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July 2010, Volume 40 Number 7 , p 72 - 72


  • Deborah Young BSN, RN, CEN, SANE-A


ACCOMPANIED BY HER HUSBAND, Tiffany Blackmore, 31, arrives at your ED complaining of severe lower abdominal and right shoulder pain. She tells you that the pain started suddenly 2 hours ago, and she also noticed some vaginal spotting this morning. Mrs. Blackmore says she feels dizzy and lightheaded; she's pale and diaphoretic.While obtaining Mrs. Blackmore's health history, you learn that she was treated for endometriosis about 5 years ago. She also tells you that she and her husband have been trying to conceive their first baby for the last 6 months. You take her vital signs: BP, 82/44; heart rate, 116; respirations, 22; and SpO2, 95% on room air. Her last menstrual period was 6 weeks ago. You perform a point-of-care pregnancy test; it's positive. She rates her pain as 8 on a 0–10 pain intensity rating scale. During your physical assessment, you note abdominal tenderness and guarding.Based on Mrs. Blackmore's history and clinical status, you suspect a ruptured

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