1718: Client brought to the ED by her roommate. The roommate reports that she has been experiencing dizziness throughout the day, which has worsened to where she has ‘blacked out’ for several moments prior to arrival. Three weeks ago, the client was discharged from an outpatient behavioral health facility for treatment of anorexia nervosa. On assessment, the client is drowsy but arousable by verbal command. Peripheral pulses 1+. Skin is dry and flaky. Excessive fine hair growth all over the client’s spinal column and arms. Patches of alopecia. Lung sounds are clear bilaterally. Bowel sounds are hyperactive in all four quadrants. She denies pregnancy as she has had amenorrhea for the past year. BMI 16.5 kg/m2. Medical history of anorexia nervosa.
1718: Client brought to the ED by her roommate. The roommate reports that she has been experiencing dizziness throughout the day, which has worsened to where she has ‘blacked out’ for several moments prior to arrival. Three weeks ago, the client was discharged from an outpatient behavioral health facility for treatment of anorexia nervosa. On assessment, the client is drowsy but arousable by verbal command. Peripheral pulses 1+. Skin is dry and flaky. Excessive fine hair growth all over the client’s spinal column and arms. Patches of alopecia. Lung sounds are clear bilaterally. Bowel sounds are hyperactive in all four quadrants. She denies pregnancy as she has had amenorrhea for the past year. BMI 16.5 kg/m2. Medical history of anorexia nervosa.
1810: Critical laboratory result received and read back to the lab. Potassium 2.9 mEq/l [3.5-5.0 mEq/l (mmol/l)]. The physician was verbally informed of this result at this time.
1815:
- insert two peripheral vascular access devices
- potassium chloride 40 mEq via intravenous infusion. Infuse over 4 hours
- 0.9% sodium chloride (normal saline) bolus, 1000 mL, infuse over 1 hour
- psychiatry consultation
- dietitian consultation
- transthoracic echocardiogram
- obtain medical records from previous behavioral health admission
- medication reconciliation for inpatient admission
- continuous cardiac monitoring
The nurse receives a critical result from the laboratory. The nurse reviews the health care provider's orders and takes action.
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