Vital Signs

1. You are a nurse caring for a 58-year-old ironworker who has been admitted to your unit with acute hypertension. He became extremely symptomatic at work and was brought to your emergency department (ED) via ambulance. After receiving a report from the ED nurse, he is brought to your unit asymptomatic (other than his BP of 178/106) and seems in good spirits. After completing his admission paperwork, he settles in and awaits his health care provider. Four hours later, you answer his call light and he reports headache (rated 6 on a 0-to-10 scale) and dizziness. 

a. Outline the pertinent information within this case study.

b. How often would you expect to measure the patient’s vital signs based on his history?

c. What would be your first intervention upon his reporting increased symptoms? Include rationale.

d. What is the patient’s pulse pressure?

e. Describe risk factors that could be contributing to your patient’s hypertension.

2. As a nurse in a critical care unit, your newest admission is a 24-year-old victim of a motor vehicle accident (MVA). Report from the OR nurse indicates that the patient has several surgically repaired fractures, a closed head injury, and elevated temperature. Additionally, he has IV fluid running postoperatively and dressing changes scheduled every shift. The patient is intermittently alert and disoriented, with his pain adequately controlled by IV analgesics. 

a. Outline the pertinent information within this case study.

b. What factors could be causing the patient’s elevated body temperature?

c. Why is determining the fever’s cause important?

d. Indicate areas that are important to monitor in a patient with elevated body temperature.

e. Describe cause-specific interventions useful in treating the patient’s elevated body temperature.