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CCRN Nursing Exam Prep - Adult Critical Care

Category - Adult Critical Care Registered Nurse Test Prep

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A patient is transferred from the medical-surgical floor to the intensive care unit for a blood pressure of 70/40, increased confusion over the past 6 hours, nausea, vomiting and urine output of 50 mL over the last 6 hours. The patient also has a diagnosis of diabetes mellitus and the blood sugars have remained less than 60 despite a bolus of 50 mL of dextrose. What would the nurse do upon receiving the patient?
  1. Begin an intravenous bolus of fluid.
  2. Administer an injection of glucocorticoid replacement.
  3. Send the patient for an abdominal x-ray.
  4. Assess vital signs, put the patient on the telemetry monitor and draw labs.
Explanation
Answer: D - The first thing the nurse should do on receiving the patient from the medical surgical floor is to take the vital signs, place the patient on the telemetry monitor and request a lab draw. After the initial assessment, begin fluid replacement. While the patient may be showing signs and symptoms of acute adrenal crisis, there is not an indication to administer glucocorticoid replacement.
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