Real Life Clinical Reasoning

Real Life Clinical Reasoning: Med-Surg – GI Bleed Using an SBAR format, write the information Nurse Esther should give to Ms. L provider when calling about her response to the blood. Refer to the EMR documents for needed information S: Dr. McGuire, this is Esther – RN. I am taking care of Ms. L in room 5206. She is a 36-year-old client admitted from the ED today for a GI bleed. She had one unit of packed RBCs and part of the second unit of blood. I stopped the second unit because I believe she is having a transfusion reaction. Her baseline temperature was 98.6 and is now 101.8. Ms. L reports having a headache, chills, and is restless. She does not have any evidence of a rash at this time. B: Ms. L has a history of Crohns disease and intermittent gastritis. Six months ago she had an ileostomy and started on infliximab IV every 8 weeks. Her last infusion was 7 weeks ago. A: Her hgb was 7 g/dL and her hct was 21% in the ED. When she arrived to the medical surgical unit, her BP was 94/56 and her pulse 110, but now her BP is 110/70 and her pulse is 110. At this time, her respirations are 26, her SaO2 is 97%, and her temperature is 101.8. I have discontinued the second unit of blood and plan to send both the bags of blood to the lab per protocol. I hung a new bag of 0.9% sodium chloride to keep the line open. R: Ms. L is requesting ibuprofen for her headache, which would also bring her fever down. Could I have an prescription for an antipyretic, and do you want to continue the IV infusion of 0.9% sodium chloride at 150 mL/hr? Identify five stress management strategies Nurse Esther should recommend to Ms. Lieberman to promote a healthier lifestyle. 1. Perform light, regular exercise. 2. Write in a journal. 3. Listen to music. 4. Consider a pet. 5. Get adequate sleep. This study source was downloaded by 100000820084347 from on 12-12-2021 15:06:42 GMT -06:00 Powered by TCPDF (

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