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September 2011, Volume 41 Number 9 , p 72 - 72


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


MR. G, 74, IS BROUGHT to the ED by ambulance after awakening with severe localized back pain. The pain was associated with difficulty getting out of bed and bilateral lower extremity weakness and paresthesias. He states he had no difficulty walking to bed last night.Mr. G is alert, oriented, and articulate. His vital signs are temperature, 98.6[degrees] F (37.0[degrees] C); apical pulse, 72; respirations, 16; SpO2, 97% on room air; and BP, 136/88. Mr. G describes his back pain as constant, rating its intensity as an 8 on a 0-to-10 scale. You place Mr. G on a cardiac monitor, which shows atrial fibrillation (AF), while a colleague obtains peripheral vascular access.During your focused physical assessment, you note that sensation and motor function are decreased from the level of his umbilicus down to his toes. You also note that Mr. G has been incontinent of urine.Mr. G's health history is unremarkable except for recent-onset AF. His medications include amiodarone and warfarin. You immediately

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