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August 2010, Volume 40 Number 8 , p 72 - 72


  • Dorothy S. Carlson DEd, RN
  • Ellen Pfadt MSN, RN


MADELINE MARTIN, 50, arrives at the ED complaining of intermittent nausea and crampy, midabdominal pain. She states that her pain seems to occur in cycles, and that she's relatively comfortable between the pain episodes. She rates her current pain intensity as a 6 on a scale of 0 (no pain) to 10 (worst possible pain). While you perform a focused physical assessment, she vomits a large amount of fluid; the vomitus contains bile and mucus. You also note abdominal distension and hyperactive bowel sounds. Her oral temperature is 99° F (37.2° C); pulse, 118; respirations, 28; BP, 112/70; and SpO2, 95% on room air.Two weeks ago, Ms. Martin had an abdominal hysterectomy for uterine fibroids. Her medical history includes hypertension, obesity, and dyslipidemia, and her postoperative course was uneventful until now. You notify the ED physician and her surgeon of your assessment findings, and administer analgesia and an antiemetic as prescribed.Based on your assessment findings

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