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October 2009, Volume 39 Number 10 , p 72 - 72


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


ACCOMPANIED BY HIS WIFE, John Bennett, 41, arrives at the ED complaining of a sudden onset of colicky (intermittent) left-sided flank pain radiating to his groin. He says the pain started 45 minutes ago, and he rates it as a 10 (worst pain imaginable) on a 0-to-10 pain intensity rating scale. Mr. Bennett says he vomited in the car on the way to the hospital.

You escort him to a bed and take his vital signs: temperature, 99°F (37.2°C); pulse, 116; respirations, 24; and BP, 140/98 mm Hg. His SpO 2 is 97% on room air. You place Mr. Bennett on a cardiac monitor, which shows sinus tachycardia.

What's the situation?

Mr. Bennett is pale, diaphoretic, and nauseated. He has no significant ...

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