Difficulty: Intermediate
Setting: Hospital
Index Words: substance abuse, overdose, chemical impairment, crisis management
Giddens Concepts: Addiction, Clinical Judgment, Gas Exchange, Health Care Law
HESI Concepts: Addiction, Advocacy/Ethical/Legal Issues, Clinical Decision Making, Health
Care Law
Name Yajaira Montor Class/Group _______________ Date _______________
Scenario
You are on duty in the emergency department (ED) when a “code blue” is called. As the code
nurse, you grab the crash cart and rush to the code, which is in the employee lounge of the
operating room. On the couch, you find a nurse, Z.H., unconscious, dusky, and barely breathing;
she has a palpable pulse.
1. What immediate assessment of Z.H. do you need to perform? Vitals
2. What intervention has the greatest priority?
a. Obtaining a STAT toxicology screen
b. Connecting her to the portable ECG monitor
c. Establishing an IV line with 0.9% normal saline
d. Supporting respirations by manually ventilating her
3. What assessment finding would lead you to suspect that Z.H. had an opioid overdose? Explain
your answer.
a. Hypertension
b. Fever and tachycardia
c. Constricted pupils and bradypnea
d. Diaphoresis and cool, clammy skin
4. Z.H.’s respirations are shallow with a rate of 8. The respiratory therapist intubates her and
continues to ventilate her manually. An IV line is established. You attach ECG leads to her chest
and find the results shown in the figure. What is your interpretation of Z.H.’s rhythm?
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