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Original Question

The nurse has reviewed the nurses’ notes, vital signs, and provider prescriptions from day 2 at 0930 and 1130.Day 1, 2130:Client admitted to the medical-surgical unit from the emergency department. Client reports abdominal pain as 4 on a scale of 0 to 10 and worsens 3 hr after eating, which has been going on for the past month and is becoming more frequent. Client states, “The pain wakes me up every night and if I eat some crackers it seems to alleviate the pain.” Client describes pain as a “burning sensation.” Client also reports feeling bloated, nauseated, and dizzy. Bowel sounds normoactive in all quadrants. Client reports dark bloody stools for the last 3 days. Abdomen is distended and tender to touch. Lungs are clear to auscultation in bilateral lobes. Reports no difficulty urinating. Pedal pulses present. Client appears pale for genetic background and diaphoretic. Alert and oriented to person, place, and time.Day 2, 0830:Client reports pain has gotten worse. Reports abdominal pain as 6 on a scale of 0 to 10. Client had one large dark bloody stool in the night and one this morning after breakfast, and had 30 mL of coffee ground emesis. Reports nausea and vomiting. Ate only 10% of meal. Intravenous fluids infusing. Provider notified.Day 2, 1130:Client received pain medication and reports pain as 4 on a scale of 0 to 10. Client continues to vomit coffee-ground emesis. Vomited x2 in last hr. Approximately 150 mL of emesis total. Client is unable to drink fluids without vomi

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