How to Answer Describe Components Focused Questions (Complete Guide)

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Original Question

Describe the components of a focused assessment of a patient with suspected GI bleed. What interventions, in order of priority, might a nurse anticipate in the care of a patient with a GI bleed? Describe what steps are taken to assure safe blood product administration. Describe hypovolemic shock and list the nursing interventions for this patient. Describe signs and symptoms of a UTI in an elderly female (over the age of 70) ………………info needed to answer Situation: Sandra Thompson is an 80-year-old female who presented to the emergency department with an acute upper gastrointestinal bleed secondary to a recently diagnosed duodenal ulcer. She has also been complaining of having to get up several times during the night to urinate she has a low-grade temperature of 100.4-100.8 over the past 3 days. This morning she was on the phone with her daughter and showed signs of confusion to time and place. Her daughter stopped by to check on her and noticed she vomited brownish coffee ground material and was pale and diaphoretic. Sandra’s daughter took her to the ED by ambulance. Background: Ms. Thompson is a widower who lives at home alone, but has an adult daughter who is a significant support system. She has no significant cardiac or pulmonary diseases. She has bilateral osteoarthritis of the knees. One week ago, Ms. Thompson was seen by her primary care provider because of abdominal pain. At that time, an endoscopy confirmed a duodenal ulcer, and she was prescribed Omeprazole 20mg PO daily. The past 3 days, Sandra told her daughter that she has to get up several times during the night to urinate, though “not much comes out.” She has also complained of chills and took her temp which was between 100.4-100.6. She has no known drug allergies and the only prescribed medications she has are Ibuprofen 600mg TID and Omeprazole 20mg daily. She is English speaking and a Full Code. Assessment: Ms. Thompson is alert, but visibly anxious and displays some intermittent confusion. She is disoriented to time and situation. Her lungs are clear to auscultation bilaterally. She is on full telemetry monitoring and is in a sinus tachycardia rhythm. S1S2 are audible. She is visibly pale, diaphoretic to touch and her capillary refill is at exactly 3 seconds. Her abdomen is distended, she has generalized pain to palpation and her bowel sounds are hypoactive. A NG tube was placed for gastric decompression upon admission to the ED and it is draining coffee brown emesis which is guiac positive. She also had an indwelling foley catheter placed upon arrival, it is draining amber urine. She has a 20g peripheral IV catheter to her right antecubital and a triple lumen central line was placed to her right chest wall. Labs have been sent and results are pending. Her most recent set of vital signs are as follows: HR 116, BP 106/70, RR 22, Temp 37C and spO2 96% on RA. She is a high fall risk. Recommendation: Initiate healthcare provider orders, monitor clinical status and assess for signs of hemodynamic instability.

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