NR 305 Week 6 Discussion Topic, Assessment of the Abdomen and Genitourinary System
Amira is a 27-year-old Syrian refugee who has been residing in a local homeless shelter since her arrival here
in the United States 4 weeks ago. She was brought into the emergency room this morning via squad after
being found by a shelter employee sitting in a pool of blood on the bathroom floor crying and holding her
abdomen. Due to her limited English speaking abilities, she is unable to provide specific details as to her
complaints but the shelter employee states that she has recently stopped eating and has not looked well for the
past couple of days.
Based on the limited information provided, please answer the following questions.
1. How will you prioritize your care of Amira, what assessments will you complete, and in what order?
Please provide rationale for choosing this order.
2. Are there any cultural beliefs/practices that must be taken into consideration when planning her
care?
3. Considering her symptoms of abdominal pain and bleeding, is it possible that her status as a
homeless refugee is a causative or contributing factor to her illness? Please provide rationale for
your response.
Professor Cox and Class,
Amira is a 27 year old female Syrian refugee who presents in the ER with
bleeding.
Based on the report from the EMT, I would initially assess Amira’s vital signs for
evidence of hypovolemia or sepsis; place her on a cardiac monitor to assess cardiac
rate and rhythm: hypovolemia can cause arrhythmias. I would start 2 large bore
needles- #16 or #18 angio if possible. If Amira is hypovolemic she may need fluid
boluses or blood transfusions.
Labs would include:
CBC - WBC – increase = possible infection
Hgb/Hct- decrease = blood loss
Platelets - decrease = possible clotting problems
CMP - electrolytes imbalance related to blood loss
PT/INR - clotting factor high level need for Vit K or FFP
HCG -to determine pregnancy
I would immediately assess Amira’s bleeding to determine where she is
bleeding from.
I would attempt to communicate with Amira with reassuring simple words and gestures
but her bleeding is considered emergent.
Amira is a 27-year-old Syrian refugee who has been residing in a local homeless shelter since her arrival here
in the United States 4 weeks ago. She was brought into the emergency room this morning via squad after
being found by a shelter employee sitting in a pool of blood on the bathroom floor crying and holding her
abdomen. Due to her limited English speaking abilities, she is unable to provide specific details as to her
complaints but the shelter employee states that she has recently stopped eating and has not looked well for the
past couple of days.
Based on the limited information provided, please answer the following questions.
1. How will you prioritize your care of Amira, what assessments will you complete, and in what order?
Please provide rationale for choosing this order.
2. Are there any cultural beliefs/practices that must be taken into consideration when planning her
care?
3. Considering her symptoms of abdominal pain and bleeding, is it possible that her status as a
homeless refugee is a causative or contributing factor to her illness? Please provide rationale for
your response.
Professor Cox and Class,
Amira is a 27 year old female Syrian refugee who presents in the ER with
bleeding.
Based on the report from the EMT, I would initially assess Amira’s vital signs for
evidence of hypovolemia or sepsis; place her on a cardiac monitor to assess cardiac
rate and rhythm: hypovolemia can cause arrhythmias. I would start 2 large bore
needles- #16 or #18 angio if possible. If Amira is hypovolemic she may need fluid
boluses or blood transfusions.
Labs would include:
CBC - WBC – increase = possible infection
Hgb/Hct- decrease = blood loss
Platelets - decrease = possible clotting problems
CMP - electrolytes imbalance related to blood loss
PT/INR - clotting factor high level need for Vit K or FFP
HCG -to determine pregnancy
I would immediately assess Amira’s bleeding to determine where she is
bleeding from.
I would attempt to communicate with Amira with reassuring simple words and gestures
but her bleeding is considered emergent.
