Abdominal pain??

Published

Hi everyone,

Today I did an assessment on a patient in an institution I am doing clinical at, let me know what you think:

Male in mid 40s, presenting with Left upper quadrant abd. pain. radiating to other quadrants. Pain on VAS scale was 9 out of 10 and increased on palpation, BS present x4, BP-110/78, O2S - 98%, P-89, T- 36.6, R - 17. No constipation or gas. Hx of cirrhosis of the liver and is a Type 1 diabetic. His BS was 21.5. He appeared slightly jaundiced. After assessment I gave him 60cc of insulin and transferred him to ER. They admitted him with abdominal pain with unknown cause and are doing further tests.

So does anyone have any ideas what this man could be suffering from? (I figured it may have had something to do with his liver) and whether I could have done anything else/better in my assessment? thanks for your advice....

Up Vote Up Vote ×

Just a guess here, but how about his pancreas? What was his amylase/lipase?

Up Vote Up Vote ×
Specializes in jack of all trades.

Hx of cirrhosis of the liver and is a Type 1 diabetic. His BS was 21.5. He appeared slightly jaundiced. After assessment I gave him 60cc of insulin and transferred him to ER. They admitted him with abdominal pain with unknown cause and are doing further tests.

Just to clarify??? BS of 21.5 and administered 60cc of insulin?? Typo?

Up Vote Up Vote ×
Specializes in Day Surgery/Infusion/ED.

???

His BS was 21.5? Does that mean blood sugar? Do you mean his blood sugar was 215?

You gave him 60cc of insulin? Do you mean 60 units? That still would be an awful lot of insulin for a BS of 215.

What kind of "institution" was this? ECF? LTC? Psych hospital?

Is he normally slightly jaudiced (icteric)? What was his mental status? Any N/V/D? Bowel sounds? Any other abd. discomfort? Does he still have his gallbladder? I&O?

There's really not enough info here hx. wise or exam wise to say. It could be many things, but there's really not enough to go on.

Up Vote Up Vote ×

sorry! 6cc

Up Vote Up Vote ×

I am guessing that the blood sugar was 215, not 21.5??? Please tell us you did not give 6 cc of Insulin....

Up Vote Up Vote ×

6 units??

Up Vote Up Vote ×
Specializes in Day Surgery/Infusion/ED.
sorry! 6cc

Insulin is given in units, not cc. Six 6cc of insulin would have probably killed your pt.

Up Vote Up Vote ×
Specializes in Pediatrics (Burn ICU, CVICU).
Hi everyone,

Today I did an assessment on a patient in an institution I am doing clinical at, let me know what you think:

Male in mid 40s, presenting with Left upper quadrant abd. pain. radiating to other quadrants. Pain on VAS scale was 9 out of 10 and increased on palpation, BS present x4, BP-110/78, O2S - 98%, P-89, T- 36.6, R - 17. No constipation or gas. Hx of cirrhosis of the liver and is a Type 1 diabetic. His BS was 21.5. He appeared slightly jaundiced. After assessment I gave him 60cc of insulin and transferred him to ER. They admitted him with abdominal pain with unknown cause and are doing further tests.

So does anyone have any ideas what this man could be suffering from? (I figured it may have had something to do with his liver) and whether I could have done anything else/better in my assessment? thanks for your advice....

6 cc's????

Please say no, please say no.:o

Up Vote Up Vote ×
Specializes in jack of all trades.

wheww, I hope it was a big typo!! Please tell me not only that it wasnt 6 cc of insulin but also there is no way insulin given with a bs of 21???

Up Vote Up Vote ×

The only reason that I ask, is that when I worked as a charge nurse several years back I had a student nurse come to let me know that one of her clinical patients needed more insulin since there was not enough for his dose and could I get some? I can not recall why I questioned her (maybe a god thing?) in any case she informed me that the BG was *** and she needed to give the patient 10cc of insulin. I calmly asked her if she planned to kill this gentleman? She gave me a blank stare.... I then spoke to her nursing instructor and she was sent home.. scary thing.. she fully intended to administer that dose, she had the 10cc syringe partially drawn up.. hmm I wonder what 10cc of regular insulin would do to a frail elderly gentleman?? Thankfully I did not have to find out.

I am guessing yours was a typo?

Up Vote Up Vote ×
Specializes in cardiac.
Just a guess here, but how about his pancreas? What was his amylase/lipase?

Yes...that's what came to my mind too.

Up Vote Up Vote ×
+ Join the Discussion