You (the LPN) are working in an urgent care center

 

You (the LPN) are working in an urgent care center on a team with an RN, Physician, and NP. You receive a client (54 year-old-male) who is complaining of acute lower back pain that began four hours ago. The client has no previous history of back pain and denies any recent injury. The client has a history of hypertension and Marfan Syndrome. You perform data collection, and the client’s vital signs are: 174/90, 112, 24, 98.0 PO. You note that the client’s skin is cool and clammy. The RN performs an assessment and notes a pulsatile mass in the client’s abdomen. His lungs are clear, and his pulse is regular. The physician orders two large bore IV’s to be inserted but no IV fluids and nitroglycerine to lower his blood pressure.

Answer the following questions:

Question # 1: What is the significance of the client’s history of Marfan Syndrome? (5-10 sentences)

Question # 2: What vital sign(s) should the LPN immediately report? Why? (5-10 sentences)

Question # 3: What is the significance of the “pulsatile mass” (5-10 sentences)

Question # 4: Why did the physician order IV’s but no IV fluids? (3 sentences)

Question # 5: Why does the client need to have his blood pressure lowered? (3 sentences)

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