The patient, Jermaine Jones, was brought to the emergency department by his wife, Denise, 30 minutes ago. She reported that he had been drinking a few beers and took one of her prescription tablets, alprazolam, for anxiety. When she returned an hour later, he was having trouble talking clearly and responding to her questions. His wife says she has been increasingly worried about his mental condition over the last few days.

Mr. Jones is a 34-year-old African American male who was diagnosed with depression 2 years ago and was prescribed sertraline 50 mg orally once daily in the morning. His wife reports that he has been having a difficult time coping with the 1-year anniversary of his father's death. According to his wife, he has been taking his medication for depression as prescribed.

Mr. Jones is drowsy but arousable and oriented to person only. His pupils are equal, round, and reactive to light accommodation, and he can move all extremities. His speech is slurred. Vital signs are: BP: 112/66, HR: 96, RR: 12/min, and SpO2 at 96% on room air. A 20-gauge IV was started in his right forearm upon arrival. Normal saline is infusing at 100 mL/hr. A blood sample has been drawn for BMP, CBC, and a serum alcohol level as ordered by Dr. Alvarez. The results should be ready any minute now.

Dr. Alvarez has placed orders in the patient's chart based on the initial assessments but has not yet seen the patient. The patient is due for vital signs and other assessments listed in the chart. Please notify Dr. Alvarez if there are any changes in the patient's condition and after you have evaluated Mr. Jones.

1. List your top 3 nursing diagnoses for this patient.
2. A serum alcohol level is ordered. How will you know if it is elevated?
3. What other tests do you recommend the doctor should order?

Question

17-07-2024
Health

College

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The patient, Jermaine Jones, was brought to the emergency department by his wife, Denise, 30 minutes ago. She reported that he had been drinking a few beers and took one of her prescription tablets, alprazolam, for anxiety. When she returned an hour later, he was having trouble talking clearly and responding to her questions. His wife says she has been increasingly worried about his mental condition over the last few days.

Mr. Jones is a 34-year-old African American male who was diagnosed with depression 2 years ago and was prescribed sertraline 50 mg orally once daily in the morning. His wife reports that he has been having a difficult time coping with the 1-year anniversary of his father's death. According to his wife, he has been taking his medication for depression as prescribed.

Mr. Jones is drowsy but arousable and oriented to person only. His pupils are equal, round, and reactive to light accommodation, and he can move all extremities. His speech is slurred. Vital signs are: BP: 112/66, HR: 96, RR: 12/min, and SpO2 at 96% on room air. A 20-gauge IV was started in his right forearm upon arrival. Normal saline is infusing at 100 mL/hr. A blood sample has been drawn for BMP, CBC, and a serum alcohol level as ordered by Dr. Alvarez. The results should be ready any minute now.

Dr. Alvarez has placed orders in the patient's chart based on the initial assessments but has not yet seen the patient. The patient is due for vital signs and other assessments listed in the chart. Please notify Dr. Alvarez if there are any changes in the patient's condition and after you have evaluated Mr. Jones.

1. List your top 3 nursing diagnoses for this patient.
2. A serum alcohol level is ordered. How will you know if it is elevated?
3. What other tests do you recommend the doctor should order?

Answer :

Final answer:

The patient may be diagnosed with risk for aspiration, anxiety, and ineffective coping. You can tell if serum alcohol level is elevated if it exceeds normal levels (usually less than 10 mg/dL). Additional tests such as a toxicology screen and liver function test may be recommended.

Explanation:

1. The top three nursing diagnoses for this patient could be: a) Risk for aspiration related to decreased level of consciousness and slurred speech; b) Anxiety related to psychological distress and inability to cope with stressors (loss of father, alcohol abuse); c) Ineffective coping related to depression and misuse of drugs/alcohol.

2. A serum alcohol level can be evaluated by reference to standard values: normal levels are usually less than 10 mg/dL, mild intoxication occurs at levels of 10-50 mg/dL, and a level above 50 mg/dL is considered potentially harmful or toxic. Any value over the normal range indicates an elevated level.

3. Additional tests that the doctor could order include a Toxicology screen to determine the presence of other substances in the patient's system, and a Liver function test to evaluate the effect of alcohol and drugs on the patient's liver.

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