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L. W. is a 50-year-old white male who presents to the emergency department with severe right flank pain. The client is severe acute distress, with significant anxiety, pallor, and diaphoresis. He cannot sit still on the ER stretcher, but continues to move around, repositioning himself. He is groaning from pain and has vomited twice from the pain. The ER nurse has given him promethazine hydrochloride IV for nausea. As the client states that he has an allergy to meperidine, he is given morphine IV for pain. The client does not smoke, and occasionally has a beer. His only medication is a multivitamin daily. The client works in construction and the weather has been unseasonably hot the past two weeks. He does have a previous history of a renal stone (2 years ago) that passed spontaneously. Vital Signs: BP 130/86, HR 90 bpm, Resp 16, Temp 98.4 deg F. On assessment, skin is pale, cool, and clammy without lesions or bruises. No cervical adenopathy or thyromegaly. Lung sounds are clear to auscultation. Normal S1/S2 no S3/S4. Regular rate and rhythm. Abdomen is nondistended. Bowel sounds are present and normoactive. No hepatosplenomegaly. No tenderness or masses. Extremities are cool but not edematous.
SCIENCE
HEALTH SCIENCE
NURSING

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