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July 2004, Volume 34 Number 7 , p 88 - 88


  • Michael W. Day RN, CCRN, MSN



  • What's the situation?

  • What's your assessment?

  • What must you do immediately?

  • What should be done later?


  • Figure. No caption a...

    ACCOMPANIED BY HIS wife, James Frost, 57, arrives at your ED complaining of sudden onset of a severe headache, nausea and vomiting, and vision changes. He's lethargic but answers your questions appropriately and can move his arms and legs normally on command.

    You attach a cardiac monitor, noninvasive blood pressure (BP) cuff, and a pulse oximetry sensor and check his vital signs. Mr. Frost's BP is 224/130 mm Hg, with a mean arterial pressure (MAP) of 161 mm Hg (normal range, 70 to 100 mm Hg). His heart rate is 98 and he's in normal sinus rhythm, his respirations are 20, and his SpO 2 is 95% on room air.

    What's the situation?

    Mrs. Frost reports that her husband, who has hypertension, ...

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