehensive metabolic panel (CMP), (d) intravenous pyelogram (IVP), (e) 1 liter 0.9% Sodium Chloride bolus, (f) Morphine 4mg IV, and (g) Zofran (ondansetron) 4mg IV. No physician orders have yet been implemented. The emergency physician informs the nurse that he suspects renal calculi to be the cause of this client’s pain. Upon further assessment, the physician reports that the client has a family history of renal calculi. Mrs. Condiff rates the pain at a 9 on a 0-10 pain scale.  She remains is admitted to the renal floor and she is waiting for her husband to visit.