NUR 4153-Deliverable 7-The Dynamic Process of Clinical Judgement Contact the physician to get an order for potassium replacement to bring the patient’s potassium level back to normal range.

Potassium creates energy for cellular function throughout the human body’s cardiovascular, skeletal, and nervous systems. The normal serum potassium range is 3.5 to 4.5 mEq/L. Severe hypokalemia can lead to membrane hyperpolarization, inducing life-threatening circumstances, including dysrhythmias and muscle weakness, leading to respiratory or cardiac failure. EH’s Potassium level is 2.9 mmol/L, which is critically low and can lead to serious complications. Her ECG is showing occasional premature ventricular contracts (PVCs), which can be a result of severe hypokalemia (Conley et al., 2021). Based on these external and internal cues, I would contact the provider to obtain an order for electrolyte replacement and start intravenous potassium as soon as possible (Conley et al., 2021). I will continue cardiac monitoring for EH and monitor for any worsening symptoms.

Arrange imaging and diagnostic tests to confirm precise organ inflammation to start prompt treatment and reduce complications.

EH presented with acute onset severe right upper quadrant pain and vomiting for the past 36 hours. She also has hyperactive bowel sounds in all four quadrants, and her abdomen is painful to touch. The signs and symptoms indicate the possibility of Acute cholecystitis. Severe right upper quadrant pain with nausea, vomiting, and fever is most common in acute cholecystitis. A classic sign of cholecystitis is the Murph’s sign, which is right upper abdominal pain with deep palpation (Powell, 2016).

Other clinical findings reveal elevated liver enzymes. EH’s Amylase is 185 unit/L, Alkaline Phosphate is 155 unit/L, and Bilirubin is 3.5 mg/dL., which are all very high. High bilirubin levels indicate a build-up of bile in the gallbladder. Liver enzymes and elevated alkaline phosphatase (ALP) indicate severe cases of gallbladder inflammation. Acute cholecystitis is an emergency that originates from gallbladder inflammation. Acute cholecystitis can be diagnosed by imaging tests such as abdominal ultrasound, MRI, and CT scan (Powell, 2016). Early diagnosis and treatment can help reduce rates of morbidity, mortality, and expenses.

Select the priority hypothesis and defend your selection.

The priority hypothesis is to contact the physician immediately to get an order for pain medication to manage acute pain. EH’s rating of pain is 10/10, indicating that she is experiencing extreme pain. A patient who is in intense pain cannot communicate and cannot comprehend questions or provide answers, which creates difficulty in assessing the patient’s symptoms.

Leaving a patient with such extreme pain is also inhumane. One of the ethical principles stated by the American Nurses Association (2015) is goodwill, which refers to the nurse’s duty to provide a balance of benefits versus harm to the patient. To let a patient continue suffering extreme pain and not provide relief breaks the nurse’s duty of beneficence.