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Question

You are an ED nurse with a 4-bed assignment. Currently, 3 rooms are occupied by patients thatrecently arrived.

1. 38 yo male ambulatory to ED with complaints of sneezing yesterday and then developing

a sudden sharp pain on the left side. Pt reports pain increases with cough. Denies SOB

and is in NAD in triage. VS WNL

2. 4-week-old male arrives with his mother. She states that he has had some congestion and

coughing for 1 week, is eating less and had a rectal temperature of 100.7 at home. The

child was born at 32 weeks gestation and spent 2 weeks in the NICU. In triage you note

retractions with respirations. VS: T 37.8, HR 184, RR 40, Pulse ox 92% RA

3. 27 yo female ambulates to triage complaining of a mass to her arm. Pt reports that she

had an I&D of the mass at urgent care 2 days ago and started antibiotics. The swelling

and redness is increasing per the patient. When questioned she admits to IV drug use.

VS WNL

For each patient, answer the following questions:

1. What ESI level would you give this patient? And then rank the patients in the order in

which you would see.

2. Based on this initial presentation, what potential medical diagnoses do you suspect? List

as many as you can.

3. What further questions do you want to ask your patient?

4. What red flags are you looking for?

5. What diagnostic tests do you expect?

6. What is your top nursing diagnosis?

7. What interventions do you anticipate?

8. What can you delegate, and to whom?

9. What is the best- and worst-case scenario for this patient?

Based on your answers, how do you anticipate planning your care for the next hour?

Step-by-step answer

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