Study You are a new graduate nurse working in a general surgical ward on an evening shift.
You are a new graduate nurse working in a general surgical ward on an evening shift. It is 16oohrs and you receive a new admission from the Emergency Department. Ms. Vera Wong is a 24 year old female who has been admitted with a 12 hour history oflower abdominal pain, increasing in intensit over the last 4 hours in the right lliac fossa (RIF). She has no relevant medical history although she is obese weighing 145kg and is 168cm tall.
She was reviewed by the surgical team in the Emergency Department and a provisional diagnosis of
acute appendicitis was given. She is also to be reviewed by the surgical registrar on the ward later in
the evening for possible surgery if her symptoms persist. Ms. Wong is currently Nil by Mouth and has
a McGill pain score of7/10. You review her medication chart and note the following PRN medications:
Morphine 1oomg lMl q4h, Metoclopramide 1omg lMl q8h and Paracetamol 1gm PO q6h.
You introduce yourself to Ms. Wong and she informs you that she is in significant pain and requests
pain relief. You inform Ms. Wong that you will administer a Morphine injection for her pain.
You ask a fellow Registered Nurse to check out the Morphine which is supplied in the following ampoule
strengths: 1omg/1ml and 3omg/1ml.
You check out 3x 3omg ampoules and 1x 1omg ampoule whilst
correctly completing the S8 register. You prepare the injection using a sterile
technique along with
Metoclopramide1omg. You administerthe medication lMl to Ms. Wong.
It is now 18oohrs and you are undertaking your
medication and observation round, when you get to
Ms. Wong, you find herto be unrousable with a respiratory rate of6. You immediately