A school nurse is performing scoliosis screenings. The nurse should recognize which of the following clinical manifestations as an indication of scoliosis?

Potential Condition: Pancreatitis

Rationale:

The client's presentation with severe upper left quadrant abdominal pain, nausea, febrile status, tachypnea, and increased amylase and lipase levels suggests pancreatitis. Pancreatitis commonly presents with abdominal pain, nausea, and vomiting (though vomiting is not reported here), and elevated pancreatic enzymes (amylase and lipase). The elevated glucose level (200 mg/dL) may also point to pancreatitis since the pancreas plays a role in glucose metabolism.

Actions to Take:

Administer opioids for pain:

Rationale: Pain management is crucial in pancreatitis. Administering opioids like morphine or hydromorphone can help manage the severe pain, improving comfort and reducing distress.

Maintain separate equipment for the client:

Rationale: In cases of pancreatitis, particularly if caused by an infectious etiology, it is essential to avoid cross-contamination. Separate equipment reduces the risk of spreading infections if relevant.

Parameters to Monitor:

Dyspnea:

Rationale: The patient is tachypneic, and it's important to monitor for any progression of respiratory issues. Dyspnea could indicate worsening respiratory status or complications such as pleural effusion.

Hypotension:

Rationale: Hypotension can be a sign of shock, a potential complication of pancreatitis due to fluid loss, or systemic inflammatory response. It is important to monitor for signs of hypotension to ensure adequate perfusion and prevent shock.

A. Interpersonal conflict occurs when there is a disagreement or negative interaction between two individuals. Insulting comments directed at a nurse by another nurse clearly represent an interpersonal conflict.

B. A complaint about handoff reporting is an issue between departments and may involve interdepartmental or communication problems, not interpersonal conflict.

C. A concern about holiday hours is a work scheduling issue and may relate to workload fairness rather than interpersonal conflict.

D. A personal difficulty with caring for clients who have HIV is an intrapersonal conflict, as it reflects the nurse’s internal struggle, not a conflict between two individuals.