What stage of shock is the client experiencing?




As a nurse on a general medical floor, the RN has received a new admit. Review the client data provided.
Richard Henderson
58 years old
Admit diagnosis: GI bleed
History: no surgical history
Medical history: Gastritis & GERD
Medications: Prilosec 40 mg PO daily, Atenolol 25 mg PO BID, Fiber daily, Alka Seltzer PO – states he takes this at least daily.

Report from physician’s office: Mr. Henderson arrived to the physician’s office today for a complaint of increasing abdominal pain. He states that he is now throwing up coffee-ground emesis. He states that he didn’t take his BP medication this morning because he was dizzy. The physician is admitting him with a diagnosis of GI bleed with an EGD scheduled for tomorrow. He is NPO, and has a 22G IV lock in the left forearm. Last set of vital signs BP 106/60 mm Hg, HR 98 beats/min, RR 20 breaths/min, Temp. 98.8 degrees F, P.O. 90% on room air. He last vomited about 45 minutes ago with a small amount of dark coffee-ground emesis. His pain is 4/10 at present. No pain medication is ordered at this time.
Lab assessments ordered: CBC and chemistry panel
CT of the abdomen shows no signs of free air (no perforation)

When he arrives to the floor, he is pale, nauseous, and his skin is cool and clammy. When he is transferred to the bed from the stretcher, he vomits a large amount of coffee-ground emesis and loses consciousness.

In the discussion post, address the following:
While receiving report, what concerns do you have regarding the client report?
What type of shock is occurring?
What stage of shock is the client experiencing?
What is your next intervention and why?
What additional lab assessments would you anticipate?
Provide additional thoughts and insights.

Please make you initial post prior to lecture. Your post is based on the reading requirements, PPTs that you have reviewed, or the knowledge you already have (or think you have) of the situation. After lecture, you will reply to yourself with “What would I do different” or “what did I learn in addition….” You will then also respond to another student’s post.
*Because we cover shock and sepsis live in class on week 8 (we combine modules 7 & 8 in theory in week 8) you have through the end of week 8 to complete this discussion.
You will need to use evidence based articles twice. 1: in your original post OR your response to yourself and 2: in your response to another student.
Initial post is worth 50 %, second post is worth 25%, third post is work 25%
Jones, D., DeVita, M., & Bellomo , R. (2011). Rapid-Response Teams. English Journal of Medicine, 365, 139-146. Retrieved from Client Safety Network.
Please make your initial post by midweek, and respond to at least two other students’ posts by the end of the week. Please check the Course Calendar for specific due dates.


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