Emily Grace is a 45 year old woman, 5 ft. 8 in.,180 lbs., of Hispanic descent, who was admitted to a medical surgical unit with a small bowel obstruction. She has had a 4 day history of abdominal pain and vomiting, with up to 12 vomiting episodes per day. The vomitus is blood streaked at times. Her medical history includes an 8 year history of hypertension and type 2 diabetes for 12 years. Recent surgeries include an appendectomy 3 years ago. She is married and has gone to community college and is of the Episcopal religion. She is an administrative assistant. She is allergic to Penicillin and Compazine.
She had had an uncomfortable night with pain from 5-8/10 with minimal relief from the morphine pain medication. Her husband spent the night with her and he is quite worried and frustrated. Mrs. Grace says her pain is in the upper abdomen with right side worse than left. The pain is intermittent and feels like bad labor pains. Her abdomen is distended and diffusely tender to palpation. Her abdomen seems more distended this am. There are minimal, hypoactive bowel sounds. The NG drained 600 mL dark brown green drainage this shift. Her urine output was 75 mL with dark yellow, thick urine. Her medication orders include Morphine Sulfate 2 mg, IVP, q2h, prn pain; Ciprofloxacin 400 mg q12hr IVPB; Metronidazole 1200 mg IV x1 dose then 500 mg q6hr prn pain, Promethazine HCL 10 IV q4-6hr prn; Regular insulin per sliding scale.
Assess this data utilizing the Roy Model in the handouts given throughout class and the Roy Holistic Manual. Look at all modes and components and cover only the ineffective behaviors and negative stimuli.
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