1. John April, 24 years of age, is a male patient admitted to thesurgical unit after a successful repair of an inguinal hernia. He is 5 feet 10 inches tall and weighs 120 kg. He has a neck circumference of 21 inches. The patient has a morphine PCA. He has no known drug allergies. His vital signs are as follows: blood pressure, 122/70 mm Hg; respiratory rate, 26 breaths/min; heart rate, 88 bpm; and temperature, 98.6°F. The patient complains of incision pain and rates it on the pain scale as 7 of 10. His family is visiting at the bedside. The nurse administers a bolus dose of morphine. Fifteen minutes after administering the pain medication, a family member enters the hallway and yells, “We need help in here! John is not breathing.” The nurse finds John having periods of apnea lasting a few seconds followed by a short snorting gasp, and then he begins breathing at a rate of 12 breaths/min. His lips are bluish in coloration, and so are his nail beds. The patient is lying supine in the bed. He awakens as the nurse enters but is very lethargic and somnolent. (Learning Outcomes 4 and 5) a. Which assessment parameters are appropriate to determine the characteristics and severity of the patient’s symptoms? b. Which nursing interventions should the nurse institute? Which intervention must be provided immediately? c. Explain the possible reasons for the patient’s sudden decline in respiratory status. 2. Mr. Williams, a 72-year-old man, is scheduled for a bronchoscopy due to changes noted on a recent chest x-ray. A retired factory worker, Mr. Williams was recently notified that the buildings that he had worked in for over 25 years were destroyed due to asbestos. (Learning Outcome 6) a. What is the rationale for the bronchoscopy in Mr. Williams? b. List preprocedure nursing interventions. c. What is the rationale for the administration of atropine? d. For what postprocedure complications should the nurse assess Mr. Williams Health Science Science Nursing NRS 220 Share QuestionEmailCopy link Comments (0)
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